Is Having More Ambulances The Solution?

[Mateo_1387]

Durham. Another place to add to the list.

They do have paramedics on their trucks, some good and others not so good.

[VentMedic]

I think he believes his agency invented this concept.

[Christopher.Collins]

Actually, since he was a minor, we would have transported him anyway. However, since it wasn't an emergency, we decided to call his mother and asked what she wanted us to do. She wanted us to wait until she got there. We don't just throw children on the back of our ambulance in non-emergent situations without first contacting a parent or guardian.

Did you determine it was non-emergent after you used all of your portable x-ray equipment to rule out internal injuries? I mean, it was an assult right? It may not have warranted an emergency response from the scene to the hospital... but ummm, yea you dont always know if something else may be going on inside.

A child's cry for help? If it meant catching those who jumped him, then that's a police and a school administration concern, both of which were there. They would be better able to meet his need than we in EMS would have.

Last I remember learning as health care providers WE ARE patient advocates. Its not our job to catch the crimminal... but rather than sitting around BSing for the truth you could have just reported your findings and suspicions. I know I wasnt there so Im not ganna purposly act like I know all the facts, but the kid had probably gone through enough, if he didnt want to tell the truth you shouldnt push it, as you said the inconsistancy of injuries spoke for themselves.

So, if anybody else has any insults for me, send them to me privately if you don't mind.

Not trying to insult... so Im going to post it here.

[n0ssb]

There is a need for more equipment out there in some areas, some areas have had cutbacks in all areas of public safety to include ems. Whether it a City or County or a Private company.

I take exception to Dusts as a EMT I better be able to make the decisions necessary to save a life or prevent further injury, I don't do that with a pgod over my shoulder, but with the aid of Medical Direction at the Hospital level or my Physican advisor as long as I act within reason under my Protocals. We have a lot of BLS only rigs here and we have ALS rigs, but we operate under one protocal for all in a 7 county area. Even if out of State I still operate under these protocals or out of the metro area.

I'm a good EMT, with many years under my belt and proud of my work

[zzyzx]

Jaxsage...as others have asked, I would also really like to see your protocol on refusing transport. The thing I don't get is, where do you draw the line? Ok, let's say you have someone telling you that they want to go to the ER to get their Vicodin prescription refilled and don't want to spend $25 for a taxi. I can see how you might refuse that person since they don't have a medical complaint. But what about, say, a diabetic with a wound infection of his foot. He needs medical attention, but he doesn't need transport by a paramedic ambulance. So do you refuse to transport him? Where do you draw the line? In this country, most people transported by ambulance don't really require ambulance transport, so do you refuse all patients except those with ALOC, unstable vitals, CP, SOB, trauma criteria, etc? Can you give us a link to your county protocols?

By the way, the example you give of refusing transport to the jail inmate is just scary. This is the stuff that 11 o'clock news stories are made of.

[spenac]

Jaxsage, As a provider that does have right to refuse I have to say the examples you have provided do not give me much comfort in your ability to properly decide which patients should be transported. Some items you mention such as ammonia inhalants in your example was abuse, even if faking.

Did you transport the kid after he admitted it was a fight rather than a bite? Honestly a fight is more reason to transport than a bite as many injurys do not show up immediately after a fight.

Just saying the way you are presenting the ability to choose right is not coming out very well. I have the right to deny but honestly it is not used often because as others have chastised you there are way to many variables. And as to common sense yes common sense says the guy that just wants a ride the 90 miles to our nearest hospital for lunch should be denied, but if you search my topics when I brought up denying him others brought up many possible reasons he possibly should be transported. Will I continue to deny some callers? Yes, but with the input I have gotten here from other professionals, I take that responsibility much more seriously.

[JaxSage]

I welcome anybody who has any concerns or questions concerning our protocol to private message me.

[VentMedic]

I welcome anybody who has any concerns or questions concerning our protocol to private message me.

You started a thread on a public forum. Did you not expect questions, comments or criticisms?

[JaxSage]

Vent, I'm really trying to keep the peace here. I'm sorry if I caused any problems. So, I'm offering to those who truly want to know where I'm coming from to PM me. Was I expecting concerns and constructive criticism? Yes. Was I expecting a name-calling spree? Not really.

[VentMedic]

Your overly cocky attitude has warranted most of my comments. That included your reply to my concern about the use of ammonia inhalants on an incarcerated patient.

Here's at article that is from your area. I think it pertains to how some things can be dismissed as BS but later lead to not so pleasant consequesnces.

State EMS probes student's death

http://www.newsobserver.com/news/story/1217009.html

Jesse James DeConto - Staff Writer

Published: Sat, Sep. 13, 2008 12:30AMModified Sat, Sep. 13, 2008 01:52AM

RALEIGH -- The state Office of Emergency Medical Services is investigating Orange County's handling of the Atlas Fraley case.

Drexdal Pratt, EMS chief for North Carolina, said Friday that state investigators are determining whether the paramedic who responded to the Chapel Hill High School football player's home a few hours before his death followed protocol.

"Any time a patient dies or suffers as a result of any action, it would definitely be a concern of ours," Pratt said. "I can't recall if we've had a situation like that where a patient has died after a paramedic assessed them."

Fraley called 911 about 1:45 p.m. Aug. 12 after a morning scrimmage with the team. A paramedic responded a few minutes later and spent 22 minutes with Fraley before clearing the scene, according to emergency radio traffic released by the county. Fraley was dead within four hours.

Fraley had requested an IV, complaining of dehydration, a condition he'd had in the past. It is not clear whether he received intravenous fluids.

"We're unsure as to the facts of the case yet," Pratt said.

Investigations

Orange County EMS is conducting its own investigation, and officials there have not explained how the paramedic treated Fraley or why Fraley was not taken to a hospital.

Pratt said the county notified his office of its investigation soon after Fraley's death, and the state opened its own investigation a couple of weeks later, at the end of August.

"Since we issue the credential to the paramedic that may have been involved, we want to make sure that they followed the appropriate protocol," Pratt said.

The state's investigation should be complete by mid-October, and a report will be made public at that time, Pratt said.

Investigations are being conducted also by the Office of the Chief Medical Examiner, the Chapel Hill-Carrboro City Schools, and the Fraley family's attorney.

Stricken Chapel Hill football player called 911

He was seen, not hospitalized

Jesse James Deconto - Staff Writer

Published: Fri, Aug. 15, 2008 12:30AM

http://www.newsobserver.com/264/story/1178629.html

CHAPEL HILL -- Atlas Fraley called 911 for help Tuesday afternoon, saying he hurt all over.

An EMS crew came to the Chapel Hill High School football player's house but did not take the 17-year-old to the hospital. It is unclear how or whether the crew treated him, but by the time his parents got home that evening, their son was dead.

Relatives want to know what happened, and the county's Emergency Services Department is investigating its response on a day that stretched resources to the breaking point.

Even as Fraley's parents were arriving home, EMS crews were being called to a two-vehicle crash with four people injured in western Orange County and to East Chapel Hill High School, where another football player lay writhing in agony waiting for an ambulance.

On Thursday, Capt. Dinah Jeffries of Orange County Emergency Services read a brief statement about the Fraley case but did not answer any questions.

"A full review of the facts is in process so that we and the family may have a clear picture of the circumstances surrounding this tragic and extraordinary event," she said. "Our focus is on getting information to the family."

And the family wants it.

"They came here, and I guess they told him to take Gatorade and just left him," said Fraley's aunt, Melissa Edwards, mother of NFL defensive back Dovonte Edwards. "Why he didn't get help, we don't know."

Fraley had played in a scrimmage against Middle Creek High School in Apex on Tuesday morning. During the game, he complained of a headache and coaches took him out until he felt better. The headache returned, and they took him out for good.

About 2 p.m., he called 911 complaining of "full body cramps."

"My body is hurting all over," he told the dispatcher. "I just came from football practice, and I think I need an IV or something. ... I think I'm just dehydrated and need an IV."

Dr. John Butts, chief state medical examiner, who completed an autopsy on Fraley's body, is waiting for test results. "Dehydration may have played a role in his death, but this is not certain, nor even that he was dehydrated," Butts said.

The death of the player came on a hectic day for the Emergency Services department.

Between 5 and 7 p.m. Tuesday, Orange 911 received 11 calls for service. Officials would not say how busy crews were earlier that afternoon when Fraley called initially.

In the evening, one call came from East Chapel Hill High School, where a running back for Carrboro High School, DeMarcus Powell, had injured his knee during a scrimmage. Powell, 16, lay on the field at least 23 minutes before a paramedic arrived in a sport utility vehicle.

"He was biting my legs. He bit on his mouthpiece," said his mother, Patrice Powell.

It was another 20 minutes before an ambulance arrived.

Capt. Kim Woodward, operations manager for Orange County Emergency Services, said personnel could not respond more quickly because they were tied up on the other calls, including Fraley's death. Efforts to reach Woodward to discuss Fraley's call were unsuccessful.

Barry Jacobs, chairman of the Orange County Board of Commissioners, said that he doesn't have any reason to think the medical response when Fraley first called wasn't adequate but that the incident raises questions that need to be answered.

"Any time a 17-year-old who's apparently OK dies after they've been seen by some kind of medical personnel ... you wonder if anything could have been done differently," Jacobs said.

"I think we owe that explanation to the family. And we owe it to people who call 911," he said. Jacobs said the county board had not yet been briefed by EMS directors.