Cardiac patient walked down stairs, medics don't document it

[Mountain Res-Q]

I still don’t see how you can compare falsification of medical documents and lying about sub-standard patient care to forgetting to restock the kerlex, speeding, or showing up a few minutes late to a shift but apparently their crimes are not as severe in your mind. Or maybe “kerlex crimes” area capitol crime in Texas… The end result is what it is… judgment is passed by the media, by the public, by their EMS system, and by there fellow EMSers who have a better clue as to what really happened than the Media or the Public. Plausible explanations (and a defense) have already been given for their actions in walking the patient. That is not where judgment is now being made… it is made solely on their actions after the fact… If you lie about what you did than how can anyone take you side; you have lost all credibility.

As for calling those that would rightly condemn their actions “judgmental and arrogant”… isn’t that a bit of an unjustified comment considering you are not here? How can you pass judgment on us simply by reading what we write because we pass judgment on those that have committed crimes that shed a bad light on the profession we love? A bit hypocritical if you ask me. But, like I said, if I commit the crimes these folks did… judge me and fry me… I would deserve it! “Everyone lies”? Yes, politicians, used care salesmen, insurance agents, your mother when she said you were smart, …and Health Care Providers? GREAT DEFENSE!!! I don’t lie unless I have something to hide… like a crime I commited… but it is a great defense in a court of law. “But, your honor, I should be found guilty because everyone lies.”

 

[firemedic7982]

I had no side to take in the first place.

This whole thing started by me being upset about people passing judgement.
If I lost my cool a little in my last post, I appologize. Thats the very thing I was arguing for and I will agree with you.

I also ageed several times in previous posts with the result of their actions.
The only argument I ever made was that people were judging them for why they took the pt. down the stairs the way they did. Thats all. Just that simple.

I think the original argument has somehow become lost in translation. Be that as it may, I appologize if I offended you.

 

[Mountain Res-Q]

I had no side to take in the first place.

This whole thing started by me being upset about people passing judgement.
If I lost my cool a little in my last post, I appologize. Thats the very thing I was arguing for and I will agree with you.

I also ageed several times in previous posts with the result of their actions.
The only argument I ever made was that people were judging them for why they took the pt. down the stairs the way they did. Thats all. Just that simple.

I think the original argument has somehow become lost in translation. Be that as it may, I appologize if I offended you.

I believe that EMSers are whay to thick skinned to be too offended by anything; maybe it is that same personality to causes us to fight so hard over things that to an outside is irrelevant. ^_^ I'm not offended by a fight over something as important as patient care, just as I hope that nothing I say here offends my fellow Emergency Service Brothers and Sisters.

That said, I as said earlier, I think everyone feels that their actions post patient care are not justifiable. There reasons for walking the patient are their own. We can all try and find reasons for why they did it, but in the end, yes, we were not there and can only speculate on what we would have done and what mitigating cirrcumstances would have "forced" us to walk the patient... but we all know that there is no justifiable cause for lying. In the end, however, patient care shouold not be the main reason for judging these medics. Whatever they did or didn't do was unjustificable in their minds, which is why they found reason to lie within 30 minutes of the call (paperwork) and latter on investigation (even trying to hang the FFs out to dry). I don't judge them because fo their patient care as Health Care Providers... I judge them because they faied to uphold their duty as public servants.

 

[CAOX3]

They were fired. Their medical director pulled a specialized skill. Is this usually the outcome when its a simple misunderstanding?

 

[AJ Hidell]

I believe that EMSers are whay to thick skinned to be too offended by anything.

LOL! You obviously haven't been around long.

 

[Sasha]

LOL! You obviously haven't been around long.

I'm offended for him that you would say that.

 

[AJ Hidell]

I'm offended for him that you would say that.

My point exactly, lol.

 

[Mountain Res-Q]

LOL! You obviously haven't been around long.

Just 8 years in EMS. Only a month on the forums. BUt these forums tend to attract the more "interesting" EMSers. I only get offended if something is said to be mean (like when friends call me an Ambulance Driver), but never when something is said by someone to get a reaction or by someone of lesser intelligence! Getting offended by people I dont know, who (I hope) are just here to share their knowledge and perspective in a field we love, and often seem to be "riding the short ambulance"... why? -_-

 

[AJ Hidell]

I agree. It just doesn't seem to work out that way for quite a few people here. We can't go a day without a couple of people getting offended here, usually over something that didn't even apply to them.

 

[Sasha]

Just 8 years in EMS. Only a month on the forums. BUt these forums tend to attract the more "interesting" EMSers. I only get offended if something is said to be mean (like when friends call me an Ambulance Driver), but never when something is said by someone to get a reaction or by someone of lesser intelligence! Getting offended by people I dont know, who (I hope) are just here to share their knowledge and perspective in a field we love, and often seem to be "riding the short ambulance"... why? -_-

Because the short ambulance is more exclusive than the long ambulance. Duh. And you get a cool helmet!

 

[Amack]

This story came up in class the other day. After reading, err-sorting, through the various replies, defenses, accusatory and equally inflammatory comments, I think that there is some concensus that agrees upon the take home points:

1.)Don't ever lie. EVER! It only will destroy your integrity...and in EMS, without it, your career as a professional is ruined. period.

2.) While some calls commands some level of improvitization, always act with the BEST interest of your patient. BE A GREAT PATIENT ADVOCATE.

3.) DOCUMENT! DOCUMENT! DOCUMENT! (Truthfully at that!..See #1)

 

[ResTech]

I would never walk a cardiac pt presenting with the symptoms and hx of the pt. in the news story down three flights of stairs. Never. The amount of exertion required on an already strained heart... no way. That pt. would be better managed by waiting an extra 15mins for additional manpower. If your gonna walk a cardiac pt. down three flights of steps then you may as well save your drugs cause you just defeated the whole purpose of decreasing myocardial O2 demand by walking down all those stairs. It sounds like laziness to me. I wasn't there but thats my impression. A Paramedic of all should know better.

If you dont have a stair chair... what about a reeves? a backboard? take one flight at a time and rest for a minute before descending the next. The FD was there... have them carry the pt. And if the pt. refuses to be carried... document it and make sure you also document that the associated risks of that action were explained to the pt. Even if a pt. refuses a specific treatment, its an obligation of the EMS provider to specifically inform the pt. of all associated risks so the pt. can make an informed decision. Because a refusal by a pt. can be disregarded completely if they were not informed of the risks involved.

I agree the news story is one sided however, a cardiac pt having an MI + three flights of steps = Never! And most importantly here.... DOCUMENT your actions and justification for them!!!

 

[reaper]

You will learn that the word NEVER is not in EMS!

 

[ResTech]

In 15 years as a career provider Ive already learned about the word never. There are always times that require adaptation and the ability to improvise... but it should never so blatantly put your pt at risk... unless of course a situation is considered immediately dangerous to life or health.... and this wasnt an IDLH case.

So unless the building was on fire, the roof was caving in, I was absolutely certain no manpower was coming, and I lacked the physical ability to carry this pt., he would NEVER have been walked down three flights of stairs.

 

[reaper]

So you force Pt's against their will, to do things they don't want to do?

 

[ResTech]

No... as I aforementioned in my above post, if the pt. refuses thats fine... but you NEED to explain to them the risks involved prior to doing something that is clearly not in their best interests and then document it.

In this case, it appears to have been a voluntary decision on part of the EMS crew to walk the pt. and an attitude of, "I don't feel like breaking my back down three flights of stairs" scenerio (ie laziness).... again just my impression of these providers actions which could be totally wrong.

So no, I don't force my pts. to do anything they don't want to do... but if I feel its indicated and in their best interests then I will be adamant about it with them and fully explain why I think so.

And in some cases I even get the pt. to sign a refusal form for a specific treatment modality... most commonly when they refuse spinal immobilization. Its then documented that they were explained all the risks or potential risks involved in refusing a specific treatment and has their signature on the refusal form to say so.

Oh, and if the pt. was presenting like the story states... I very highly doubt this pt. was volunteering to walk down three flights of stairs and refusing the EMS offer to carry when he cant breathe and chest is crushing.

 

[reaper]

That is fine.

I was referring to your comments that made it sounds like you could never do it at all.

"So unless the building was on fire, the roof was caving in, I was absolutely certain no manpower was coming, and I lacked the physical ability to carry this pt., he would NEVER have been walked down three flights of stairs."

 

[ResTech]

My bad... I was just trying to say as an EMS provider... I would not voluntarily make that decision just to save me the extra work involved of carrying a pt. down so many steps.

 

[reaper]

I agree.

I was just worried about someone reading that and thinking they could force a Pt to do it!

 

[Sasha]

In this case, it appears to have been a voluntary decision on part of the EMS crew to walk the pt. and an attitude of, "I don't feel like breaking my back down three flights of stairs" scenerio (ie laziness).... again just my impression of these providers actions which could be totally wrong.

So you can tell the Paramedic's intent by a one sided, biased article based on a family member who wasn't there's commentary?

Are you like connected with all EMTs/Paramedics and can tell their intent and mindset? Like are you the Professor X of EMS?

Oh, and if the pt. was presenting like the story states... I very highly doubt this pt. was volunteering to walk down three flights of stairs and refusing the EMS offer to carry when he cant breathe and chest is crushing.

You must not deal with a lot of stubborn old people who refuse to accept the fact that it's worse than they thought and want to maintain their pride/dignity by ambulating to the stretcher/down the stairs/to the ambulance or what have you.