What would you do in this situation?

[Tigger]

I am wondering why two fully trained paramedics would skip over protocol and then try to cover it up. Does anyone not take responsibility for their actions. If a mistake is made own it. Regardless if they were approaching 24 hours on the clock. Certain symptoms warrant certain tests like an ecg, forget about he capo, the ecg would have told them all they needed to know and how to proceed.

Have your brought your concerns directly to the EMS agency and/or your state's EMS regulatory body? Your state EMS office should have a way to deal with provider complaints. That is the right way to do it, not to go digging around looking for someone's peers to fry them for you. If you want something changed and people held accountable, go out and do it the right way.

 

[jdox0776]

Have your brought your concerns directly to the EMS agency and/or your state's EMS regulatory body? Your state EMS office should have a way to deal with provider complaints. That is the right way to do it, not to go digging around looking for someone's peers to fry them for you. If you want something changed and people held accountable, go out and do it the right way.

I already have.

 

[jdox0776]

I had to wait until I got the ecg report because only then did I have the evidence to back up what I was saying. From what I was told it should have been attached to the PCR when I originally picked it up. It took forever to get the hospital records but their ecg wasn't in there. They are investigating my complaint. It's hard to have to wait

 

[Angel]

No one here has the answer for you. If you want to vent that's fine, but maybe it would be better suited for a blog or diary of some sort.

 

[Tigger]

I had to wait until I got the ecg report because only then did I have the evidence to back up what I was saying. From what I was told it should have been attached to the PCR when I originally picked it up. It took forever to get the hospital records but their ecg wasn't in there. They are investigating my complaint. It's hard to have to wait

I'm sorry, but that's how these things work. We aren't going to tell you that something was done wrong when you haven't presented anything close to an easy to follow story, and even then I still would not pass judgement.

 

[triemal04]

While a very unfortunate situation, I saw the thread that ERDoc referenced earlier, and for what it's worth the OP made it much clearer that she was getting involved in a lawsuit and looking for anything to bolster that.

 

[PFDEMT]

since good ol louisville metro lets me as a emt get 12-lead i will check that..
also I would perform a stroke assesment buddy.. bp elevated and alterted= possible cva.

But no cardiac history I am thinking CVA!!!!!!!!!!!!!!!!!! 2lpm via n/c, with some nice diesel flapping in the wind.

 

[Akulahawk]

PFDEMT - while doing a stroke assessment isn't a bad thing, it's probably way down the list of things to do. My sense is that this guy had multiple issues going concurrently. This guy has respiratory complaints, a non-diagnostic ECG that is somewhat suspicious for something, a BP that's elevated, pale/diaphoretic skin signs, a note above that seems to indicate that the guy's trachea is deviated left (why?), posturing, along with a seizure disorder due to some metabolic issues, I'm just thinking that 2L of O2 by N/C and some diesel is going to be the magic treatment that's going to prevent this guy's demise.

There's just too much missing from this for me to even begin to figure this one out. Toss into the mix that there's a lawsuit brewing about this situation... I have my own suspicions about what may have happened in the hours before the call happened, but I'm not going to say what I think in this case.

 

[Gurby]

I'm just thinking that 2L of O2 by N/C and some diesel is going to be the magic treatment that's going to prevent this guy's demise.

Seems to me that probably nothing we do is going to have much impact on this patient's long-term outcome, aside maybe from making a good transport decision and not spending too much time ****ing around on scene?

 

[Akulahawk]

Seems to me that probably nothing we do is going to have much impact on this patient's long-term outcome, aside maybe from making a good transport decision and not spending too much time ****ing around on scene?

Actually, mostly my comment was "aimed" at the 2L of O2 by N/C... Seriously small drop in the bucket for what this guy needs... and needed probably a few hours ago. Making a good transport decision, while it would have been good to have done it early on, probably wouldn't have affected the outcome one whit.

 

[JamesW]

How old is this patient? Male or female? Any other med Hx? HTN, DM, CHF? Any other symptoms, chest pain? Been sick lately? Has this been going on for days or hours?

If I was BLS I would probly O2 @2L, request ALS intercept and transport Code 2, no reason to hang around.

ALS interventions would depend on a more thorough Hx and physical exam.

Code 2? Here in Texas, we are not allowed to go code 2 since there was an issue of crashes related to drivers not hearing us. We only drive code 1 or 3.

 

[TransportJockey]

Code 2? Here in Texas, we are not allowed to go code 2 since there was an issue of crashes related to drivers not hearing us. We only drive code 1 or 3.

Not all places use the same.terms for.emergent and nonemergent transport

 

[JamesW]

911 call dispatched breathing problems. Pt had BP 200/110, RR 30 labored, diminished breath sounds bilaterally, tachypnic, diaphoretic peril, spO2 94%, glucose 208, seizure hx due to metabolic disorder (malabsorption of Calcium, potassium, magnesium)

Would you perform ECG (cardiac monitoring)? capnography waveform?, apply o2? IV access? Load and go VS stay and play?

As a basic, I would definitely start with PPV w/ oxygen. I would consider CPAP if I felt he could maintain his breathing on his own, if not then BVM. He would definitely get a 12 lead also. those vitals are not stable enough for stay and play, he would need advanced care pretty fast. He would probably get insulin from ALS along with some kind of blood pressure meds.

 

[STXmedic]

Code 2? Here in Texas, we are not allowed to go code 2 since there was an issue of crashes related to drivers not hearing us. We only drive code 1 or 3.

I go code 2 all the time... Especially at night. We may not designate as "code 2", but we do it all the time.

 

[JamesW]

Not all places use the same.terms for.emergent and nonemergent transport

Ah. Code 1 here is non-emergent (no lights or sirens)
Code 3 is both lights and sirens.

 

[STXmedic]

As a basic, I would definitely start with PPV w/ oxygen. I would consider CPAP if I felt he could maintain his breathing on his own, if not then BVM. He would definitely get a 12 lead also. those vitals are not stable enough for stay and play, he would need advanced care pretty fast. He would probably get insulin from ALS along with some kind of blood pressure meds.

Do you work for an area that ALS gives insulin? That's exceptionally rare if so.

 

[JamesW]

I go code 2 all the time... Especially at night. We may not designate as "code 2", but we do it all the time.

I would definitely understand the issue of driving code 2 at night in neighborhood areas.

 

[STXmedic]

I would definitely understand the issue of driving code 2 at night in neighborhood areas.

Or highways at any time.

 

[JamesW]

Do you work for an area that ALS gives insulin? That's exceptionally rare if so.

I just finished EMT-B school. Im not sure about insulin but i know for a fact that they can do glucagon.

 

[TransportJockey]

I just finished EMT-B school. Im not sure about insulin but i know for a fact that they can do glucagon.

Glucagon raises blood sugar via a release and conversion of glycogen