Voice Recorders

[akflightmedic]

the ER's in our area REQUIRE us to bring polaroids of MVA's..

there is no "loss of control" issue, as the pics are left with the ER.

has NOTHING to do with them performing an exam, but has EVERYTHING to do with helping them to understand the mechanism.. why do we look at the damage? why do we inspect the interior? to determine what the mechanism is and where it should lead us.
since the ER doc is not there to see it, what better way to help relate mechanism that to show photos. I'm sure they will be able to decide if it helps their assessment or not.

i'm sure it was unintended, but your post implies that mechanism is unimportant, and you will do the same exam no matter what.

The loss of control I implied was when multiple pics are taken or even when digital cameras or cell phones are utilized on scene.

I tried finding the case where some pictures ended up somewhere they didnt belong and the employee was terminated but currently am at a loss.

It was not me who stated the pictures were useless, it was some of the country's top Level I trauma surgeons (arent they all the best, if you are familiar with a trauma surgeons ego)...lol

I do agree with them however. A picture really does nothing for them if they perform a complete and systematic assessment everytime on every patient. I do not care which way you slice it, a picture is not going to make me investigate a certain area any more or any less on a trauma patient from a MVC. I will start with the basics and go from there, as always.

With the way cars are designed today it is irrelevant to look at a picture as I explained why in previous posts.

As far as looking at the interior and "inspecting" for damage, a quick cursory glance is all I need to do on scene. Knowing the steering wheel is deformed or the windshield is starred is nice for documentation purposes but as far as my exam process goes, again it has no bearing on how I proceed. Every body part/system will be examined to the best of my ability and my actions will not really change that much, if at all.

As I stated previously, I have been fooled by MVCs with so little damage that I thought for sure the patient had an underlying medical issue to be presenting the way they were. Imagine my surprise when I discover they are critical due to internal trauma. However the way we perform exams allows you to discover these things without zeroing in on one specific area and developing tunnel vision.

Again this practice is only from my personal areas of operation in several different states and under different systems. There is no right or wrong but it does make sense to me.

 

[rgnoon]

And yet again, just to nit pick...lol, I am glad to see someone knows what HIPAA stands for,but yet again not surprised at how many people mispell it.

Yes this is not grammar class, but this is an educational and professional issue. We definitely should know how to spell words that are critical to our profession.

Wink Wink this is all said with tongue in cheek, and is mostly just to be an informative remark not a mean one.

HIPAA only applies to agencies that bill for services. So yes, to quote one poster, technically your VFD could do whatever they want with patient information however ethically it is not the right thing to do. See above post as well, good response. Therefore most agencies just use a blanket policy and make everyone conform to it. It is a good practice to get used to anyways, makes the provider more aware that the information that they are obtaining from the patient IS sensitive and not just a name and number with no meaning that could never bring harm upon the individual.

Please bare in mind I am not a medical lawyer and do not claim to be the authority on such matters, please consult your local leagl rep for further clarification.

I'm glad someone caught the irony, I was waiting....and almost couldn't bear it.

 

[JPINFV]

I tried finding the case where some pictures ended up somewhere they didnt belong and the employee was terminated but currently am at a loss.

Off the top of my head, there was the case of the off duty fire fighter caught taking pictures for "educational" purposes after being asked to leave the scene. There was also a case in California where pictures from a pretty horrific accident was leaked during the investigation.

 

[JPINFV]

For the second incident, here's a little more information on it.


Lasting images create pain for parents
http://www.ocregister.com/ocregister/news/homepage/article_1538883.php

Graphic accident-scene photos, including close-up shots of Nikki, who suffered massive head trauma, have been leaked onto the Internet.

The images have turned up on hundreds of Web sites and in countless chat rooms and e-mails – from Australia to Italy. The photos often are accompanied by debates about the merits of the images, with many viewers even vilifying the dead teen.

http://www.snopes.com/photos/accident/alton.asp
Snopes has some pretty good non-graphic pictures of that accident that shows why when a Porshe going 100+MPH challenages a concrete structure, the structure wins.

 

[BossyCow]

I know that if you tape a public meeting, that record is a part of the legal record of the meeting and thus is a part of any discovery in a legal proceeding. However, there is an acception for tapes taken for the purpose of meeting minutes that can be and should be destroyed after they are transcribed into the legal record.

The legal key is to make sure that the tape is temporary and regarded as a part of 'notes' and that it is destroyed after use.

Aside from that, I'd rather use a pencil and paper because of the infection control issues. I'm not sure I want to touch something with patient icky gloves and then hold it up to my mouth to speak into it. Not only that, but the clarity of the recording from the back of the ambulance with all the road noise may not be understandable later.


As to the HIPAA comments, I think a lot of agencies are confusing HIPAA with basic patient confidentiality because they do address some of the same issues.

 

[JJR512]

This has been discussed previously, if you'd care to read any of the earlier replies to my similar question: [thread]3341[/thread]

 

[firecoins]

I don't see a problem in discussing it in this thread. It is a topic that comes up from time to time.

 

[ffemt8978]

I don't see a problem in discussing it in this thread. It is a topic that comes up from time to time.

And there's no harm in referring back to previous threads on this subject

 

[skyemt]

it's my experience that many patients can be guarded about their medical history... you need to gain their trust in many cases for them to be forthcoming...

so if you use the recorder, what is the message to the patient?
either you can't remember what they just told you (not good), or you plan to share the information (also not good)...

just look at it from the patients perspective, not your own... there is no upside to using the recorder.

 

[JJR512]

I don't see a problem in discussing it in this thread. It is a topic that comes up from time to time.

Just for the record, I'd like to point out that I didn't say anything about discussing anything anywhere. I merely pointed out that there are some other replies to the same question if the OP or anyone else would like to "read" (my original word) them as a reference. Some people who replied to the earlier thread might not still check in here so you might not get those replies now. I'm just providing a service to the community.

Thank you, ffemt8978.

 

[Jon]

Anyway - there was an article in JEMS or EMS magazine that discussed an agencies' routine use of voice recordings as part of critical call review... their monitor has a voice recorder that gets used during ACLS resuscitation, as well as to document AMA refusals.

The article made some points where a recorder could be a benefit to the provider.