Whats Your Opinion ?

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RiverpirateEMT

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You arrive on scene to a Pt with known mental problems. It is dispatched as a possible allergic reaction. You as a EMTB arrive and find the PT shallow breathing and weak. Pulse and BP are normal. Medic says he believes it is a anxiety attack and after you discuss it with the medic you and the medic decide to transport without the medic. This is the medic suggestion. On the way in ( 5 minute drive to hospital ) the PT develops some wheezing and a pulse ox of 88 on 4 liters. The on duty RN in the ER tells you you should have had a medic and your supervisor jumps all over you. Over the next few days your supervisor keeps bringing up the fact the PT got worse and makes life hell. Do you back down and take the BS or do you point out to your supervisor that the medic is the one that made the call and to lay off?
 
Did you feel comfortable taking the patient as an EMT AND did you make sure that the paramedic knew it? It takes two to tango and if you willing accepted the patient, then the only advise I can give is to buck up and take the critique.
 
I'd be ok with the patient, but I'd also start an albuterol neb if the wheezing started and spo2 started dropping at around the same time. And that'd be as a basic in my home state.

But if you don't feel comfortable attending on a patient, discuss it with your medic. If you agree, then it is all on you that you were attending the patient.
 
JPINFV said:
Did you feel comfortable taking the patient as an EMT AND did you make sure that the paramedic knew it? It takes two to tango and if you willing accepted the patient, then the only advise I can give is to buck up and take the critique.
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after talking to the medic and getting his opinion I felt comfortable in transporting without him. medic came up later on the next call and apologized but of course didnt bother to tell my supervisor he was in on the decision to transport without medic.
 
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Did you leave him on 4 liters?

I can see how bringing in a patient presenting like that would upset some EDs.
 
CAO said:
Did you leave him on 4 liters?

I can see how bringing in a patient presenting like that would upset some EDs.
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Moved him to 5 liters we were literally in the hospital parking lot, even switched over to Spare tank for the carry in to ED. Im new to this station and supervisor has said we never cancel Medics even though I know different. Of course supervisor was with me the whole time and did nothing on the way in.
ED Nurse was cool about it , presented it to me as a learning experience ( which it was ) , just getting sick of every call since of supervisor bringing it up over and over. Not as a teaching aid , just to be a pain.
 
Wait...so the supervisor was there during the whole exchange? He actually witnessed the decision?
 
...then shouldn't the supervisor have had some say in the matter?
 
If the supervisor was there, the supervisor also shares culpability. He should have stepped in to prevent you from taking a patient you weren't supposed to. If the supervisor was with you in the back the whole time, then he's even more on the hook for participating and allowing what he thought was an inappropriate action occur.

Sooo... in other words, the supervisor is also at fault. If he thought the action was improper at the time and he's your supervisor and was supervising at the time... he should have stepped in. He didn't. He's responsible for you too...

And if the supervisor is an EMT-P... he definitely should have known better than to allow an EMT to take such an "unstable" patient. Not having the other medic in the back is, well, a HUGE clue that an EMT took the patient...
 
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He is a Medic. You are a Basic. If somebody really pushed, couldn't he get in trouble for some form of abandonment? He left the patient with somebody less trained than himself.

Sounds a little like fecal matter on a slope to me.
 
Akulahawk said:
If the supervisor was there, the supervisor also shares culpability. He should have stepped in to prevent you from taking a patient you weren't supposed to. If the supervisor was with you in the back the whole time, then he's even more on the hook for participating and allowing what he thought was an inappropriate action occur.

Sooo... in other words, the supervisor is also at fault. If he thought the action was improper at the time and he's your supervisor and was supervising at the time... he should have stepped in. He didn't. He's responsible for you too...
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The supervisor didnt say a word to me until the ER nurse complained. He was standing there when the conversation with the medic took place. He watched the medic get in his truck and leave. He helped put the PT in the back of the rig. He then got in the front and drove to the ER. He didnt say a word to me until the ER nurse said something. At that point I thanked the ER nurse for the suggestion ( it was a learning thing ) and since then he ( supervisor ) has been a jerk about everything.
 
CAO said:
He is a Medic. You are a Basic. If somebody really pushed, couldn't he get in trouble for some form of abandonment? He left the patient with somebody less trained than himself.

Sounds a little like fecal matter on a slope to me.
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I suppose he could. At the time the pt seemed completely stable. BP and Pulse were completely normal and the pt was known to have mental issues. it wasnt till about 2-3 minutes from the er door did the pt seem worse off. ive since told the medic he will never get a cancellation from me. it is the supervisor that keeps bringing it up over and over even though he was along for it the whole time. nothing was said to him because he is old friends with everybody in the er.

ive since said yes i would do things differently but the supervisor doesnt even acknowledge that the medic was part of the decision. I took the medics word for it ( wont do that again ).
 
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If the supervisor keeps going on about it, remind him that you are always learning and that without input from him and the medic you have no way to know that it wasn't ok. Admit you made a mistake and could have made a better decision, and hope they leave it there. If they continue, you need to find a higher supervisor to talk to.
 
If you're just getting razzed, no big deal. But if this is something that looks like it will impact your record, while it is still fresh DOCUMENT the incident and have it placed in your file. Give the specifics, name the names and quote the medic who "released" himself from the call. You had two layers between you and the choice; first, the medic, then, your Super who was a medic. Make that clear
 
jjesusfreak01 said:
If the supervisor keeps going on about it, remind him that you are always learning and that without input from him and the medic you have no way to know that it wasn't ok. Admit you made a mistake and could have made a better decision, and hope they leave it there. If they continue, you need to find a higher supervisor to talk to.
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Today seems to have gone better. My super finally dropped it ( well atleast didnt say anything ) today. Had a call today that could have transported without the medic but thought better of it. He wasnt ( the medic ) to happy with the decision but I told him Im playing it safe from now on. I think my super was happy about that.
 
if the pt was shallow and weak, and his stats drop to 88, why didnt you move to a NRM and treatment?

You need to talk to your super but it sounds like you guys are some serious training and communication issues already.
 
firetender said:
If you're just getting razzed, no big deal. But if this is something that looks like it will impact your record, while it is still fresh DOCUMENT the incident
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I agree it should already be in the PCR that the medic decided to decline coming on transport and that the super was on scene with no objectctions. However if you accepted the patient in the state he was, you do have a responsiblity for what happens in the back of the truck.

Remember documention is your best friend.
 
Wait if the supervsor is a medic then why do you have another medic responding?

Pt conditions change, he was stable when he handed him off, I believe he is still stable, although with the wealth of information provided who knows. Titrate his O2, give him a neb if you can and bring him in the ER.

How do you know this wasnt attributed to anxiety?

What was the supposed allergen?

Why does everyone present half a story lately?
 
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