What does Turfing mean?

[O 2]

I've heard the phrase 'the ALS unit turfed us a pt.' a few times, or something to that effect. . . can't figure it out.

Thanks.

 

[Shishkabob]

One provider says that they don't need to be with the patient and drops them on another provider.


IE, a BLS truck calls for a Paramedic intercept for a chest pain call. The Paramedic comes and deems that it's not cardiac in nature, and that ALS care is not required, so instead of the Paramedic transporting with the patient, the Paramedic leaves the patient with the BLS crew.


Sometimes used negatively like a provider was being lazy and didn't want to do their job.

 

[JPINFV]

Hear ye, hear ye. I now read from the holy scripture of The House of God. Page 389, the glossary, followed by page 383 of the same chapter.


"Turf: get rid of, as TURF a gomer to Urology; often preceded by a BUFF, as in BUFF and TURF; occasionally followed by a BOUNCE, as "I TURFED my gomere to Urology, but she BOUNCED back to me"; to BUFF and TURF, according to the Fat Man, is the essence of the delivery of medical care, the concept of the "Revolving door."

BUFF: polish to make look good, as BUFF a car, BUFF a chart, BUFF a gomer; part of BUFF and TURF"

A reading from The House of God,
Thanks be to the Fat Man.

 

[LonghornMedic]

Not transporting a patient can be considered turfing. Dropping a patient in the ER waiting room is another term for turfing. Basically any reason to not transport or to hand off the patient to another agency (ie PD, ER lobby) would be turfing.

 

[Akulahawk]

Turfing = quickly and expeditiously finding a way to make something someone else's responsibility... the key thing is to ensure that it's done in a legal manner so as to not bring wrath upon oneself...

A turf god would be one that can turf so skillfully that the recipient never realized they've been turfed...

 

[JPINFV]

...and to directly answer (and use the lessons from HoG) the OPs question, ALS providers can turf patients who the ALS provider believes doesn't require ALS level treatment or monitoring to BLS providers, which allows the ALS provider to either drive or, if different units, go to a different call.

If the ALS provider was, shall we say, loose with details in documentation and the hand off report, then the ALS provider buffed the patient prior to turfing. If the BLS provider refused the turf citing a need for ALS level care, then the patient bounced back to the ALS provider.

/Hates the terms "ALS" and "BLS"
//Buff/turf/bounce doesn't really apply as much to EMS as to the hospital.

 

[jjesusfreak01]

Not transporting a patient can be considered turfing. Dropping a patient in the ER waiting room is another term for turfing. Basically any reason to not transport or to hand off the patient to another agency (ie PD, ER lobby) would be turfing.

We drop patients in the ER lobbies by order of the hospitals only. Otherwise, they get a room.

 

[LonghornMedic]

We drop patients in the ER lobbies by order of the hospitals only. Otherwise, they get a room.

We have wait time protocols. If the ER doesn't place the PT in a room after waiting for 20 minutes, they get put in the lobby or placed on a bed next to the triage area. The ER's abused EMS for many years as free PT babysitters. At one time we spent hours watching our patients in the hallway waiting for ER beds to open up. That has been put to an end.

 

[jjesusfreak01]

We have wait time protocols. If the ER doesn't place the PT in a room after waiting for 20 minutes, they get put in the lobby or placed on a bed next to the triage area. The ER's abused EMS for many years as free PT babysitters. At one time we spent hours watching our patients in the hallway waiting for ER beds to open up. That has been put to an end.

We won't be sent to the waiting room with any patient who triages as an ESI 1 or 2, and usually not 3s either. If we do go to the waiting room, the patient is left in a wheelchair, report is given to the triage nurse, and we sign the patient over to them. We never babysit patients at the hospital.

 

[hippocratical]

Delegating with extreme prejudice

 

[Tigger]

Turfing is more applicable to the hospitals since turfing someone to another specialty or unit doesn't mean they are getting a level of care that is drastic step up or down (hopefully). The goal of a turf is to make the patient someone else's responsibility. I guess in EMS turfing also occurs with ALS intercepts, the basics want the patient off their hands. They might need medics, or they might just want the medics to transport so they can go back to bed. It works both ways...


Sent from my out of area communications device.

 

[the_negro_puppy]

We have wait time protocols. If the ER doesn't place the PT in a room after waiting for 20 minutes, they get put in the lobby or placed on a bed next to the triage area. The ER's abused EMS for many years as free PT babysitters. At one time we spent hours watching our patients in the hallway waiting for ER beds to open up. That has been put to an end.

We won't be sent to the waiting room with any patient who triages as an ESI 1 or 2, and usually not 3s either. If we do go to the waiting room, the patient is left in a wheelchair, report is given to the triage nurse, and we sign the patient over to them. We never babysit patients at the hospital.

I wish it was like that here. We call it 'ramping' and is extremely common. Most of our crews are tied up babysitting patients on our stretchers at hospitals due to no beds. My longest wait is 4 hours.

 

[DrParasite]

One provider says that they don't need to be with the patient and drops them on another provider.

IE, a BLS truck calls for a Paramedic intercept for a chest pain call. The Paramedic comes and deems that it's not cardiac in nature, and that ALS care is not required, so instead of the Paramedic transporting with the patient, the Paramedic leaves the patient with the BLS crew.

Sometimes used negatively like a provider was being lazy and didn't want to do their job.

That isn't turfing... that's called triaging... or releasing the patient to the BLS crew.... it's a good practice. why would you tie up an paramedic unit when one is not needed? they checked her out, found nothing acutely wrong with her, let the BLS take the patient to the hospital.

nothing to do with being lazy, or not wanting to do your job; it is utilizing your resources appropriately, and not tying up resources on a call when they are not needed.

I wish it was like that here. We call it 'ramping' and is extremely common. Most of our crews are tied up babysitting patients on our stretchers at hospitals due to no beds. My longest wait is 4 hours.

4 hours???? our agency policy is you get 10 minutes in the ER for minor patients, 20 minutes for more serious patient. after that, you are available for the next job. damn, a 4 hour wait, that's a great way to kill half of an 8 hour shift, or a 3rd of a 12 hour shift. better to spend it in the air conditioned ER than doing 12-20 jobs in 90 degree weather during the summer.

 

[JPINFV]

That isn't turfing... that's called triaging... or releasing the patient to the BLS crew.... it's a good practice. why would you tie up an paramedic unit when one is not needed? they checked her out, found nothing acutely wrong with her, let the BLS take the patient to the hospital.

nothing to do with being lazy, or not wanting to do your job;

Depends on the attitude and reasoning behind transferring the patient to the EMT crew. It can easily be a turf, especially depending on the conditions.

Alternatively, if there is no such thing as paramedics turfing to EMTs, then this entire lecture snippet is bogus.

[YOUTUBE]http://www.youtube.com/watch?v=4MSmk10afro[/YOUTUBE]

 

[abckidsmom]

Depends on the attitude and reasoning behind transferring the patient to the EMT crew. It can easily be a turf, especially depending on the conditions.

Alternatively, if there is no such thing as paramedics turfing to EMTs, then this entire lecture snippet is bogus.

[YOUTUBE]http://www.youtube.com/watch?v=4MSmk10afro[/YOUTUBE]

Absolutely. There are plenty of times that it makes good sense for a patient to be transported by EMT-Bs, and plenty other times it happens because the system is hopping and the crew hopes to get put on the accident with entrapment, or like this guy said, the smoke showing.

 

[DrParasite]

Depends on the attitude and reasoning behind transferring the patient to the EMT crew. It can easily be a turf, especially depending on the conditions.

Alternatively, if there is no such thing as paramedics turfing to EMTs, then this entire lecture snippet is bogus.

[YOUTUBE]http://www.youtube.com/watch?v=4MSmk10afro[/YOUTUBE]

His argument is 100% valid; if you ALS to BLS a patient because there is smoke showing, you deserved to be fired from your job, lose your cert, and sued by the patient. similar argument can be made for turfing a job because a shooting or MVA comes in. As the attorney says, once you are on the call, it's your call.

however, if the patient is stable, does not need any ALS intervention, or just needs a ride to the hospital, than there is nothing wrong with letting the BLS crew take the patient to the hospital.

In fact, I bet an attorney can make a better argument if an ALS crew meets up a BLS crew on a broken finger, doesn't do anything for the patient and rides in to the hospital, and as a result, there is no ALS unit available for the cardiac arrest that comes in, and my family member dies. I'm pretty sure I can get a pretty good negligence lawsuit filed.

 

[JPINFV]

In fact, I bet an attorney can make a better argument if an ALS crew meets up a BLS crew on a broken finger, doesn't do anything for the patient and rides in to the hospital, and as a result, there is no ALS unit available for the cardiac arrest that comes in, and my family member dies. I'm pretty sure I can get a pretty good negligence lawsuit filed.

Against who? Also, you're going to be able to prove that the outcome would have been any different?

"Your honor, out of the standard medical treatments available for cardiac arrest, the only two treatments that have evidence that they work is defribrillation and CPR, which the EMT crew is trained and equipped to provide. The fact that the paramedic crew was currently on another call would not have resulted in any different outcome."

 

[mintygood]

Gomers go to ground is the most relevant to ems