Dispatch treating CVA with ASA

[AnthonyM83]

This is why bad idea to treat over the phone. If it was a good idea and worked no need for any of us ambulance drivers. Just dial 911 get told what to do and take care of it yourself. Do it yourself medicine. When I owned a contracting company I made more money fixing do it yourselfers mistakes. Guess could save money and do it my self CPR, bag my self, push my own chest, clear shock :shock: . I see it now time life books do it your self emergency medicine. If only we could charge more to fix the do it yourselfers medical mistakes.

If you're talking specifically about recommending medication over the phone, then I agree. But EMD can provide other simple info, such as CPR instruction, choking procedures, and how to position patients. For more than that, you'd want to do a live assessment first on-scene.

I do disagree with the logic that if it worked, there would be no need for ambulance drivers. Even if someone came up with he closest to perfect algorithym for EMD, we (responders) would still be needed. The point of giving advice over the phone, even if system worked perfectly, wouldn't be (and was never meant to be) to replace responding units. It's to help increase survival and prepare for EMS arrival.

[spenac]

Way too damn funny. I'm gonna have to sing that to my neighbor, she's a dispatcher for our county.

Think of it this way, we in the EMS field are the most under recognized profession. We may have EMS week but it isn't on any calendar or talked about on the news. Even secretaries get their day. So it's not that we are picking on dispatchers, we are picking on EMS in general.

Thank you! Thank you very much!!!! I'll be here till tuesday, no wait I'll actually be here another 9 days, darn it.

Wish we could do more to promote EMS, but with that big old HIPO can't show actual footage like fire and law enforcement to convince the public we are needed. The footage shown of FF and LE you would think all they do every day is save lives, that there is never a dull minute. EMS is seen as earning money sleeping because unless your at their house thats what they think we do. Hell dispatch gets more good coverage than we do. I wish when the news contacted us about certain calls could hand them video showing us doing glamourous bloody work, but I'm stuck basically saying do to patient privacy rights I have no comment. Then they interview the dang firemonkey that almost crushed me and my partner why we were in the vehichle saving the patient talking like he had saved the person and done all the work. Before ya'll let me have it vehichles are stable no reason to cut em up but you know those guys gotta justify the toys so they go cutting posts for no reason, making the scene unsafe, thankfully we saw them before they got a good bite. My point is we need to find a way to get our patients blood and guts on the news instead of le and ff getting all the credit.

[spenac]

If you're talking specifically about recommending medication over the phone, then I agree. But EMD can provide other simple info, such as CPR instruction, choking procedures, and how to position patients. For more than that, you'd want to do a live assessment first on-scene.

I do disagree with the logic that if it worked, there would be no need for ambulance drivers. Even if someone came up with he closest to perfect algorithym for EMD, we (responders) would still be needed. The point of giving advice over the phone, even if system worked perfectly, wouldn't be (and was never meant to be) to replace responding units. It's to help increase survival and prepare for EMS arrival.

Some minor instructions maybe but not much else. And no I don't think dispatch would ever replace because somebody has to go pick the caller up and take them to lunch.

[katbemeEMT-B]

Here is a good example of why dispatch needs to concetrate on dispatching calls and not providing interventions to patients. One of our rigs was paged out to a collision between two semi truck on the Interstate. Our rig was not active at the time so we were able to listen to the radio traffic. This is how the call went:

I blocked rig numbers and state trooper numbers for privacy reasons.

Dispatch: Dispatch to RIG (our rig), you're needed on the Interstate at mile marker 60 for a collision between two semi trucks.

RIG: Copy dispatch. Put us enroute.

Dispatch: RIG, Air care has been dispatched.

RIG: Copy that

Dispatch: STATE (State Patrol car) do we know what is really going on

STATE: No, not on scene yet

Dispatch: 10-4 STATE. I will let RIG know that CPR has been started.

RIG: RIG to dispatch, has rescue been paged. We don't hear them yet.

Dispatch: 10-4 RIG. They are enroute

There is about a 15 second pause

Dispatch: Rescue, you're needed for an MVA on the Interstate at mile marker 60

Cross traffic that can't be understood

Rescue: Rescue to dispatch, you can put us enroute

Dispatch: 10-4 Rescue

Not even ten seconds later

Dispatch: Rescue you can cancel it's not an MVA it's a possible medical

Rescue: 10-4

Dispatch: Did you copy that RIG

RIG: Copy

Dispatch: Dispatch to RIG, you can cancel. It's not a medical

RIG: Copy

Dispatch calls our station an hour later to apologize for the mix up. The call came in as an MVA but was actually one trucker helping the other secure his load. The medical (CPR being performed) was actually a different call. Sorry again.

So you see, they have enough to do just keeping the calls straight. They were trying to give CPR instruction to some one and got the two calls mixed up. I say leave the patient killing to those that are better qualified.

[JakeEMTP]

That particular sort of thing should never happen. Why on earth were they working two calls simultaneously? Or is that standard procedure. If it is, it shouldn't be.

Oh, just a pet peeve of mine. I hate the term rig. A rig has 18 wheels. What we use is called an ambulance.

[spenac]

That particular sort of thing should never happen. Why on earth were they working two calls simultaneously? Or is that standard procedure. If it is, it shouldn't be.

Oh, just a pet peeve of mine. I hate the term rig. A rig has 18 wheels. What we use is called an ambulance.

It's one of those mass casualty rigs maybe?

[JakeEMTP]

It's one of those mass casualty rigs maybe?

Perhaps they use the SMAT trailer on a regular basis. :roll: The thought never crossed my mind.

Thanks spenac

[katbemeEMT-B]

That particular sort of thing should never happen. Why on earth were they working two calls simultaneously? Or is that standard procedure. If it is, it shouldn't be.

Oh, just a pet peeve of mine. I hate the term rig. A rig has 18 wheels. What we use is called an ambulance.

Not sure what was going on with dispatch. Didn't ask. Usually they are pretty good about relaying information. I'm thinking part of it was confusion from the scene on the Interstate. Can't be sure though. Our EMS Manager is checking into as he wasn't very happy.

I used the term "rig" just for the sake of the example. I was feeling a bit lazy after putting in 13 hours at work and serveral more at home as it was raining and we had no shingles on our roof so we were getting wet. We're dry now though and the roofers are almost done. =D> Sorry about that.

[JakeEMTP]

No problem khanek.

Just having a wee bit of fun on a otherwise slow day.

I thought the term "rig" was a midwest thing. Similar to the NYC term, "bus".

P.S., Glad you have your roof fixed. :toothy2:

[notsobuff]

While I can see why the immediate reaction of the EMS community is that medication advice shouldn't be given over the phone, in this case there was no real potential for harm. Aspirin's anti-coagulative properties are most potent in the coronary system and least potent in the brain. This is why aspirin is never used to treat CVA patients, even after a CT shows no bleed; it simply wouldn't be effective. So even if the patient did have a bleed, it wouldn't have made the situation worse. The other thing to keep in mind is the abysmal morbidity rate for hemorrhagic CVA, so even if the aspirin were to promote bleeding, it wouldn't really change the final outcome. I suppose the bottom line for me is that there is a clearly demonstrated benefit for getting an MI patient aspirin as soon as possible, and it won't really change the outcome for a patient with a CVA, so instructing the patient to take a safe, readily available medication over the phone seems the right thing to do.