Decison making on scene

PapaBear434 said:
Also have to keep in mind that you practice under your Medical Director's medical license, not some random Doc that walks up. You do what YOUR Doc says.
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Also remember that you work under that medics license, that is on scene. It is fine to say no or do something you believe to be right. You just better be right and be able to prove it! I have seen many EMT's lose their cert over this very thing.

I have no problem telling a Dr. no, if I know I can prove they were making a bad decision. This happens very rarely and you had better be right.
 
VFFforpeople said:
I do y training, I know BLS and that is what I am going to do. Like stated if the Medic says hey you stop..I am going to keep doing my duty and call it a day.
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This thing is you only know BLS. You do not know what someone at a higher level of training and education is seeing. So yes, if they tell you to stop, you had better, at the very least, listen to why. Going blindly and bullheadedly forward with limited knowledge will do your patients no good and may possibly harm them.
 
VentMedic said:
This thing is you only know BLS. You do not know what someone at a higher level of training and education is seeing. So yes, if they tell you to stop, you had better, at the very least, listen to why. Going blindly and bullheadedly forward with limited knowledge will do your patients no good and may possibly harm them.
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And make for a really strained partnership for the rest of the shift, which is not good for patients.
 
reaper said:
Also remember that you work under that medics license, that is on scene. It is fine to say no or do something you believe to be right. You just better be right and be able to prove it! I have seen many EMT's lose their cert over this very thing.

I have no problem telling a Dr. no, if I know I can prove they were making a bad decision. This happens very rarely and you had better be right.
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I work under no medics license, as they are not licensed (Albeit there are "Licensed Medics" in Texas, but that's a different story) They are responsibile for keeping their own cert, not me.

Medics can only practice medicine under a doctors license, the same license I work under.



If you can articulate why you did something, and it's in your protocols, that's all that matters.
 
Linuss said:
I work under no medics license, as they are not licensed (Albeit there are "Licensed Medics" in Texas, but that's a different story) They are responsibile for keeping their own cert, not me.

Medics can only practice medicine under a doctors license, the same license I work under.



If you can articulate why you did something, and it's in your protocols, that's all that matters.
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Sorry but when a medic is on scene, he or she is in charge and is responsible for the patient and what happens and it's their license on the line when you screw up. You had better listen to what they say.
 
As stated, the medic knows best. If he tells you to do something (as long as it falls within your scope of practice) or not to do something, you'd better listen.
 
Linuss said:
If you can articulate why you did something, and it's in your protocols, that's all that matters.
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EMT-B: "I did 'it' because protocol said to."

EMT-P: "I told the EMT not to do 'it' because I understand why this patient is in distress and the underlying pathophysiology."
 
Sasha said:
Sorry but when a medic is on scene, he or she is in charge and is responsible for the patient and what happens and it's their license on the line when you screw up. You had better listen to what they say.
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Doesn't change a thing I said, does it? I don't work under their license. Period. End of question.

But you also missed the point I was saying, which is do what you know what to do, as long as you're supposed to do it.

redcrossemt said:
EMT-B: "I did 'it' because protocol said to."

EMT-P: "I told the EMT not to do 'it' because I understand why this patient is in distress and the underlying pathophysiology."
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You obviously need to look up the word "articulate"
 
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Linuss said:
Doesn't change a thing I said, does it? I don't work under their license. Period. End of question.

But you also missed the point I was saying, which is do what you know what to do, as long as you're supposed to do it.

You obviously need to look up the word "articulate"
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In my state, the medical provider with a duty to act, and the highest medical licensure, is in charge of the patient's care.

If I (as a paramedic) believe something is not in the patient's best interest, and I tell you (as a basic) not to do it, you had better not do it.

That's not saying that I don't value input as to what should be done for the patient, or if an EMT starts obvious treatments such as holding c-spine, applying a nasal cannula, etc. If an EMT, for instance, starts holding c-spine and I determine that c-spine immobilization is not called for, I will thank the EMT for maintaining c-spine and tell them that it's okay to let go now.

You as an EMT can always say/document, "the medic told me not to". As a paramedic, I take full responsibility for the patient's care, and can lose my license if you do something inappropriate and I don't intervene.
 
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I'm not debating the on scene CoC at all, red, as most of the time, the higher credentialed person is in charge. Common sense and common knowledge dictate as such.




I was just stating the fact that I do not work under a medics license, period.

Medics, in the state of Texas and quite sure many other states, do NOT have a 'real' medical license to where they can practice, and delegate practice, outside of an MD's orders. That is ALL that my post was stating.
 
Linuss said:
I'm not debating the on scene CoC at all, red, as most of the time, the higher credentialed person is in charge. Common sense and common knowledge dictate as such.

I was just stating the fact that I do not work under a medics license, period.

Medics, in the state of Texas and quite sure many other states, do NOT have a 'real' medical license to where they can practice, and delegate practice, outside of an MD's orders. That is ALL that my post was stating.
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Fair enough.

In Michigan, we are licensed providers, but required to work under an MD's orders. That being said, I am allowed to delegate supervised practice to others as allowed in their scope of practice.
 
redcrossemt said:
Fair enough.

In Michigan, we are licensed providers, but required to work under an MD's orders. That being said, I am allowed to delegate supervised practice to others as allowed in their scope of practice.
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Same as with Texas.



Texas is weird though... we have "Paramedics" and "Licensed Paramedics". But LP's don't have a 'real' license, they just have an AAS in paramedcine, or a BS in any other area.




I always nitpick statements and argue them... tis how I role and why some on here despise me ;)
 
lafmedic1 said:
I have had a "Mds"show up on scene sometimes with an obscure non emergency related cert. If they direct you to do something harmful make sure you repeat it to them what they asked you to do and if you transport the patient have them attend the patient as they are a higher level than you and can not leave as it would constitue abandonment in some areas.Usually as soon as you mention that they WILL be riding to direct treatment all the way they back off. Drs can also be a big help so dont discount them right away .
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Unless they have a cert in something related to the patients problem, then I'll wait until my medical director gives me the OK that they can run the scene.

I don't see much point in letting a dermatologist run my scene unless the patient has broken out in a trauma rash.
 
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Linuss said:
Necrotizing fasciitis?
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That requires an Infectious Disease doctor and a wound care specialist or maybe even an Intensivist depending on the extent. As well, reconstructive physicians may be called in during the healing process. This also can consist of a variety of other doctors depending on the location. Ex. ENT may be on the case if it is in that region.

A dermatologist will usually not be part of the team.
 
Linuss said:
Necrotizing fasciitis?
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And what do you expect the dermatologist to do in the field?? The treatment for that includes antibiotics, possible grafts, possible amputations, maybe a hyperbaric chamber none of which are field treatment. Treatment would be fully supportive, perhaps I'm naive, but I don't see how a dermatologist would have anytinhg to add. It doesn't really "eat the skin" it's an infection that causes destruction of the tissue, not so much a skin disease.
 
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Sasha said:
And what do you expect the dermatologist to do in the field?? The treatment for that includes antibiotics, possible grafts, possible amputations, maybe a hyperbaric chamber none of which are field treatment. Treatment would be fully supportive, perhaps I'm naive, but I don't see how a dermatologist would have anytinhg to add.
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You're such a fan of my wit, aren't you?
 
It is difficult to tell what it is on a forum since we cannot see facial expressions.

It could be one of wit or of cluelessness.
 
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