Unless our transport time is less than 5 minutes QA gets all over us if we don't get at least 2 sets of vitals. Also if the reading the monitor gets is always recorded in my report, if it's way off of my manual readings I fill out a faulty equipment report and in my report I document the report number and any additional follow up done. I like to leave a mile long paper trail of anything that inhibits patient care and when it makes it's way into a PCR things tend to get fixed quicker than otherwise. Seems they're afraid of something going to court and having several documented areas that equipment was faulty and finding they didn't correct it.
Let's Take vitals!
- Thread starter WuLabsWuTecH
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Actually, I dont work with a medic.
Was that your attempt at educating me? Thanks for the in depth description of the disease process.
I think I'll be o.k.
WuLabsWuTecH
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You guys require vitals every 5 minutes even on stable patients? We were taught 15 and that's usually what we go with on stable patients. And good for you in documenting faulty equipment as a barrier to patient care. My old private company was very good about fixing things so I never had the problem. Currently the FD i'm on checks things very regularly and we have spares of almost everything so if something is bad we switch it out right away and it gets fixed right away. (Yes, for those of you who are wondering we carry two monitors on the rig. Excessive? Maybe, but they also serve as our defibrillators and when you're defibing someone is not the time you want to figure out that you've run your monitor batt pretty dry and you'll either need to change batteries which takes time, or you'll need to do without, which is bad for the patient. It doesn't take up much space and its out of the way with our MCI stuff. Ok, end preempting comments about having two of everything)
Well I hope you mean that you'll be ok b/c you're the ranking guy on the rig and you make your partner take vitals. Because if not, one of these days one of the members in the group you describe as "the majority of your patients" will keel over and you will have no idea how to explain what just happened! At best, that can turn into a red faced moment, at worst... well...
I hope you are being facetious here (its hard to tell via internet) and if you are this does not apply to you but I do want to put it out there for others reading this whi might be thinking vitals aren't worth taking. Because it's a very bad mentality to get in that "I'm too good to take vitals" or "Taking vitals is not important." Is your JOB to do so. Now I know medics that won't do it if basics are around but they still know vitals are important and they need to get someone to get them. Even if you are the ranking member on the rig, you need to practice to keep up your skills. There might be a double critical victim MVA that you respond to. Are we going to wait 15 minutes for the other rig to show up, or are we going to split these patients among us. Obviously the latter, which means, guess what! It's your turn to take vitals on your own guy!
I routinely don't work in EMS or take vitals for 3-4 months at a time due to school. That first shift back is a tough one. I still remember how to do what in a given situation, but taking vitals can take a lot more time than it usually does.
Did I say vitals werent important?
By the way pink, warm and dry are vital signs.
WuLabsWuTecH
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What I was saying was that the quantitative vital signs are just as important if not more important than the qualitative ones.
Please do tell me that SOMEONE on the rig gets those?
Hockey
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I had a student with me and he swore he was the next best thing to god. Well we had a DOA and he walked in with a BP cuff and asked what can he do. Partner who is a medic, asked well what would his BP be (Kind of sarcastically and theres more to it so don't freak)? He said "Oh, let me check". Put the BP cuff on and thats when we had to interrupt him and give him a lesson on what happens when you die.
SUPPOSEDLY he did this once before and kept saying "I can't hear anything" with another crew but who knows
SUPPOSEDLY he did this once before and kept saying "I can't hear anything" with another crew but who knows
Yes we obtain vitals, including the ones I mentioned.
Sasha
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But shouldn't be the only vital signs you take which was stated in your previous post.
medic417
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Not according to your earlier post I replied to. So which post is a lie? This one or the the other one?
Yes skin condition is part of a proper exam but it does not replace the BP's pulse, lung/heart sounds, etc. You said all you do is skin condition on most patients as such you fail either in the field or as a liar on the internet.
Every patient that initiates the 911 system needs a complete set of vital signs? State why please?
We allow people to sit in ER waiting rooms for 8 hours, but because they dialed 911 they need a blood pressure every five minutes?
Well you told me didnt you.
A complete set of vital signs is taken when its warranted.
Sasha
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Uh excuse me?
When are they not warranted? Stop. Being lazy and do your job. You are an emt, what else is there for you to do? No wonder emts get no respect with posts like this
When are they not warranted? Stop. Being lazy and do your job. You are an emt, what else is there for you to do? No wonder emts get no respect with posts like this
yes everyone deserves a complete set of vitals. Every 5 minutes? no... But why? Because they really may be an underlying cause of problems which may not be symptomatic yet. I had a patient the other day who has an hx of HTN and is morbidly obese. His BP was in the 80/xx's but was completely asymptomatic. If I only looked at him in terms of how he looked, skin signs. There's a good possibility something would have happened to him.
And honestly? Really! It takes less than two minutes to get a full set of vitals. I can understand fluffing things like Resp's for ER Discharge IFT's. But fluffing anything on 911 is unacceptable.
WuLabsWuTecH
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State why please? I'm starting to think you're not being sarcastic. A stable patient gets vitals (a full set, including the ones that have numbers and that you may need to do math for) upon arrival to establish baseline. Then every 15 minutes. The 5 minute vitals are for unstable patients.
And people who sit in ER waiting rooms have been TRIAGED by a nurse. Guess what? The triage nurses take vitals, including the fancy ones with numbers!
WuLabsWuTecH
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Exodus, I have to disagree with you here. Even ER discharges and IFTs need a baseline vital. I have never not taken baseline after my first week on the job when my partner was in the back and I was driving IFT to dialysis. The PT went unconscious on him and he told me to divert code to the nearest ER. He started freaking out b/c he got abnormally high BP and wasn't sure if that was normal for the patient or if it was something wrong and had to look through charts to figure it out.
I get baseline with everyone. I said the only vital I can see fluffing being acceptable is the RR with a stable patient on something like an ER discharge.
When are they not warranted? I repeat JUST BECAUSE SOMEONES INITIATES 911 DOES NOT MAKE THEM SICK.
Thats why EMTs don't get any respect? Who doesn't get any respect? EMS as a whole does not get any respect because we have providers out there who think its ok to tape ASA to someones forehead and so on, I dont realy need to go there you get the picture.
Lazy? Yes I'm lazy cause I can determine who needs a complete set of vitals signs and who doesn't?
Wululabswuthech
Again you are assuming that every patient I come in contact with is sick. I am more then competent enough to distinguish who needs a blood pressure.
Exodus
You have a problem with me not taking a blood pressure on someone who isn't sick but think its completely OK to "fluff vitals" or better stated falsify a medical record. I don't fluff anything, if I don't take a pressure one isn't written.
Both of your examples are ridiculous, dialysis patients are sick and so are severely obese patients.
As far as the ER, them recording vital signs is a liability issue, so when you keel over and die after waiting eight hours for treatment, they can say well we took his vital and he was stable.
Sasha
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And you determine if they are sick by doing an assesment. An assesment includes a full set of vitals! Blood pressure, pulse, temp, the works!
Sasha
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Anyway what? What else do you have to do back there? Nothing! You are an EMT, your whole job is to take vitals and shuttle them to the ER. Don't get lazy and possibly hurt your patients. If you can't bring yourself to take five minutes out of your hospital ride to grab a blood pressure, lung sounds, pulse rate, temp, BGL (and that's if you are slow.) then you should reconsider your position. You don't run a wheel chair van, you run on an ambulance where the patients expect care. Care does not include you sitting on your butt not doing anything because you believe it's a waste of time.
Only a foolish person belives that they can look at a patient and tell that they are sick.