Med control

[rhan101277]

If you are needing some assistance from med control in nailing down exactly what is going on with your patient, how do you handle it with your patient right there?

Obviously you can't leave them to discuss issues. Is there a best way to do this without making the patient be more anxious thinking that something is very wrong?

 

[Dominion]

If you are needing some assistance from med control in nailing down exactly what is going on with your patient, how do you handle it with your patient right there?

Obviously you can't leave them to discuss issues. Is there a best way to do this without making the patient be more anxious thinking that something is very wrong?

I think the closest I can think of to what your asking would be to call med control and say "I have this this this and this, we'll see you in 5, any orders?" I don't think I've ever heard a medic partner call in and ask the doc what they thought was wrong flat out like that. Maybe pride? Most of them if they had no idea; VOMIT. Then again I don't have much time on the streets compared to others around.

 

[robthe]

Based on a practioner’s scope of practice, it would be prudent to contact medical control when the interventions you are trained to perform could benefit the patient. Ie: beta blocker overdose and you don’t recall the doses for medications (and you don’t have a field guide available). To ask online medical direction to Dx your pt may not be the most appropriate choice – but to give them a “heads up” of their incoming pt including Hx and findings would be very appropriate.
Next – while your writing your report, why not wait in the ED and observe the assessments and Tx of the nurse / Dr. These are great teaching moments. After that is all said and done, research what you just encountered including reviewing your medical control guidelines. Too many times have I seen an EMR, EMT, or paramedic not learn anything about what they just had for a call.

 

[Akulahawk]

Another excellent time to call in to Base is get orders for a patient that isn't covered by any existing protocol, or you need to deviate from protocol for a specific patient.

For the OP: you can simply say that you need to make Base Hospital contact with every patient, and to let them know what's coming to them.

 

[Flight-LP]

If you are needing some assistance from med control in nailing down exactly what is going on with your patient, how do you handle it with your patient right there?

Obviously you can't leave them to discuss issues. Is there a best way to do this without making the patient be more anxious thinking that something is very wrong?

Do you really need to nail down the exact issue??? I really do not believe so.

Re-visit the basics.......

AIRWAY, BREATHING, CIRCULATION, DISABILITY (i.e. neuro), EXPOSE.

fix what you find with what you have. Then take them to the ER.

If in doubt, remember the KISS principle...................

You aren't going to know all in the field, nor are you expected to. The expectation of quality care is to deliver the patient to a higher and more definitive level of care in a reasonable amount of time; intervening with basic treatment as needed and as available.

If you are really stumped, then yes, call OMD. Although, personally I wouldn't recommend asking drug dosages for available treatment modalities. For one, the answer is in your protocol book, and two it does not instill a lot of confidence in the OMD. If orders are required, you may not get them, instead be told to just transport expeditiously................

 

[Jon]

When I've had to make a report or have a command consult and I didn't want the patient hearing, I've stepped away and left the patient with my partner... not perfect, but gives me a little privacy.

This is especially the case when I'm notifying the ED of a patient having an acute psychiatric crisis.

I've only seen a medic have the phone call you are asking about once - SVT that ended up being uncontrolled rapid A-fib. He was debating with the doc if he should lead off with cardizem or still give adenosine. He ended up with a compromise, 6mg of adenosine, slowed to obvious a-fib, and then cardizem. Pt. felt lots better afterwards.

 

[rhan101277]

Do you really need to nail down the exact issue??? I really do not believe so.

Re-visit the basics.......

AIRWAY, BREATHING, CIRCULATION, DISABILITY (i.e. neuro), EXPOSE.

fix what you find with what you have. Then take them to the ER.

If in doubt, remember the KISS principle...................

You aren't going to know all in the field, nor are you expected to. The expectation of quality care is to deliver the patient to a higher and more definitive level of care in a reasonable amount of time; intervening with basic treatment as needed and as available.

If you are really stumped, then yes, call OMD. Although, personally I wouldn't recommend asking drug dosages for available treatment modalities. For one, the answer is in your protocol book, and two it does not instill a lot of confidence in the OMD. If orders are required, you may not get them, instead be told to just transport expeditiously................

Thanks for the replies thus far. This is a hypothetical question by the way.

I wish or med control physician was more involved. Actually meeting everyone or having some quarterly meeting. Instead of just signing a paper.

Anyhow starting patient assessment in class tomorrow. Last test in fundamentals to.