DFIB Posted October 24, 2011 Share Posted October 24, 2011 Do any of you as medics recapitulate your treatment to the patient after arrival to the hospital? When you give a medication do you specify all the details of the medication or simply say I am going to run an IV, or I'm giving you some medicine for nausea? Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted October 24, 2011 Share Posted October 24, 2011 From the quote in Red above The Emergency Medical Technician refuses to participate in unethical procedures, and assumes the responsibility to expose incompetence or unethical conduct of others to the appropriate authority in a proper and professional manner When you witness a unethical procedure then your duty is to expose it but not directly to the patient. Are you completely sure that what you consider unethical as to truly be unethical. I'm sure there are cut and dried examples of unethical behaviour but there are many more examples and with a new baby in our house I'm running on about 3 hours sleep over the past 4 days so I cannot think of any concrete examples on either side but give me about 10 more hours of sleep and I'll provide some. So telling a patient that something was done unethically without going through the correct channels puts you on the slippery slope of being on the wrong side of the argument. As far as I'm concerned the patient is not the correct authority nor do they have really have the knowledge of knowing what is ethical or unethical? ah I just thought of one Drunk patient, was nasty and beligerent on scene. Had pretty good lacerations to head as well as a large hematoma. Patient spit in medics face. Medic said to the patient that he was goign to paralyze the patient if the patient didn't settle down. Patient didn't settle down so the medic RSI'd the patient. Medic wrote in patient report that due to head trauma and transport time that he felt the patient was too unstable to tolerate the transport so RSI was considered and implemented. Unethical? OR slightly unethical or good medicine? The EMT came to me and told me what happened. We went to the medical director. EMT said he felt the RSI was unnecessary due to patient being awake and drunk. Reviewed chart as well as discussed with trauma team at the trauma center. The patient ended up having a large subdural so the intubation and paralysis was needed. So what initially looked to the EMT as an unethical or unnecessary procedure was in all reality a vitally needed intervention. So what one person considered unethical or a mistake may not actually be that. Link to comment Share on other sites More sharing options...
RaceMedic Posted October 24, 2011 Share Posted October 24, 2011 Do any of you as medics recapitulate your treatment to the patient after arrival to the hospital? When you give a medication do you specify all the details of the medication or simply say I am going to run an IV, or I'm giving you some medicine for nausea? Depends on the PT, If the ask then yes i will tell them what i am giving. However if i am giving them a med and do not tell them what it is, i do ask them to tell me if anything changes and will specify side effects that i really need to know about (if any) But most of the time i just ask them to tell me anything that changes no matter how minor they think it might be. Race Link to comment Share on other sites More sharing options...
DFIB Posted October 24, 2011 Share Posted October 24, 2011 Drunk patient, was nasty and beligerent on scene. Had pretty good lacerations to head as well as a large hematoma. Patient spit in medics face. Medic said to the patient that he was goign to paralyze the patient if the patient didn't settle down. Patient didn't settle down so the medic RSI'd the patient. Medic wrote in patient report that due to head trauma and transport time that he felt the patient was too unstable to tolerate the transport so RSI was considered and implemented. So what one person considered unethical or a mistake may not actually be that. This reminds me of something I saw many, many moons ago. It was the same kind of patient, same spitting scenario only in the ER. He had been in a MVC and the Doc was suturing his face and head. the patient kept spitting. The doc pulled his tongue out and sutured it to his chin. THe Doc said "Try spitting on me now" Should I have reported it? Probably. Did I report it? Not a chance. I never even told anyone. Depends on the PT, If the ask then yes i will tell them what i am giving. However if i am giving them a med and do not tell them what it is, i do ask them to tell me if anything changes and will specify side effects that i really need to know about (if any) But most of the time i just ask them to tell me anything that changes no matter how minor they think it might be. Race The reason i ask is that if we don't mention all the things we do correctly directly to the patient why would we go out of our way to mention the incorrects? Link to comment Share on other sites More sharing options...
DwayneEMTP Posted October 24, 2011 Share Posted October 24, 2011 Wait just a damn minute...! Did a homosexual just call me a Liberal? I'm not really sure what to do with that.... But it does go to show that every walk of life can see that Liberals are a problem..so that's good news.... :-) As stated, I believe multiple times, I've truly reported every significant error that I've Ever made made. And I say that with no reservations whatsoever. The first time I pushed Phenergan I accidentally pushed 25mg into an 80 year old man and nearly needed to intubate him before we got to the hospital. I have no idea if that was reported to the family or not, but it was reported in my run report. What benefit do you see that the family would have received by me or the doc reporting that to the family? How would they have been better served? I didn't hide it to protect myself, as I reported it, and documented it in every way that had the ability to get me jammed up should the system decide that jamming me up was what was necessary. And you're almost certainly mistaken about the embulus. I think someone posted a study here once that said that for their to be significant danger from an air embulus that the amount would need to exceed 1cc/kg of pt body weight. That is a LOT! Though I would imagine that it would depend on the site of introduction. Look only at the effect that you've had on your family. You've gone off half cocked, admitting that you've not seen the pt file, gotten everyone all upset, when you have no idea what you're talking about. Medicine is a practice. Someone isn't necessarily at fault every time something unexpected happens. That, brother, is a fact. Please answer this question, that you continue to ignore. What benefit, other than the right to litigation, would the family gain by being made aware of any and all medical errors? Dwayne Link to comment Share on other sites More sharing options...
flamingemt2011 Posted October 25, 2011 Author Share Posted October 25, 2011 Dwayne, the patient would know the truth, and the truth shall set you free. When you state that the patient would be too stupid to understand the truth, you sound like the cigarette companies years ago. We are talking about a mistake that is potentially life threatening, too hide and cover up to save your ass is not the definition of patient advocate. In any other industry it would be called criminal. Link to comment Share on other sites More sharing options...
RaceMedic Posted October 25, 2011 Share Posted October 25, 2011 (edited) RaceMedic, on 24 October 2011 - 05:07 PM, said: Depends on the PT, If the ask then yes i will tell them what i am giving. However if i am giving them a med and do not tell them what it is, i do ask them to tell me if anything changes and will specify side effects that i really need to know about (if any) But most of the time i just ask them to tell me anything that changes no matter how minor they think it might be. Race The reason i ask is that if we don't mention all the things we do correctly directly to the patient why would we go out of our way to mention the incorrects? Me not telling the PT and/or family exactly what i am giving has nothing to do with hiding anything from them and everything to do with giving them the medications they need in a timely manner. If i stopped and explained every medication i am going to give the PT and/or family the scene times would be horrendous and your needlessly delaying treatment. I did not come about this thought process through school. I did used to explain the meds i was giving but after being yelled at "Just gimme the gawddamn medicine if its what i need" or " I dont care what it is, Just give it already" you start to just give the meds and answer questions as they come up later. Someone brought up auto makers and vehicle recalls ... well i was a certified mechanic for 10 yrs, i can assure you that not all recalls are big news. there are many recalls you never know about and are taken care of as the cars come though the dealership shops or as the parts break and are replaced by the auto shop mechanics at the cost of the owner. the only time there is a "News Worthy" recall is if it has killed someone or several accidents have occurred due to the issue. The auto industry is not subject to full disclosure as you seem to think they are. Race *edit* Lets not forget when the flaw is identified by the auto maker they do not just automatically issue a recall. They must report it the government regulators get involved. why do you think recalls cover Years of production and not just a single model or serial number range? Edited October 25, 2011 by RaceMedic Link to comment Share on other sites More sharing options...
DwayneEMTP Posted October 25, 2011 Share Posted October 25, 2011 Dwayne, the patient would know the truth, and the truth shall set you free. When you state that the patient would be too stupid to understand the truth, you sound like the cigarette companies years ago. We are talking about a mistake that is potentially life threatening, too hide and cover up to save your ass is not the definition of patient advocate. In any other industry it would be called criminal. Please answer the question or stop wasting my time. I'm not claiming that any patients are stupid, simply uneducated in the matters that you want to dump on them. After the space shuttle blew up were you disappointed that the entire technical report wasn't splashed across the TV? Not really, right? Because we couldn't have understood it. That information would have confused and confounded us. Not because we're stupid, but uneducated in the ways of the space shuttle. "A seal failed." We can all get that. They didn't withhold information to hide, they did it because that information was not useful, and possible damaging to those that can't understand it. Like your father in laws cardiac issue. You got just enough information to get you fucked up, and you in turn fucked up the rest of your family. Shame on the cardiac folks for releasing information that was strong enough to make you cry but too complicated for you to understand in context. Again, continue to twist words in any way you want, but you're not dealing with the 5th graders that you normally win arguments with, if this is common logic/tactics for you. You're gonna have to sack up here man and debate like an adult if you want to play. The truth shall set you free? That's truly your argument? Idiotic in this context Friggin' rocked when King said it. Answer the question, stop waffling, stop restating the same bullshit without addressing the issues, ok? Dwayne Link to comment Share on other sites More sharing options...
RaceMedic Posted October 25, 2011 Share Posted October 25, 2011 I will admit this is remained much more civilized, however this thread is beginning to reak of the now locked "Patient Advocate" thread. .... Just getting that out there, I know im not the only one thinking it. Race Link to comment Share on other sites More sharing options...
DFIB Posted October 25, 2011 Share Posted October 25, 2011 Race - Your point is the point I was trying to make. I guess I didn't express the idea very well. Not that we hide things from the patient but only give them pertinent information according to the current situation. Longer explanations would only delay care in most instances. Link to comment Share on other sites More sharing options...
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