pt has no complaints....

[911 DJ]

Documentation is the key. Our department policy is transport ALL who wish to be transported. If we feel that a transport is medically UNnecessary, we document that & have the pt. sign a form agreeing (sp?) to pay for the trip when the insurance (or lack thereof) kicks the bill back to them.

As far as the nurse goes.... I used to carry a bottle of Midol for just such an occasion. Nurses (male or female) don't like it when a male EMT offers the Midol. B)

 

[Jon]

Nah... you don't know this guy... great provider, very knowlegable....

 

[asys007]

Since when do patients not have to sign refusals??? And for that matter, why does it matter who actually called 911?
Where I work, all patients who are not transported must sign a refusal...this includes 'lift assists', MVCs with no injuries, and walk-ins at our station. In other words, unless you find a call with no people...a refusal must be completed. Furthermore, medical command should to be contacted even for the most minor of complaints. There is a rather lengthy list is criteria on our forms...

Bottom line, not obtaining a refusal is opening yourself and your agency to a huge liability. In my opinion, my certification isn't worth skipping 20 minutes of paperwork and a simple phone call...

 

[TTLWHKR]

Originally posted by MedicStudentJon@Jul 5 2005, 04:19 PM
presented with weakness and sudden onset SOB. Pt stated condition improved, but also conplained of chest palpitations.

I had that a few years ago, same symptoms, except I had severe pain in both hands. I dropped to my knees when the SOB hit me, never experienced anything like that before. My heart was pounding, heart rate irregular, Hit me suddenly, no warning... Made me nauseated, I vomited repeatedly for three hours. Very bad day.

The only explainable cause was:

I was bitten by a spider, didn't do anything for like five hours, then I bumped my leg where the bite was and w/ in five minutes I was on the floor.

Epi & Benadryl IM and some O2 and I was fine.

:blink:

 

[Stevo]

Since when do patients not have to sign refusals???

when they're NOT a patient for starters....of course there's always a good nazi-emser that'll harass anyone even rubbernecking for a signature right?

~S~

 

[TTLWHKR]

Originally posted by asys007@Jul 7 2005, 01:04 AM
Since when do patients not have to sign refusals???

Because ambulances in South East PA were accused of Insurance Fraud. They were billing for refusals.

So the state made it so that if you want to seek treatment, you can. If you call, then you are the patient. If an adult calls for a child, the child is the patient. If someone is not capable of making the decision, they are still a patient. BUT if someone was rear-ended, and the people in one car claim injury, but not the other. You can't make the other group sign anything. Document that they refused to sign, etc; and have a witness sign. I prefer a SP officer.

Another reason is over use of 911. Two cars bump on car pool lane of TP-476, minor scratch on the paint, 4 people in each vehicle. Both vehicles are drivable, the State Police do not respond when vehicles are able to be driven and there is no ETOH involved. Do you send Two Engines, a Rescue, and ambulances for every patient to get refusals from everyone in both cars?

Isn't that the same as 911 abuse, sending ambulances out like Taxi Cabs, keeping them from the people who may really need it?

 

[Ridryder911]

Yes, we do respond. Is it abuse of EMS because you respond ?. Maybe arriving officers can see no one is injured & cancell EMS.
Just because the state had unprofessional managers with excessive greed & poor ethics, should the emergency services not respond ? Sounds like they should had punished, & corrected the source of the problem.

How many accidents have you responded to, that patients needed to be tx & evaluated not knowing the risks involved ? Yes, paperwork can be a pain in the butt, yet again "are the patients there for us ... or .. are we there for the patients ?

I have been an expert witness against medics who did not adequately inform patients of the risks & potential injuries... & then later did have injuries. The medics were more worried of either going to the next "big one" .. or getting offf shift on time"....not realizing they missed the "big one"..

Be safe,
Ridryder 911

 

[Jon]

Originally posted by Stevo@Jul 7 2005, 05:01 PM

Since when do patients not have to sign refusals???

when they're NOT a patient for starters....of course there's always a good nazi-emser that'll harass anyone even rubbernecking for a signature right?

~S~

Yeah... why? If they are not hurt, and I don't think they need medical attention, why am I having them sign that they are refusing medical attention AGAINST MEDICAL ADVICE????

 

[Stevo]

ok....

so , seems we have the risk anaylisis/cost benifit camp, and the liability camp of people

still no patient advocates....

gee, what do we do this for?

~S~

 

[Jon]

Originally posted by Stevo@Jul 8 2005, 05:33 PM
ok....

so , seems we have the risk anaylisis/cost benifit camp, and the liability camp of people

still no patient advocates....

gee, what do we do this for?

~S~

I'm advocating for the pt....... I'm not harassing the pt. by making someone a pt. who doesn't need to be.

Even If I'm clearing an MVC as "no services needed" if I speak with any of the involved parties and they deny both complaints and transport, I advise them that they can be evaluated by us by calling 911, or speaking with any of the LEO's onscene.

Jon

 

[Stevo]

some good replys here fellas.....and no Jon, your not doing anything wrong

the system obviously isn't universal is it ?

~S~

 

[Jon]

Originally posted by Stevo@Jul 8 2005, 06:44 PM
no Jon, your not doing anything wrong

I'm priniting that out and framing it....

 

[TTLWHKR]

Originally posted by MedicStudentJon+Jul 8 2005, 06:01 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (MedicStudentJon @ Jul 8 2005, 06:01 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-Stevo@Jul 8 2005, 06:44 PM
no Jon, your not doing anything wrong

I'm priniting that out and framing it.... [/b][/quote]
Don't be so hard on yourself baby medic.

Maybe we can get you a star of life pacifier.

My wife bought a thermometer pacifier for her whacker bag... She got it from a pacifier catalog... a whole catalog full of pacifiers. We started getting all these baby catalogs. I asked what they were for, and she said "Guess". Why hell, the last time we were going to have a baby, she took me to Baskin Robbins and told me with an ice cream cake with a baby on it. But either way, it was happy news. Even though it will be a 21st century baby. Expensive baby, that is.

 

[Wingnut]

CONGRATULATIONS!!!!!!!!!!!!!!!

 

[vtemti]

Originally posted by asys007@Jul 7 2005, 02:04 AM
Bottom line, not obtaining a refusal is opening yourself and your agency to a huge liability. In my opinion, my certification isn't worth skipping 20 minutes of paperwork and a simple phone call...

I agree, but remember that any refusal is only as good as the documentation that backs it. If a patient does decide to go back on EMS and gets a good lawyer, anything can be picked apart to make your life miserable.

 

[Jon]

Congrats, Alex.... Are you really going to name him Epi????

 

[TTLWHKR]

Originally posted by MedicStudentJon@Jul 9 2005, 12:54 PM
Congrats, Alex.... Are you really going to name him Epi????

I don't think so...


But when you have a kid, knock yourself out.

 

[vtemti]

Originally posted by TTLWHKR@Jul 9 2005, 04:20 PM
knock yourself out.

I think he already has or has tried a few times. :blink:

 

[Jon]

Originally posted by TTLWHKR+Jul 9 2005, 04:20 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (TTLWHKR @ Jul 9 2005, 04:20 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-MedicStudentJon@Jul 9 2005, 12:54 PM
Congrats, Alex.... Are you really going to name him Epi????

I don't think so...


But when you have a kid, knock yourself out. [/b][/quote]
So I should name my kid Diprovan?

 

[asys007]

At our service, a 'refusal' doesn't necessarily mean that you are refusing treatment/transport against medical advice. It simply means thats you are refusing treatment and/or transport. Basically, we came and saw, we did not abandon or neglect you. By signing, you acknowledge this fact.

As far as documentation goes, I agree that a refusal is only as good as the documentation that supports it. ALL of my charts, including refusals, include documentation of what did/did not happen. Everything is written there, down to the patient's belongings.

And yes, I do get signatures from all patients who are able to sign. And yes, this does include refusals...who do by the way sign billing cards because they are billed for our services.


Also, for people so against 'personal attacks', you were pretty quick to call me a 'nazi-emser'....thanks ever so much.