akflightmedic
Forum Deputy Chief
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I am still in awe that this was turfed to a BLS crew....lazy *** medics for sure.
Did i mess up will.i get fired
- Thread starter chickj0434
- Start date
chickj0434
Forum Lieutenant
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From my assessment she didnt seem to have any trauma other than just the bruising on the eye. had no complaints of pain besides the chest pain which wasnt due from the fall becasue she stated its what made her fall. i am very disapointed in myself and very upset with my descision. what kind of trouble can i be expected to get in for this
akflightmedic
Forum Deputy Chief
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Your reply is so horrific, I am unsure if I should reply back and tell you everything wrong with what you just said.
chickj0434
Forum Lieutenant
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Pls do
NysEms2117
ex-Parole officer/EMT
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you should not be worried about what work will do to you... you should be worried about what you will do to a patient. Im not being overly critical or mean either. Just think about if this lady had an internal injury, you gave blood thinners, so now no OR. go back REVIEW your material, and have that count as your "punishment"
chickj0434
Forum Lieutenant
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I agree. pretty much hate myself right now
VentMonkey
Family Guy
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I love how honest people can be on this forum.
Op, slow down, talk to your supervisors about it if you haven't already. Be as forthcoming with them as you have been on here.
One last bit of advice: can I suggest you change you username?
@Bigbadworrywort25, or @Bigbadgermaphobe25
Ligthen up a little, bud, ok a lottle
.chickj0434
Forum Lieutenant
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I love how honest people can be on this forum.
Op, slow down, talk to your supervisors about it if you haven't already. Be as forthcoming with them as you have been on here.
One last bit of advice: can I suggest you change you username?
@Bigbadworrywort25, or @Bigbadgermaphobe25
Ligthen up a little, bud, ok a lottle
So i should go see my supervisor and tell them? or should i just take ot as a learning mistake and see if i get called in.
VentMonkey
Family Guy
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If you're being serious and this isn't a troll pranking, then yes, be honest and perhaps remediation is all that will result. Best of luck...in life in general, laterz.
RocketMedic
Californian, Lost in Texas
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So, here's the reply from an honest EMS educator.
1) This is not a basic patient. The timeline you report is suggestive of several acute pathologies, to include cardiac dysrhythmia, ischemia, infarct and a few other things that are not easily identifiable in a prehospital environment.
2) You actually sound like you did a decent job of gathering a history, but your decision to use aspirin was ill-informed. Aspirin is an anti-platelet agent that impedes further clot formation to some degree. With a fall that caused bruising and other blood thinners already aboard, she is at an increased risk of suffering a head bleed from the fall; but on the flipside, there isn't much danger either in dropping in aspirin. It's not really going to matter one way or another.
3) This patient needs both a cardiac assessment and a trauma assessment. As stated, those medics are lazy, but you can't fix that. It's on you to be a patient advocate and push this data forward to the receiving facility, especially the timeline reported.
As for you, you're not going to get fired unless you're a total goober. Use this as a learning opportunity and keep networking and asking these questions to get better.
1) This is not a basic patient. The timeline you report is suggestive of several acute pathologies, to include cardiac dysrhythmia, ischemia, infarct and a few other things that are not easily identifiable in a prehospital environment.
2) You actually sound like you did a decent job of gathering a history, but your decision to use aspirin was ill-informed. Aspirin is an anti-platelet agent that impedes further clot formation to some degree. With a fall that caused bruising and other blood thinners already aboard, she is at an increased risk of suffering a head bleed from the fall; but on the flipside, there isn't much danger either in dropping in aspirin. It's not really going to matter one way or another.
3) This patient needs both a cardiac assessment and a trauma assessment. As stated, those medics are lazy, but you can't fix that. It's on you to be a patient advocate and push this data forward to the receiving facility, especially the timeline reported.
As for you, you're not going to get fired unless you're a total goober. Use this as a learning opportunity and keep networking and asking these questions to get better.
medichopeful
Flight RN/Paramedic
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This ^
chickj0434
Forum Lieutenant
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I know i will.never make this mistake again. so there isnt too much danger i put the patient in? she was a&ox3 seemed on good spirits just the chest pain. in the back before goving the aspirin i even googled because i thought you shouldnt but then i read articles saying it was fine so just a ****ty job on my end. we brought her to a major hospital on the city. what are the chances this gets back to me
medichopeful
Flight RN/Paramedic
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OP, you are right in that the patient may have been having a cardiac event. The problem, though, is that there was a major contraindication to the ASA (potential head bleed, possibly other trauma).
Although we can all agree that the ASA was a bad call in this situation, keep in mind that many geriatric fall ARE due to a cardiac emergency. In addition, you can have "normal" vitals while having a STEMI. Just a thought.
Although we can all agree that the ASA was a bad call in this situation, keep in mind that many geriatric fall ARE due to a cardiac emergency. In addition, you can have "normal" vitals while having a STEMI. Just a thought.
Of course. But based on the situation described, I personally would be more worried about an evident s/p fall trauma as my 1st priority, rather than a possible STEMI scenario. Especially since it's a BLS crew (yickes) turfed by ALS, whose 1st priority should've been sticking the leads on. Overall, this entire thing is just bad right, left and centre...
akflightmedic
Forum Deputy Chief
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BigBadWolf....do you know WHY you gave Aspirin?
There is a lesson here. Please humor us and tell us why you give ASA to a Chest Pain patient...do not google. There is no shame here. Plenty of learning if you want it and are sincere.
There is a lesson here. Please humor us and tell us why you give ASA to a Chest Pain patient...do not google. There is no shame here. Plenty of learning if you want it and are sincere.
Flipping through your posting history, OP, I'm seeing some very telling symptoms of WorryWortitis. It's not an uncommon condition among new workers, and is fortunately often managed with a simple administration of job experience. If you find that experience isn't helping and it's affecting your day-to-day life or ability to work, consider sitting down with a therapist once a week for a while. My guess is that this job isn't the only aspect of your life that gives you anxiety, and it could be a huge load off of shoulders- yours, your partner's, and your patients' shoulders, that is.
EpiEMS
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For one, this is poor ALS management and delegation - I would suggest that in the future, you should refuse to accept such a patient from ALS, if at all possible. This patient needs an ALS assessment, because of the possible cardiac (among other possibilities) origin of the fall.
At a minimum, BLS care for this patient includes cervical motion restriction (more for protocol compliance than anything else), trending vital signs (HR, RR, BP, SpO2, hemorrhage control, an ice pack, and a nice warm blanket.
What made you think that this was an ACS patient?
This, this, this! Also, you should strongly consider refusing to take a patient you're not comfortable with - especially if you can identify a reason why you need an ALS assessment or intervention.
RocketMedic
Californian, Lost in Texas
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(Refusing to accept care from the medics, NOT refusing to transport!)
In my system, this would be a "let's chat" with clinical for the medics. The aspirin onto a potential head bleed certainly isn't good, but isn't terrible either- it won't make a clinical difference.
In my system, this would be a "let's chat" with clinical for the medics. The aspirin onto a potential head bleed certainly isn't good, but isn't terrible either- it won't make a clinical difference.
EpiEMS
Forum Deputy Chief
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Yes, yes, absolutely - totally necessitates a transport (heck, I'd make sure QA/QI and my medical director were aware that medics dumped a clear ALS patient on me without doing a real assessment and went back in service).
Just a point of interest - after reading this thread and seeing the vehement opposition to ASA for a patient on blood thinners, I couldn't remember that being a contraindication in my state. I checked the MA protocols on ASA and found that the only contraindication listed is an active GI bleed.
So by the numbers, a patient on blood thinners with suspected cardiac related chest pain would get 324mg of aspirin, so long as they didn't have a GI Bleed. Sounds like we are an outlier here.
So by the numbers, a patient on blood thinners with suspected cardiac related chest pain would get 324mg of aspirin, so long as they didn't have a GI Bleed. Sounds like we are an outlier here.