Not quite my first death, but close

[JJR512]

On Sunday [August 7, 2011], a 1999 Buick LeSabre crossed from the westbound lane into the eastbound lanes of Guilford Road at Stirling Bridge Drive, struck a tree and overturned.

An ambulance transported the lone occupant... to Shock Trauma. Police said (the patient) is in “critical” condition.

From http://columbia.patch.com/articles/savage-collision-sends-one-to-shock-trauma

I was on that ambulance.

Three days ago I heard a grapevine report that life support would be terminated the following day, and the patient was not expected to survive.

I have yet to experience a patient of mine dying while directly in my care. This is the closest so far. In fact this is the only death (that I know of) of a patient for whom I provided any real care or skills at all. It's kind of a crappy feeling. I guess we get used to it, or immune to it. I'm not sure if that's a good thing, from a humanity point of view, but I guess it's a necessity from a personal survival point of view.

 

[BandageBrigade]

Helpful advise

Please for your sake and your patients, refrain from posting identifying information about patients and/or incidents you have been involved in.

 

[Sasha]

Privacy violation!

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[JJR512]

I considered it but since the article is, in fact, publicly available for anyone to read in print and online, it didn't really seem like a privacy violation. In other words, I have not revealed anything, including the name, that isn't public information.

 

[BandageBrigade]

But you linked to a patients name, posted details about the incident, admitted you were there, and posted details about the aftercare/patients outcome. Anyway you look at it, it is wrong. It does not matter that it was already public information, that does not give you the right to spread it around.

 

[RocketMedic]

OP or mods, you'll want to edit this down.

Putting a patient's identifying info is rarely ever acceptable, and it's never acceptable to put a name to the action. The only exception to the first I can think of is one such as the Siegfried&Roy incident, since it was rediculously rare. Even then, I wouldn't attach a patient's name to it ever.

 

[Anjel]

OP or mods, you'll want to edit this down.

Putting a patient's identifying info is rarely ever acceptable, and it's never acceptable to put a name to the action. The only exception to the first I can think of is one such as the Siegfried&Roy incident, since it was rediculously rare. Even then, I wouldn't attach a patient's name to it ever.

OP it does suck. And its tough when you have a pt die in or out of your care. Just dont let it get to you.

Buttt.... You cared for him. You have to abide my HIPPA. News agencies dont. You found out his outcome because you are a medical provider. That is privledged info. You are violating hippa with this post.

 

[WuLabsWuTecH]

Now wait a second here... What did he reveal that was privileged information. He merely states that he was on that run, but seeks support/advice about his personal issue without disclosing anything from that run.

If a pt I transport comes up on the evening news, I can say that I was there (since people know that I was on at the time) and as long as I don't say anything regarding that run I'm ok under HIPPA as it is not privileged healthcare information.

 

[Meursault]

Now wait a second here... What did he reveal that was privileged information. He merely states that he was on that run, but seeks support/advice about his personal issue without disclosing anything from that run.

Just took another look at USDHHS's advice on the matter. I could see the combination of pt's name, transport info, and "critical condition" counting as PHI, but that's all in the article. Neither the police, who provided the info, nor the newspaper, who republished it, can violate HIPAA because they're not covered entities. The providers who gave the police info were probably doing so for law enforcement purposes, so they don't appear to have violated HIPAA. It would be too perverse even for the government if a statement that doesn't violate HIPAA suddenly violates HIPAA when linked to by a covered entity.

So the only things I see that could have violated HIPAA are:

I was on that ambulance.

for whom I provided any real care or skills

Three days ago I heard a grapevine report that life support would be terminated the following day, and the patient was not expected to survive.

All three are identifiable, and "that relates to" care/treatment/condition is a very broad standard for PHI, but in any case, #3 is not a violation on JJR512's part. After looking into this more, I don't know if #1 and #2 count.

But I got distracted by all the vague wording. What I meant to say is
Stop invoking HIPAA when you really want to talk about our ethical standards of patient privacy

 

[clibb]

I am sorry, but this is idiotic. Did you learn nothing during your HIPAA lectures? Talk this private stuff out with your crew, not people on the INTERNET!

 

[nomofica]

Although my HIPAA is not present in my country, nor are there really any such organizations (just service protocols, which cover the same things), this would not be a violation of anything (again, in my country).

It's not against any rules, protocols, or guidelines to point to an article and say "He was in my ambulance. I heard/think he might die." Now if you divulged information like "he had multiple fractures here, here, and here, an avulsion to the crown of the skull, severe blood loss" or any other sort of information along those lines, then it would violate rules.

Disclaimer: this is the interpretation given to me by my employer and the one I stuck by while working and will continue to do so until told different by a more senior individual.

 

[Sasha]

I am sorry, but this is idiotic. Did you learn nothing during your HIPAA lectures? Talk this private stuff out with your crew, not people on the INTERNET!

I disagree. Talk about it on the internet but keep your patient as john doe. Dont identify him in any way shape or form. Especially by posting something with his name in it.

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[ah2388]

To OP,
I want to apologize on behalf of the community for the lack of support you've received. I assume that you were coming here not to "glorify" your job...but to seek support for an experience you've had which was traumatic. Anyone who has worked in this field for any length of time will have experienced death. Often it is tragic, other times a blessing. With all this being said, here are some tips that I hope will help you in your time of need.

Speak to your co workers, no one will understand better what you are going through than those who experienced it with you.

Speak to your family/spouse/partner...while it will often feel like they dont understand, or cannot relate to your experiences..the love and compassion they will show you in your time of need will be invaluable in the long term.

Speak to other healthcare professionals, whether it be in person, via telephone/text, or online...the ability to express yourself and prevent things from getting bottled up will contribute to your long term mental health, help prevent burnout, and help you to absorb the experience, turn it into a learning experience and move past it.

For those of you who have been hostile, I can only say to you that I hope you receive the compassion and care that you will seek should you experience a traumatic event.

Regarding HIPPA, OP, always keep in mind and take care not to release any PHI. By my understand of the law, OP's post did not reveal anything which would implicate him in litigation regarding hippa. With that being said, I would never claim to be a lawyer, and I would certainly never claim to be an expert on health law.

OP, if you need someone to chat with and prefer to do so via pm, please message me and I'd be happy to converse with you.

 

[Flightorbust]

Now im not hoping on that band wagon and i do feel for the OP. But because he stated the they were going to take the pat off of life support on a certain day. That was not in the news and any of that. To me that would be considered confidential. I think thats where the hippa violation would be. But dont take what every one says to had. Take it as a learning opportunity. Like it has been said. Speak with people you work with. That whats great about the people you work with is your able to lean on each other in times of need

 

[ah2388]

he stated that this was a grapevine report..it would be like saying, "The president is a transexual." Its all hearsay without any factual merit.

And, additionally, it isnt necessarily identifying. I could see the argument for this type of conversation being "unprofessional" or in poor taste perhaps, but probably not a violation that would find him being cited for a HIPPA violation.

 

[Flightorbust]

he stated that this was a grapevine report..it would be like saying, "The president is a transexual." Its all hearsay without any factual merit.

And, additionally, it isnt necessarily identifying. I could see the argument for this type of conversation being "unprofessional" or in poor taste perhaps, but probably not a violation that would find him being cited for a HIPPA violation.

I admit I missed where he had said it was a grapevine report. I read it yesterday and was goin off of that. But how can you say that link he posted isnt identifying? It gives the pat. name and location/details of the wreck.

 

[traumaluv2011]

My first death was like the 7th call on this new squad. It was for a CPR in progress. We got on scene went through three AED cycles with CPR and could not bring him back. I don't know why we didn't transport him after the two cycles of AED like I was taught, but it was the Captain's call and I did what I was told.

 

[johnrsemt]

To the OP: if you continue to feel 'crappy' about it: talk to EMS chief of department, or to doctor at local ED. They can help you get counselling if you feel like like that will help. (It doesn't hurt if you get a good counseler with experience with PD/Fire/EMS situations).
Do NOT let it sit inside you and make you sad/depressed.

Good luck in your career.

 

[Sasha]

My first death was like the 7th call on this new squad. It was for a CPR in progress. We got on scene went through three AED cycles with CPR and could not bring him back. I don't know why we didn't transport him after the two cycles of AED like I was taught, but it was the Captain's call and I did what I was told.

Because rushing dangerously to the ER with a dead person is silly.

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[Lady_EMT]

Because rushing dangerously to the ER with a dead person is silly.

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Not sure protocols for your area, but in mine, if CPR has been started, it can't be stopped. I agree it's stupid (I took in a woman a few weeks ago that was gushing blood from her mouth and nose, enough to make it look like a homicide at first), but because she was warm (no rigor/lividity), per our protocols we had to go through the whole song and dance and "rush" her to the hospital.

I've had a few codes where it should have been called, but because of silly protocols/people jumping the gun, I've had to transport.