Breaking the Rules

There's plenty of rules to be broken, but those 2 maybe I'd stay away from. You're responsible for a lot, as is your employer, so keep that in mind. A lot of stupid sounding rules were made for a reason.

You drive a couple miles off the road that most would take, and are invlolved in a wreck. Then what? If...if...if, you can't be afraid to do anything because of what may happen, but you have to think about it.

You don't have that LOL history and give her something she's allergic to. then what?

Sounds stupid I know, but you have the responsibilty to act like a professional, no matter how cold it seems.
 
Flightmedic, you rock!! It is true, we sometimes have to walk a little faster!:)
 
There are rules and there are RULES. As far as the food thing, there's a frequent flyer in our area that fakes chest pain when he's hungry. Bystanders call 911 and he gets a nice warm meal at the ER. The ALS crew knows if the weather is cold, its after 9pm and its a bystander called in chest pain, it's probably this guy. So they generally grab something to eat from the station and take it with them on the call. Once the pt. gets his belly full, he's not so chest painy any more. Otherwise he'll continue to have his episodes all night until he gets to the ER.

I have chosen to interpret the rules on calls for the benefit of my patient. The key is you better be right! I am however in a rural area with a very forgiving MPD who gives us a lot of latitude. If its a meds issue or something I'm not sure of, we can call Medical Control and get permission to act outside of the rules and the consequences are legally on them if things go south.
 
BossyCow said:
There are rules and there are RULES. As far as the food thing, there's a frequent flyer in our area that fakes chest pain when he's hungry. Bystanders call 911 and he gets a nice warm meal at the ER. The ALS crew knows if the weather is cold, its after 9pm and its a bystander called in chest pain, it's probably this guy. So they generally grab something to eat from the station and take it with them on the call. Once the pt. gets his belly full, he's not so chest painy any more. Otherwise he'll continue to have his episodes all night until he gets to the ER.

I have chosen to interpret the rules on calls for the benefit of my patient. The key is you better be right! I am however in a rural area with a very forgiving MPD who gives us a lot of latitude. If its a meds issue or something I'm not sure of, we can call Medical Control and get permission to act outside of the rules and the consequences are legally on them if things go south.
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I'm sorry, but that's so irresponsible. You can call me a cold hard *******, many have before so it doesn't hurt my feeling. But you need to treat all your patients the same.

First, if this man gets a sandwich, you get a refusal? If you transport and he gets a meal in the ER then why feed him first?

If he's a homeless guy, or not and is so malnourished, then he's chronically unhealthy. Who are you to say whether he is having CP or not? Wow, I think I wouldn't want that responsibility, that's a dangerous game to play. You do it like that too long and you'll get bitten.

Compassion is one thing, poor judgement and not adhearing to a standard of treatment is another.
 
BossyCow,

I love your plan. A lot of our frequent fliers play the system really well. I'm sure if he was having more than "hunger pains" he would say he needs the ER not a sandwich.
 
I think the case Matt is talking about is one I've had... Someone is getting D/C'd from the hospital at mealtime and they don't bother feeding him. You know by the time you get to the SNF, it will be just after lunch and the patient won't get food. In a couple of cases I've had patients remind me of this, so I go, explain it to the nurse, and they get the guy a last meal before we leave - but, they've got to eat fast.

As for the detour to see X-Mas lights, etc... As long as it isn't a significant distance out of the way, and the patient is stable, taking the senic route isn't nessicarly a bad thing. In many cases, it will brighten the mood of the shut in signifcantly, so it is usually worth it. (This came up a year or two ago inone of the EMS magazine's - I think it was a Thom **** Column).
 
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