Interfacility Transport

[Sasha]

What is there to violate HIPPA by looking at the chart? As the person assuming care for the pt you are entitled just as much as the pts nurse in the hospital to look at that chart and get a complete history on your pt before you recieve care

On IFT I never take a patient before looking at the chart, especially if they're demented. Some nurses are reluctant to give citing HIPAA, but once you remind them that you're an EMT and involved in the patient's care until they reach the next facility ( NICELY and politely.) they USUALLY are compliant.

And yes, I assess and talk to my patient about their condition, but I'd like to read up on why they were there and what happened incase the recieving facility didn't get a report.

 

[djmedic913]

What is there to violate HIPPA by looking at the chart? As the person assuming care for the pt you are entitled just as much as the pts nurse in the hospital to look at that chart and get a complete history on your pt before you recieve care

I know....

 

[VentMedic]

Hospitals have to be protective of this information and suspicious of people. We get well over 100 ambulances per day and that may just be in the ED. The hospitals get anyone from taxi drivers, van drivers to family members wanting access to a chart. You would also be surprised at how many family members will dress up in their hospital or ambulance uniform from another employer and pretend they work at a facility to gain access to information. What they don't realize they just have to ask the patient to grant permission to see the chart and most of the information is available to them.

 

[JPINFV]

On IFT I never take a patient before looking at the chart, especially if they're demented. Some nurses are reluctant to give citing HIPAA, but once you remind them that you're an EMT and involved in the patient's care until they reach the next facility ( NICELY and politely.) they USUALLY are compliant.

What I love is when they give the chart in a sealed envelope with a face sheet attached. This becomes a "nod my head and say yes" with the chart making it to the facility in the ambulance company's envelope rather than the hospital's envelope.

 

[TransportJockey]

What I love is when they give the chart in a sealed envelope with a face sheet attached. This becomes a "nod my head and say yes" with the chart making it to the facility in the ambulance company's envelope rather than the hospital's envelope.

I've actually opened it up right then and there before we move the pt to my gurney. It does tend to annoy some staff

 

[Sasha]

Hospitals have to be protective of this information and suspicious of people. We get well over 100 ambulances per day and that may just be in the ED. The hospitals get anyone from taxi drivers, van drivers to family members wanting access to a chart. You would also be surprised at how many family members will dress up in their hospital or ambulance uniform from another employer and pretend they work at a facility to gain access to information. What they don't realize they just have to ask the patient to grant permission to see the chart and most of the information is available to them.

I understand but when you have been on that floor four times that day and you're wearing an EMT uniform, with photo ID tag, one patch with the company name, one state EMT/Medic patch, your partner is standing there next to you with the stretcher against the wall I'm kind of hard pressed to believe that they think you are a family member, taxi or van drivers. The services that run vans here work solo and wear polos and push wheel chairs.

 

[Tincanfireman]

Just my .02 to add:

I did IFT work for nearly two years after I recerted for my -B the last time, then moved over to 911 after getting my -I cert back in '07. There is not one shift that goes into the books where I do not use something I learned in my IFT days to provide better care for my 911 patients. Doing IFT's gives you the opportunity to sharpen your diagnostic skills, along with seeing the progression of a condition, disease, or illness. People need to remember that patient care is a continuum, and both 911 and IFT is a part of that continuum. I know some 911 people who are excellent providers, but won't do IFT because they don't want to be cooped up in the back of the unit with the same patient for several hours. I also know some superb (competition award-winning) IFT folks who have no interest in 911. My advice is do what you want to do, and be the best provider you can be. All the patient (and their family) cares about is that they receive the best possible care, and it doesn't matter a hoot to them what the paint job on the outside of the box looks like.

 

[djmedic913]

All the patient (and their family) cares about is that they receive the best possible care, and it doesn't matter a hoot to them what the paint job on the outside of the box looks like.

Actually, the family doesn't even truly care that they get the best, but the perception of care.

They say you give bad care but good customer service and treat the Pt and family with dignity and politeness and it will be excuse...
But if you give the best care ever from anyone but are short, crass and demeaning, the family will complain and sue

 

[VentMedic]

I understand but when you have been on that floor four times that day and you're wearing an EMT uniform, with photo ID tag, one patch with the company name, one state EMT/Medic patch, your partner is standing there next to you with the stretcher against the wall I'm kind of hard pressed to believe that they think you are a family member, taxi or van drivers. The services that run vans here work solo and wear polos and push wheel chairs.

Ever hear of blending? Some of the EMT(P)s do have family members in the hospital and are occasionally asked to check on them or even neighbors. We have so many different transport companies as well as FFs walking around the hospital and students in various uniforms, it is difficult to know who is who sometimes. We also get transports from other parts of FL and other states or even other countries.

We do have to keep an eye on the name tags since some do wear tags from other employers to look official but keep them turned away from view. Usually our security will catch those.

The van drivers for various appointments from the clinics to dialysis come for the condo communities to commercial companies. We may get 200 - 300 of these transports per day easily if not many more. Again, it is hard to keep track of all the polos or uniforms from everyone. And yes, we get a large number of taxis dropping off and picking up.

 

[Shishkabob]

I've actually opened it up right then and there before we move the pt to my gurney. It does tend to annoy some staff

I've had a doctor almost get in an argument with me and my partner because he refused to sign the PCS form and put a reason as to why the pt needed to be transferred, because he didn't think we needed to know that info, as we "weren't privy" to it.

 

[Sasha]

Ever hear of blending? Some of the EMT(P)s do have family members in the hospital and are occasionally asked to check on them or even neighbors. We have so many different transport companies as well as FFs walking around the hospital and students in various uniforms, it is difficult to know who is who sometimes. We also get transports from other parts of FL and other states or even other countries.

We do have to keep an eye on the name tags since some do wear tags from other employers to look official but keep them turned away from view. Usually our security will catch those.

The van drivers for various appointments from the clinics to dialysis come for the condo communities to commercial companies. We may get 200 - 300 of these transports per day easily if not many more. Again, it is hard to keep track of all the polos or uniforms from everyone. And yes, we get a large number of taxis dropping off and picking up.

Perhaps where you work, but I was referring to my own experience where it's not nearly as busy as you describe, and there are three IFT companies. One hospital based, and two privates. The unifors from those companies are very similar except for shirt color. The companies are small and employees know many of the nurses on common pick up floors by name, and nurses know many of the employees by name.

Truly the ones who give the most trouble are the people who aren't even nurses, I don't know who they are or what they are but they sit and answer phones and will snatch a chart from you in a heart beat and you have to go hunt the nurse down again to get it back.

I'm not bashing nurses by any means who are trying to protect their patients privacy. Good for them. But once the emt calmly and respectfully explains who they are and what they need, that should be the end of it. They ARE involved with the care of the patient and should see the chart, especially if the patient is demented and can't answer for themselves.

 

[djmedic913]

I've had a doctor almost get in an argument with me and my partner because he refused to sign the PCS form and put a reason as to why the pt needed to be transferred, because he didn't think we needed to know that info, as we "weren't privy" to it.

Our company policy is, if the PCS is not filled out appropriately and completely then we don't take the Pt.

 

[marineman]

Challenge flag is out.
The psych hold that should be walked to the truck, who is cooperative, but going through a rough time, and merely choose the "wrong" ER to go to does not need a a head to toe physical, and vitals q15 min.
A comfy seat, and the reassurance that you are there to help, or talk to if they so choose.

Gather the hx from RN and pt to see what lead to the event, and to see if you might need to take extra precautions (flight risk, violent, triggers, etc)

The little old lady who FDGB, has a brain bleed, is on Coumadin, has a fx hip, and AMS DOES get the full ride. I would be the one doing the initial assessment, making sure shes properly C-Spined, on the monitor, drips switched to our pump, and then my MICN would assume care as soon as he/she is done getting report.

Granted, those are the extremes that I mentioned, just to play devils advocate, but you get the point.

I didn't say that every patient needed to get a full head to toe, I said every patient should get the absolute best possible care you can provide. There are some patients like you mentioned that will be better off if you leave them alone for the most part. Using your example that doesn't excuse you from checking the psych patient for anything treatable that could be causing the psych issue but if they're already having psych issues and it makes them worse when you keep checking vitals and such then yes by all means watch them for any obvious signs of deterioration but don't keep coming at them with the BP cuff and stethoscope just for practice. If you leave them alone because it's the best thing for them aren't you still providing the best care possible within your scope?

 

[Guardian]

From the fingers of Miss VentMedic

who is miss ventmedic? is our ventmedic a woman or is there another ventmedic?

 

[JPINFV]

There can be only 1 Ventmedic...

 

[Guardian]

We also now have another fine Paramedic show, The Listener, that has made the statement about IFTs are for those who fail their cert evaluations and must become just taxi drivers.

I'll start another thread about the show.

Yea, they need a good technical advisor. I think they're mistaking "IFTs" for RRTs.


In reality, they're more right than wrong. Most "inter facility" (nursing home transfers for example) transports that are done throughout the country don't even remotely resemble an emergency. Yet, most of the time they are staffed with emts and have trucks with emergency equipment on them. Doesn't make much sense to me. Who are they trying to fool? The patient, the insurance company, the public, or themselves?

 

[VentMedic]

who is miss ventmedic? is our ventmedic a woman or is there another ventmedic?

After 2 years of debating each other you haven't figured that out? This could be the reason, other than just my education and experience, why I won most of our debates.

 

[JPINFV]

Oh, now that's a low blow. At least the good driving gene is on the Y chromosome.

 

[Sasha]

After 2 years of debating each other you haven't figured that out? This could be the reason, other than just my education and experience, why I won most of our debates.

You know, after you posted on the bra thread I thought most people would get that you're indeed a female...

 

[TransportJockey]

You know, after you posted on the bra thread I thought most people would get that you're indeed a female...

We had some males posting on it too... not that I went in there or anything