# Cardiac patient walked down stairs, medics don't document it



## ffemt8978 (Apr 26, 2009)

http://www.telegram.com/article/20090426/NEWS/904260399/1116/NEWSREWIND


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## Mountain Res-Q (Apr 26, 2009)

Wow.  We all have EMSA procedures and policies that we don't agree with, but still follow.  But in this case, this wasn't an issue of Medics disregarding a bad policy; they practiced _bad medicine _with no apparent reason.  What's more, they lied about it over and over again.  And when one lie was revealed, they came up with another.  A stupid disision that had a horrible outcome for them, the agency, and EMS in general.  Not to mention the patient and family.  Can we really say that their actions killed him.  Not w/ 100% certainty, but it didn't help treat the patient.  The article doesn't mention several things that I am concerned with; most notably: What other care was/wasn't provided that should have been?  When this man was walked down the stairs was he on O2?  Had he been given Nitro, ASA, or any other meds?  Did they run an ECG or get a set of vitals pre stupidity?  The way it sounds: They walked him into the amblance before doing anything!  And the excuse about Fire not being their to help?  LAME; even if they weren't on scene to help (they were) does that mean that we withhold proper treatment and care?  Since when does the presence of 3-4 firefighters dictate how a Paramedic provides care for a MI?  if he was overweight and requird more hands to move: fine, wait a few moments for FD to arrive and provide care in the appt.  2 minutes of waiting to transport is the lesser of two evils here.

I feel for the family, even though he might have dies regardless of the paramedic's lack of care, because dealing with a death is bad enough without this mess.  There actions are a stain on EMS and they should be shot!!!


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## JPINFV (Apr 26, 2009)

Wow...


1. Every ambulance in Mass is supposed to have a stair chair on it, so it wasn't like they didn't have the equipment.

2. 





> Purpose
> The information below provides EMTs with some common complaint findings that are of concern and in violation of the regulations. Please take note of the following issues while practicing as an EMT.
> 
> 11.  Allowing/ encouraging a patient to walk to cot or ambulance.


http://www.mass.gov/?pageID=eohhs2t..._emergency_services_p_complaints&csid=Eeohhs2


Now, to be fair, just about every EMT is going to violate that one (and item 14) just about every shift because both are stupid blanket rules. Unfortunately when you get doofuses that engage in this sort of stupidity, OEMS's hands are kinda of forced in the manner. They are, for lack of a better term, screwed.


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## HotelCo (Apr 26, 2009)

They were wrong. Plain and simple.

A fresh, newly-minted basic knows that you don't have a pt experiencing chest pains walk more than absolutely necessary. Those Paramedics knew better, probably just didn't want to carry him down the stairs.

HotelCo


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## boingo (Apr 26, 2009)

Ever have a patient refuse to be carried?  I have had plenty. If the option is leaving the patient (this patient) home or letting them walk, they walk.  I will explain my concern, but at the end of the day, they need to go.  I've watched patients panic on a 3 story carry down, I'd be curious what is worse for the patient, a controlled, slow walk, down stairs, or a catecholemine dumping hell ride down in a stair chair....something to think about.


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## daedalus (Apr 26, 2009)

I disagree. I do not think they were in the absolute wrong. What if they did not  have the proper equipment to carry a large man down the stairs? Why risk their backs with a backboard down three flights of narrow stairs? WHat if they had dropped him? What if mid way down they couldn't handle it anymore? At least they walked him down carefully. Sometimes there is no other option.


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## ffemt8978 (Apr 26, 2009)

But, if you do let your patient walk for whatever reason, you need to document it and NOT lie about it when questioned.


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## Sasha (Apr 26, 2009)

daedalus said:


> I disagree. I do not think they were in the absolute wrong. What if they did not  have the proper equipment to carry a large man down the stairs? Why risk their backs with a backboard down three flights of narrow stairs? WHat if they had dropped him? What if mid way down they couldn't handle it anymore? At least they walked him down carefully. Sometimes there is no other option.



What if the patient, wanting to keep his dignity, insisted on walking down the stairs? Pride gets in the way of a lot of things.



> But, if you do let your patient walk for whatever reason, you need to document it and NOT lie about it when questioned.



That, I totally agree with!


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## daedalus (Apr 26, 2009)

Sasha said:


> What if the patient, wanting to keep his dignity, insisted on walking down the stairs? Pride gets in the way of a lot of things.
> 
> 
> 
> That, I totally agree with!



I have had many patients like this also! There are way to many factors and this is such a one sided news story like all the rest. You can already see the lawsuit brewing on the horizon. Lets not judge these medics, but take this as a lesson in proper documentation. Its paramount.


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## boingo (Apr 26, 2009)

I certainly wouldn't lie about it, but I'm not in the habit of documenting how I extricate a medical patient from their home.  Maybe it is something to think about.  I suppose if he looked like they say, and he refused to be carried (big assumption) documenting that would probably be a good idea in retrospect, however having walked too many patient to remember (their choice) I honestly can't remember documenting a single one.


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## Aidey (Apr 26, 2009)

It's impossible to judge from the article if they made the man walk, or if the man refused to be carried. 

That being said, they absolutely should not have lied about it, and that is what is going to screw them royally. 

We have massive issues in my service with carrying patients and stairs. We have stair chairs, but I doubt anyone could remember the last time they used one. The general consensus among my co-workers is that lifting is too dangerous, and that having to lift anything beyond the gurney straight up to the load position is a violation of the EMTs/Medics safety. The FD also does not provide lift assist services. If they are already on scene, they will help, sometimes. But they will not respond to a scene in order to help lift. 

Therefor the vast majority of patients end up walking some distance if they are able to, since it's against company policy, I'm pretty sure it's not getting documented either.


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## JPINFV (Apr 26, 2009)

daedalus said:


> I have had many patients like this also! There are way to many factors and this is such a one sided news story like all the rest. You can already see the lawsuit brewing on the horizon. Lets not judge these medics, but take this as a lesson in proper documentation. Its paramount.



Oh, ok. We shouldn't lie about people who lie on their documentation? I have this one regular patient who is able to, with assistance, slide from his wheel chair to the gurney but gets lifted via draw sheet into and from the dialysis chair. Guess what, it get's documented that he is assisted to the gurney and moved via draw sheet from the gurney. 

If it had been documented properly, then I would agree with giving them the benefit of the doubt. Now lying on both whether fire was on scene AND on using the stair chair? Can someone get me my pitchfork and torch please?


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## Mountain Res-Q (Apr 26, 2009)

So, based on most replies, I take it that most "professionals" here would have walked this man down?  You have the stair chair, man power, and a man having a heart attack on the third floor... and you walk them down?  I disagree, (even if the man refused to go don this way, because our communications skills should have been employed as advocates for our patients health), but fine, if that is your companies commonly accepted malpractice... eh... practice.  But, if that is in your medical opinion the right call to make, your defense when called to the mat is what... to lie?  The obviously knew that what they did was wrong because their paperwork (completed enroute to the hospital - not months later) was a lie and a crime.  Yes I agree that walking a patient is often easier and a better course of action with some patients (especially the obstinate ones) but NOT IN THIS CASE.  Stabbing chest pain and dying heart muscle and you allow the patient to walk down 3 flights?  You make the argument "what if we had dropped him?"  What if he had coded as he took his first step of the third floor?  Yes, lifting is dangerous for us and the patient, but if we are competent in our lifting techniques and strive to have additional hands (the FF's) the risk to the patient and ourselves is reduced and is preferable to LETTING A MAN HAVING A MI (stressed heart, shortness of breath, imminent death) WALK DOWN THREE FLIGHTS.  Just because these folks were fellow EMSers doesn’t mean we should automatically defend them... they practiced piss poor medicine.  If this was your father having an MI would you walk them to the ambulance?


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## boingo (Apr 26, 2009)

I'm not sure how wide your staircases are, but in Worcester, as in a lot of NE cities you have the "triple decker", wooden, 3 story apartment buildings with narrow, poorly lit, and often poorly maintained steps.  It doesn't matter how many FF's you have, only two people can fit on the staircase, the person at the top of the chair and the one at the bottom.  We purchased new stairchairs about a  year ago, I'm not sure who makes them but they are heavy duty, with treads like a tank track and a handle that extends vertically from the top of the chair. Its like moving a refridgerator on a dolley, the chair is heavy, but once you hump it up, it makes the trip down sooo much easier. I don't know it they have them in Worcester.  I do believe that as a whole, we (EMS) carry way too many people.  I'm not condoning walking this patient or others like them, but  how many systems require you to carry everyone?


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## Sasha (Apr 26, 2009)

Mountain Res-Q said:


> So, based on most replies, I take it that most "professionals" here would have walked this man down?  You have the stair chair, man power, and a man having a heart attack on the third floor... and you walk them down?  I disagree, (even if the man refused to go don this way, because our communications skills should have been employed as advocates for our patients health), but fine, if that is your companies commonly accepted malpractice... eh... practice.  But, if that is in your medical opinion the right call to make, your defense when called to the mat is what... to lie?  The obviously knew that what they did was wrong because their paperwork (completed enroute to the hospital - not months later) was a lie and a crime.  Yes I agree that walking a patient is often easier and a better course of action with some patients (especially the obstinate ones) but NOT IN THIS CASE.  Stabbing chest pain and dying heart muscle and you allow the patient to walk down 3 flights?  You make the argument "what if we had dropped him?"  What if he had coded as he took his first step of the third floor?  Yes, lifting is dangerous for us and the patient, but if we are competent in our lifting techniques and strive to have additional hands (the FF's) the risk to the patient and ourselves is reduced and is preferable to LETTING A MAN HAVING A MI (stressed heart, shortness of breath, imminent death) WALK DOWN THREE FLIGHTS.  Just because these folks were fellow EMSers doesn’t mean we should automatically defend them... they practiced piss poor medicine.  If this was your father having an MI would you walk them to the ambulance?




No one is defending them but we're looking at other possiblities. It's easy to jump to conclusions, but you've got to remember, unless the patient is a child or unresponsive the PATIENT has final say on what his or her treatment will be, including on how he or she will get to the stretcher. 

If the patient REFUSES to get stair chair'd down the stairs, then you have no right and legally cannot FORCE them down on one.  You can talk their ear off all day why (wasting cardiac muscle while you do.) they should get on the stair chair and be carried down, but some people are too proud to be carried down the stairs. 

Men have had it ingrained in their minds since child hood that they should be strong at all times. How weak is it to be carried down the stairs? And of course, how many patients have you run into who insist "I'm alright, my wife/husband/son/daughter/sister/neighbor is just overreacting!"

If they didn't give him an option and forced him to walk down the stairs, by all means shame on them. Shame on them anyway for falsifying paperwork and not going over it before you turn it in.

Instead of outrage, take away the importance of proper documentation from this article.


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## Aidey (Apr 26, 2009)

I wouldn't have walked him down no, I'm young, healthy and know proper lifting techniques, granted, it takes more than one person willing to carry a patient to get them down the stairs though. As for my co-workers, I'm not really sure what they would have done. 

If it was my father, yes, I may have had to. The man weighs 400lbs, and I know he will not fit in a stair chair.


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## Mountain Res-Q (Apr 26, 2009)

For me in my area:
I live in the mountains.  Houses are built to fit the terrain, which often means redwood stairs that extend 1-3 stories up to the front door.  The stairs are usually old and rotting after 20 years of little care and the scorcing summer sun and hevy snow.  They are usually covered in et slippery pine needles, ice, rain, or snow.  They are no more than 3 feet wide.  I could never, ever, see myself walking a heart attack patient down them.  That's why god invented FF's.    Just kiddin'.  But really, yea I agree that their are circumstances where not carrying you patient down those stairs is the right call for safety sake.  BUT NOT IN THIS CASE.  If anyone here would walk a MI patient down 3 flights when other options existed for moving him, then falsify reports, and then lie over and over again...  get the hell out of EMS now before I hunt you down and beet you with your dust covered stair chair...


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## Sasha (Apr 26, 2009)

Mountain Res-Q said:


> For me in my area:
> I live in the mountains.  Houses are built to fit the terrain, which often means redwood stairs that extend 1-3 stories up to the front door.  The stairs are usually old and rotting after 20 years of little care and the scorcing summer sun and hevy snow.  They are usually covered in et slippery pine needles, ice, rain, or snow.  They are no more than 3 feet wide.  I could never, ever, see myself walking a heart attack patient down them.  That's why god invented FF's.    Just kiddin'.  But really, yea I agree that their are circumstances where not carrying you patient down those stairs is the right call for safety sake.  BUT NOT IN THIS CASE.  If anyone here would walk a MI patient down 3 flights when other options existed for moving him, then falsify reports, and then lie over and over again...  get the hell out of EMS now before I hunt you down and beet you with your dust covered stair chair...




So, since you've got all the answers, what would you do if your patient refused to be carried down the stairs and insisted on walking down them?


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## Mountain Res-Q (Apr 26, 2009)

Sasha said:


> So, since you've got all the answers, what would you do if your patient refused to be carried down the stairs and insisted on walking down them?



I am very convincing.  
They called me because they felt that they needed help and if I don't do the best I can to provide the BEST CARE then I might as well have become a LEO.  I am going to pull a VentMedic line of thought here and scream out the importance of COMMUNICATION.  It is one of those things that seperates a good EMSers from a great one and you obviously think I am great "since you've got all the answer".    (Ya know, if I could find a woman that said that to my face without the sarcasm, I might consider getting married one day.)  I can communicate and convince my pateint that I am here to help and would do nothing to endanger him... including walking him.  I am an advocate for my patient and their health.

However, your argument here is based on a belief that this man refused to be carried.  No information exists in this article to support this.  I doubt that a patient in that much pain and suffering would protest a quick, safe carry to the hospital, or couldn;t be convinced by a quality EMT with a basic grasp of the Ameriglish Language..  But, let's take it one step further... what if your patient was deathly affraid of vehicles and refused transport my ambulance or other vehicle, but wanted to go to the hospital... you gonna walk the MI patient to the hospital?  However, all ridiculous hypotheticles aside, would you have walked this patient... not some hypothetic patients?  And then would you lie about it, a sure sign that you feel guilty for providing a lower standard of care than you ought?


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## daedalus (Apr 26, 2009)

JPINFV said:


> Oh, ok. We shouldn't lie about people who lie on their documentation? I have this one regular patient who is able to, with assistance, slide from his wheel chair to the gurney but gets lifted via draw sheet into and from the dialysis chair. Guess what, it get's documented that he is assisted to the gurney and moved via draw sheet from the gurney.
> 
> If it had been documented properly, then I would agree with giving them the benefit of the doubt. Now lying on both whether fire was on scene AND on using the stair chair? Can someone get me my pitchfork and torch please?



I do not understand the hostility, did you misunderstand my post? I said that documentation is important to protect oneself from legal trouble. I meant nothing more than that. 

I have on more than one occasion document that a patient was "assisted to gurney by EMTs" and if asked about it, I will state that I had them stand up, with help, pivot, and sit back down on the gurney.


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## Mountain Res-Q (Apr 26, 2009)

daedalus said:


> I have on more than one occasion document that a patient was "assisted to gurney by EMTs" and if asked about it, I will state that I had them stand up, with help, pivot, and sit back down on the gurney.



I would argue that it should have read in that case, "EMT's assited pt. in stnading and pivoting onto gurney."  If that is what happened then document it that way.  If you write "Assisted to gurney by EMT's" how are you gonna remember the details 6 months latter when you get asked by an investigator.  I am by no means being a smart a** here or being rude.  Documentation is a sore point with me for that reason.  I was investigated on some BS deal and it was my paperwork that saved my but, because I had documented it just as it happened and was able to reference it and recall teh exact event in question (tansient looking for a fix 6 months ago and now looking for a settlement).  But I know (hope) that no matter what you wrote, even if vague) it would not be an outright lie to CYA.  If you provide quality medical care then you have no reason to lie.


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## JPINFV (Apr 26, 2009)

Your post reads like it's a simple hatchet job that takes the day to day operations out of context for no more reason than to lynch a pair of EMTs. I don't think the factors matter much once the providers lied, twice. If the story was "We walked him because the situation was such that we couldn't use a stair chair (patient weight, tight quarters, etc)" then I could agree that the story is very one sided. A classic "They didn't follow the rules even though the situation made it so the rules couldn't be followed." Once they lie, though, the story has much more force behind it.


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## Mountain Res-Q (Apr 26, 2009)

JPINFV said:


> Your post reads like it's a simple hatchet job that takes the day to day operations out of context for no more reason than to lynch a pair of EMTs. I don't think the factors matter much once the providers lied, twice. If the story was "We walked him because the situation was such that we couldn't use a stair chair (patient weight, tight quarters, etc)" then I could agree that the story is very one sided. A classic "They didn't follow the rules even though the situation made it so the rules couldn't be followed." Once they lie, though, the story has much more force behind it.



Exactely, they lose all credability once they lied, and lied to cover a lie, and lied some more becasue they didn't know what else to say...  hard to side with them even if the walk was justified.


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## daedalus (Apr 26, 2009)

JPINFV said:


> Your post reads like it's a simple hatchet job that takes the day to day operations out of context for no more reason than to lynch a pair of EMTs. I don't think the factors matter much once the providers lied, twice. If the story was "We walked him because the situation was such that we couldn't use a stair chair (patient weight, tight quarters, etc)" then I could agree that the story is very one sided. A classic "They didn't follow the rules even though the situation made it so the rules couldn't be followed." Once they lie, though, the story has much more force behind it.


I choose to defer judgement, because I no nothing more than the headline and a paragraph or two into the story. They very well could be deserving of whatever is coming to them, whatever that might be. I have no idea, and care very little. All I know is that this strengthens the case for me to cover my ***. I simply do not get paid enough for risking law suits. I do not lie in my documentation, even if I am breaking company policy to be accommodating. So far, I have explained the circumstances and have never had a problem. My post should have read "Lie, and pay the consequences".


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## Sasha (Apr 26, 2009)

Mountain Res-Q said:


> I am very convincing.
> They called me because they felt that they needed help and if I don't do the best I can to provide the BEST CARE then I might as well have become a LEO.  I am going to pull a VentMedic line of thought here and scream out the importance of COMMUNICATION.  It is one of those things that seperates a good EMSers from a great one and you obviously think I am great "since you've got all the answer".    (Ya know, if I could find a woman that said that to my face without the sarcasm, I might consider getting married one day.)  I can communicate and convince my pateint that I am here to help and would do nothing to endanger him... including walking him.  I am an advocate for my patient and their health.
> 
> However, your argument here is based on a belief that this man refused to be carried.  No information exists in this article to support this.  I doubt that a patient in that much pain and suffering would protest a quick, safe carry to the hospital, or couldn;t be convinced by a quality EMT with a basic grasp of the Ameriglish Language..  But, let's take it one step further... what if your patient was deathly affraid of vehicles and refused transport my ambulance or other vehicle, but wanted to go to the hospital... you gonna walk the MI patient to the hospital?  However, all ridiculous hypotheticles aside, would you have walked this patient... not some hypothetic patients?  And then would you lie about it, a sure sign that you feel guilty for providing a lower standard of care than you ought?



For someone who claims to be so good in communication you're missing a big part of it, listening and comprehending what the other person is saying.

I NEVER advocated forcing a patient to walk down the stairs, I never advocated lying in your paperwork. 

Have you worked in the field? Even in my short field experience I have run into the stubborn old goats who, no matter what you say, want to do what THEY want. It is within their right to refuse any part of treatment, which includes being walked down the stairs. 

I am not saying that is what happened, I'm presenting it as another possible side to the story. You're right, there isn't anywhere in the article that hints at it, but there is no where in the article that hints that he was forced to walk down or not given an option, it doesn't give you enough information on what had happened. It's up to interpertation.

What daedalus, boingo and I are trying to say is it's VERY possible that the patient refused. it's also possible that the patient wasn't given an option, it's not clear in the article.

Again, instead of going on a rant about the paramedics why don't you take the moral of the story? Document document document, and document CORRECTLY.


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## daedalus (Apr 26, 2009)

I think Sasha and I were misunderstood. I will not risk my health or life unnecessarily when something can reasonably done to prevent it. Falsifying a report is illegal and unethical.


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## ffemt8978 (Apr 26, 2009)

We don't know enough about what happened on scene to make any judgments about the care they provided or did not provide....and it doesn't matter at this point.  Their lack of documentation, followed by their alleged lying, will be their downfall.  Regardless of what happened on scene, once you lie about it in your documentation, you can't win because everything you say or do after that becomes suspect.


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## Mountain Res-Q (Apr 26, 2009)

I understand that everyone wants to find a "possible other side to the story" to defned them.  And I agree that there are cases where it may not be possible to do what is in the best interest of your patient.  But if you must choose the lesser of 2 evils then back up your desision.  People who lie are guilty of something.  There is no reason to lie if you are inocent.  You all want to come up with defences for theses Medics actions (not their lies), but there lies are a manifestation of their guilt for not providing teh best care they could have... not neccisarily should have if they couldn't convince the man to be lifted.  Obvioulsy we have a very one sided story, but the lies solidify the story for me.  Once a public servent lies about someones health and safety (and death) then they lose are credability and should not be defended in anyones hypothericals.  That is my point.  They obviously knew that they were providing a lesser form of care than was expected.  If the man refused to be carried down after they tried to convince him than document it, just as we all would.  But that is obvioulsy not the case as they were caught in a lie and continued to lie.

There was no misunderstadning on my part.  I understood your attempts to find explainations for why these guys screwed up.  Sasha, even in your "short field experience" (dirrect quote) you know not to lie about patient care, especially when you are forced to diviate from stadard protocol and common sence.  Why didn't they?  My 8 years experience (short compared to many), my foot-stool status as an EMT, and my experience dealing with California's sue-happy patients has taught me that A. you don't lie, B. If you lie you are probably guilty, and C. NO ONE should defend a smear on the face of EMS.


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## Sasha (Apr 26, 2009)

Mountain Res-Q said:


> I understand that everyone wants to find a "possible other side to the story" to defned them.  And I agree that there are cases where it may not be possible to do what is in the best interest of your patient.  But if you must choose the lesser of 2 evils then back up your desision.  People who lie are guilty of something.  There is no reason to lie if you are inocent.  You all want to come up with defences for theses Medics actions (not their lies), but there lies are a manifestation of their guilt for not providing teh best care they could have... not neccisarily should have if they couldn't convince the man to be lifted.  Obvioulsy we have a very one sided story, but the lies solidify the story for me.  Once a public servent lies about someones health and safety (and death) then they lose are credability and should not be defended in anyones hypothericals.  That is my point.  They obviously knew that they were providing a lesser form of care than was expected.  If the man refused to be carried down after they tried to convince him than document it, just as we all would.  But that is obvioulsy not the case as they were caught in a lie and continued to lie.
> 
> There was no misunderstadning on my part.  I understood your attempts to find explainations for why these guys screwed up.  Sasha, even in your "short field experience" (dirrect quote) you know not to lie about patient care, especially when you are forced to diviate from stadard protocol and common sence.  Why didn't they?  My 8 years experience (short compared to many), my foot-stool status as an EMT, and my experience dealing with California's sue-happy patients has taught me that A. you don't lie, B. If you lie you are probably guilty, and C. NO ONE should defend a smear on the face of EMS.




I can't explain why they lied. I don't know why the lied in their documentation. Do I believe that he could have written it automatically? Yes. I used to all the time on my IFT patients. Some days at the end of a long hard shift there was more crossing out and initialing than there was actual written text. Do I believe that absolves them from guilt? No. That's why they should go back and read their paperwork before turning it in.

Do I believe they could have forced the patient to walk? Certainly. Do I believe that a middle aged man could have insisted on walking? Again, certainly.

You speak lesser of two evils. Which evil is less, leaving them on scene because they refuse to get on a stair chair, or assisting them in walking down the stairs? Or even sitting their, burning valuable cardiac tissue while you try and talk them into getting on a stair chair???

You're not listening. I'm not defending them, just stating that I'm not so quick to be outraged at their deviation from standard of care.


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## Mountain Res-Q (Apr 26, 2009)

Sasha said:


> I'm not defending them.



If you say so... -_-


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## Sasha (Apr 26, 2009)

Mountain Res-Q said:


> If you say so... -_-



You can see a possible other side of the story without absolving someone from guilt, dear.


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## daedalus (Apr 26, 2009)

Mountain Res-Q said:


> If you say so... -_-



Why would she lie? Better, why do you persist with this? Take what she said for what she said, and move on.


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## Mountain Res-Q (Apr 26, 2009)

Sasha said:


> You can see a possible other side of the story without absolving someone from guilt, dear.





daedalus said:


> Why would she lie? Better, why do you persist with this? Take what she said for what she said, and move on.



Okay... -_-


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## ffemt8978 (Apr 26, 2009)

Do I really need to remind everyone?


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## Sasha (Apr 26, 2009)

ffemt8978 said:


> Do I really need to remind everyone?



I love the gun totin' star!!


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## AJ Hidell (Apr 27, 2009)

FAIL!

That's all there is to say.


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## CAOX3 (Apr 27, 2009)

1.  They lied about the fire department being there.

2.  They lied about him walking on they're paperwork.

3.  Then they lied about it when they were questioned.

They were terminated, why would this be if it was all a big misunderstanding?

They also lost a extended procedure(RSI) from their medical directors. 

The manager who didnt follow up with the family's complaint, he gets the axe too.

If any of my patients refuse any treatment, being carried, immobilization, o2 or anything they sign a refusal stating such, and it gets stapled to my run form.

Get out your check book,  its going to be costly.

We all face these situations daily, we dont walk people with chest pain down three flights of stairs, its simple.  

This is one of the easy ones.


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## boingo (Apr 27, 2009)

I don't know how much they can expect, it would be awfully hard to prove that the patient walking down 3 flights of stairs was the final nail in his coffin.  Bad judgement, less than standard of care?  Maybe, but actually causing his death?  A bit of a stretch.


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## CAOX3 (Apr 27, 2009)

boingo said:


> I don't know how much they can expect, it would be awfully hard to prove that the patient walking down 3 flights of stairs was the final nail in his coffin.  Bad judgement, less than standard of care?  Maybe, but actually causing his death?  A bit of a stretch.




I dont believe this will ever see the nside of a courtroom.  

Settlement.


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## bmennig (May 2, 2009)

I love how everyone argues over the dumbest crap on this forum, there is hardly ever a cival thread on here. I've had cardiac pt's that insist on walking, I usually make them refuse moving equipment with a signature. It is up to them. It should also be documented in the narrative what took place. You then have 2 items that back your arse up in court. I understand what these medics did, they just did a horrible job with documentation which, if your a Medic, EMT, or FR, you best know all about. Falsification of what was done was not appropriate either....

and oh my god, a PAID PROFESSIONAL did this, not a volunteer, what next?


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## el Murpharino (May 4, 2009)

bmennig said:


> and oh my god, a PAID PROFESSIONAL did this, not a volunteer, what next?



How does throwing this little quip in here benefit the argument at hand rather than beat an already deader than dead horse??  Seems to satisfy your own personal agenda, to me...


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## CAOX3 (May 6, 2009)

bmennig said:


> I love how everyone argues over the dumbest crap on this forum, there is hardly ever a cival thread on here. I've had cardiac pt's that insist on walking, I usually make them refuse moving equipment with a signature. It is up to them. It should also be documented in the narrative what took place. You then have 2 items that back your arse up in court. I understand what these medics did, they just did a horrible job with documentation which, if your a Medic, EMT, or FR, you best know all about. Falsification of what was done was not appropriate either....
> 
> and oh my god, a PAID PROFESSIONAL did this, not a volunteer, what next?



Ever spent any time in urban EMS?  I could write a book about getting people out of tight spaces.  This is a tired excuse. It was unsafe there was no help, give me a break.  They didnt write that did they, they didnt write it was unsafe, they  didnt write the guy refused.  Im guessing this isnt how it went down.

Face it these guys dropped the ball. They got what they deserved which was canned.  If it was a simple misunderstanding then why were lie after lie told?  Yeah and the medical director stripped them of RSI, because it was a simple misunderstanding.

OMG paid lazy professionals, well I guess you havent spent much time in a professional system.  There is plenty of laziness going around. 

Im seriously leaning towards a case of "I dont think your having chest pain now get your *** down stairs."  Unfortunatley this isnt uncommon either.

Now I hope im wrong.


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## bmennig (May 6, 2009)

el Murpharino said:


> How does throwing this little quip in here benefit the argument at hand rather than beat an already deader than dead horse??  Seems to satisfy your own personal agenda, to me...



No, people love to point out on this forum that paramedics are so professional and they have an education and that they are best people ever. EMT's suck, we know squat. This time a medic screwed up, proving that education and professionalism doesn't make you a better provider. It did satisfy my own agenda, quite a bit actually.


As far as Urban EMS, haha, what the hell is that? I don't have a big town in a 20 mile radius. It's not just medics that are lazy, I've talked to hospitals that have hung up the phone stating "we're to busy, go somewhere else" while trying to call a report on a patient I'm bringing in. Talk about Lazy, that's a downright disgrace. I made sure the patient knew that the hospital did that  as well as the communication center. The hospital wasn't on divert status either. In fact, it was Chest Pain call. That certainly makes me feel better if I ever need to go to the hospital. I'm sure you guys will have something to back the hospital up, you always seem to have the answers.


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## rescuepoppy (May 6, 2009)

I am not taking sides but everybody has been around a while has had patients refuse certain parts of treatment. This includes being carried. I was not there so I dont know if this was the case. My biggest problem comes from the alleged not documenting and false statements. If these are true that is what will be their downfall. Not the patient walking or even whether they are professional or volunteer. What we all should concentrate on is being careful of what statements we make. Tell the truth then you do not have to try to remeber what you said and be sure to document.


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## firemedic7982 (May 8, 2009)

The old adage applies here... It wasnt your pt. You werent on scene. Dont armchair quarterback, and blame the crew when you werent there to see what really happened. 

Secondly I think everyone who has read this article has lost sight of something. It's the media... How one sided do you think this is? And come on how many of you are naive enough to blindly think that this pt. actually died as a DIRECT result of the crew walking him down the stairs? REALLY? If there is a person on here who believes that, go find another profession. Im not saying that it couldnt have been a contributing factor, but there are people on this blog who seem to be quick to hang the crew as the absolute cause, just the same as the media. 

How about the big *** MI he was having when they got there? Dont suppose that would have killed him? NAH! how aout the extensive medical history? NAH! Probably not that either. Therefore it is safe to presume that the ONLY contributing factor, and the direct cause of his death must have been the medics on scene. 

And for the people on here who immidiately hung the crew out to dry by going by what the article said.... Shame on you! Not backing your own? Not having at least the professional courtesy to say " you know what? I wasn there, I shouldnt judge" I bet some of you are the same people that drop your partners in the grease just to save your own *** dont you?

Threads like this make me sick!


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## JPINFV (May 8, 2009)

So your justifying lying, twice?


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## firemedic7982 (May 8, 2009)

I didnt mention the lying. 

My argument was that the thread had lost site of the article.

And in regards to the lying... shame on them. But tell me you have never told a lie, and I will show you a liar. 

My main point is this. Its really none of our place to judge what happened... WE WERENT ON SCENE.


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## Sasha (May 8, 2009)

> And for the people on here who immidiately hung the crew out to dry by going by what the article said.... Shame on you! Not backing your own? Not having at least the professional courtesy to say " you know what? I wasn there, I shouldnt judge" I bet some of you are the same people that drop your partners in the grease just to save your own *** dont you?
> 
> Threads like this make me sick!



This "good ol boy" attitude makes ME sick.


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## firemedic7982 (May 8, 2009)

Really? "Good Ole Boy"

So when you dont completely restock your truck at the end of a really busy shift... Lets say your short something simple.... like a kerlix... You want me as your relief to write you up and turn you in to the field supervisor.... Or would you rather me just forget about it.


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## firemedic7982 (May 8, 2009)

Sasha said:


> This "good ol boy" attitude makes ME sick.



And what is "good ol boy" about not passing judgement?


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## Sasha (May 8, 2009)

firemedic7982 said:


> And what is "good ol boy" about not passing judgement?



Not passing judgement is fine, I encourage it, but your comment specifically about backing your own bugs me. Backing your own when they were wrong? You can't fudge that they lied on their report, but that's okay because everyone lies at some point? That's outrageous.


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## Mountain Res-Q (May 8, 2009)

Sasha said:


> This "good ol boy" attitude makes ME sick.



Ditto.  EMS is not a club where we randomly protect our own.  Your actions need to reveal a competency that deserves the respect of the public and your peers.

Here is the bottom line:  Whether or not these EMSers (no matter their level) screwed up on allowing a cardiac patient to walk down three flights of stairs is debatable.  Yes there are cases when walking a patient will happen, but the fact remains that these folks falsified documentation and then lied over and over again.  These are actions you take only when you realize that you screwed up and you need to to try to cover your a**.  They obviously realized that they could not justify their actions, otherwise they would have documented justification and explained their actions on review.  And their lies got desperate; saying that FD was not an scene when the fact that they were could be easily verified?  We can try to justify their actions in regard to patient care, but we can not justify the black mark they put on EMS when they commited crimes that call into question their patient care and the professionalism of all EMSers.  Yes the media is always biased, and yes we were not there, but I doubt anyone here can justify falsifying documentation and then lying (over and over) about patient care...

If they believed that they were providing the best possible patient care then they would have truthfully documented it that way and stood by their actions!  How can you respect or defend them when they take the opposite stance?


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## firemedic7982 (May 8, 2009)

Im not standing by them, nor am I defending them.

I have made no statement in their defense. I have said that I did not approve of them lying.

The main point of my argument, was people need to quit being martyrs. Quit acting like a group of people that have never screwed up. We all have. This thread is yet another exaple of many here on this website. People get on here and bash one another all the time. 

The name of this website is EMTLIFE. We are a small profession in our infancy. Now is the time to help one another out. Not throw one another to the wolves. 

If the article is accurate, and is in fact the sequence of events that occured without deletion... Than yes! Off with their heads for lying, and falsifying documentation. 

But come on. We have more viable discussions on here than spanking someone for screwing up when that already been done. Theyve lost their jobs. Theyve been punished. Dont kick them anymore.


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## Sasha (May 8, 2009)

Did you read more than one page of posts on this thread? We have talked about the different situations that could have come up instead of just "spanking them"


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## Mountain Res-Q (May 8, 2009)

firemedic7982 said:


> Im not standing by them, nor am I defending them.
> 
> I have made no statement in their defense. I have said that I did not approve of them lying.
> 
> ...



You liken failure to restock the kerlex with falsification of documentation and lying on investigation in an effort to cover over what they obviously knew was a dereliction of duty?

I still fail to see your point.  I am not judging them; the EMS system in which they worked (as well as the courts possible one day) judged them and found them to be guilty of being sh*ty EMSers.  I'm just agreeing, despite the fact that many here (especially in the first few pages) are defending their patient care by offering possible scenerios for why they did what they did.  But whatever casues we can find for walking the patient, there is no justification for everything else.

You are saying that we weren’t there therefore we are no position to analyze their actions... but since we all have been or will be in similar situations in our EMS careers, then yes we can analyze what we would have done.  I can say with 100% certainty that if I had been in their shoes and was “forced” to walk this patient, then I wouldn’t have falsified reports and then lied.  I would have stood by my actions and defended my decisions in the course of providing the best possible patient care.  We only lie when we have something to hide (i.e. substandard patient care).  If I was to commit the same disservice to EMS as these medics did then I would hope that it would not be brushed under the rug a some insignificant “Kerlex Incident”.  I would hope that the rest of the EMS community would disown me and distance themselves form a disgrace to the profession.  Anything less for their actions _is_ a defense of their actions based purely on the fact that they are part of the “EMS Club”.


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## firemedic7982 (May 8, 2009)

It doesnt matter what could have happened. Its not your place to speculate. You and no one else on here was there on scene, myself included.

The patients death is indeed unfortunate. The reported actions of the crew, inrresponsible. 

My initial point... I continue to state this ...

There are quite a few posts in this thread that have completely immasculated the medics strictly on what the article said. 

Thats wrong! If you werent on scene, then you do not know what happened. And it is no ones place to pass judgement in regards to their actions on scene. 

I am completely in agreeance with severa people in this thread... There a several situations that I can think of that would prevent a pt. from being moved by EMS down the stairs. Maybe the stair chair was broken, maybe he didnt want to be chaired down the stairs, maybe he wanted to walk, was it a dignity issue? 

While all of these are valid points that I agree with , along with th fact that I agree that their falsification of documentaton, and their dishonesty when conftonted about it is wrong, and inexcusable; I completely disagree with sitting here and passing judgement on people. 


The final point Im going to make is in regards to your comment about the "good ol boy" mentality... 

What is "good ol boy" about not passing judgement? Dont be a martyr. Youve screwed up before... You, me, and everyone else knows that! Its a fact of life.

But to say that we shouldnt protect your own because thats the "good ol boy" system is rediculous. 

In fact if you ever need the help of an ambulace, I don't know lets say for terribel abominal pain... My protocols specificallty state that abdominal pain is the only thing that I cannot use narcotic pain management for. I can only give toradol if I am absolutely certain that it is kidney stones, and I can absolutely rule out ranl cohlic. 

But normall if I were to pick up another medic for a situation like this, I would call my on duty supervisor, and ask for permission to medicate you anyway since you are a medic, and you know what your true situation is. 

That my dear is professional courtesy.

Or how about the cop that you speed by, and instead of nailing you to a wall like he would anyone else, he lets you slide a little bit, remembering the time you helped him out on location. 

Or what about when you are supposed to relive me at the end of my shift, and you call and say you are going to be late because your kid is sick and you need to take them to the doc. Should I stay over a little late for you? Sure I would. Because thats taking care of your own. When the fact of the matter is you are late! period. The job does not stop just because your child is sick. You should make other arrangements to get your child to the docotr like a grandparent, a neighbor, a sibling, the other parent. I should probably report that to the supervisor because when it boils down to it.... you violated policy because you are late! But i don't.... why? because we take care of each other.

What it boils down to is that it is not the "good ol boy" system. And if you cant manahe to stand by and not pass judgement on someone.... You are in the wrong line of work. And Ill tell you this much, I wouldnt work with you as a partner. That just tells me you are judgemental, and arrogant.

Im done with you!


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## firemedic7982 (May 8, 2009)

I appologize for the flagrant spelling and grammatical errors in my last post...

I was typing faster than my computer was... LOL.


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## Sasha (May 8, 2009)

> I am completely in agreeance with severa people in this thread...





> You are in the wrong line of work. And Ill tell you this much, I wouldnt work with you as a partner. That just tells me you are judgemental, and arrogant.



And I'm probably one of the ones you agree with, because I said almost the exact thing you said in many posts when this thread first came about.  It tells me you didn't read the posts beyond the first page.



> There are quite a few posts in this thread that have completely immasculated the medics strictly on what the article said.



immasculated? So now you want to make this into a gender thing?



> In fact if you ever need the help of an ambulace, I don't know lets say for terribel abominal pain... My protocols specificallty state that abdominal pain is the only thing that I cannot use narcotic pain management for. I can only give toradol if I am absolutely certain that it is kidney stones, and I can absolutely rule out ranl cohlic.
> 
> But normall if I were to pick up another medic for a situation like this, I would call my on duty supervisor, and ask for permission to medicate you anyway since you are a medic, and you know what your true situation is.



Do you understand why you don't give pain medication to abdominal pain??



> Or what about when you are supposed to relive me at the end of my shift, and you call and say you are going to be late because your kid is sick and you need to take them to the doc. Should I stay over a little late for you? Sure I would. Because thats taking care of your own. When the fact of the matter is you are late! period. The job does not stop just because your child is sick. You should make other arrangements to get your child to the docotr like a grandparent, a neighbor, a sibling, the other parent. I should probably report that to the supervisor because when it boils down to it.... you violated policy because you are late! But i don't.... why? because we take care of each other.



That's common courtesy, dear, not professional courtesy. As for the cop letting an EMT/Paramedic speeder slide, s/he shouldn't. Speeding is still speeding and it can kill whether it was a teacher behind the wheel or a paramedic.

I don't agree with the "protect your own" that gives the impression that you should stand by someone, despite right or wrong, because they're a "brother or sister" News flash. We're not related just because you're in the same profession. You tried to justify them by "Everyone lies at some point." True, everyone lies at some point, but that doesn't make it anymore right.


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## medic417 (May 8, 2009)

Sasha said:


> Do you understand why you don't give pain medication to abdominal pain??



I don't understand why or how any service would still have the out dated no pain meds for abd pain protocol?  Makes no sense.  Anyone that allows someone to suffer needlessly needs to be tortured.


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## firemedic7982 (May 8, 2009)

Didnt say we didnt give pain meds to abd pain. 

We withhold pain management on new onset undiagnosed abdominal pain. Unless we feel that it is suggestive of renal colic. If this is the case go ahead with the narcs. 

Just to be clear. ONLY witheld on NEW onset, UN-diagnosed. 

Otherwise it is

30mg Ketorlac
2-5mg IV, Morphine titrated to effect ans repeated PRN
0.5 - 1mcg/kg IV, Fentanyl titrated to effect, and repeated PRN
12.5 mg IV / 25 mg IM, Promethazine for control of N/V 

As to why, because the medical director says so! If you would like a copy of our abdominal pain protocol, or any other protocol you may PM me.


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## Mountain Res-Q (May 8, 2009)

I still don’t see how you can compare falsification of medical documents and lying about sub-standard patient care to forgetting to restock the kerlex, speeding, or showing up a few minutes late to a shift but apparently their crimes are not as severe in your mind.  Or maybe “kerlex crimes” area capitol crime in Texas…  The end result is what it is… judgment is passed by the media, by the public, by their EMS system, and by there fellow EMSers who have a better clue as to what really happened than the Media or the Public.  Plausible explanations (and a defense) have already been given for their actions in walking the patient.  That is not where judgment is now being made… it is made solely on their actions after the fact… If you lie about what you did than how can anyone take you side; you have lost all credibility.

As for calling those that would rightly condemn their actions “judgmental and arrogant”… isn’t that a bit of an unjustified comment considering you are not here?  How can you pass judgment on us simply by reading what we write because we pass judgment on those that have committed crimes that shed a bad light on the profession we love?  A bit hypocritical if you ask me.  But, like I said, if I commit the crimes these folks did… judge me and fry me… I would deserve it!  “Everyone lies”?  Yes, politicians, used care salesmen, insurance agents, your mother when she said you were smart, …and Health Care Providers?  GREAT DEFENSE!!!  I don’t lie unless I have something to hide… like a crime I commited… but it is a great defense in a court of law.  “But, your honor, I should be found guilty because everyone lies.”


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## firemedic7982 (May 8, 2009)

I had no side to take in the first place.

This whole thing started by me being upset about people passing judgement. 
If I lost my cool a little in my last post, I appologize. Thats the very thing I was arguing for and I will agree with you.

I also ageed several times in previous posts with the result of their actions. 
The only argument I ever made was that people were judging them for why they took the pt. down the stairs the way they did. Thats all. Just that simple. 

I think the original argument has somehow become lost in translation. Be that as it may, I appologize if I offended you.


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## Mountain Res-Q (May 8, 2009)

firemedic7982 said:


> I had no side to take in the first place.
> 
> This whole thing started by me being upset about people passing judgement.
> If I lost my cool a little in my last post, I appologize. Thats the very thing I was arguing for and I will agree with you.
> ...



I believe that EMSers are whay to thick skinned to be too offended by anything; maybe it is that same personality to causes us to fight so hard over things that to an outside is irrelevant.  ^_^  I'm not offended by a fight over something as important as patient care, just as I hope that nothing I say here offends my fellow Emergency Service Brothers and Sisters.

That said, I as said earlier, I think everyone feels that their actions post patient care are not justifiable.  There reasons for walking the patient are their own.  We can all try and find reasons for why they did it, but in the end, yes, we were not there and can only speculate on what we would have done and what mitigating cirrcumstances would have "forced" us to walk the patient... but we all know that there is no justifiable cause for lying.  In the end, however, patient care shouold not be the main reason for judging these medics.  Whatever they did or didn't do was unjustificable in their minds, which is why they found reason to _lie_ within 30 minutes of the call (paperwork) and latter on investigation (even trying to hang the FFs out to dry).  I don't judge them because fo their patient care as Health Care Providers... I judge them because they faied to uphold their duty as public servants.


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## CAOX3 (May 8, 2009)

They were fired.  Their medical director pulled a specialized skill.  Is this usually the outcome when its a simple misunderstanding?


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## AJ Hidell (May 8, 2009)

Mountain Res-Q said:


> I believe that EMSers are whay to thick skinned to be too offended by anything.


LOL!  You obviously haven't been around long.


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## Sasha (May 9, 2009)

AJ Hidell said:


> LOL!  You obviously haven't been around long.



I'm offended for him that you would say that.


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## AJ Hidell (May 9, 2009)

Sasha said:


> I'm offended for him that you would say that.


My point exactly, lol.


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## Mountain Res-Q (May 9, 2009)

AJ Hidell said:


> LOL!  You obviously haven't been around long.



Just 8 years in EMS.  Only a month on the forums.  BUt these forums tend to attract the more "interesting" EMSers.  I only get offended if something is said to be mean (like when friends call me an Ambulance Driver), but never when something is said by someone to get a reaction or by someone of lesser intelligence!    Getting offended by people I dont know, who (I hope) are just here to share their knowledge and perspective in a field we love, and often seem to be "riding the short ambulance"... why? -_-


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## AJ Hidell (May 9, 2009)

I agree.  It just doesn't seem to work out that way for quite a few people here.  We can't go a day without a couple of people getting offended here, usually over something that didn't even apply to them.


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## Sasha (May 9, 2009)

Mountain Res-Q said:


> Just 8 years in EMS.  Only a month on the forums.  BUt these forums tend to attract the more "interesting" EMSers.  I only get offended if something is said to be mean (like when friends call me an Ambulance Driver), but never when something is said by someone to get a reaction or by someone of lesser intelligence!    Getting offended by people I dont know, who (I hope) are just here to share their knowledge and perspective in a field we love, and often seem to be "riding the short ambulance"... why? -_-



Because the short ambulance is more exclusive than the long ambulance. Duh. And you get a cool helmet!


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## Amack (May 12, 2009)

This story came up in class the other day. After reading, err-sorting, through the various replies, defenses, accusatory and equally inflammatory comments, I think that there is some concensus that agrees upon the take home points:

1.)Don't ever lie. EVER! It only will destroy your integrity...and in EMS, without it, your career as a professional is ruined. period.

2.) While some calls commands some level of improvitization, always act with the BEST interest of your patient. BE A GREAT PATIENT ADVOCATE.

3.) DOCUMENT! DOCUMENT! DOCUMENT! (Truthfully at that!..See #1)


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## ResTech (May 14, 2009)

I would never walk a cardiac pt presenting with the symptoms and hx of the pt. in the news story down three flights of stairs. Never. The amount of exertion required on an already strained heart... no way. That pt. would be better managed by waiting an extra 15mins for additional manpower. If your gonna walk a cardiac pt. down three flights of steps then you may as well save your drugs cause you just defeated the whole purpose of decreasing myocardial O2 demand by walking down all those stairs. It sounds like laziness to me. I wasn't there but thats my impression. A Paramedic of all should know better. 

If you dont have a stair chair... what about a reeves? a backboard? take one flight at a time and rest for a minute before descending the next. The FD was there... have them carry the pt. And if the pt. refuses to be carried... document it and make sure you also document that the associated risks of that action were explained to the pt. Even if a pt. refuses a specific treatment, its an obligation of the EMS provider to specifically inform the pt. of all associated risks so the pt. can make an informed decision. Because a refusal by a pt. can be disregarded completely if they were not informed of the risks involved.

I agree the news story is one sided however, a cardiac pt having an MI + three flights of steps = Never! And most importantly here.... DOCUMENT your actions and justification for them!!!


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## reaper (May 14, 2009)

You will learn that the word NEVER is not in EMS!


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## ResTech (May 14, 2009)

In 15 years as a career provider Ive already learned about the word never. There are always times that require adaptation and the ability to improvise... but it should never so blatantly put your pt at risk... unless of course a situation is considered immediately dangerous to life or health.... and this wasnt an IDLH case.  

So unless the building was on fire, the roof was caving in, I was absolutely certain no manpower was coming, and I lacked the physical ability to carry this pt., he would NEVER have been walked down three flights of stairs.


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## reaper (May 14, 2009)

So you force Pt's against their will, to do things they don't want to do?


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## ResTech (May 14, 2009)

No... as I aforementioned in my above post, if the pt. refuses thats fine... but you NEED to explain to them the risks involved prior to doing something that is clearly not in their best interests and then document it. 

In this case, it appears to have been a voluntary decision on part of the EMS crew to walk the pt. and an attitude of, "I don't feel like breaking my back down three flights of stairs" scenerio (ie laziness).... again just my impression of these providers actions which could be totally wrong.   

So no, I don't force my pts. to do anything they don't want to do... but if I feel its indicated and in their best interests then I will be adamant about it with them and fully explain why I think so. 

And in some cases I even get the pt. to sign a refusal form for a specific treatment modality... most commonly when they refuse spinal immobilization. Its then documented that they were explained all the risks or potential risks involved in refusing a specific treatment and has their signature on the refusal form to say so.

Oh, and if the pt. was presenting like the story states... I very highly doubt this pt. was volunteering to walk down three flights of stairs and refusing the EMS offer to carry when he cant breathe and chest is crushing.


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## reaper (May 14, 2009)

That is fine.

I was referring to your comments that made it sounds like you could never do it at all.

"So unless the building was on fire, the roof was caving in, I was absolutely certain no manpower was coming, and I lacked the physical ability to carry this pt., *he would NEVER have been walked down three flights of stairs."*


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## ResTech (May 14, 2009)

My bad... I was just trying to say as an EMS provider... I would not voluntarily make that decision just to save me the extra work involved of carrying a pt. down so many steps.


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## reaper (May 14, 2009)

I agree.

I was just worried about someone reading that and thinking they could force a Pt to do it!


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## Sasha (May 14, 2009)

> In this case, it appears to have been a voluntary decision on part of the EMS crew to walk the pt. and an attitude of, "I don't feel like breaking my back down three flights of stairs" scenerio (ie laziness).... again just my impression of these providers actions which could be totally wrong.



So you can tell the Paramedic's intent by a one sided, biased article based on a family member who wasn't there's commentary? 

Are you like connected with all EMTs/Paramedics and can tell their intent and mindset? Like are you the Professor X of EMS?



> Oh, and if the pt. was presenting like the story states... I very highly doubt this pt. was volunteering to walk down three flights of stairs and refusing the EMS offer to carry when he cant breathe and chest is crushing.



You must not deal with a lot of stubborn old people who refuse to accept the fact that it's worse than they thought and want to maintain their pride/dignity by ambulating to the stretcher/down the stairs/to the ambulance or what have you.


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## JPINFV (May 14, 2009)

ResTech said:


> If you dont have a stair chair... what about a reeves? a backboard? take one flight at a time and rest for a minute before descending the next. The FD was there... have them carry the pt. And if the pt. refuses to be carried... document it and make sure you also document that the associated risks of that action were explained to the pt. Even if a pt. refuses a specific treatment, its an obligation of the EMS provider to specifically inform the pt. of all associated risks so the pt. can make an informed decision. Because a refusal by a pt. can be disregarded completely if they were not informed of the risks involved.



Now that would be a tough call. A reeves, backboard or breakaway transfer flat would be a tough choice over walking. In general they are extremely unstable since the center of gravity is above the support. Additionally, unlike a stair chair and basket stretcher, there's nothing besides the straps preventing the patient from sliding off. A basket stretcher would definitely work better, but I sincerely wonder if the stress of being strapped and carried in something so unstable would be worse than the exertion of walking.


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## ResTech (May 14, 2009)

I've carried many pts in a reeves and they are great for navigating down steps... the reeves encircles the pt. somewhat and they are strapped. So you have some flexibility to manipulate the reeves when rounding corners and what not. I love the reeves. A backboard would not have been an ideal choice but would work. For one, its hard and prob a little more uncomfortable then the reeves and its more difficult to maneuver around corners. One of the newer Stryker stair chairs with the tracks would be perfect... they are awesome for steps!

Sasha ::
When the Paramedics don't take the time to document their actions and justifications... and instead lie and falsify a report... it leads to the old saying "if your didn't write it, you didn't do it". Its one thing to accidently omit and another to lie.  Agreed? So, that is in part where my opinion draws from. And not to mention they lied to investigators... if the pt. was adamant about walking down steps... then why didn't they say that. Instead, they lied and tried to say the FD was not there yet. And I even said, I could be wrong in my impression... the news story was posted for discussion and if new information comes to light I will change my opinion accordingly.  

And I've dealt with many, many, many "old and stubborn" pt's. Luckily, I have a pretty great ability of convincing pt's not to refuse or let their pride get in the way  That's just me advocating for my pt. Not always successful, but that's when I document it.

And the stress of laying still on a reeves would by far be much less stress on the heart then walking down three flights of stairs.


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