|
Post by 911wacker on Jul 7, 2004 18:57:07 GMT -5
Is there a different classification for patients that I am not aware of? I have been to way too many scenes where the first on scene units were labeling patients as class one and really they were not even close. Class 1 - LIFE THREATENING Class 2 - is a Potentially unstable or life threatening Class 3 - is a stable patient/minor injury ANY QUESTIONS?
|
|
|
Post by canton1 on Jul 8, 2004 0:31:47 GMT -5
;D Well all mighty, sorry we are all not a awesome as you "almighty medics" Somehow I think it may have something to do with we do not deal with these all day everyday. Anyway, I was always told to make the error on behalf of the pt., not rather a medic is gonna get mad at me for classifying the pt wrong. I think you need to just "run along and get married" and leave us WHACKERS or WACHOS alone.
|
|
|
Post by chief322 on Jul 8, 2004 17:20:17 GMT -5
Scott nothing personal here but I (NFT) have been asked on numerous PIA's the condition of the patient(s) prior to EMS arrival and I am expected to give a decent account?
Severe bleeding from the head from a small laceration looks the same to me as someone that might have a fractured skull w/ a laceration.
Conversely, I have had PIA's where the patient ends up dying and I thought they weren't in all that bad a shape.
I give assesments on what I am trained to do. Just because I will tell a Rescue Company officer what type of confinement/entrapment they have and what they will have to do upon arrival doesn't necessarily mean the patient is in good or bad shape. Same thing goes when asked if we should fly the bird. How the hell should I know. Being an NFT when it comes to EMS, my gut feeling is why not because, like calling an extra alarm on a structural assignment, you can always cancel it. As far as calling it a Class 1 patient (which I don't understand class assesment being NFT) what does it matter. Isn't the job of the responders to respond in a fashionable and timely manner regardless?
Love ya Brother! Now show me some love!
Tim
|
|
|
Post by Chris VanDruff on Jul 9, 2004 20:25:55 GMT -5
Ill be honest man I still get the classifications wrong 1 is bad 5 is dead "WTF" lets just get there and provide the best care possible, within our scope of work. I understand what your saying stermie but not everybody always gets it right. Be safe!
|
|
|
Post by 911wacker on Jul 14, 2004 15:54:47 GMT -5
Just so you guys know, nothing personel especially from the fire side, a firefighter can only assess what they see or hear. On the other hand a first responder or EMT, has training and knowledge that can be put to really good use. If you are one of these people and have not taken BTLS, I would recommend one of Paramedic 16's fine classes!! Rapid assessment established in 20-30 seconds can define a life threatening injury from a non-life threatening issue. Even with that siad, patient conditions change rapidly and to error on the side of the patient is a good thing!! ;D But lets put our best effort into making an educated decision, not a "gut" feeling! Just food for thought!
|
|
|
Post by canton1 on Jul 19, 2004 23:25:57 GMT -5
Scott,
The other night we had a call, ATV over a bank.
It was a GUT feeling for the most part (as I understand it) that he was taken by helicopter to RPH.
We all kinda thought he would be released right away with no injuries or real minor ones.
After a FEW days in ICU he has returned home with some pretty severe concerns.
What I am getting at is, maybe it was a good thing that we errored on behalf of the patient.
|
|
Mansfield2
Junior Member
Jim Welch, Mansfield Hose Company Chief
Posts: 23
|
Post by Mansfield2 on Jul 22, 2004 8:01:01 GMT -5
I know that the patient classification system is utilized in Bradford Co. and it seems to work well. But is there any significant difference in the care received between a class 1 or 2. We don't use the classification system in Tioga Co., and maybe we should but my sense is that it is a source of confusion and added tension. I'm sure that this was a decision sent down from the regional EMS council not by the local responders. Bottom line is that people out there have different training levels and they are making a call based upon their assessment of the patient. Am I wrong that a class 2 patient can be upgraded or downgraded at any time? Every call is a learning experience and the next time maybe we'll do it better because we've seen that before.
|
|
|
Post by 911wacker on Jul 22, 2004 11:35:17 GMT -5
Jim, I think that you are right with regards to the policy being handed down from the council many moons ago, but this does't negate the fact that responders should have a pretty good idea of what they mean if they are going to use it. Canton 1 - I agree with the fact that if there is any doubt, we should always error on the patients side. We EMS providers that do it every day are well prepared for such because thats the way that we are told to care for the patients in our care. I was trying to get people thinking about the "class one" patient, seems that many patients we respond to are class one until we arrive and evaluate these patients further. Personally many of these trauma patients would fall into a "class 2" status which certianly would not lighten my foot off the gas pedal any at all.
|
|
|
Post by Matt Russell on Jul 22, 2004 15:48:29 GMT -5
-You are right the "T" is for Tioga and the "L" is for Lycoming and a a matter of fact the "S" is for Sullivan but let me tell ya brother, that don't mean we're all playin' from the same sheet of music! SHS has "their own" protocols.
The other issue to patient classes is that 1-3 are the pretty much the same whereever you go but 4-? differs by the county.
|
|
Mansfield2
Junior Member
Jim Welch, Mansfield Hose Company Chief
Posts: 23
|
Post by Mansfield2 on Jul 22, 2004 15:49:31 GMT -5
The priority Class issue hasn't been pushed by the County EMS council, heck we still don't require an EMT number to recall ALS or a helicopter. I guess the bottom line is as previous posts state you have to make a decision with what's presented to you at the time and report it. We've all made mistakes (yes it's true, I too have made mistakes) hopefully you errored on the side of caution and provide the best care you can with the resources available at the time. And yes the "T" in LTS is Tioga, although I think some times Tioga and Sullivan are treated like the ugly step child who are just told what to do by the "L". But thats a local problem and a whole other story.
|
|
|
Post by canton1 on Jul 23, 2004 1:12:22 GMT -5
Scott,
Agreed but, class still has to be in the eyes of the beholder. To me it may be serious but then again (for some stupid reason) they wont give me needle and crap to stick people and make them better. Your level of care is higher (well in theory) and this may make it not look as serious or you can fix it faster than me with better tools (needles)
|
|
|
Post by 911wacker on Jul 24, 2004 9:18:40 GMT -5
Hey Chief, just remember that all bleeding stops eventually and most traumatic injuries look worse than they are. But what I was getting at at the beggining of this post was sometimes people who haven't even "touched" the patient are calling reports to county or even the hospitals before they have been really assessed.
Not picking on any one service because this happens almost everywhere, but - at Greater Valley some of the "supervisors" are making classifications for patients before a provider has had a chance to really assess them. The hospital likes the early heads up, but many times is shocked to find that our patients are not as serious as the picture that was painted for them early on. Sometimes this can be an embarresment when you arrive to meet the trauma team and you have a patient with nearly no complaints, and this has happened.
So, I suppose that I was looking for suggestions on how to better "triage" or even train people so we have less of this happening??
Any suggestions??
|
|
|
Post by canton1 on Jul 24, 2004 21:50:58 GMT -5
Scott, Agreed as do all building stop burning. Hell I think I have burnt the mineral rights out of the ground. Does this mean that we don't try to put it out like hurrying just a TAD to stop the bleeding. We have it in the fire service..... Fully involved when it is only one end maybe Smoke showing and no one has looked at other sides I still say that it all depends on your level of training and experience in the field, and the amount of other excitement going on.
|
|
|
Post by valleytech36 on Jul 26, 2004 5:13:21 GMT -5
At Greater Valley EMS we try to classify all patient in these categories: Class 1
-GCS<13 -SBP<90 -All penetrating injuries to head, neck, torso and extremities proximal to elbow and knee. -Flail chest -Combination trauma with burns -Amputation proximal to wrist and ankle -Pelvic fractures -Limb paralysis -Severe life-threatening injuries -Disabling injury
Class 2
-Potential life-threatening -Possible disability -High index of suspicion due to: *mechanism of injury *death in same passenger compartment *pedestrian vs. auto *bicycle vs. auto *patients accepted in transfer if meets physiologic and/or mechanism of injury criteria *unstable single system injury
Class 3
-non life-threatening -minor injuries/ walking wounded
|
|