change one thing...

[Melclin]

I would like for evidence based decision making and reasonable practice to be defended publicly by the service.

Eg. Bogan x complains to the service that one of their miniature, fell over, scrapped its head. You left them at home using a combination of say the PECARN decision tool, common sense, physical exam, and minor head injury pt education and the kid then vomits once later after 3 litres of red cordial and they spend the evening in an ED waiting room only to be told the kid is fine and to go home. This of course turns into, "Your paramedic left my kid at home, he vomited blood and we had to rush him to ED".

I know of plenty of cases similar to this (although this one is completely hypothetical) where the paramedics involved were slapped on the wrist simply for PR reasons, not because anyone really thought they made a mistake. The pt's family could have complained that the paramedic failed to stop the sun from setting and they would still have been scolded.

Similarly, I left a pt at home once with one hour of minor generalised abdominal cramping, 1 day feeling generally unwell, 5 x diarrhoea since lunch time. Advised that he take OTC pain relief, keep his fluids up, see his GP in the next few days, or as required or if the pain/ his condition worsened to run him down to ED themselves. I saw them in the ED 2 days later, chap had appendicitis. They appreciated and followed the care plan I offered them and to good affect, but they just as easily might not have, then complained that I risked their sons life some how and I bet I would have been in the s**t for no good reason.