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Inter-facility transports


brentoli

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Real ambulances do not need to be used to take grandma to her appointment, it is a waste of resources and tax payer money. To argue I once saved a person because they were in the ambulance instead of a taxi is a bogus argument. By that logic ambulances should be used instead of taxis, busses, and even private vehicles cause we just might catch someones heart attack before it becomes bad.

It's time to choose are you a taxi driver or a healthcare professional?

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example of way an ambulance is needed.....I had a pt that needed transport from hosp to nursing home. I was driving my partner was in the back with her. The PA that was in charge said that she was fine and could go 'home'. The pt had a little anxiety, but was otherwise fine. Enroute to the 'home' her blood pressure went throughout the roof and would not calm down.

Define "through the roof." True, it's a judgment call, but it would take a really large change for me to decide to turn my ambulance around. For the record, that decision would have nothing to do with what my company would have wanted me to do.

Right there my partner and I had to make the choice of turning around or not. My partner said f... it and we turned around and was able to use our lights and sirens and make it back to the hosp without having any trouble.

1. L/S would probably make your patient more anxious. Why would you do something that would make the situation worse, especially since the current studies show a remarkable lack of time actually saved by transporting L/S? [note: L/S do save time. That amount, though, is rarely enough to change an outcome]

2. If your partner needs to use L/S to drive with little problem, then your partner sucks at driving. I must digress, MOST people suck at driving [i'm looking especially at you, Boston drivers]

Now would a taxi be able to do that? I don't think so. Just because the pts seem like they can walk, you have to remember that any pt can be healthy one minute and crash the next.

That's a nice straw man argument there. As stated before, then everyone should be transported by an ambulance since, at any given time, there is a chance that they could drop dead. Furthermore, that would be an argument to reject the EMT-Basic level in favor of a level that would be able to actually do something for the patient.

Our company has a few ambulances, they are used for many different reasons. We are all here to help people and that is what I will continue to do!

Huh?

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Enroute to the 'home' her blood pressure went throughout the roof and would not calm down. Right there my partner and I had to make the choice of turning around or not. My partner said f... it and we turned around and was able to use our lights and sirens and make it back to the hosp without having any trouble.

And thirty minutes later, a different transfer car from a different ambulance company showed up and took her back home, like you were supposed to. :D

That post should be moved to the, "Things that make you go 'wtf'" topic.

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As a wise man once said "Looky here, looky here, looky here!" For the name of all thats holy lets stop having every argument end up in "well if it had been a Medic who could have actually done something." I call foul. Ever since I have been on this site that has been the way to end and argument: "Well if it had only been ALS." Ya know what, most of the medics I know couldnt find their arses with both hands and a flashlight. Simply bungling your way through medic school and learning how to stick a needle in a vein and some basic pharmacology (yes there are medics who are extraordinary...we are privileged to have several of them among) doesnt mean that a medic is gods gift to EMS. Besides the idiotic decision to go C-3 L/S, what would a medic have done differently? Seriously? Give her a dose of Vitamin H so she would shut up? As for the EMT, the next time you get within striking distance of your partner, clock him a good one on the forehead for me. Any idiot who can get one eye open knows that when you have a hyper-excitable patient whose excitability is driving up her vitals, thte last thing you do is start running hot. Unless she was stroke imminent high, there was no reason to go L/S at all, let alone turn about and take her back where you just came from. Those decisions are made as a crew, so I guess I need to talk to your partner about giving you a knuckle sandwich too. From what you have said, her B/P was elevated, you two eggshells made it worse by going hot. If I were your supervisor you would both be sitting at home picking belly button lint for the next week watching three stooges and hoping the lights stay on cause you wouldnt be getting paid for it. And do gimme that you werent there crapola on a stick...I have been there. On a recent tour I did 20 hospital to nursing home runs with the medic driving. Ya know how many of them we turned around. None. Nada. Zipinski. You should both have your little rattly toy ambulance keys taken away from you and have to surrender every one of the thousands of star of life t-shirts, key chains and chick magnet caps you have over to the city to be burned. Then you should have to spend the next year working as bed pan attendants.

"Ive tried nasty and Ive tried nice. Nice makes em think you are their buddies. Nasty gets s*&^ done." So sayeth the gospel according to me. Blasphemers repents before the gods of Mt. NREMT pulleth thy cards for good. "Repent, Repent I say, for the end of the world is nigh....especially if you two keep transporting our elders."

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The company that I used to work for had 2 divisions, EMS and Ambulette. The EMS division was responsible for handling 911 calls within the system, and the ambulette division would take grandma to her appointments.

The people hired in the ambulette division had a CDL and CPR...that was it. Some people that had their EMT cert chose to work in the ambulette division because they were guaranteed hours for the same pay as an EMT. (which says alot about the company)

For a while, on the weekend if there was a discharge from the hospital the 911 crew got stuck handling the discharge. Which caused a lot of commotion among our ranks because there were times when we would be unloading grandma at her house and we'd get a call for an ALS intercept with the nearby volly squad. On one occasion we weren't out until about 10 minutes after dispatch. We only ran 1 truck because of the call volume and service area, so it was hectic at times.

Eventually they began to have an on call ambulette operator on the weekend that we could call to perform discharges and the like.

In my opinion, the two divisions can run together, but they are not the same. Unfortunately because one company runs both, they are often seen as interchangeable and the same thing. They are not. If we want to be taken seriously as a profession, it is imperative that we separate the two.

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I agree. We have a local service who does pretty much nothing but transfers, so that helps. But then we have another which is hospital based which has ambulances and what you are calling ambulettes (a term I had never heard til I came here...we call em wheel chair vans....tomato tomahto). The only problem with this services divided system is that often it is still medics that are driving the ambulettes to take Grandma back to the death trap...er...i mean nursing home. There have been times where the medic has had to race Granny to the home, transfer her as fast as possible and then run an ALS call when the service is backed up. There really does need to be a clear division of who is doing what, or at least something like every 10 shifts, you have to take an ambulette/wheelchair van shift, and thats all you do so you dont end up with the snafu I mentioned above.

And so, like sand through the hourglass....these are the days of our lives.....

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As a wise man once said "Looky here, looky here, looky here!" For the name of all thats holy lets stop having every argument end up in "well if it had been a Medic who could have actually done something." I call foul. Ever since I have been on this site that has been the way to end and argument: "Well if it had only been ALS." Ya know what, most of the medics I know couldnt find their arses with both hands and a flashlight.

Unless I missed something you are the first to say that on this topic. Dust our most famous "if ALS" person did not bring it up best I can tell. All any have said is it doesn't take medical people to take people to appointments, thats what taxis are for.

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Unless I missed something you are the first to say that on this topic. Dust our most famous "if ALS" person did not bring it up best I can tell. All any have said is it doesn't take medical people to take people to appointments, thats what taxis are for.

I have to admit that it left me scratching my head for a few minutes of re-reading the thread too. I thought I had missed something. But, what I finally got out of that post was that he was simply comparing the "If we only had ALS" argument to the other poster's argument that, "If she had been in a taxi, she would have needed an ambulance." I think he was just reinforcing the "what if" theory, and not specifically introducing an ALS element to it.

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In my county we can to inter-facility transport but only if the patient requires or has the potential to require ALS care. Otherwise we have BLS services that can do the transfers instead. We can transport burn patients from an ED to a burn center, OBs to a delivery center, etc. However we can only transport within our county or to neighbouring counties. We don't do long-distance transfer. I have come to notice that it differs in a lot of EMS agencies as to how they handle interfacility transports. I suppose it depends on your resources, how rural your area is, and what the need of the patient is.

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