Need some tips!

[Shishkabob]

Any one ever hear of subtle changes that could indicate something major about to happen? While distracted oops missed it, bye bye Mrs IFT.

I'm sorry, my ~200 hours first aid course didn't teach me to notice those subtle changes in IFT pts.


They tend to save those kinds of pts for critical care transports.

 

[JPINFV]

I guess every healthcare facility that doesn't do 1:1 nursing is neglecting their patients as well.

 

[Sasha]

It happens. Your lack of attention may be why this patient does not get returned to ER for needed treatment and instead dies at home or in the nursing home. Patients can change quickly or show briefly signs of an impending event yet you missed while writing. Dissappointed in our future doctor I am.

Then why don't they have someone to sit and stare at them in the nursing home?

 

[medic417]

So how do medics treat their patients? Don't they have to look away to draw up meds, get the monitor ready, prepare to cannulate?

Those are brief seconds. Writing a narrative is minutes. Big difference.

 

[exodus]

They tend to save those kinds of pts for critical care transports.

I did a CCT today

 

[medic417]

Then why don't they have someone to sit and stare at them in the nursing home?

Thats not their job. We have one patient and patient care is supposed to be our focus. Write the report when you actually know how the transport ends.

 

[Shishkabob]

Thats not their job. We have one patient and patient care is supposed to be our focus. Write the report when you actually know how the transport ends.

My report that I write inside of a transport goes up to the point that I load them in the truck. I don't write anything past that until they are in their own bed.

 

[Sasha]

Thats not their job. We have one patient and patient care is supposed to be our focus. Write the report when you actually know how the transport ends.

So their focus is not patient care as well?

A report is a few minutes, but as I said, talk to them while you're writing, if they talk back they have an airway.

I don't know about you, but staring at ME intently makes me feel uncomfortable. I wouldn't wanna do that to my patients.

 

[exodus]

Medic417. have you ever worked for a dedicated IFT company? If not. Please leave the conversation discussing reports on an IFT.

 

[Shishkabob]

I don't know about you, but staring at ME intently makes me feel uncomfortable.

 

[medic417]

I don't know about you, but staring at ME intently makes me feel uncomfortable. I wouldn't wanna do that to my patients.

So you feel uncomfortable with people looking you in the eye while talking to you? Might need to seek help for that.

 

[medic417]

Medic417. have you ever worked for a dedicated IFT company? If not. Please leave the conversation discussing reports on an IFT.

So you are saying you do not work on an ambulance? Normally IFT people say they do the same thing us 911 people do. Go figure different when convenient.:wacko:

 

[exodus]

So you are saying you do not work on an ambulance? Normally IFT people say they do the same thing us 911 people do. Go figure different when convenient.:wacko:

Because we still have to assess... What's the difference? We're not in an emergent state like a 911 medic is. Today we were dispatched to a private residence for a medical aid, where we basically took the role of 911, but on a bls call. That call, we didn't write the patient report without watching the pt. We had 2 in the back, one working on paper, and the other doing pt stuff.

 

[medic417]

Because we still have to assess... What's the difference? We're not in an emergent state like a 911 medic is. Today we were dispatched to a private residence for a medical aid, where we basically took the role of 911, but on a bls call. That call, we didn't write the patient report without watching the pt. We had 2 in the back, one working on paper, and the other doing pt stuff.

So why am I being excluded if patient care is patient care? I pointed out a flaw in methods described and apparently stepped on some toes. I will not apologize because the patients are more important than the toes stepped on. Just maybe my words will pop up in one of the IFT peoples minds and they will look up from their paper work and actually do something that benefits the patient.

 

[Sasha]

So why am I being excluded if patient care is patient care? I pointed out a flaw in methods described and apparently stepped on some toes. I will not apologize because the patients are more important than the toes stepped on. Just maybe my words will pop up in one of the IFT peoples minds and they will look up from their paper work and actually do something that benefits the patient.

Are you missing where we're all saying we look up and check on the patient? it's not as if we sit there and ignore the patient during transport. Can you not multi task?

At the BLS level there is very little that we can do to benefit the patient, BLS IFT patients have little that can be done for them to begin with, as they are STABLE when signed over.

You seem to forget you are not above being wrong and your words are not the gold standard.

 

[medicdan]

When I fill out my medical necessity forms for non-emergency or inter-facility transportation, the most often reasons are "monitoring due to high risk of fall", "non-self administered oxygen", "patient requires two operators and use of a stair chair to enter/exit building", etc.

These are not inherently medical reasons. When I meet the patient, I perform an assessment, and in consultation with the vitals I assess, I conclude that my patient is stable for transport (if they are not, I arrange for a higher level of care). Since the reasons why the require an ambulance are not medical in nature, more often mechanical, I am operating as a bed coach of sorts. The use of hte ambulance is not for the medical equipment, supplies or personnel, but the stretcher, stair chair and oxygen.

Since my patient is stable for transport, I maintain an ongoing assessment, and transport while completing my paperwork. If that means that I sit next to them, and have them in my peripheral vision, thats what happens.

 

[flhtci01]

I certainly do not spend the entire 45 minute ride to the hospital peering at my patient constantly.

Our IFTs to a Level 1 can be 1.5 hours or more. :sad: I usually jot down notes. If the pt is stable and would rather rest/sleep, I'll do the report on the laptop while monitoring the pt.

 

[Shishkabob]

Our IFTs to a Level 1 can be 1.5 hours or more. :sad: I usually jot down notes. If the pt is stable and would rather rest/sleep, I'll do the report on the laptop while monitoring the pt.

Lucky *blank* getting a laptop. I get a paper and a pen.

 

[BossyCow]

I pointed out a flaw in methods described and apparently stepped on some toes. I will not apologize because the patients are more important than the toes stepped on.

I think the issue has become a bit polarized. There is a lot of ground between ignoring a patient and hovering over them constantly for the entire transport. One is poor patient care and the other is a personality disorder.

I think most of us are somewhere in the middle. We are able to multi-task. We have many things to do while transporting. In my case, we have to call the ER and make a short report, giving pt information so they can pull the chart before we arrive at their doors with the pt. I can take my eyes off the patient while I get the IV set up. I can look away while I get a NRB to replace the NC that was already in place (or vice versa) Writing parts of the report can be done while watching the patient.

I think some of your posts made it seem that you felt any momentary discontinuation in eye contact with the patient was tanatamount to abandonment.

 

[Jon]

How to write in the back? Very carefully. Of course, my handwriting is so bad, it actually gets better when there is external motion

When I do IFT, I'll write up MUCH of the info as I get time - that means that the To/From areas and as much demographic info as I have goes on the form before we go onscene. If we have a minute while the staff is getting the Pt. ready, I'm filling out paperwork. During transport, I'll copy over PMH/Meds off of their paperwork (or GASP, ask the patient). If it is a longer run, I might start writing the narrative, but I don't finish it - I'll write my exam and initial stuff, then leave the narrative open-ended. If the transport goes normally, then all I need to do is write "Pt. transported on stretcher, secured with straps x2+Chest harness without incident. Vitals as noted above. On arrival at _____, Pt. placed in bed with drawsheet, care/info transferred to facility staff, crew availible without incident.

This is just an example... but it is part of my standard IFT chart. Keeps the folks who QA the darn things happy.