Save 1-2 million patients in 2009 ??

[p3medic]

A witnessed signature refusing transport against medical advice, in a patient documented to be competent to refuse care, and a well documented chart is more than enough. In the U.S. people are allowed to make stupid decisions regarding their health, and if informed of the potential of not allowing treatment and transport they assume all liability. No need for a supervisor, doctor, nurse, etc....

[crotchitymedic1986]

P3, we are not talking about the patients who truly refuse AMA, we are talking about the ones where lazy medics talk someone out of transport, and then have them sign a refusal, leaving the patient at home to die.

[Arizonaffcep]

OK, the math was questioned, lets address that:

1. A 1-2% failure rate is universal to almost every business.

2. We know for a fact that 400,000 US citizens die each year from hospital medical mistakes. I think the last number I heard was that there was about 5,000 hospitals in the US, and there are far MORE EMS providers than there are hospitals. So it is reasonable to assume that our numbers would be proportionally higher.

Ok...I have a few issues on this.

First and foremost, there is NO SUCH WORD as ALOT. Doesn't exist. If you'd listen to the spell check option before posting, that's why it highlights it.

Alot=no word

a lot=many

allot= to give/ration, example: I have allotted $20.00 each month for entertainment.

Get your grammer right.

Second: You stated that there were an estimated (I'm rounding up here) 1/2 million Pts who died as a result of "Dr. Issues" in the U.S. Here's my issue with this, you have compared this number to the number of "estimated hospitals" in the U.S., as opposed to the CORRECT correlation of number of VISTS by patients to hospitals. So...I did a little research, according to the CDC "There were over 1.2 billion patient visits to physician offices, hospital outpatient clinics, and emergency rooms in 2005." (http://www.cdc.gov/nchs/pressroom/07newsreleases/patientvisit.htm), and if you don't want to include PCP and clinics, heres another quote: "In 2002, Americans made 110.2 million visits to hospital emergency rooms, a 23 percent increase over the 90 million visits made in 1992." (http://www.cdc.gov/nchs/pressroom/04facts/emergencydept.htm) So, lets take the LOWEST number of visits, and get a "failure" percentage for Dr. (this is all estimated, and assumes the 1/2 million number is good)=0.0045%. A LOT lower than 1-2%. So, if that's the case, why would EMS have such a dramatically higher "failure" rate, when, I'd say a good average contact time with the patient is 30 minutes or less? I was unable to find stats on number of transports via EMS for the U.S., so I can't "fight" the given stats, other than, where did you get them? You need a source..."I just know" is not viable.

[crotchitymedic1986]

http://www.trueposition.com/web/guest/emer...y-call-location

Indicates 200M 911 calls, not every county has 911, and not all emergency ambulance calls are handled by 911, so 200M is a low number.

But that is fine, lets assume all my numbers are bogus. How many is too many ? If the real number is only 100,000 deaths, does that make it better ?

[Arizonaffcep]

And in the case of a patient that died after truly refusing, wouldnt it be great to be able to tell the jury: Hey, not only did we beg him to go, but we had a supervisor come to the scene or called the patient on a recorded line, and we still couldnt get him to go. Please admit this taped conversation as defendant's exhibit- A, and play the tape for the court (or note our refusal form that was also witnessed by the supervisor).

This is the WORST witness to a refusal! Why: because it is almost anticipated that they will CYA each other. The best: family/friends of the Pt, second best: LEO's.

[crotchitymedic1986]

Thats fine, I am open to suggestion, how would you reduce this problem ? Even if we are just killing 5000 per year, it is something that needs to be addressed. So suggest something.

[akflightmedic]

I suggest leave it as it is because it is not a dirty little secret and it is really not the issue you make it out to be. I mean if you can hypothesize with no facts to support, then so can I.

5000 people out of 330 million...hmmmm, not bad odds eh?

How many babies are born every day replacing those 5000? Yes, I am being harsh, but we all have to die. So what if we assist with the thinning of the herd?

What I find funny is yet again, you are stumping on a moral issue and only your view is going to be right. You are asking how many is too many, which even though you did not say it outright, it sounds as if you are on the side that says "even 1 death is too many".

You also keep quoting these burnt out medics who talk them out of refusals, like we all have been there or are there every single shift. You present an argument from a very narrow frame of reference, which consists of your experiences and is based on nothing else. Not a good position to be in during a debate.

[crotchitymedic1986]

yes, you are right, I do believe that any "preventable death" in our industry is "1" too many. Although there may not be a magical solution that prevents 100% of needless deaths to our patients, or EMS workers for that matter, that doesnt mean we should stick our heads in the sand and pretend no problem exists.

Using your logic, there is no reason to use safety needles to protect our workforce; I mean out of the thousands of EMS calls every day, how many ems workers actually got stuck by a contaminated needle ? Less than 1% I am sure, and there were enough babies born today to replace that worker.

And its not just the burned out medics. I am sure we kill too many with medication errors and misdiagnosis of illness/injury too (using my definition of one being too many).

How many drugs do you have in your drug box that look very similar to each other ? Dobutamine and Dopamine, Atrovent and Albuterol, Solucortef and solumedrol. At least hospitals are trying to work with drug manufacturers to fix this problem. Is there a national voice for EMS trying to fix this problem ?

[akflightmedic]

Glad you see my point and agree.

Flawed logic with no evidence is a wonderful thing, isn't it?

I just wanted to argue like you do for once.

[crotchitymedic1986]

You are right, if you are argueing that it is not a problem at all, then I can not convince you otherwise.