My BIGGEST pet peeves

[Leafmealone]

Thats fraud.

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I didn't mean it as so, Please, don't get me wrong. When I say taken to giving them O2, I meant that most of the time their sat is low, and I justify it by giving them O2. I wouldn't needlessly give treatment to a person who doesn't need it. Almost all of my patients get oxygen, because it is really a wonder drug. I'm just stating that most if not all of my medicare/medicaid patients get oxygen for one reason or another. It covers everything from SoB to nausea and even with the fall victims. Please don't think that I would knowingly falsify information for a payment, its not like I am the one collecting on the bills.

 

[JPINFV]

I meant that most of the time their sat is low, and I justify it by giving them O2.

Just curious, what do you define as a low stat?

its not like I am the one collecting on the bills.

Note, this is not directed at Leaf as it's a wide spread feeling in EMS.

While I don't condone giving even a false appearance of fraud, I think this completely the wrong attitude. I don't get why EMS providers aren't concerned over billing when the money their company receives from billing is what they use to reimburse their employees. The money for pay has to come somewhere.

 

[Sasha]

I didn't mean it as so, Please, don't get me wrong. When I say taken to giving them O2, I meant that most of the time their sat is low, and I justify it by giving them O2. I wouldn't needlessly give treatment to a person who doesn't need it. Almost all of my patients get oxygen, because it is really a wonder drug. I'm just stating that most if not all of my medicare/medicaid patients get oxygen for one reason or another. It covers everything from SoB to nausea and even with the fall victims. Please don't think that I would knowingly falsify information for a payment, its not like I am the one collecting on the bills.

Thats not what your post said, it specifically stated you put all your patients on o2 JUST TO JUSTIFY BILLING.

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[socalmedic]

yes, if your system wants you to transport all the way from Houston to Seattle, then yes, the appropriate thing is to transport the patient to Seattle, and then either quit, grin and bear it, or work towards changing the policy. Intentionally ignoring a policy such as the patient's ability to choose their destination is not an option.

the one thing California has going for it right now is that we transport all patients the the "Closest most appropriate facility" that is unless I as the paramedic feel that the patient is justified in requesting a different hospital i can bypass with base hospital approval.

 

[Aprz]

People who think oxygen is a wonder drug. :\

 

[JPINFV]

the one thing California has going for it right now is that we transport all patients the the "Closest most appropriate facility" that is unless I as the paramedic feel that the patient is justified in requesting a different hospital i can bypass with base hospital approval.

It's a local thing as I know OC's protocol states patient preference if with in a 20 minute transport, unless a medically valid reason is present or no preference is expressed.

Besides, within a reasonable transport time and provided no need for a specialty center, isn't the patients home hospital more appropriate than non-home hospitals?

 

[MrBrown]

Besides, within a reasonable transport time and provided no need for a specialty center, isn't the patients home hospital more appropriate than non-home hospitals?

Stop speaking sense!

You know common sense and rational clinical judgement is not planned for in the 100 hour cirriculae

 

[Epi-do]

"Why can't I pass NR?!?!?!?" posts. Seriously, the test isn't all that difficult. If you haven't taken a computer based test before, I'll grudgingly give you one fail for being freaked out by the format. However, the second time around you know exactly what to expect from the format, and the style in which the questions are written. At that point, is there really any excuse for not passing, except you just don't know the material? And since EMS in the US isn't rocket science, if you can't pass on the second attempt, do you really think this is a good fit for you?

 

[Sasha]

They don't pass because the NR is a money stealing scam!!!!

 

[Epi-do]

They don't pass because the NR is a money stealing scam!!!!

So all of us that passed the first time around either just got lucky or figured out how to scam the scammers? :rofl:

 

[Shishkabob]

They don't pass because the NR is a money stealing scam!!!!

Well, it IS, but that's not why people don't pass

 

[Leafmealone]

Just curious, what do you define as a low stat?

Anything under patients norm/ roughly 96 or less. even if its a couple of points, a minor improvement is still an improvement, IMO.

 

[usalsfyre]

Anything under patients norm/ roughly 96 or less. even if its a couple of points, a minor improvement is still an improvement, IMO.

Your just trying to make numbers look pretty. Physiologically pulseox is a poor indicator of hypoxia, albeit the only objective measure we have. Your not really hypoxic till 90-92% assuming a normal H&H and even then it's often a relatively mild hypoxemia. Trying to manipulate numbers with supraphysiologic levels of O2 isn't productive.

 

[JPINFV]

Anything under patients norm/ roughly 96 or less. even if its a couple of points, a minor improvement is still an improvement, IMO.

Ah, the problem is that while 96 is "normal," the normal range is actually anything above 92. Starting a patient on supplemental oxygen because the SpO2 is 94/95 (baring other issues, least a certain other poster starts whining) is like a paramedic giving a fluid bolus because a patient's systolic blood pressue is 110 and not 120.

 

[Hunter]

They don't pass because the NR is a money stealing scam!!!!

So all of us that passed the first time around either just got lucky or figured out how to scam the scammers? :rofl:

I passed the first time, I don't believe in luck I figured out how to scam the scammers myself

No I actually studied my *** off, had no trace of a social life for at least 2 weeks, and made sure to minimize distractions, facebook, IM services, Cellphone, EMT Forums about the things that bother us... <.< last ones a biggy :lol:

 

[Hunter]

Thats not what your post said, it specifically stated you put all your patients on o2 JUST TO JUSTIFY BILLING.

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Actually... vvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvv

Medicare/Medicaid makes you jump through a lot of hoops also when it comes to transporting. Not only do they do the whole closest facility thing, but they also require EMS to state why an emergency transport was needed, and why they couldn't have driven themselves. I've taken to placing all my Medicare/Medicaid patients on 2lpm O2 just so I can justify billing.

wich technically is fraud...

 

[Farmer2DO]

Anything under patients norm/ roughly 96 or less. even if its a couple of points, a minor improvement is still an improvement, IMO.

Since I work in the same system as you, at our elevation above sea level, 92% and above on room air is considered normal.

 

[Leafmealone]

Fair enough, I have stated in other posts that I am still relatively new. Good to have this information, and I will adjust accordingly.

 

[firecoins]

-Supervisors with lower certification than yourself.:rofl:

-IFT dispatchers who call you while providing patient care on the SNF emergency they sent you too wondering why its taking so long.

-People who enjoy long walks on the beach. Can't you find something else you enjoy less cliche?

 

[sirengirl]

-IFT dispatchers who call you while providing patient care on the SNF emergency they sent you too wondering why its taking so long.

hospitals that call me for a gurney transport back to a nursing home and when I show up they are just serving the patient lunch, or there are still IVs/lines/random machines still hooked up to the pt :glare: