frequent flyers and public relations

[Arizonaffcep]

What about good enough for the patient?

I was actually referencing "good enough for us" as far as documentation of the encounter. But thanks.

[firedoc5]

How about good old fashion "common courtesy". We didn't check vitals or anything. Whether the weather being extreme, hot or cold, especially when they put out a heat or cold advisory is when we go to those we knew were at a higher risk of not having any sources for relief.

You just check that they have some source of heat when it's cold And that they would at least have a fan when it's hot.. If they didn't have these things, then you contact social service or any other agency. The Red Cross was very good at taking care of those people that needed anything.

Most are thinking too deep into the matter. Worrying about legalities, and what if's, and such. It's almost a paranoia. Lighten up. You just see if they are OK and have the basics, that's all.

[VentMedic]

Most are thinking too deep into the matter. Worrying about legalities, and what if's, and such. It's almost a paranoia. Lighten up. You just see if they are OK and have the basics, that's all.

I would love to lighten up but unfortunately I see another side to a very discouraging reality. There are too many people that fall through the cracks of our health care system that have little choice but to become frequent flyers. Even that rarely gets them the necessary or appropriate care they need. Instead, EMS considers them a nuisance and the EDs/hospitals are out of ideas where to put them if they don't qualify for this or that service. At any given time in almost any hospital, out of 1000 patients there will be over 300 that are inadequately insured but don't qualify for any assistance. Most when discharged can not get the meds they are prescribed to even be compliant if they wanted to. This is not because of a lack of trying. Many involved in the several systems try their best to get things right for Americans caught the healthcare entanglement.

Again, as to the OP, it just depends what type of people will be included to be checked on and what policies will be in place to guide how much will need to be done. There should still be a plan in place for those that do require more assistance rather than just dumping them in the ED only to continue an endless cycle and not providing a solution to better meet the needs of the people.

Welfare checks following a storm or extreme weather are of course a courtesy that should be done.

[Arizonaffcep]

I would love to lighten up but unfortunately I see another side to a very discouraging reality. There are too many people that fall through the cracks of our health care system that have little choice but to become frequent flyers. Even that rarely gets them the necessary or appropriate care they need. Instead, EMS considers them a nuisance and the EDs/hospitals are out of ideas where to put them if they don't qualify for this or that service. At any given time in almost any hospital, out of 1000 patients there will be over 300 that are inadequately insured but don't qualify for any assistance. Most when discharged can not get the meds they are prescribed to even be compliant if they wanted to. This is not because of a lack of trying. Many involved in the several systems try their best to get things right for Americans caught the healthcare entanglement.

Again, as to the OP, it just depends what type of people will be included to be checked on and what policies will be in place to guide how much will need to be done. There should still be a plan in place for those that do require more assistance rather than just dumping them in the ED only to continue an endless cycle and not providing a solution to better meet the needs of the people.

Welfare checks following a storm or extreme weather are of course a courtesy that should be done.

Here's my definition of a frequent flyer. Anyone who calls 911 on a regular basis...for what turns out to be no medical emergency. An example...the 82 yof who calls for "difficulty breathing" and she won't be quiet, who when asked, lives alone, vitals all better than the respective providers vitals. This same patient, when all tests are back from the hospital, is discharged with no significant findings.

It is this type of person who doesn't necessarily need medical care...as opposed to someone to talk to.

Now, there are other frequent flyers who have ETOH, drug problems and such, and are transported all the time. They either refuse rehab, says they will go to rehab, only to refuse and walk out in the morning, etc. etc.

These type, while I have no use for on a personal level, although one is quite funny once he's sober...but when drunk usually ends up assaulting staff. These are the more intensive frequent flyers who wouldn't be helped by going over to their house to see how they are and carry on a conversation. They need lots of other services, if they are willing to utilize them. They are NOT who we are talking about.

[VentMedic]

Here's my definition of a frequent flyer. Anyone who calls 911 on a regular basis...for what turns out to be no medical emergency. An example...the 82 yof who calls for "difficulty breathing" and she won't be quiet, who when asked, lives alone, vitals all better than the respective providers vitals. This same patient, when all tests are back from the hospital, is discharged with no significant findings.

It is this type of person who doesn't necessarily need medical care...as opposed to someone to talk to.

Now, there are other frequent flyers who have ETOH, drug problems and such, and are transported all the time. They either refuse rehab, says they will go to rehab, only to refuse and walk out in the morning, etc. etc.

These type, while I have no use for on a personal level, although one is quite funny once he's sober...but when drunk usually ends up assaulting staff. These are the more intensive frequent flyers who wouldn't be helped by going over to their house to see how they are and carry on a conversation. They need lots of other services, if they are willing to utilize them. They are NOT who we are talking about.

Thank you. You have just made my point from an earlier post.

Until you know the expectations of what is being asked of Paramedics by whoever is suggesting this program and the needs of the frequent flyers which could be serious medical needs patients, it would be difficult to say what is actually good enough. I think you may have a stereotyped view of "frequent flyers" as being BS. The "frequent flyers are not always just lonely old person who wants to serve milk and cookies to the young firemen. Many of ours have lung problems or very brittle diabetics both of which are also compounded by recurring infections in various areas of their body. Helping them management their care at home would be more appropriate than a BP check and a not to say "Been there".

[Arizonaffcep]

Thank you. You have just made my point from an earlier post.

Until you know the expectations of what is being asked of Paramedics by whoever is suggesting this program and the needs of the frequent flyers which could be serious medical needs patients, it would be difficult to say what is actually good enough. I think you may have a stereotyped view of "frequent flyers" as being BS. The "frequent flyers are not always just lonely old person who wants to serve milk and cookies to the young firemen. Many of ours have lung problems or very brittle diabetics both of which are also compounded by recurring infections in various areas of their body. Helping them management their care at home would be more appropriate than a BP check and a not to say "Been there".

Which was what? That you didn't know the expectations? Or you didn't know what was being discussed and included every "frequent flyer" in the discussion?

[spenac]

Vent I think you are missing the point. Any untrained person can do what is being talked about here and go give these people a little attention. If anything is noticed that needs more then get that ball rolling. If noone stops by that ball never gets rolling. So hey stop by say hi. Ask about the kids, grandkids etc and make a blue hairs day.

[VentMedic]

Which was what? That you didn't know the expectations? Or you didn't know what was being discussed and included every "frequent flyer" in the discussion?

No, the OP has not given an outline or guidelines if there are other agencies involved.

Again, your definition of a "frequent flyer" may be entirely different from a medical point of view.

Paramedics on fire engines may have a totally different view of what they perceive to be "BS" and may view a "welfare check" as something totally different than one who is all about EMS and medicine with no other obligations or agendas.

Spenac,

Read my posts. I am NOT talking about the drunk on the corner who, yes, those of us in the medical profession realize he/she has many needs and most of which EMS is not capable of providing. I see other patients with medical needs who fall through the cracks EVERY day and many rely on EMS to get them to the ED for just daily maintenance. Do I think of them as bullshit calls? NO! They have legitimate needs that fail to somehow get into the correct system.

You are talking about PR calls which are warm and fuzzy but there is a greater need. Unfortunately, Paramedics at this time may not be ready to step up to the plate to much more than that. However, Paramedics in other countries have been doing this for quite some time.

[Just Plain Ruff]

ok this program we are looking at starting is more of a "hi how ya doin?" kind of check rather than welfare checks and review of their living situations.

We have the support of our social services department and they will take the reigns of the ones we bring to them.

It is also to cover our butts on welfare checks when we are looking in on our regulars and administration gets a call saying the ambulance was on our street and we don't want the disruption type calls. If you know what I mean.

We have a few select patients who are strictly attention seekers and are good people and if we can "smother them with kindness" if you get my drift we think that they will stop calling.

We will be getting guidelines and some training on what to look for when we are doing these so called "welfare checks" so we won't be hung out to dry.

After talking to my EMS supervisor he says that this will be like 1% of our total duties when not on calls.

thanks for all the input.