Wednesday, March 29, 2006
Paramedics wants to treat patients in the ER. I wonder what Dr. Crippen has to say about that? Speaking of the good UK doc, Dr. Crippen pleads that you should immunize your children.
Posted by Kevin |
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I wonder if liability is with the paramedic? Ah I doubt it, they wwould still try to take the hyde out of the doctor.
True story yesterday. 80 y/o woman calls ambulance to take her to the hospital because she has had diarrhea and "feels weak". She has no chest pain, dyspnea, etc. Paramedics hook her up to a moniter and "think" they possibly see ST segment elevation on the single moniter lead. So thinking they may have discovered something cardiac they think it would be a good idea to give her ntg. On arrival she is now syncopal, hypotensive and needs to be rescued from the prehospital care. An example of people who don't know trying to think and do too much.
True story yesterday. 80 y/o woman calls ambulance to take her to the hospital because she has had diarrhea and "feels weak". She has no chest pain, dyspnea, etc. Paramedics hook her up to a moniter and "think" they possibly see ST segment elevation on the single moniter lead. So thinking they may have discovered something cardiac they think it would be a good idea to give her ntg. On arrival she is now syncopal, hypotensive and needs to be rescued from the prehospital care. An example of people who don't know trying to think and do too much.
# posted by 
: 9:59 AM
: 9:59 AM
You can't completely blame the Paramedic. They operate under medical control so when they give a drug it's under the auspices of an EMS physician. There are a number of meds they can give without med control, ie asking a doc on the radio, nitro is usually one of them. So some physician decided when he accredited these medics that they were competent enough to make medical decisions. The sodomites could go after that EMS doc too!
# posted by : 12:10 PM
: 12:10 PM
Yes they would probably go after a doc. Although NTG for "I think I see st elevation" for diarrhea is not in any protocol.
# posted by : 12:52 PM
: 12:52 PM
A lot of these EMS people think they are better than docs...I saw them do some crazy stuff when I was a resident. They always try to give some medication to show how knowledgeable they are...they would bring in a guy in Afib and have started him on a cardizem drip in the ambulance...then we would have to stop it and correct the hypotension...they don't know how to just bring the patient to the hospital...
# posted by : 12:56 PM
: 12:56 PM
When they introduced 12 lead ECGs into London, they sat the paramedics down with some A&E SHOs and tested them all.
The paramedics did better.
On two seperate occasions.
Training is the main thing - if you are trained and competent to do something, then you should be able to do so.
But yes, us paramedics ain't Docs and we should remember that.
The paramedics did better.
On two seperate occasions.
Training is the main thing - if you are trained and competent to do something, then you should be able to do so.
But yes, us paramedics ain't Docs and we should remember that.
Now - on the original post.
It's one of the things that ambulance services are being expected to do.
Since the government stopped making GP provide 24 hour cover the care has fallen to the (much cheaper) ambulance personnel.
And it's the paramedic who'll have liability, and may end up losing their registration should something go horribly wrong - it's reason #212 why I won't do it.
London ambulance service is trying to train more of us up to this level, and the grand plan is to cut the number of ambulances by 60% and replace them with these 'emergency care paramedics' in cars instead.
I despair...
It's one of the things that ambulance services are being expected to do.
Since the government stopped making GP provide 24 hour cover the care has fallen to the (much cheaper) ambulance personnel.
And it's the paramedic who'll have liability, and may end up losing their registration should something go horribly wrong - it's reason #212 why I won't do it.
London ambulance service is trying to train more of us up to this level, and the grand plan is to cut the number of ambulances by 60% and replace them with these 'emergency care paramedics' in cars instead.
I despair...
My only real complaint about ALS (Advanced Life Support) EMTS: They are often quite aggressive, doing everything they see in the algorithm, here in Boston, when the nearest hospital is 5 minutes away. That's fine in Texas, where you may have to drive 40 miles to get to a hospital, but when the ride is 5 minutes, you can probably wait on the Cardizem. Though on the other side, they've already done all my work for me, so by the time the patient arrives, all I have to usually do is type in an admission.
# posted by : 1:52 PM
: 1:52 PM
"When they introduced 12 lead ECGs into London"
Is London in a third world country?
"they sat the paramedics down with some A&E SHOs"
Speak the king's english, man...
Is London in a third world country?
"they sat the paramedics down with some A&E SHOs"
Speak the king's english, man...
# posted by : 2:05 PM
: 2:05 PM
I meant 'introduced 12 leads into ambulances so that us EMTs can diagnose STEMI and blue light them into a cardiac cath lab (of which there are four in London) rather than into A&E for thrombolysis'.
A&E = Emergency Room.
SHO = Grade of doctor, somewhere around a starting resident (I think) - they can treat and discharge patients on their own say-so.
Is that clear enough?
:)
A&E = Emergency Room.
SHO = Grade of doctor, somewhere around a starting resident (I think) - they can treat and discharge patients on their own say-so.
Is that clear enough?
:)
"When they introduced 12 lead ECGs into London"
Is London in a third world country?
*introduced - bring in
"they sat the paramedics down with some A&E SHOs"
*sat down - assemble, convene, meet, gather
Close enough? He really sounds very English to me.
'...us paremedics' = we,paramedics
They refer to it as Queen's English :)
Is London in a third world country?
*introduced - bring in
"they sat the paramedics down with some A&E SHOs"
*sat down - assemble, convene, meet, gather
Close enough? He really sounds very English to me.
'...us paremedics' = we,paramedics
They refer to it as Queen's English :)
# posted by : 2:25 AM
: 2:25 AM
With the accent a British paramedic would sound more knowledgeable than an American neurosurgeon...
# posted by : 9:26 AM
: 9:26 AM
His accent makes him more knowledgeable than a neurosurgeon??? He's merely expressing his opinion.
"But yes, us paramedics ain't Docs and we should remember that.
1:37 PM
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"But yes, us paramedics ain't Docs and we should remember that.
1:37 PM
# posted by : 1:39 AM
: 1:39 AM
