Paramedic sits up front on transfer, patient dies

[Dustdevil]

Who knows, maybe his service will promote him to supervisor, we all know that some people rise to their levels of incompetence.

LOL! Ya know, that wouldn't surprise me in the least.

But seriously, there are a lot of questions about this incident. A patient on a ventilator going for outpatient dialysis? WTF? And does any hospital actually send a patient out on one of their ventilators without an RT accompanying them? Or, if this was an ambulance ventilator, isn't the company negligent for not having properly trained and certified this medic to operate it? Or, was it really a ventilator at all? Perhaps that's just the term the witness and media is using for a BVM, which changes the entire scenario, and the kinked tube was just a curly O[sub:88d150067e]2[/sub:88d150067e] supply line. Or maybe even just an O[sub:88d150067e]2[/sub:88d150067e] mask.

What we have here are two separate accusations: First, that he abandoned his patient, and second, that he is incompetent. What if only one is true? What if he was indeed at the patient's side the entire time, but is incompetent? Or vice versa? Does that make a difference?

And think about this... was there a doctor or nurse at that patient's side, constantly, 24/7, while she was hospitalised? No. It's not like she just came from an ER. So why would anybody expect that she needs constant bedside care during a 30 min ambulance transport?

Again, not defending anybody here. Just food for thought. Like Ruff suggested, he may have actually come out okay on this thing if he hadn't panicked and started covering up.

[VentMedic]

But seriously, there are a lot of questions about this incident. A patient on a ventilator going for outpatient dialysis? WTF? And does any hospital actually send a patient out on one of their ventilators without an RT accompanying them? Or, if this was an ambulance ventilator, isn't the company negligent for not having properly trained and certified this medic to operate it? Or, was it really a ventilator at all? Perhaps that's just the term the witness and media is using for a BVM, which changes the entire scenario, and the kinked tube was just a curly O[sub:91cddcb5d6]2[/sub:91cddcb5d6] supply line. Or maybe even just an O[sub:91cddcb5d6]2[/sub:91cddcb5d6] mask.

Not many hospitals have dialysis available in house. Even fewer have CVVH available even at some of the higher level ICUs.

Except for the part about the Paramedic sitting up front, this is not that uncommon. Many Paramedic services can tranport just about anything if all the meds and equipment including balloon pumps are set up for them at the hosptial. Some accept a LVAD without knowing what it is or because they don't know what it is. They "monitor" the drips and technology attached to the patient.

I know of no hospital RT department that would allow a ventilator to be trusted to anyone but their own staff. It is bad enough when hospitals must allow their IV pumps accompany the patient without a nurse and not knowing the knowledge or competency of the paramedic. Again, the paramedic will probably just "monitor" the pump and not do any intervention with it.

Surely you've read some of my posts ragging on CCT or some ALS trucks that consider themselves capable of handling anythng because their company bought them some very simplistic vent like the ParaPac or lower level. There's virtually no alarms on these things and very little monitoring capability by the technology itself. The HCW must watch the patient and monitor vital signs. I could give you pages of examples of mishaps that don't make the news because someone is already writing a settlement to the family and/or the state is writing a cert revocation notice. However, it does get a little sticky when the service is part of a government entity.

Hospitals are getting wiser and establishing their own CCTs. They then don't have to rely on the inconsistencies in education, skills and training of whoever happens to show up on the ambulance.

I've had a few Paramedics tell me they can do ARDSnet protocols because their little Eagle Univent 754 has a plateau pressure button on it. That only tells me they got no education or training about ARDS, plateau pressure or how their machine works.

We've even had Paramedics who think their little "face mask with the resistive valve" is the equivalent of a hospital CPAP machine.

The saddest part is these transport companies can actually get some hospitals to believe they are capable of things that they actually shouldn't be due to inadequacy of education/training. The Paramedics working for these companies need to also understand the difference between Critical Care Medicine and ALS.

[JakeEMTP]

Hospitals are getting wiser and establishing their own CCTs. They then don't have to rely on the inconsistencies in education, skills and training of whoever happens to show up on the ambulance.

The level 1 trauma hospital here indeed has their own CCT. These units are staffed by at minimum, 1 Paramedic, 1 Critical Care Nurse and a driver. I cannot confirm whether or not some are RTT but I wouldn't doubt it.

The medic in question is indeed a buffoon. If he was in the back of the ambulance, why wasn't he working the code? And, how does a ECG strip wind up going through the laundry :?? Enquiring minds want to know. The company charged for Pulse Ox, however, the equipment wasn't on the unit. Sounds like fraud to me.

The whole story stinks. Far too many inconsistencies. The Basic on the truck should have told the truth originally instead of changing her story at a later date. However, Basics are a dime a dozen and sending her through the class again serves zero purpose.

I re-read the article again, and more and more, I have to agree with Rid. Sign the check, fit the medic for an Orange jumpsuit and while their at it, get one for the company President as well.

[katbemeEMT-B]

I just couldn't imagine what these two were thinking. I realize that some times the media can screw things up, but to screw up the entire story doesn't make sense. I have a feeling there are many truths here (or should I say lies). Whether the so called medic was in the patient compartment or not does not dissolve either one of them from the responsibility that they ultimately killed a patient due to negligence. Part of the basic's job is to (respectfully) let the medic know that this is not right and if the medic continues to disagree, involve medical control.

I have seen co-workers fired for less than this.

[Dustdevil]

...they ultimately killed a patient due to negligence.

That's a pretty tough point to prove. After all, a great many people who crash on us die, despite even the very best of immediate care. Sometimes, it's just your time to die.

[Niftymedi911]

yea but Dust, simply put if the person was blue, and the vent line was witnessed as kincked causing her to be cyanotic and arrest and he didn't catch up on it.......... that is neglience.

[EMS49393]

Believe it or not, Arkansas Emergency Transport (AET) is a combination company. They hold the 911 contract in a few areas of central Arkansas. This point, I'd be shocked if they had more than 2 contracts at present.

The post below sums up what type of quality organization AET is much better than I have done. Sadly, the "intoxicated" medic commited suicide before she was punished for her behavior.

Guinness,

K.

[VentMedic]

Sounds like an interesting company. Just a quick Google got quite a few hits.

It is a partnership and the EMT driving should know his paramedic doesn't belong up front when there is a patient in the back.

My question in this article that popped up is if you know someone is impaired, why do you still allow them to be on an ambulance?

Sherwood Cuts Ties With Ambulance Provider

Wednesday, Oct 4, 2006 @07:42pm CST

http://arkansasmatters.com/content/fulltext/?cid=49800

- The City of Sherwood is cutting ties with ambulance provider Arkansas Emergency Transport (AET).

Next Tuesday morning at 8 a.m., MEMS will take over as the interim service provider for the city of Sherwood.

This comes on the heels of several recent incidents involving on-the-job performance for AET.

On Monday morning, September 25th, Sherwood paramedic Amy Smith was arrested for public intoxication.

According to a police report, she showed up to a home on a medical call, where her speech was slurred and she stumbled around the living room.

In that report, co-workers say she had been up for 72 hours and was taking seizure medications.

In another incident, according to Lt. Cheryl Williams of the Sherwood Police Department, AET did not properly respond to an emergency call made by a man with a heart problem.

MEMS Executive Director Jon Swanson says two ambulances will be sent over on Tuesday, and they will be prepared to operate 24 hours a day, seven days a week.

He says this added coverage will not short-change the regular fleet.

Swanson added that most of the AET workers are good paramedics, and he has encouraged them to apply for jobs with MEMS.

[firedoc5]

Hmm ...fire him and revoke certs. Negligence? Abandonment? Something must fit.

But I have to wonder if he was maybe kneeling in the "alley" at the front of the box. I think this may be more common than we care to think it is within transfer companies. My sister-in law was recently transfered between 2 hospitals for a C-Section, my brother said the medic sat in the airway seat, rotated to face the front and chatted up his partner for the majority of the 1.5hr transfer. He did however do a couple sets of vitals and ask about pain along the way.

I am not going to say I have never slipped to the front of the alley for a sip of my coffee on a 6:00 am prescheduled transfer. But I am never away from my patients side for more than a minute or two.

I believe this medic was a little too complacent and maybe even "burned out".

OOOOOooooo, this story makes me cringe.

We kinda had an unwritten rule. If we had a patient on the cot, there was an EMT on the squad bench. Sure the EMT may have temporarily had to sit on the jump seat to say something to the driver, but it would of had to been a minute or two. You never make a patient feel as if they are alone.

[streethealer535]

We kinda had an unwritten rule. If we had a patient on the cot, there was an EMT on the squad bench. Sure the EMT may have temporarily had to sit on the jump seat to say something to the driver, but it would of had to been a minute or two. You never make a patient feel as if they are alone.

I understand what your saying but think about this... three years ago I read a study conducted on ambulances. Any Crash over 35mph and anyone sitting on the bench had a 98% chance of not living through it seat belted or not.

just some food for thought

JJ