Once
this happened in Massachusetts, it was all over for OEMS. I started working at Brewster not long after the state included phrasing to pretty much insist patients be carried in the state protocols, we had supervisors coming to do spot checks. Woof.
Unfortunately, knee jerk reactions are all too common in EMS. Based on that report, it appears that two providers failed to do their jobs, and a supervisor willfully failed to investigate a valid complaint. Hopefully they all lost their jobs, and the two medics had their certs yanked (and not just suspended).
It does appear the agency had some issues, ones that aren't a sign of systemic issues in EMS
The notice of deficiency lays out a list of serious problems, including failure to ensure personnel meet state regulations, failure to comply with state laws, failure to provide personnel with appropriate policies and failure to maintain an effective quality assurance program.
The ambulance service also was criticized for not ensuring that its paramedics consistently begin advanced life support on first contact with a patient, rather that waiting until he or she is extricated to an ambulance.
If you don't check that your people are doing the right thing on a consistent basis, is there any surprise that people cut corners and do stuff they shouldn't be?
That's a very reasonable point - location is all too pertinent here. However, the vast majority of ems calls, i would posit, are in a setting where having a wheeled carrying device for patients is not exactly unreasonable.
Not sure what you mean by this.... If you mean on the vast majority of EMS calls you should be bringing in a carrying device, then I absolutely agree with you.
If you mean the patient should be carried on the vast majority of EMS calls, when EMS is used as a taxi service for a person who simply needs a ride to the hospital, or the ambulatory patient can walk to the ambulance, or the toothache at 3am on the 3rd floor walk up now wants to go to the hospital, well, I'm going to have to respectfully disagree.
Agencies that mandate that everyone be carried to the ambulance either don't trust their provider's clinical judgement, are written by managers that don't care about the backs of their employees (and the policies don't apply to them, since they don't ride the truck anymore), or are overly concerned about the theoretical threat of greater liability or perception of the public if we don't carry everyone from their location to the ambulance. That all being said, inappropriate walking of patients to the ambulance should be met with progressive discipline, and should be QAed like any other medical procedure.
