Why the hate on dialysis runs?

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SurfEMT

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I've been an EMT for several years in the LA area and have never IFT'd a dialysis patient. Yep. True story. When I mention this to others, the response is that I'm lucky, or that being a "dialysis taxi" sucks, or words and sentiments to that effect. So excuse my Mary Poppins moment when I ask: "What's so awful about transporting dialysis pts.? Why the hate on dialysis runs? What can I expect when I finally get one?"
Thanks.
 
Nothing.

It's the people that thought getting their EMT would immediately get them a ticket to running shootings, rollovers, and cardiac arrests every shift who complain incessantly about it.

In reality, many EMT jobs are almost purely IFT. Dialysis patients make companies a lot of money. Almost a guaranteed six transports a week until well, often times death. Anyone that thinks these patients are beneath them compared to other IFT transports is not seeing the whole picture. Often times EMTs will moan about how dialysis patients don't really need an ambulance to get to the clinic. Whether or not they are right are wrong does not get around the fact that many of the ED to SNF discharges or BLS hospital to hospital calls also probably don't need ambulance level of care. BLS IFTs by definition are not acutely ill, but that does not mean they do not need medically trained transportation, and like it or not the BLS ambulance is about all that exists in this country to provide that.
 
Generally dialysis runs the patients require no medical attention, and you become a shuffle truck so to speak.

You run one to dialysis, return another, and that's your day shuffling dialysis patients.

Which gets kinda boring after a while, But reality is IFT dialysis runs pay the bills. Your paycheck and keeps the company in the green.

911 doesn't always guarantee a payday. Some insurances will pay some, if you get any money at all.

IFT is almost a guaranteed 100% pay, or your company would not do the transport.
 
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unleashedfury said:
Generally dialysis runs the patients require no medical attention, and you become a shuffle truck so to speak.

You run one to dialysis, return another, and that's your day shuffling dialysis patients.

A lot of dialysis pts have a GCS incompatible with life so you can't even talk to them. Which gets kinda boring after a while.
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Most BLS transfers don't require any treatment period. All require your attention, even if that means concentrating on providing excellent customer service along with transportation.
 
Tigger said:
Most BLS transfers don't require any treatment period. All require your attention, even if that means concentrating on providing excellent customer service along with transportation.
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Much better put than I could say it. Ive been trying to get my company to start to dip into the IFT side of things but they don't want to add another crew to start IFT transports, So we let the IFT company down the street take it all.
 
As a 911 provider, going to the dialysis centers are usually calls that result in aggravation. Getting called for variances in blood pressure happen often but require little interventions and take a 911 ambulance from the street for a complaint that will rectify itself given some time
 
I have run quite a few dialysis PT's when I worked for a small private transport. These folks are human beings and generally have more going on then just dialysis. I found I liked all of them very much, even the ones with dementia,Alzheimer's and some that had strokes in the past. Quite a few of them had PEG tubes and foley's. This is not the kind of Pt that can just take a Taxi ride for dialysis. I enjoyed it very much but unfortunately the company I was working for just closed up shop one day and that was it.
Good luck and I will say Dialysis PT's are not bad at all! :)
 
double the paperwork and rude staff plus lots of time waiting "just a few minutes" for the machine to finish.
 
It's a combination of factors. One is that many of the runs are on shaky medical necessity to begin with. Often the patients are more "demanding" than the average patient. A big part of this is that they are more comfortable with the setting, so they ask for it things that the average patient doesn't feel comfortable asking for.

You have to write 2 charts... coming and going.

It's not sexy.

No one tells war stories about "that good dialysis transfer"
 
beano said:
double the paperwork and rude staff plus lots of time waiting "just a few minutes" for the machine to finish.
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Also this, when we do actually get sent for what seems to be an emergency, Cardiac or Pulmonary, we have to wait for them to disconnect the machine and stop the bleeding before we can transport.

If you are calling 911, why are you only disconnecting the machine when we arrive?
 
Bullets said:
Also this, when we do actually get sent for what seems to be an emergency, Cardiac or Pulmonary, we have to wait for them to disconnect the machine and stop the bleeding before we can transport.

If you are calling 911, why are you only disconnecting the machine when we arrive?
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I see what you mean, but think about how many of these cardiac and pulmonary problems are caused by electrolyte or fluid issues. In many cases, dialysis is just what the patient needs, and leaving them on the machine as long as possible is the best fix we can provide.
 
And the clot time can be lengthy for some of these folks. I've started interventions while a patient is still getting D/Ced from the dialysis machine. I guess I just got there too quickly. :/
 
Dialysis transfers are educational; if you approach them the right way.

That is where I learned about medications; I had a program in my PDA (you can get them in apps, on smartphones/I-phones now) that you enter the medication and it gives you what it is for, what the side effects are, etc.
That gave me a large head start for medic school; knowing the medications ahead of time.

Also you can usually talk to the patients: ask them questions, what their symptoms are when they have problems; etc.

Always do at least 2 sets of vital signs; at the unit and as you get to destination. Saves alot of headaches. wait till you get back to the ECF to take the only set of VS and find out that the patient has a BP of 50/20, when the Dialysis center could have fixed it for thepatient before you transported them. Now you have to write more on your chart of why you had to go to the ED
 
SurfEMT said:
I've been an EMT for several years in the LA area and have never IFT'd a dialysis patient. Yep. True story. When I mention this to others, the response is that I'm lucky, or that being a "dialysis taxi" sucks, or words and sentiments to that effect. So excuse my Mary Poppins moment when I ask: "What's so awful about transporting dialysis pts.? Why the hate on dialysis runs? What can I expect when I finally get one?"
Thanks.
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It's not the act of one run that does it. It's solely doing ifts all day long.

Run 24's for dialysis for 6 months..... Then we shall see who stays "Mary popping" and who gets burnt out.
 
chaz90 said:
I see what you mean, but think about how many of these cardiac and pulmonary problems are caused by electrolyte or fluid issues. In many cases, dialysis is just what the patient needs, and leaving them on the machine as long as possible is the best fix we can provide.
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Oh I agree as to the cause but once you decide to call an EMERGENCY ambulance, for whatever reason, then it's time for dialysis to end.

my favorite is the complaints that had an onset of around 4 hours....how long is the treatment? 4 hours
 
Rano Pano said:
It's not the act of one run that does it. It's solely doing ifts all day long.

Run 24's for dialysis for 6 months..... Then we shall see who stays "Mary popping" and who gets burnt out.
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Did it for a year. Not 100% dialysis, but the majority. Didn't really hate it that much, certainly wasn't burnt out.
 
I did it too. Learned a lot about chronically ill patients, moved a lot of patients to bed and back. Met some really nice people.
 
I spent a couple of years doing mostly IFT. Rural dialysis runs hurt more, just saying.

But I got to know a few really interesting old people, and I read a lot of books while getting paid.

It's all part of the job, just not glamorous.
 
Jon said:
No one tells war stories about "that good dialysis transfer"
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45 y/o m post dialysis, scheduled customer and we transport goon a few times a week, bp of 90/40 and dropping, BLS truck so can't get a line or ekg, keeps going in and out of consciousness. Transported to ER which was less than 3 minutes away, coded 30 seconds after we dropped him off, they brought him back after a shock, fluid bolus and dopamine helped stabilize him. The dialysis clinic hasn't checked his bp in the last 30 minutes, if we weren't there and didn't do our job correctly he would've coded on the way home would've been 5-10 minutes before als and probly wouldn't have noticed right away. We saved that guys life. He was discharged a few days later, no deficiencies.


Edit
This was the easiest, best job I've ever had in my entire life, writing a report during a 20+ minute transport was cake, taking vital signs every 15 was a joke. I got to drive around and get to know my city better than most people. Learned a lot from stone really good people, lessened a lot about medications and history and how they relate. I could go on and on. That job is what you make of it, people just don't know how to see the good and positive.
 
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Hunter said:
45 y/o m post dialysis, scheduled customer and we transport goon a few times a week, bp of 90/40 and dropping, BLS truck so can't get a line or ekg, keeps going in and out of consciousness. Transported to ER which was less than 3 minutes away, coded 30 seconds after we dropped him off, they brought him back after a shock, fluid bolus and dopamine helped stabilize him. The dialysis clinic hasn't checked his bp in the last 30 minutes, if we weren't there and didn't do our job correctly he would've coded on the way home would've been 5-10 minutes before als and probly wouldn't have noticed right away. We saved that guys life. He was discharged a few days later, no deficiencies.


Edit
This was the easiest, best job I've ever had in my entire life, writing a report during a 20+ minute transport was cake, taking vital signs every 15 was a joke. I got to drive around and get to know my city better than most people. Learned a lot from stone really good people, lessened a lot about medications and history and how they relate. I could go on and on. That job is what you make of it, people just don't know how to see the good and positive.
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I had a Dialysis patient code on me once, we brought him back to find out later he was a DNR. (dialysis transfer paperwork said nothing about DNR) So honoring his wishes family came out and had him extubated to die on a floor in the hospital. Needless to say he lived another week.
 
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