I don't believe this - how stuipd can one be ?

[Shishkabob]

No, screw that. If you have a reasonable expectation that no one from the public will hear your comments, there is NOTHING wrong with voicing them. If someone happens to hear them, oh well.

Crass, blunt, 'immature', whatever, it is not the publics place to tell us what we say out of expected earshot is or is not right, professional, accepted, whatever. Until they do this job, they have no room to stand.

No civilian has the right to tell me that my coping mechanism is wrong. Or that I wasn't urgent enough to someone that was obviously clearly dead and had no idea what may or may not have happened BEFORE the camera turned on.


Sorry, I highly doubt the firefighter started taping BEFORE they checked out to make sure they had no viable patient to work on.

 

[skivail]

Am I the only one tired of civilians complaining about what we say on / after a call when we think no one else will hear it?

Civilians need to quit thinking they know what goes on at a scene and what we do on a scene, as it just shows how little they truly know.

You took the words out of my mouth.

 

[Aidey]

Never said that it was a HIPAA violation....just that it may open them up for civil liability.....

What civil liability is that? They may try for a suit, but they aren't likely to win unless they can prove that it was done with malicious intent.

Sorry, but if the Westboro Baptist Church can get away with the stuff they do, I'm pretty sure there isn't much that can be done about a legally taken photo.

 

[jjesusfreak01]

Personally, I think FFs should be covered by HIPAA as they are medical caregivers, but I guess the law is what it is. I do remember when the Nikki Catsouras photos came out on 4chan. Definitely good photos for driving classes, but I digress.

 

[CAOX3]

No, screw that. If you have a reasonable expectation that no one from the public will hear your comments, there is NOTHING wrong with voicing them. If someone happens to hear them, oh well.

Crass, blunt, 'immature', whatever, it is not the publics place to tell us what we say out of expected earshot is or is not right, professional, accepted, whatever. Until they do this job, they have no room to stand.

No civilian has the right to tell me that my coping mechanism is wrong. Or that I wasn't urgent enough to someone that was obviously clearly dead and had no idea what may or may not have happened BEFORE the camera turned on.


Sorry, I highly doubt the firefighter started taping BEFORE they checked out to make sure they had no viable patient to work on.

Coping mechanism?

Your smarter then that, not everybody copes the same way and crude behavior may offend some including other professionals that may be on scene. Sure I agree sometimes things are humorous and all you can do is laugh at times, be sure your audience is of the same belief.

Theres also a place for it. I believe the scene of a fatal accident isn't somewhere I would feel comfortable with my crew cracking jokes. God knows who is in the crowd, it very well could be a member of the patients family. If one of my crew couldn't keep a mature and professional attitude they can go sit in the truck until I have time to deal with them.

Sorry we got off topic here. Videos are out until the bodies have been respectfully covered or removed. If you want to snap pictures and roll video get a job with accident reconstruction.

My opinion.

 

[emtJR86]

Any law passed is going to exempt pictures for things like training or education. Just like training/education is an exemption for HIPAA.

...I'm wondering about this one. We discussed this last night in class and we were told that as long as there were no identifiable marks on the body, or landmarks, that pictures for ed/training were okay, but otherwise, may be an issue. ie: A guy with a red beard and Dianne Summers tattoo on his chest, may be very easy to identify....

Just for my information, I guess I'd like to know if there's any law supporting your stance that I may take back to my instructor to question this. Thanks in advance.

 

[akflightmedic]

Personally, I think FFs should be covered by HIPAA as they are medical caregivers, but I guess the law is what it is. I do remember when the Nikki Catsouras photos came out on 4chan. Definitely good photos for driving classes, but I digress.

Not every medical caregiver is covered by HIPAA either....

If an agency does not bill insurance for services rendered, then HIPAA is not a law to be concerned with.

 

[JPINFV]

...I'm wondering about this one. We discussed this last night in class and we were told that as long as there were no identifiable marks on the body, or landmarks, that pictures for ed/training were okay, but otherwise, may be an issue. ie: A guy with a red beard and Dianne Summers tattoo on his chest, may be very easy to identify....

Just for my information, I guess I'd like to know if there's any law supporting your stance that I may take back to my instructor to question this. Thanks in advance.

http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/index.html

I would argue that initial release to a QA or education department (albeit censored prior to release to students) would fall under the health care operations exemption. Of course if someone wants to be really careful, you could always get a wavier signed.

 

[eynonqrs]

There are questions being raised about HIPPA being only for only transport vehicles. Well, what about services that run QRS, or Rescue regardless if fire or EMS based who bill for rescue services ? It's obvious that they need demographics about the pt's involved. I know with QA/QI sessions where I am employed, the pt's demograhics are elimated, and only generic info, i.e. age/sex of pt and assesments and treatments are gone over. This fire dept that was at this accident may or may not bill for services. Regardless, any first responder, from police to fire to qrs to rescue services should be bound to the privacy act just like everyone else. That is just my tow cents.

 

[JPINFV]

HIPAA, in terms of providers, only applies to "covered entities." To be a covered entity, you must provide care AND bill for services AND bill electronically (and this does not mean using ePCRs). If you do not do ALL of those things, you are not a covered entity and not bound to HIPAA. Now not being bound to HIPAA and not being bound to state or local laws are two different things. So, if the QRS doesn't bill, then they are not a covered entity. If a police officer provides care (which is common in areas where police cars are equipped with AEDs), then they are not bound by HIPAA since they don't bill for their response (police based EMS obviously being the exception).

Additionally, HIPAA doesn't mean you can't release anything at all without consent. One of the exemptions is for "treatment (which covers your hand off report), billing (so your billing people can read your PCRs without fear of HIPAA), and health care operations (which covers things like QA/QI)." No consent or wavier is needed for any of those things.

 

[citizensoldierny]

As for the tone of the Medics conversation would the family have felt better if the medics where screaming in a panic state and running around like chickens with their heads cut off? Based on the MOI described it sounds like they might have been able to observe signs of obvious death from outside vehicle. Or perhaps they had already done their assessment before the filming started.
As for the firefighter with the low impulse control adios. Your being stupid didn't just hurt you this time.

 

[Aidey]

As for the tone of the Medics conversation would the family have felt better if the medics where screaming in a panic state and running around like chickens with their heads cut off? Based on the MOI described it sounds like they might have been able to observe signs of obvious death from outside vehicle. Or perhaps they had already done their assessment before the filming started.
As for the firefighter with the low impulse control adios. Your being stupid didn't just hurt you this time.

From the 30 seconds of googling I did on the accident it sounds like that was the case. I think people have the idea that there is always something that can be done, even when the person is very obviously dead.

Something else interesting I found was that the person who sent the family the video was an ex-in law. So I'm gonna say the FF wasn't the only one with poor judgment.

 

[CAOX3]

I actually just saw an interview with the father on one of the news shows, the in law called the father and stated that there was a video going around of his daughters accident and the father asked him to send it to him.

From his tone I didn't get the feeling that he was looking for any law suit just to assure that this never happened again and to realize that patients have families and we should be treating them with some dignity which isn't much to ask.

As if we should have to explain to a provider that maybe taking pictures or video of an accident victim may not be a good idea.

 

[abckidsmom]

I actually just saw an interview with the father on one of the news shows, the in law called the father and stated that there was a video going around of his daughters accident and the father asked him to send it to him.

From his tone I didn't get the feeling that he was looking for any law suit just to assure that this never happened again and to realize that patients have families and we should be treating them with some dignity which isn't much to ask.

As if we should have to explain to a provider that maybe taking pictures or video of an accident victim may not be a good idea.

I take frequently take pictures on patients with injuries from MVCs and attach them to my PCR electronically. They are usually not identifying in any way, and clearly show the damage to the vehicle and how it relates to the patient's position in the car.

The difference here is that I share the image only with people who have a right to that patient's PHI.

I would like to use the images in my teaching, but I feel a little skeevy about that, and don't. One of the best sets of pictures I have is of an accident of a co-worker's dad. That helps keep it in perspective for me.

 

[Aidey]

The ER docs here really like it if we have pictures for them, especially on accidents where the pt isn't able to tell us what happened, whether it's because of injury, intoxication, age, or whatever. I know someone who used to work in Seattle, and at Harborview there is a TV with a SD card reader attached in the ER, so they can stick the card for the camera in and display the pictures on the big screen.

One of the very very scary things this family wants to happen is a law banning EMS personnel from having a cell phone while on a call. They argue that the radio can do everything.

I can't find out what a drug is over the radio, I can't talk to the doc at the ER over the radio, I can't give dispatch certain information over the radio, and I can't talk about problems with my supervisor over the radio. All things that I or my partner have used a cell phone on scene for, on more than one occasion.

"Dispatch Acme unit 100"
"Dispatch, go ahead"
"Yeah, we need the supervisor to meet us at the hospital, my partner had an exposure".

Sorry. No.

Or better yet:

"Dispatch, Acme unit 100"
"Dispatch, go ahead"
"Yeah, we need the supervisor here becuase the fire fighter is violating the pts DNR, and he and the patients son are yelling at each other and my partner just had to step in and tell the firefighter if he didn't stop we were going to have to contact PD".

Again, no.

I've had 10 minute conversations with docs about complicated cases, not really something that works over the radio.

The only way that something like that would fly with the EMS community is if also included in the law was a provision that employers have to provide each crew with a camera-less cellphone. If it isn't in the law, employers won't do it, and people will continue to carry their personal phones.

 

[akflightmedic]

Wow! Who knew a cell was so vital...how the heck did we ever survive pre-cellphone days??? <------SARCASM

I am just baffled. <------More Sarcasm

FYI, in my area, the trauma team (Level I center) stopped us from bringing pictures to them because they are useless. We stopped picture delivery in 99 or 2000...dont remember which.

Pictures cause you to be tunnel vision, make preconceived and possibly in accurate diagnosis instead of relying on the good old fashioned hands on approach of learning as you assess.

With today's car designs, pictures are irrelevant. A 20 mph crash with minimal damage could produce more bodily harm than a 70 mph freeway rollover. I have had cervical fx in the first case and a walk away shaken in the latter...it happens and in neither situation would you guess which patient came from which vehicle based on pictures.

 

[abckidsmom]

The ER docs here really like it if we have pictures for them, especially on accidents where the pt isn't able to tell us what happened, whether it's because of injury, intoxication, age, or whatever. I know someone who used to work in Seattle, and at Harborview there is a TV with a SD card reader attached in the ER, so they can stick the card for the camera in and display the pictures on the big screen.

One of the very very scary things this family wants to happen is a law banning EMS personnel from having a cell phone while on a call. They argue that the radio can do everything.

I can't find out what a drug is over the radio, I can't talk to the doc at the ER over the radio, I can't give dispatch certain information over the radio, and I can't talk about problems with my supervisor over the radio. All things that I or my partner have used a cell phone on scene for, on more than one occasion.

"Dispatch Acme unit 100"
"Dispatch, go ahead"
"Yeah, we need the supervisor to meet us at the hospital, my partner had an exposure".

Sorry. No.

Or better yet:

"Dispatch, Acme unit 100"
"Dispatch, go ahead"
"Yeah, we need the supervisor here becuase the fire fighter is violating the pts DNR, and he and the patients son are yelling at each other and my partner just had to step in and tell the firefighter if he didn't stop we were going to have to contact PD".

Again, no.

I've had 10 minute conversations with docs about complicated cases, not really something that works over the radio.

The only way that something like that would fly with the EMS community is if also included in the law was a provision that employers have to provide each crew with a camera-less cellphone. If it isn't in the law, employers won't do it, and people will continue to carry their personal phones.

A nightmare, because many systems rely on the phones they have in place. We receive our dispatch info by text message.

Not having cell phones is ridiculous, but maybe I'm just phone-addicted.

 

[JPINFV]

Wow! Who knew a cell was so vital...how the heck did we ever survive pre-cellphone days??? <------SARCASM

I am just baffled. <------More Sarcasm

A radio? How did the police survive before radios? Cellphones are extremely useful, the question, unfortunately, is, "Can you trust all of your field survivors with a cell phone?"

With today's car designs, pictures are irrelevant. A 20 mph crash with minimal damage could produce more bodily harm than a 70 mph freeway rollover. I have had cervical fx in the first case and a walk away shaken in the latter...it happens and in neither situation would you guess which patient came from which vehicle based on pictures.

Not being a racing fan, one thing that has always stuck in my mind is the difference the vehicle damage in the crash that killed Dale Earnhardt and the pictures of the crashes that normally makes the nightly highlight reel where the driver walks away from a shredded car.

 

[Shishkabob]

I use my cell fairly often to call med control / receiving physician.


Sure, we have Nextels at my company but alas, expecting every Paramedic unit to have a Nextel is obviously too much for the higher-ups...

 

[Aidey]

Not being a racing fan, one thing that has always stuck in my mind is the difference the vehicle damage in the crash that killed Dale Earnhardt and the pictures of the crashes that normally makes the nightly highlight reel where the driver walks away from a shredded car.

I know nothing about racing. Was there a lot of damage or was it seemingly minor?