Some input on a missed femur fracture.

[Ridryder 911]

Rid as I understand it, every health care agency who transmits health information electronically is covered regardless of their size. It is also my understanding that a hospital ED may give a patient's billing information to an ambulance service who transported the patient to the ED, but that the hospital may not disclose any protected health information about the patient's condition or treatment to the ambulance service once the patient/provider relationship has ended without written consent from the patient.

It can be very confusing, but basically the continuum of care is allowable for follow ups as well as possible exposure etc..

Hospitals have to offer either the ability to disclose or private. I have yet found one that would not give me pertinent information in regards to care. Yes, I may have to jump through hoops to get the "password" etc.. but, when they find out it is for educational and TQI process, there is less resistance.

R/r 911

[medic403]

Don't lose sleep over this. Some things we just can't predict or foresee. I believe it was wrong to have that individual call you, just to tell you that you missed a femur fracture.

Our med control gives us tips to help us with differiantal field diagnosis. Example; to check for a femur fracture tap bottom of the foot. If the patient cries in pain I would suspect femur fx, if not crying out in pain, I would be suspicous of bruised bone. Don't hit the foot with all your might but give it a sensable tap.

In PHTLS we were taught that young children and small adults when hit by vehicle it tends to be chest and facial injuries. With adults ab, pelvis, and lower ex, injuries. 20-25 is pretty fast. Especially with car vs pedstrian (i can not spell). I am not critisizing you, I think you did your job to you fullest capability, just giving you some tips to grow off from and info to put into your already really full file cabinet.

Take care and good luck. Be safe out there.