Ekgs on the bls level

[CobraIV]

So I work in an ER as a tech besides being an EMT. The other night a bls crew showed up with a pt who's chefs complaint was abdomen pain, on arrival to the ER the pt was in the trendelenburg position since the bls crew wasn't able to get a pulse. The pt was speaking in full sentences and didn't appear in distressed. Anyways I got the page to preform an ekg. I did the ekg and printed it. The ekg read normal sinus rhythm. After an ekg the protocol is to show the doctor assigned to them. As I leave the room both of the bls crew ask to look at it. I showed them it, one crew member stared it for almost 20 minutes. They asked me to print them out a copy. I thought to myself why you're bls? You don't do ekgs. If they were medics and asked alittle nicer id print them a copy. I didn't say that to them since I am typically a nice guy plus it was 6:15 in the morning. Obviously I didn't give them a copy but another tech did because they were up her a $$.



So my question lies with if a bls crew ask for a copy of the ekg do I give it to them? I understand if they need it as a study aid for medic school but it falls under hippa laws. The pts name, med rec, social are on the ekg as well as my name. This isnt a face sheet thats going with the report , they wanted it for :censored::censored::censored::censored:s and giggles. If its so important for their "studies" couldn't a clinical instructor provide their students with an ekg?

 

[DesertMedic66]

It is still their patient so the HIPAA laws do not apply here. Many companies have a follow up with patients so the crews can find out what was going on and what the outcome was.

Just because an EMT isn't in medic school doesn't mean they aren't trying to learn about EKGs. Heck I'm an EMT and if there is an interesting cardiac patient I will ask nicely for a copy of the 12-lead for my own interest, never have I been denied.

There is a very simple fix to take off patient info. After you make a copy, use a sharpie to cover the info you don't want them to have.

Since that was their patient in the first place, they already have the patients social number and medical info

 

[Tigger]

HIPPA isn't real, HIPAA is.

Also, I see no reason for you to deny a perfectly legitimate request made by someone who in all likelihood who just wants to be a better EMT.

I'm a basic and am required to learn basic interpretation. Should I not have access to my own patient's EKGs?

 

[DesertMedic66]

 

[Mariemt]

Actually, they may have wanted it for their paper work as they had a pt they couldn't find a pulse on speaking in full sentences . They only asked for a copy, they never said they needed it for medic school. If that is what they wanted it for they could find 5,000,000 of them online.

If you if your partner hadn't given them one, the nurses or the er physician probably would have and then given you strange looks the rest of the day wondering why you hadn't.

The pt was theirs to begin with. Let's remember that. They know the laws. Apparently more than you do as you thought you couldn't share this with them.

 

[Mariemt]

And as am EMT myself? I have been taught how to do ekgs, 12 leads and we do 3 leads and include the strips in our paperwork.

 

[Brandon O]

They probably want to learn. This usually falls under professional courtesy.

Are you concerned about the HIPAA issue or the inconvenience?

 

[Jawdavis]

If they needed it for their paperwork, absolutely. If they just wanted it to study sure, just make sure names and patient information are blacked out.

 

[Christopher]

I thought to myself why you're bls? You don't do ekgs.

Ho ho ho, how mistaken. Our EMT's do 12-Leads (they don't interpret, but they acquire them).

Hopefully we'll move out of the old world mindset and start embracing BLS 12-Leads.

 

[Mariemt]

Ho ho ho, how mistaken. Our EMT's do 12-Leads (they don't interpret, but they acquire them).

Hopefully we'll move out of the old world mindset and start embracing BLS 12-Leads.

The er doc really likes it when we send one ahead. Or have a strip in our hand as we walk in.

I learned during clinical to do all three. They had me do the 12 leads then I did ekgs in the er as it was what they did during down time.

 

[unleashedfury]

They wanted to study it? Or learn more about 12 Leads

I'll be honest 12 Lead ECG inteperitation is probably one of my weakest points. I get them from medics, ER techs and various people all the time in a way to improve my skills.

If HIPAA is what your concerned about, simply black out the info with a sharpie. It was their patient, so the continuum of care applies. not a big deal.

 

[CobraIV]

HIPPA isn't real, HIPAA is.

Also, I see no reason for you to deny a perfectly legitimate request made by someone who in all likelihood who just wants to be a better EMT.

I'm a basic and am required to learn basic interpretation. Should I not have access to my own patient's EKGs?

excuse my french

 

[jaksasquatch]

EMT's are able to do 12 leads where I'm from. I don't see anything wrong with it.

 

[medicdan]

EMT's are able to do 12 leads where I'm from. I don't see anything wrong with it.

I don't think the issue is whether EMTs can obtain 12 leads, but the interpretation.

 

[VFlutter]

I don't think the issue is whether EMTs can obtain 12 leads, but the interpretation.

Exactly. Our techs, non-certified with a few weeks orientation, obtain EKGs with no problem.

 

[jaksasquatch]

I don't think the issue is whether EMTs can obtain 12 leads, but the interpretation]

True I've seen a few that really desire to be the best medic print out a strip and read it. HoweverI've never seen one ask for a copy. Still it doesn't violate HIPAA so it should be alright. I would wan't to be safe and have the personal info blotted out though.

 

[Clipper1]

It is still their patient so the HIPAA laws do not apply here. Many companies have a follow up with patients so the crews can find out what was going on and what the outcome was.

Actually this is a direct violation of HIPAA, state and hospital policies.

The ECG was done on the hospital machine and contained patient information. Therefore it is part of the hospital chart. It was not generated by the EMTs.

If a student wants a copy, all patient identifying information must be removed and there must be a contract identifying the student and the school's association with the hospital.

For follow up info this should be done through an liaison agreement. There have been situations where the "off the side courtesy" has come back to haunt hospital employees. Often this happens when some in EMS abuse the privilege by trying to learn details about a patient which actually was not theirs but the person was a friend of a friend, a celebrity or a news worthy trauma. All it takes is someone saying they got the info from ER Tech Joe or Joe RN, a "reliable" source while discussing the patient at the station or in the restaurant for some deep trouble for the hospital employee to happen. The EMT or Paramedic will be clear since it is the hospital employee who should have known better.

This is all basic stuff which should have been stressed in the hospital orientation regarding privacy and restressed frequently in privacy notices. Prehospital providers do not get as much training on HIPAA which would account for the attitudes encountered when you try to explain why you can not just hand out patient records.

 

[DesertMedic66]

Actually this is a direct violation of HIPAA, state and hospital policies.

The ECG was done on the hospital machine and contained patient information. Therefore it is part of the hospital chart. It was not generated by the EMTs.

If a student wants a copy, all patient identifying information must be removed and there must be a contract identifying the student and the school's association with the hospital.

For follow up info this should be done through an liaison agreement. There have been situations where the "off the side courtesy" has come back to haunt hospital employees. Often this happens when some in EMS abuse the privilege by trying to learn details about a patient which actually was not theirs but the person was a friend of a friend, a celebrity or a news worthy trauma. All it takes is someone saying they got the info from ER Tech Joe or Joe RN, a "reliable" source while discussing the patient at the station or in the restaurant for some deep trouble for the hospital employee to happen. The EMT or Paramedic will be clear since it is the hospital employee who should have known better.

This is all basic stuff which should have been stressed in the hospital orientation regarding privacy and restressed frequently in privacy notices. Prehospital providers do not get as much training on HIPAA which would account for the attitudes encountered when you try to explain why you can not just hand out patient records.

I wouldn't say its basic stuff. Many providers in the field setting and in the hospital setting feel that it doesn't not violate HIPAA. Just to be sure I looked at the law again and found nothing that says it can or can't be done.

Also in my first post you will see that I stated you can/should black out all patient identifiers.

 

[Clipper1]

I wouldn't say its basic stuff. Many providers in the field setting and in the hospital setting feel that it doesn't not violate HIPAA. Just to be sure I looked at the law again and found nothing that says it can or can't be done.

Also in my first post you will see that I stated you can/should black out all patient identifiers.

For a hospital employee in California to be okay with this is disturbing especially since California privacy laws make HIPAA look tame. There have been enough examples of violations sent out to all hospitals in California which should have been mandatory reading for all.

The law specifically prohibits an individual or entity that receives medical information based on a patient authorization from further disclosing the medical information without a new authorization.

The above is straight from California and HIPAA makes a similar statement. If you want the records for your own purpose, you must have authorization. Your care of that patient is done. The ECG was done after arrival and is no longer pertinent to your treatment of this patient since you are no longer treating them. Therefore you do not need your own personal copy. But, you can discuss it while still in the hospital and the patient is still in the ER with other direct care givers.


I can also point out a few more things with your earlier post.

It is still their patient so the HIPAA laws do not apply here. Many companies have a follow up with patients so the crews can find out what was going on and what the outcome was.

Just because an EMT isn't in medic school doesn't mean they aren't trying to learn about EKGs. Heck I'm an EMT and if there is an interesting cardiac patient I will ask nicely for a copy of the 12-lead for my own interest, never have I been denied.

There is a very simple fix to take off patient info. After you make a copy, use a sharpie to cover the info you don't want them to have.

Since that was their patient in the first place, they already have the patients social number and medical info

First, you have now violated the trust of the hospital employee who probably was "doing you a favor" by announcing what they did on a very public forum where you have put a lot of information to make identifying you fairly easy. This is exactly what I meant in my earlier post about Joe RN told me or gave me the info. Your open comments about people giving you part of the patient's chart could put those at the hospitals you frequent under scrutiny.

The next point is that it "WAS" their patient as in past tense. The ECG was done in the hospital and is now part of the patient's chart in the hospital. If you want to discuss something about the patient and what is in the chart, you can probably do so while still in the hospital but just having the patient earlier does not give you the authority to take copies of the patient's hospital chart with you. Even the patient has to sign a form to take copies of their chart. Even hospital personnel who have been direct care providers in the ER will not be allowed access to the patient's chart once report is given to the next care giver.

The last part about already having access to the patient's info and social security number is why certain privacy rules had to be put into place. You should never use this information to access the patient's chart for your own gain and all copies of this information should be handed over to the appropriate people or shredded.

I suggest you read HIPAA and California law again. I also suggest that if someone does give you something as a favor which could be seen as a violation, don't tell everyone on a public forum.

 

[jrm818]

Dear Clipper,

Please define "protected health information," according to the federal government (OP is not in california). Assume that the tech blacked out all demographic info from the EKG..

Thanks