Worse malpractices on field

dalmain

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What are some of the worse malpractices you have seen out in the field? It could even be accidents like rolling a patient on a stretcher down a hill.
 
1mg 1:1000 Epi IVP. It was belt notching time.
 
1mg 1:1000 Epi IVP. It was belt notching time.

What was the outcome on it? 1mg of epi is bad...but it makes no real differnce is it's 1:1000 or 1:10,000
 
What was the outcome on it? 1mg of epi is bad...but it makes no real differnce is it's 1:1000 or 1:10,000

Well, it is an order of magnitude overdose.

It was an unsuccessful code, but based on downtime, it was probably going to be one anyhow. Don't think I ever heard what the upshot of the inquest was...this was way back when, I was a basic rolled as backup to be a human thumper.
 
200mgs of Dopamine IV push.


Please tell me this is related to the other story I read recently...

I have a feeling it's not.

Good god.
 
Taking a patient down stairs (10 steps) on a stretcher rather than getting the stair chair.
 
1mg 1:1000 Epi IVP. It was belt notching time.

We only carry 3 1:10k pre fills in our bags then 3 more in the truck. Once we get past 3 rounds we either bust open a 30mg 1:1000 vial or use 1 mg 1:1000 ampules. Rather than using a bunch of saline flushes to make 1:10k I draw up 1 mg of 1:1000 and give it into the top most med port on a running line.

Same concept.
 
We only carry 3 1:10k pre fills in our bags then 3 more in the truck. Once we get past 3 rounds we either bust open a 30mg 1:1000 vial or use 1 mg 1:1000 ampules. Rather than using a bunch of saline flushes to make 1:10k I draw up 1 mg of 1:1000 and give it into the top most med port on a running line.

Same concept.

I was just about to say the same thing.
 
At one time I had to meet with the Vice President of one of the largest malpractice and EMS providers; he informed me that most of the lawsuits involved most everyday things like... incidents involving stretchers was number one and ... running out of gasoline?... poor or severe delayed response... and so on. From what I had seen that was being presented, very few was involving direct patient care such as medication(s) etc.. and many of course settle out before court date if possible.

R/r 911
 
An EMS attorney once told me, even the most egregious errors can be forgiven if you're nice enough about it. I thought that that was worth remembering. It all comes back to the, "they don't remember your medicine, they just remember how you made them feel." Now obviously, an unrecognized esophageal intubation isn't the same as dropping someone on a stretcher… But if you're a jerk about it, you're more likely to be sued over the stretcher drop them the misplaced tube.
 
One of my former partners gave 1:1000 Epi IV also. Pediatric (10yo if I remember right) anaphylaxis. Other than palpitations for a few minutes, the patient apparently had no other adverse effects.
 
An EMS attorney once told me, even the most egregious errors can be forgiven if you're nice enough about it. I thought that that was worth remembering. It all comes back to the, "they don't remember your medicine, they just remember how you made them feel." Now obviously, an unrecognized esophageal intubation isn't the same as dropping someone on a stretcher… But if you're a jerk about it, you're more likely to be sued over the stretcher drop them the misplaced tube.

That is so true. Many people who sue say they wouldn't have, if everything had just been explained to them better and they got the feeling that those involved were truly sorry.

Everybody makes mistakes. Everybody.

My vote for the "worst practice" is making a mistake and not owning up to it immediately.
 
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Well, it is an order of magnitude overdose.

It was an unsuccessful code, but based on downtime, it was probably going to be one anyhow. Don't think I ever heard what the upshot of the inquest was...this was way back when, I was a basic rolled as backup to be a human thumper.

1mg is an order of magnitude greater than 1mg?

If they pushed 10 miliLITERS sure. But there's zero difference between 1mg of 1:1000 vs 1mg of 1:10000 other than how much fluid it's dissolved in.
 
Undisclosed transport company dropped a pt of a gurney during a dialysis run. Dropped them off in their room and told no one... Several hours later pt was transported via 911 after the Dr. at the SNF noticed deformity, pain and shortening of one leg. The SNF had to call the transport agency with their Dr's findings before they admitted the incident.
 
Undisclosed transport company dropped a pt of a gurney during a dialysis run. Dropped them off in their room and told no one... Several hours later pt was transported via 911 after the Dr. at the SNF noticed deformity, pain and shortening of one leg. The SNF had to call the transport agency with their Dr's findings before they admitted the incident.


I hope those crew members lost their certifications.
 
Taking a patient down stairs (10 steps) on a stretcher rather than getting the stair chair.
That's not malpractice, unless they dropped the patient or the patient suffed some type of injury as a result of their actions.

it is, however, stupid and lazy on the part of the providers.
 
OP, define malpractice exactly. Is it the same as an accident (unintentional event), a mistake (intentional event but wrong without will to do wrong), or a misadventure (willfully going off the reservation).
I don't class losing a lift on someone and dropping them along with giving a kid an adult medicine because you don't have a pedi dose, or doing it because you misread the label, or extravasating an IV and causing a necrotic infiltration.
 
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1mg is an order of magnitude greater than 1mg?

If they pushed 10 miliLITERS sure. But there's zero difference between 1mg of 1:1000 vs 1mg of 1:10000 other than how much fluid it's dissolved in.

Ah, you beat me to it! You're right, 1mg = 1mg… And there were times when due to either budget issues or 1:10,000 preloads being unavailable when we had to carry around the "party vials" with 30mg 1:1,000 and draw from that on codes.



I stopped a great potential mistake once where a fire medic (silly, silly fire medics, so many great stories…) was about to cardiovert a stable a-fib patient.

Rate was 120-140, super stable vitals and no real complaint other than mild chest discomfort.

Him - "But it's rapid a-fib!"

Me - :glare:
 
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