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Post by CMTMedic on Dec 1, 2004 2:42:27 GMT -5
I ask this question after hearing an ambulance service respond to a hospital BLS with a "class 1 respiratory" on board after cancelling ALS (they were coming from the other direction). The ambulance then proceeded to the hospital after specifically requesting that the next ALS service not be dispatched. HOW DOES THIS BENEFIT THE PATIENT? We, as emergency responders, are granted a large amount of, for many laypeople, blind trust. Most people assume that they will receive the best service available when they call for help. They don't care if we are volunteer or paid, or what the paint on our apparatus says. They are counting on us to deliver this service. We need to step up and put aside differences that may hinder this responsibility. WE ARE HERE FOR THE PEOPLE WE SERVE. We are not here to pick and choose who we work with or call for help. If we do have issues with others we need to resolve them before they can affect the service we provide. I realize that this is not a perfect world and not everybody sees things the same, thats what makes life so interesting, but we need to be mature and think about more than ourselves. Sorry for the rambling, but I see this in too many places and it doesn't help anybody.
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Post by valleytech36 on Dec 1, 2004 6:56:29 GMT -5
No, it doesn't benefit the patient, its called negligence.
Patient illness or injury forces them to go to the hospital by ambulance, and they can generally be assured that the EMT's years of experience and training will results in excellent treatment of their ailment. But in truth, EMT is only human and as such, errors are always possible. Negligence occurs when a negligent act by medical professional results in damage or harm to a patient.
By Pennsylvania Statewide BLS Protocol Section 210 (Indications for ALS use)
In the case of a long BLS transport time with a nearby ALS service coming from the opposite direction, it may be appropriate to delay transport for a short period of time while awaiting the arrival of ALS if this delay will significantly decrease the time to ALS care for the patient. When BLS transport time to a receiving facility is relatively short, this delay is not appropriate.
But if the BLS squad has an ALS service in the same direction, which they are going to the hospital. That ALS service should be notified to rendezvous.
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Post by Chris VanDruff on Dec 1, 2004 23:52:13 GMT -5
well chris I have to say you expressed some really legitamate points here Im not sure if they are giving EMT certs out in cracker jack boxes I know I worked hard for mine and I value it. I go through every call in my mind when Im done and try to think of anything I could have done better, or differently and usually I can think of at least one thing its called learning. As for QR I guess they are not held to the same standards as EMS im not sure why I have asked questions and been told that they are not governed under the same guidlines. As for the 25 liters on a nasal something should have been done about that. We are here for the patient no matter what that is our duty when we rollover at night or get up out of the chair no matter how you do it paid or volunteer doesnt matter. The patient period. When the tones drop the bull shit stops ok. Its time people start to realize this. We all have the same mission to accomplish lets accomplish it.
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Post by valleytech36 on Dec 2, 2004 12:42:50 GMT -5
Here is the link for a copy of the Pennsylvania Department of Health Quick Response Service Recognition Program guidelines:
[ftp]http://www.pacode.com/secure/data/028/chapter1015/chap1015toc.html[/ftp]
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Post by rob13t1 on Dec 2, 2004 22:06:41 GMT -5
the call that prompted this,emt recalling als, the emt made a good decision. the closest als care was AOH emergency room..the emt,being on a first name basis with the pt,also respected the pts wishes by doing so.
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Post by CMTMedic on Dec 2, 2004 21:19:36 GMT -5
Actually, the closest ALS was Erway EMS and St. Joseph's ED. Cancelling the inital ALS unit was appropirate due to their location. But another should be dispatched. If the patient's condition had deteriorated further (already a "Class 1") while enroute the EMT was responsible. It doesn't matter how well he knows the patient, he still has a responsibility to that patient, as we all do, to provide the best care available.
It was not my intent to "pick" on a certain call. I have just noticed a trend that does not appear to be in favor of the patients. The point is that we need to do what is in the best interest of our patient, not ignore who we may not get along with or agree with.
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cledus
Full Member
the unknown medic
Posts: 37
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Post by cledus on Dec 4, 2004 20:55:59 GMT -5
I would state that we are hear for the Pt. Some of use have forgotten that. Rob13t1 shame on you for trying to justify not calling ALS . If you are confused about what ALS can do for a respitory Pt fill free to send me a message and I will show you, if it is how bad a Pt can get, they can die from this, ALS has the ability to reveres this in some cases. I can't even think of a good reason why you would not want a medic to help a Pt, even one you know.
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Post by rob13t1 on Dec 5, 2004 17:07:18 GMT -5
Shame on me? You dont even know me.I understand that this was not intended to pick on a particular call so enough said. It was mentioned that there is a trend that does not appear in favor of the pts.I cannot agree more.Some of us,in fact all of us im sure,started into this line of work with one thing in mind and that was to help others. Some people seem to have forgotten that.
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Post by CMTMedic on Dec 5, 2004 19:12:15 GMT -5
Judging by your response I am assuming that we are on the same page about what the problem is 13Tech1. I do understand that there are factors on both sides of the perverbial fence that influence your organization. Has any headway been made to address the problem as far as contracts, ect.? The other thing I wonder about is the legality of taking your patient out of your ambulance, changing stretchers, then sending them on their way with the other service. I don't like that procedure any more than you do. It falls right back to what is best for the patient. I do wish you luck finding a solution and remember that there are resources here that you may be able to tap to assist you and others find solutions to issues such as this. After all, that is what we are here for.
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Post by 911wacker on Dec 6, 2004 7:43:53 GMT -5
Enough brow beating folks, we can see that many people have slightly different opinions as to how we would handle such a situation. Truth of the matter is, if the patient doesn't want something and they are alert and oriented, its their decision to make. This doesn't mean that a reasonable person would not cover their A$$. If we do something for a patient who is capable of decision making on their own, we can be charged with assault and battery!! Plain and simple, and I'm not saying we shouldn't try and talk the patient into it, but if they absolutely-positively refuse, its their choice to make and who made us God? Concentrate on the things you CAN do, instead of the things you CANNOT!!
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