Putting all patients on stretcher

[leoemt]

B.s. 911 patients who can walk will be seated on the bench. The cot is for sick people.

Why would you want to put your pt anywhere other than the cot? For starters you lose control of the patient. They can reach equipment, attack you, hurt themselves, etc.

Second, the captains chair / bench is more difficult to clean than the cot

To me this sounds just like total laziness. If you can't do the basic job and provide a basic standard of care for every patient then its time to get out of the business.

 

[rescue1]

Why would you want to put your pt anywhere other than the cot? For starters you lose control of the patient. They can reach equipment, attack you, hurt themselves, etc.

Second, the captains chair / bench is more difficult to clean than the cot

My thoughts exactly.
Also, it's no harder to put a patient on the cot as opposed to any other seat, in my opinion. Patients still can walk to or from the cot as well.

 

[Medic Tim]

Why would you want to put your pt anywhere other than the cot? For starters you lose control of the patient. They can reach equipment, attack you, hurt themselves, etc.

Second, the captains chair / bench is more difficult to clean than the cot

To me this sounds just like total laziness. If you can't do the basic job and provide a basic standard of care for every patient then its time to get out of the business.

It is far easier to clean the bench or jump seat than the cot(at least where I have worked in the past and currently work). A pt can just as easily try and attack you from the stretcher as the bench or jump seat.
How does having a pt(stable, ambulatory, does not require any interventions, no risk of going unstable......they do exist) not ride on the stretcher make a provider inferior of lazy? Why should I lift and pull on a pt that does not need/want it.
If a pt is as I described above they get the option(some people who don't need it feel degraded by being told/forced to...nurses aren't the only ones who are supposed to be pt advocates). Most of my pts go on the stretcher for whatever reason though there are a few who ride on the bench. Extra riders(family, non injured or sick) ride up front...very few exceptions.

 

[DrParasite]

B.s. 911 patients who can walk will be seated on the bench. The cot is for sick people.

what he said. if they can walk, than they don't need to be carried.

Why would you want to put your pt anywhere other than the cot? For starters you lose control of the patient. They can reach equipment, attack you, hurt themselves, etc.

Second, the captains chair / bench is more difficult to clean than the cot

To me this sounds just like total laziness. If you can't do the basic job and provide a basic standard of care for every patient then its time to get out of the business.

1) they can attack yo from the cot, and it's easier for them to grab equipment.

2) the captains chair, yes, but that's usually my seat. the bench no. wipe it down with a sani wipe, and your good to go.

3) it's not laziness, it's saving your back to ensure you have a long career. they walk to the truck, sit on the bench, and go to the ER. and then either walk in or get placed in a wheelchair if one if provided by the ER entrance. if they are on the cot, than 99% of the time you will now be carrying them in (once someone is on the cot, it's pretty hard to get the to now willingly walk in). If they are sick, I will risk my body and carry them to the truck, and secure them on the cot. if they are not sick, they can walk, and sit on the bench and be dropped off in the ER.

 

[WestMetroMedic]

Even sick patients can be much more comfortable on the bench. Things like Asthma and Back pain generally don't like the positions that a stretcher can provide and do better sitting upright with legs dropped.

Patient care can still occur, patient satisfaction can still be achieved. If we boast about the angles we once intubated a patient under, or our IV success rate, then we probably can handle dealing with a patient anywhere in our office.

Is the stretcher the safest place to be? Maybe. A loaded cot often pops out of the antlers in moderate rollover accidents, bags go flying every where, computers become projectiles and most medics don't wear a seatbelt. Its all relative.

Mitigate your own risks by putting a seatbelt on your equipment and yourself and get a stretcher system that actually retains the appliance in an accident and then you can stay making that argument.

Until then, the bench is a viable option for patients who triage appropriately.

 

[usalsfyre]

Usalsfyre,
Please, explain your perception of my attitude.

Also, please explain how you judged my assessment skills and clinical decision making, inferring I somehow am incompetent in determining who is 'sick' and 'not sick', or, alternatively, 'B.S. 911' as firecoins stated from a few sentences.

Simple. My judgement of your attitude is based off of the use of judgmental terms and an inferred undertone that only life threats are worth your time. As for the guess on your assessment skills, it's just that, a guess. However, it's an educated one, based off of seeing FAR too many paramedics who think they are there for life threats only that can't pick up subtle presentations of big problems. I see this almost daily. Just because they are ambulatory and can sit doesn't mean the patient is not sick and doesn't deserve treatment.

I'll put patients on the bench, but the assessment is more "is this going to wait a few hours in triage" than "are they sick".

In summary, I may be way off on my judgement. But my one of my primary jobs at the moment is to figure out what happened based on written and verbal statements, and the way you worded your post makes me suspect.

You never answered why you would expose non-patient riders to the additional risk of the patient compartment.

 

[Bullets]

Ok, there is no "safe" place in an ambulance. These things are all rolling death traps

The cot is a treatment like any other. I don't give oxygen to everyone, I don't give the cot to everyone. Based on their complaint and presenting condition I will decide accordingly. I generally put asthmatics in the captains chair and have seen better results.

Our state Trauma center has an asthma room. It's just a bunch of chairs and oxygen tanks. They never get put on a bed

 

[usalsfyre]

generally put asthmatics in the captains chair and have seen better results.

The logistics of moving a patient who deteriorates from the captains chair to the cot while enroute are scary enough to be mind boggling.

Our state Trauma center has an asthma room. It's just a bunch of chairs and oxygen tanks. They never get put on a bed

I have ZERO data to back this up, but I'd be willing to bet that, on average, patients who self present to the ED with asthma are less severe than those who present via EMS.

 

[Trashtruck]

Usalsfyre,
I may entertain the first part of your post later. I'm in a hurry...

Somebody(non pt) up front is a safety issue. Somebody sitting up front can be a distraction to the driver, who is ultimately responsible for the safe operation of the vehicle.
People don't question aircraft/helo pilots, train engineers, bus drivers, or boat captains when it comes to the safe operation of that which they are solely responsible for. Same for an ambulance.

 

[usalsfyre]

Usalsfyre,
I may entertain the first part of your post later. I'm in a hurry...

Somebody(non pt) up front is a safety issue. Somebody sitting up front can be a distraction to the driver, who is ultimately responsible for the safe operation of the vehicle.
People don't question aircraft/helo pilots, train engineers, bus drivers, or boat captains when it comes to the safe operation of that which they are solely responsible for. Same for an ambulance.

Since your in a hurry, I suggest you look up crew resource management, and ask yourself why there is a front seat at all in an ambulance.

 

[Bullets]

The logistics of moving a patient who deteriorates from the captains chair to the cot while enroute are scary enough to be mind boggling.


I have ZERO data to back this up, but I'd be willing to bet that, on average, patients who self present to the ED with asthma are less severe than those who present via EMS.

Oh, no, patients who present via ambulance go to the asthma room too

 

[JeffDHMC]

I always kind of looked at the job as a marathon as opposed to a sprint. If I can remove a risk to my back by putting a pt that does not need the bed on the bench, you bet I'm going to. I feel it's far from lazy thinking, simply sel preservation. We get plenty of people hat need the bed for one reason or another. Why buy trouble.

 

[rescue1]

I always kind of looked at the job as a marathon as opposed to a sprint. If I can remove a risk to my back by putting a pt that does not need the bed on the bench, you bet I'm going to. I feel it's far from lazy thinking, simply sel preservation. We get plenty of people hat need the bed for one reason or another. Why buy trouble.

I always just walk people into the ambulance and put them on the stretcher (assuming I was walking them in to begin with). Then when we get to the hospital I unbuckle them and walk them out there. All I have to do then is change the stretcher sheet.

I guess it's just preference though.

 

[JeffDHMC]

I always just walk people into the ambulance and put them on the stretcher (assuming I was walking them in to begin with). Then when we get to the hospital I unbuckle them and walk them out there. All I have to do then is change the stretcher sheet.

I guess it's just preference though.

That works too. I just try to avoid any unnecessary lifting.

 

[Trashtruck]

Since your in a hurry, I suggest you look up crew resource management, and ask yourself why there is a front seat at all in an ambulance.

Usalsfyre,
Please put up a link and enlighten us all.

 

[ffemt8978]

Play nice, or become the focus of my complete and undivided attention.

 

[Trashtruck]

ffemt8978,
I would like to know, and I'm sure I'm not the only one.
A link would be helpful.

 

[ffemt8978]

I have no problem with that...the issue is the attitudes I'm seeing in this thread and how it is affecting the tone of the conversation. If people can't remain polite and civil, this thread will be closed.

 

[NomadicMedic]

I don't see any problem with walking people who are able to walk. If their condition won't be exacerbated by walking the 20 yards from their house to the ambulance, then let them walk. If there are respiratory issues, cardiac issues… Do they have something that I feel will be made worse by them walking? Then they go on the stretcher. I find that BLS providers here get very upset when I suggest the patient walk to the ambulance. But again, I don't see that there's any problem with asking the four magic questions to my low acuity patients

One: can you walk?
Two: have you tried?
Three: where are your shoes?
Four: which hospital do you want to go to?

 

[Trashtruck]

I don't see any problem with walking people who are able to walk. If their condition won't be exacerbated by walking the 20 yards from their house to the ambulance, then let them walk. If there are respiratory issues, cardiac issues… Do they have something that I feel will be made worse by them walking? Then they go on the stretcher. I find that BLS providers here get very upset when I suggest the patient walk to the ambulance. But again, I don't see that there's any problem with asking the four magic questions to my low acuity patients

One: can you walk?
Two: have you tried?
Three: where are your shoes?
Four: which hospital do you want to go to?

Precisely.
And sometimes when they have their bags in hand, waving, and are waiting on the curb, I do the limo driver, open the side door, take their bags, and help them in. Then, I assess.
Now, I've had some sick people meet me like this, and end up putting them on the stretcher based on my findings.