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Thanks for offering your expertise on this forum. For nearly all of us paramedics, how billing works is a mystery. Hope you stick around for a while! Can you give examples of poor documentation that would result in Medicare or Medicaid not reimbursing a transport or treatments?

I would have to doubt that the INR was that high. It is not unheard of to see "super therapeutic" INR levels in patients taking Coumadin. It is notorious for interacting with many other drugs.

Yeah, can't believe the ER doc would send a patient like that out by ambulance.

What percentage of say, a $1000 ALS transport bill does Medicaid usually reimburse? How much would say, Kaiser insurance reimburse for the same transport? How do you think the proposed massive cuts in Medicaid (with the repeal of Obama Care) will affect private ambulance companies?

I like what Hometownmedic said: "Never get comfortable. Always be looking at the next step. Whether its the next job, the next cert, perhaps even the next career choice. Always be moving towards a goal. When you stop trying to get somewhere, you stay where you are. That may be fine if you're...

In my research, I have come across a couple of community paramedic programs that have programs specific for helping opiate addicts. It does make sense since the main purpose of CPs is to visit frequent users of EMS and ER services, and opiate addicts often are such super users. Also, if you...

Does anyone know of community paramedic programs that are involved in seeing opiate addicts; i.e. visiting patients who have in the past OD, providing them with harm reduction (Narcan), facilitating them going to group meetings or other outpatient appointments, etc. I'm not sure if I totally...

Sounds like what you did worked. That type of call, with AF + RVR thrown into the mix, gets complicated. By the way, you can't trust the ETCO2. The only thing you know is that the true CO2 level was at least 25 mm Hg, but it could've been much higher too.

Thanks for all the replies!

Do you have any stats from you county showing how often it has been administered by basics, cops, firefighters? Thanks

Has your county allowed EMT basics, cops, and/or firefighters to administer Narcan? If so, any stats on how often it has been used and if there is any evidence of lower OD deaths?

As ERDoc has said, the fact that he was also septic is not surprising. I see a lot of DKA patients, and infection is often the underlying cause.

Sorry, my bad. In the second photo the QT looks long, but looking at it more closely in the other photos it's less than about 400.

I'll have no problem admitting I was wrong if in the near future we are told that vitamin C, steroids, and thiamine are as important for curing sepsis as antibiotics. Reread the article, and consider that he is claiming a near 100% cure rate for sepsis. Remi, I think you're missing the point...

Remi, is this a competition for you? Moving on, the podcast I linked to is a really interesting discussion on how the media very often does a bad job of reporting on medical news. It's not media bashing, but rather a good exploration on why the media so often gets it wrong.

Here is an excellent podcast on how the popular media can be predicated to do a bad job on reporting medical news. http://www.wnyc.org/story/on-the-media-2015-12-25

"But yeah, he's just a hack.....totally in the same vein as Dr. Oz. :rolleyes:" Well, Dr Oz also has impeccable credentials. He's a cardiothoracic surgeon and lecturer at Columbia. But he's still a hack. Why? Because he peddles pseudoscience. He knows better, but he's made the decision to...

Yikes, that's a long QT.

Here is another example of extraordinary claims made by a doctor using language that a medical professional should not be using. I''ll leave it up to someone else to spot all the red flags..

Vent, you asked why I suspect this doctor is a hack. 1) First, consider the headline, “doctor claims to have found cure for sepsis.” Really?! And not only that but a “miracle cure?” Surely any medical professional would be have a hard time believing such an extraordinary claim. Again...