Comments on this story; signs and symptoms of a stroke.

[IAems]

Always better safe then sorry

I am a supervisor for an medium sized IFT company in LA. We had a paramedic with a similar scenario, he didn't upgrade a BLS call to ALS (even though he thought he should and the patient met base hospital contact criteria) because he didn't want to anger the con-home staff or lose the contract. End result? Patient died 5 minutes after we dropped off at a non 9-1-1 receiving ER (a physician on call, none on staff). I tore that medic a new one and told him that if it ever happened again, he would be terminated on the spot. I can't speak for your IFT company, but I tell my guys to ALWAYS do what's best for their patient! Know your local protocols and policies, and then follow those policies. If they fire you for following your local EMS Agency Policies, then you've got wrongful termination or at least unemployment (a company policy can't supersede a County or State policy), not to mention working for a company like that will burn you out (guaranteed).

 

[JPINFV]

What concerns me most is that there are EMTs who aren't comfortable bagging...

What concerns me even more are EMTs who aren't comfortable bagging a patient with a trache. What could be easier?

I never wrote that.

We know, hence why "JPINFV" and not "emt seeking first job" was named in the quote box.

 

[JPINFV]

Wtf do you mean they werent comfortable with the bvm

I have no clue... that was what was relayed to me after getting to the hospital. All I knew at the time was I was told to upgrade and go to the new destination.

 

[JPINFV]

Here's what gets me. I've worked for a company that normally gets slammed as being one of the down and dirty IFT companies in So Cal. However, either working weekends where I don't normally see upper management, or I really impressed upper management without ever really seeing them, but I've never felt like I've been in a "right choice for the patient, right choice for the company" decision. Sure, I've had to justify a few incidents (like my mandated reporter incident), but after discussing a few incidents, my decisions were always validated.

I have to wonder how often these issues are actual issues with the company, or issues with the provider being able to justify why they did what they did. Sure, you can be right, but if you can convey why you're right, then it doesn't matter, and that's not the company's fault.

 

[usalsfyre]

I have to wonder how often these issues are actual issues with the company, or issues with the provider being able to justify why they did what they did. Sure, you can be right, but if you can convey why you're right, then it doesn't matter, and that's not the company's fault.

This is advice that everyone needs to pay attention to.

 

[JPINFV]

but if you can't convey why you're right, then it doesn't matter, and that's not the company's fault.

ftfm.

 

[emt seeking first job]

It depends. Most of the time in most states, such repeated and flagrant violations are simply dealt with by the medical director backing out which shuts the service down without that "state" getting involved. That said, be very cautious voicing even a hint of such desires or leanings or you will find yourself unable to find employment.

If it were that bad I would quietly leave the service.

In NYC there are quite a few privates, some have a bad rep, other big names, they compete with each other so I think the competition keeps them somewhat 'honest.'

That and I would say the majority of people in EMS in NYC have a certain code of ethics about how things should be done, to a degree.

 

[emt seeking first job]

They COULD side with the transport service. If they did, what would your next level of appeal be?
Sometimes you have to stand up and take it when bad things happen, but usually there is a better and more productive way...judo, not WWF.

Bad day for the frog AND the egret:

Mycrofft, that picture has been on my frdige for the past five years !!

 

[DrParasite]

I am just curious, if an IFT person got disciplined directly for not calling for permission to go to an ER, would the DOH interviene if that person went to them ?

I would make a guess it would not go down like that, the person would not get disciplined for that, but every other little thing they did wrong which for another person would go unnoticed.

No, the DOH wouldn't intervene. the DOH has no authority about what a company does. they can yank your emt cert, they can fine you, but if your boss makes an operational rule that you break, than no, the DOH won't intervene, esp if it involves a private company.

if they penalize you for a clinical issue (you didn't call ALS for this person, etc), than maybe you can get the DOH to back you, but it's still a company decision.

Right, since money's not AT ALL important to a 911 provider...

no, patient care comes first. money, billing and revenue is important, but it should NOT trump patient care. sadly, most private companies forget this little detail

 

[usafmedic45]

If it were that bad I would quietly leave the service

Then why ask about whining to the state about it? That's an option that's never really an option if you want to keep working in this field. Take it from someone who spent the majority of his ground EMS career working for a medical director "cleaning up" services. The term "egregious" doesn't even begin to describe what it takes to get the state involved on a clinical matter. Now, fraud? You'll have the IRS, state and probably the FBI so far up your *** you fast that your pyloric sphincter will be like "What the :censored::censored::censored::censored: was that?"

 

[Sandog]

Then why ask about whining to the state about it? That's an option that's never really an option if you want to keep working in this field. Take it from someone who spent the majority of his ground EMS career working for a medical director "cleaning up" services. The term "egregious" doesn't even begin to describe what it takes to get the state involved on a clinical matter. Now, fraud? You'll have the IRS, state and probably the FBI so far up your *** you fast that your pyloric sphincter will be like "What the :censored::censored::censored::censored: was that?"

"egregious" Nice word,

pyloric sphincter will be like "What the :censored::censored::censored::censored: was that?"

Now I don't know why, but that was funny...