To Take or not to Take?

[Too Old To Work]

Here's a completely meaningless post for discussion.

You bring a patient (non acute) into one your local EDs. You give report to the traige nurse. Said nurse asks if you got vital signs. You say you did, the ones that you just reported. No, she means did you get vital signs at triage for her to put in her report.

So, is this our responsibility?

 

[Shishkabob]

Nope. Not our job... we got our vitals that satisfy our needs, if they aren't good for her she can do her own.


Having said that, once in the patients room I tend to hook them up to BP / SpO2, and maybe an EKG is warranted, while the nurses do other things.

It's a holdover from clinicals




But no, not a "responsibility".

 

[mcdonl]

I dont mind doing it.

I always hook the pt up to the bp monitor while giving my report. Maybe it is not my job, but little things like that make their job a little easier, and makes them more willing to spend time with me as I like to ask questions about the patient and learn from each call when time permits.

I have never been asked to do it.

 

[Akulahawk]

I have been known to help get patients hooked up to whatever the ED needs... but it's their responsibility to read the info for themselves. My info is my info, and their info is their info, for documentation purposes. In other words, I'll help... but it's their job.

 

[terrible one]

Is it your responsibilty? No.
However, I have no problem taking an extra 2 minutes to get them a set of vitals, definetly goes along way with the RNs and I'd rather be with them than against them.

 

[JPINFV]

Responsibility? No.
Worth getting in a fight over? Definately not.

 

[KY_EMT]

It's not our responsibility but my partners and I will help hook up the different things (BP, O2 Sat, etc.) while the nurse is asking questions and taking the patient's report. It's not what we HAVE to do, but I have found it helps keep things smooth between us and our local hospitals.

 

[feldy]

Not your responsibility.
But if you are in an area that has short transport times, then you should get another set for your report. Some places say that they require at least two sets of vitals, once at initial contact, the other depending on the stablilty and c/c of the pt, should follow every 5-15 mins. But Short transport times dont allow for that so it couldnt hurt to have a second set at the ED.

If you are all set, then you shouldnt have to take vitals and run a 12-lead at the ed. That is either the nurse's or the ER Techs job.

 

[Sasha]

Not my job, but there are two of you at least, and what else do you have to do really? Only one of you writes the report, especially if you're holding the wall for awhile, it takes two minutes to hook them up to a BP cuff and a pulse ox, it makes the nurse happy and happy nurses get you rooms quicker.

 

[medicman90]

So all I'm really responsible for is reporting the vitals I got in the field right?

 

[Too Old To Work]

So all I'm really responsible for is reporting the vitals I got in the field right?

I'd say so. It's also not my job to make the nurse's job easier. Nor does it matter that I'm standing there doing nothing. I was doing plenty on the call and I don't recall the nurse being there to help me out. Nor do any of them ever offer to help move the patient over to the hospital bed.

I did ask one nurse for his cell phone number so I could call him for help next time I needed a leg bag emptied. Apparently my humor was too sophisticated for him. :unsure:

 

[Sassafras]

Hmmm, this is news to me. Hospitals here hook up their own BP cuff and triage their own patients. We don't touch their stuff.

 

[Too Old To Work]

Hmmm, this is news to me. Hospitals here hook up their own BP cuff and triage their own patients. We don't touch their stuff.

It used to be that, but like a lot of things, it started out as a courtesy and now is "expected". The nurses take advantage of the BLS guys in particular, and generally leave the medics alone. Still it's annoying that they expect this and become downright nasty when we don't do it.

 

[firetender]

Overall I'd say it's a patient by patient, situation by situation, institution by institution choice. Some you want to. Others you don't. In some cases, maybe seeing the track of the patient's vitals would be useful to the patient's care. Asking YOU to be aware of and note any changes could unearth something easily missed.

 

[Too Old To Work]

A somewhat related question, since a couple of people mentioned it. How many sets of vital signs do you generally take?

 

[KY_EMT]

A somewhat related question, since a couple of people mentioned it. How many sets of vital signs do you generally take?

In the truck? Depends on what sort of call it is. Just a general non-emergency transport from one facility to another or something similar, I'll do 1 or 2 depending on how stable pt is, etc. It varies from pt to pt. On emergency/serious runs, I'll take the vitals every 5-10 mins, give or take, depending on state of the pt and what sort of call it is. It's pretty much a case-by-case decision.

 

[mcdonl]

I'd say so. It's also not my job to make the nurse's job easier. Nor does it matter that I'm standing there doing nothing. I was doing plenty on the call and I don't recall the nurse being there to help me out. Nor do any of them ever offer to help move the patient over to the hospital bed.

I did ask one nurse for his cell phone number so I could call him for help next time I needed a leg bag emptied. Apparently my humor was too sophisticated for him. :unsure:

I must be reading this wrong. It comes across very bitter, angry and very much like you are not a part of a patient care team, but an entity all your own. As a hospital administrator I can tell you that the way you are portraying yourself is NOT a part of a solution, but a part of a problem. It may sound cliche or idealistic but EMS is all part of the patients line of care, and we should work together.

But, like I said. I am only reading a two dimensional post and I am sure you are nothing like you came across.

 

[Sassafras]

A somewhat related question, since a couple of people mentioned it. How many sets of vital signs do you generally take?

At least two. Non critical I aim for the protocol of every 15 min but sometimes it is 20-25 if they are chatty little things. I figure they have a patent airway and a pulse if they are telling me stories lol. Critical definitely more often more like 5-10 min. And if they fall asleep I watch them breathe non stop and reach over often if I can't see chest rise just to ensure nothing has happened. We have hour long transports so it's nothing to get multiple sets of vitals. Also I try to re assess after any interventions about 5 minutes later. Doesn't always happen but I at least get "do you feel better or worse now?" asked.

 

[Sasha]

A somewhat related question, since a couple of people mentioned it. How many sets of vital signs do you generally take?

Need 2 to bill!

 

[Too Old To Work]

Need 2 to bill!

I never heard that. We just went through a billing refresher and that was not among the things that we were told needed to be done. There are certainly clinical reasons to do repeat BPs and I've done four or more on complex cases. We have generally short transport times, but at a minimum I get two, usually three.