Patient's Medications: To take or not to take?

[dmc2007]

Just to clarify, I wasn't referring to EMS losing the medications, but rather them getting lost in the course of the patient being in the ED and/or getting transferred to other departments.

 

[Aidey]

Who is talking about it being EMS's fault if the information is simply unavailable. The whole point is to gather information that will help enhance the effectiveness of individual healthcare. I fail to see how you cannot grasp this.

You would be amazed how often EMS gets blamed for information that is simply unavailable. Not just medications, but things like is family coming (I don't know, the guy was alone and unresponsive!), or who the patients primary doctor is (they have dementia and think it's 1972!) etc. It's especially frustrating when we pick up a patient at some sort of facility and the staff hands us the paperwork and then answers all of our other questions with "I don't know" and then the hospital staff get upset with us for not having the answers.

What is the most fun is when we ask the patient questions and get one set of answers, and then the nurse asks and gets a totally different set and the nurses blame us. This usually gets resolved when the patient gives the doctor (or a different nurse) a 3rd set of answers.

 

[8jimi8]

You would be amazed how often EMS gets blamed for information that is simply unavailable. Not just medications, but things like is family coming (I don't know, the guy was alone and unresponsive!), or who the patients primary doctor is (they have dementia and think it's 1972!) etc. It's especially frustrating when we pick up a patient at some sort of facility and the staff hands us the paperwork and then answers all of our other questions with "I don't know" and then the hospital staff get upset with us for not having the answers.

What is the most fun is when we ask the patient questions and get one set of answers, and then the nurse asks and gets a totally different set and the nurses blame us. This usually gets resolved when the patient gives the doctor (or a different nurse) a 3rd set of answers.

Aidey, we aren't even discussing the same topic anymore. I have no nterest in your EMS vs. Nurses argument. It doesn't exist for me, I am both.

The long and short of it is collect as much history and information as you can, for the benefit of the patient. I'm not interested in your ancdotes about how nurses mistreat you.

 

[fortsmithman]

At my service we take the meds in with the pt.

 

[LondonMedic]

Please for the love of all that is holy bring the bottles.

We need the medication, the dose and when the last prescription was filled as a minimum.

I cannot believe that someone on this thought that multiple issues of the same medication wasn't significant. That's precisely why EMS should be bringing these meds to hospital.

 

[Veneficus]

If the patient has meds in an organizer, please ask if they have the bottles or even a list somewhere.

A bunch of unlabled pills takes a lot of time and effort to figure out what those pills are, and it is not always even possible.

I know about the index n the PDR and as out of curiosity decided to see how accurate it is. After 45 minutes I narrowed down the 1 pill I was looking for to 3 possible choices.

 

[MrBrown]

i have always just written down a list

 

[JPINFV]

I cannot believe that someone on this thought that multiple issues of the same medication wasn't significant. That's precisely why EMS should be bringing these meds to hospital.

I can't believe the question of simply asking for clarification between clinically significance and statistical significance is being questioned in regards to a study that hasn't been posted yet.

 

[Eydawn]

Aidey, we aren't even discussing the same topic anymore. I have no nterest in your EMS vs. Nurses argument. It doesn't exist for me, I am both.

The long and short of it is collect as much history and information as you can, for the benefit of the patient. I'm not interested in your ancdotes about how nurses mistreat you.

Easy there! Sounds like Aidey works in a system where nurses don't dig paramedicine and don't understand how EMS providers work. It sounds like he's as frustrated with not getting the answers as the hospital staff is, and someone gets made the whipping boy... I've seen it happen many times.

You'd love to see how EMS acts when I send someone out of my facility (on occasion, not saying it's all of the time...) based on protocols I didn't write and have no power over... the "my job is so much more important than yours" thing exists EVERYWHERE. Trust me.

As far as medications, sending someone out of a facility I send along copies of the Medication Administration Record (MAR) which has all of the dosage, frequency, last given, even PRN records. I would very much advocate getting the bottles if you don't have all of that information available readily in a home setting.

Wendy
CO EMT-B

 

[Aidey]

You'd love to see how EMS acts when I send someone out of my facility (on occasion, not saying it's all of the time...) based on protocols I didn't write and have no power over... the "my job is so much more important than yours" thing exists EVERYWHERE. Trust me.

As far as medications, sending someone out of a facility I send along copies of the Medication Administration Record (MAR) which has all of the dosage, frequency, last given, even PRN records. I would very much advocate getting the bottles if you don't have all of that information available readily in a home setting.

She, but thank you. We have a facility here that has a rule that if the pt has had MRSA within the last 10 YEARS they have to go by amb, even if they are ambulatory and do not have an active MRSA infection. I have to admit I wondered WTF the staff was thinking the first time I encountered a pt that was being transferred by amb because of that, but once the staff explained they were following a protocol things made more sense.

I honestly wonder how many EMS people (fire and amb) understand that 99% of facilities have their own protocols that the staff have to follow.

As far as medications, sending someone out of a facility I send along copies of the Medication Administration Record (MAR) which has all of the dosage, frequency, last given, even PRN records. I would very much advocate getting the bottles if you don't have all of that information available readily in a home setting.

And we love you for it, lol. If only people at home filled out their own MARs.

 

[8jimi8]

Easy there! Sounds like Aidey works in a system where nurses don't dig paramedicine and don't understand how EMS providers work. It sounds like he's as frustrated with not getting the answers as the hospital staff is, and someone gets made the whipping boy... I've seen it happen many times.

You'd love to see how EMS acts when I send someone out of my facility (on occasion, not saying it's all of the time...) based on protocols I didn't write and have no power over... the "my job is so much more important than yours" thing exists EVERYWHERE. Trust me.

As far as medications, sending someone out of a facility I send along copies of the Medication Administration Record (MAR) which has all of the dosage, frequency, last given, even PRN records. I would very much advocate getting the bottles if you don't have all of that information available readily in a home setting.

Wendy
CO EMT-B

I really don't feel like i was being rude. i was being direct.

The point kept getting made over and over again about how mistreated EMS is. Which wasn't the topic. Aidey's point was something to the effect of "its not my fault"

and my point is, " i'm not blaming you"

beyond that, there was no correlation past the fact that the information isnt always available.... the more important point was: Gather all the info you can...