Sunday, November 22, 2009
EMS education
Want an easy way to keep up with the latest in EMS. Check out podcast. You can listen to them on your computer or you can download them to your MP3 player. I put them on my IPOD and listen to them over my car radio while I am traveling. Works out great since I have an hour drive to both my jobs. I have found them to be very educational. You can even download them through itunes. Some of the ones to search for are Mediccast, EMS Garage and EMS EdUcast. Hope you guys take the opportunity for this free educational material.
Did you really call 9-1-1 for this?
Since I have begun working in the prehospital field I have seen year after year that the number of non-emergent 9-1-1 calls increase greatly. Even with these calls being non-emergent most services are required to respond lights and siren, just in case there is a 'true' emergency. I could comment on how dangerous it is for emergency vehicle racing to a scene with lights and siren. However, I believe everyone reading this can probably understand the danger associated with large Ambulances and Fire Apparatus' rushing to "Emergency" calls.
We arrive at most, not some, calls to find that no true emergency exist. I do understand that even though I don't see something as an emergency the caller may. I act professional on every call even when there is no true medical emergency present. Sometimes it is hard to remain professional. Sometimes I feel the urge to "educate" the caller on what an emergency is. Due to the current high level of litigation in our country our medical professional have to be politically correct to avoid "upsetting" anyone. My question is - If I can't educate the patient without fear of litigation or a reprimand, who can?
In the 1980's there was a big education push to teach everyone, especially children, to call 9-1-1 in case of an emergency. Shows like Rescue 911 helped to educate us by showing real life results. I remember watching this show as a teenager. It was exciting. I remember being told in school the importance of 9-1-1. I think the education effort was phenomenal. It obviously was effective. That is obvious by the sheer number of 9-1-1 calls that are handled by Dispatch centers around the country.
I always cringe when I see a news commercial that says - TONIGHT 'Channel so and so is doing a special investigation about hold times at 9-1-1 centers. Our investigators will show you how one man died because his family could not get through to dispatchers.' The story takes the same route almost every time. It shows how the center is understaffed. The story rarely tells of the sheer volume of non-emergent calls bombarding the center. The story never tells us about the calls that come in everyday that are totally unrelated to Emergency Services. I am not a dispatcher so I won't try and give examples. Comments are welcome from those with first hand knowledge. I do know from talking to dispatchers that they have many calls daily that make them say "WOW".
I think there is a solution. I think there needs to be an effort in this country to re-educate people on when not to call 9-1-1. That effort needs to be as big as the effort was to educate people to call 9-1-1. Organizations may never educate people not to call due to the fear of litigation and political correctness. So, What do we do? Do we continue to allow Police, Fire and EMS services to be bombarded by these calls? Worse than that, Do we allow victims of Strokes, Heart Attacks, Gunshots or other life threatening condition to have their care delayed because the nearest Ambulance to them is assessing a patient with back pain that began 2 weeks ago? Once the Ambulance arrives on the back pain call they cannot abandon that patient for a more critical patient. That patient has to wait for the next closest unit. In larger cities with many Units available the delay may only be 1-2 minute, but in rural areas that next available Unit may be 10 minutes away.
What a lot of people don't understand about Emergency Health Care is, our job is not about "Life and Death". Ten minutes may be the difference in walking and a wheelchair. The care we provide may be the biggest factor that influences a persons quality of life after a major medical event. Our efforts may mean that a person lived. That in itself is a great thing. But isn't it just as important that someone can hold their child again. Isn't it just as important that a father is able to throw a football with his soon. Isn't it important that a teenager walks during their graduation instead of being pushed in a wheelchair to receive a High School Diploma. The quality of life that a person maintains after a severe illness or injury is directly effected by the care they receive. The care they receive is directly effected by the efficiency of the emergency response system in their community. The efficiency of the emergency response system is directly effected by the guy that has and back pain for 2 weeks.
There has to be a better way to serve our communities. There has to be a more efficient way to get care to the sick and injured. It certainly is not the system we currently use. We can't keep adding dispatchers to a system that is losing money everyday. Most Cities and Counties cannot pay two more dispatchers and add two more consoles for them to staff. It just isn't feasible. Why not re-educate people. Why don't we say this is not what you call 9-1-1 for? Are we really people that are more concerned with "getting seen faster because we came in by ambulance"?
I will go out on a limb and say not only is this behavior the root cause of inefficient call centers, but it is also the reason for overcrowded emergency departments. That may be a topic for another day. We can improve our 9-1-1 centers with common sense. Yes, I know you can't teach common sense. We can educate people though. Where does it start? I wish I knew. I do know that there is a Paramedic in San Fransisco that is seeing first hand how it is being done in other countries. He is called the Happy Medic. Click on his name to be taken to his Blog. He is working on the project with Medic999. Both of these guys are Bloggers that took an interest in improving their own systems by combining ideas. The project is being covered by Setla Films, the creator of Level Zero. His company is filming the project to air as a Documentary called The Chronicles of EMS. These EMS professional s have posted updates using multiple forms of social media. You can find their updates on Twitter, youtube and Facebook. If you are not following it already then jump on board. We all have something to learn from what others are doing to improve prehospital health care. Don't fall into the trap of thinking just because you have a Paramedic or EMT license, you can't make a difference. Our system needs change. That change starts with you. Take a look at the project. If you don't get as excited as I am about improving prehospital health care, then you may be in the wrong field.
We arrive at most, not some, calls to find that no true emergency exist. I do understand that even though I don't see something as an emergency the caller may. I act professional on every call even when there is no true medical emergency present. Sometimes it is hard to remain professional. Sometimes I feel the urge to "educate" the caller on what an emergency is. Due to the current high level of litigation in our country our medical professional have to be politically correct to avoid "upsetting" anyone. My question is - If I can't educate the patient without fear of litigation or a reprimand, who can?
In the 1980's there was a big education push to teach everyone, especially children, to call 9-1-1 in case of an emergency. Shows like Rescue 911 helped to educate us by showing real life results. I remember watching this show as a teenager. It was exciting. I remember being told in school the importance of 9-1-1. I think the education effort was phenomenal. It obviously was effective. That is obvious by the sheer number of 9-1-1 calls that are handled by Dispatch centers around the country.
I always cringe when I see a news commercial that says - TONIGHT 'Channel so and so is doing a special investigation about hold times at 9-1-1 centers. Our investigators will show you how one man died because his family could not get through to dispatchers.' The story takes the same route almost every time. It shows how the center is understaffed. The story rarely tells of the sheer volume of non-emergent calls bombarding the center. The story never tells us about the calls that come in everyday that are totally unrelated to Emergency Services. I am not a dispatcher so I won't try and give examples. Comments are welcome from those with first hand knowledge. I do know from talking to dispatchers that they have many calls daily that make them say "WOW".
I think there is a solution. I think there needs to be an effort in this country to re-educate people on when not to call 9-1-1. That effort needs to be as big as the effort was to educate people to call 9-1-1. Organizations may never educate people not to call due to the fear of litigation and political correctness. So, What do we do? Do we continue to allow Police, Fire and EMS services to be bombarded by these calls? Worse than that, Do we allow victims of Strokes, Heart Attacks, Gunshots or other life threatening condition to have their care delayed because the nearest Ambulance to them is assessing a patient with back pain that began 2 weeks ago? Once the Ambulance arrives on the back pain call they cannot abandon that patient for a more critical patient. That patient has to wait for the next closest unit. In larger cities with many Units available the delay may only be 1-2 minute, but in rural areas that next available Unit may be 10 minutes away.
What a lot of people don't understand about Emergency Health Care is, our job is not about "Life and Death". Ten minutes may be the difference in walking and a wheelchair. The care we provide may be the biggest factor that influences a persons quality of life after a major medical event. Our efforts may mean that a person lived. That in itself is a great thing. But isn't it just as important that someone can hold their child again. Isn't it just as important that a father is able to throw a football with his soon. Isn't it important that a teenager walks during their graduation instead of being pushed in a wheelchair to receive a High School Diploma. The quality of life that a person maintains after a severe illness or injury is directly effected by the care they receive. The care they receive is directly effected by the efficiency of the emergency response system in their community. The efficiency of the emergency response system is directly effected by the guy that has and back pain for 2 weeks.
There has to be a better way to serve our communities. There has to be a more efficient way to get care to the sick and injured. It certainly is not the system we currently use. We can't keep adding dispatchers to a system that is losing money everyday. Most Cities and Counties cannot pay two more dispatchers and add two more consoles for them to staff. It just isn't feasible. Why not re-educate people. Why don't we say this is not what you call 9-1-1 for? Are we really people that are more concerned with "getting seen faster because we came in by ambulance"?
I will go out on a limb and say not only is this behavior the root cause of inefficient call centers, but it is also the reason for overcrowded emergency departments. That may be a topic for another day. We can improve our 9-1-1 centers with common sense. Yes, I know you can't teach common sense. We can educate people though. Where does it start? I wish I knew. I do know that there is a Paramedic in San Fransisco that is seeing first hand how it is being done in other countries. He is called the Happy Medic. Click on his name to be taken to his Blog. He is working on the project with Medic999. Both of these guys are Bloggers that took an interest in improving their own systems by combining ideas. The project is being covered by Setla Films, the creator of Level Zero. His company is filming the project to air as a Documentary called The Chronicles of EMS. These EMS professional s have posted updates using multiple forms of social media. You can find their updates on Twitter, youtube and Facebook. If you are not following it already then jump on board. We all have something to learn from what others are doing to improve prehospital health care. Don't fall into the trap of thinking just because you have a Paramedic or EMT license, you can't make a difference. Our system needs change. That change starts with you. Take a look at the project. If you don't get as excited as I am about improving prehospital health care, then you may be in the wrong field.
Saturday, November 21, 2009
Cobb Police: Nurse Recorded Sexual Abuse 112009 | myfoxatlanta.com
This type of crime effects us all in healthcare. It just amazes me how sick some individuals can be. Of course this guy is innocent until proven guilty. Plus he probably had a bad childhood. His parents probably mistreated him. The he was probably picked on in school. The type crimes should be prosecuted to the full extent with no consideration for bogus excuses about why he did what he did. There is no excuse and no one else to blame.
Cobb Police: Nurse Recorded Sexual Abuse 112009 myfoxatlanta.com
Cobb Police: Nurse Recorded Sexual Abuse 112009 myfoxatlanta.com
Friday, November 20, 2009
This isn't a Trauma center!
Over the past 15 years in the field I have noticed a trend here in Georgia. Here we have a Trauma system that rates a hospital's ability to take care of trauma victims. Level one is the top tier for a Trauma Center. Interestingly enough we only have 15 designated trauma centers. Only 4 are designated as Level 1. The rest are considered Level 2 (2 are pediatric). If you want to learn more about the Trauma System and the push to improve it see this link: http://georgiaitsabouttime.com/
The topic I want to discuss is the famous line by nurses all around: "Why did you bring them here? This isn't a trauma center". Now I must say that all hospitals do not operate on the assumption that they cannot care for trauma patients. Their are a sporadic few that don't complain when you bring a trauma patient to an Emergency Room. However, it is much more common to hear this complaint. I understand that sometimes it may be a little taxing to take care of a patient with a traumatic injury. They call it an Emergency Room because it is equipped to handle medical emergencies. Yes, some are better equipe than others. I do understand that some patients have been inappropriately transported to a hospital that is not equipped to handle surgical intervention for a critical trauma patient. What I don't understand is the automatic assumption prior to evaluating a patients condition that the injuries require a trauma center to intervene. I have seen many complaints about the condition being to critical only to find out that the patient was discharged 2 hours later with a minor injury. I don't think that some health care providers understand our level of training and our ability to triage patients. I can appreciate the fact that some Medics are burned out or just plain lazy. But I cannot accept that it is assumed that the Paramedic on shift today is substandard because the Paramedic that worked yesterday made a poor decision.
I know that most ER's are overwhelmed with high volumes of patients at times. I understand that many times staffing is an issue. Patient care comes first. Part of patient care is instilling confidence in the patient that we can handle their condition. If a patient hears either of us complaining about the fact that they may not be at the appropriate facility then they have every right to believe that they are not at the right facility. ED staff please refrain from automatically assuming the patient has not been properly triaged and the proper facility chosen. EMS staff please refrain from being lax in your assessments. Please don't be too lazy to transport your patient to a designated trauma center if their condition warrants transport to the proper facility.
I don't want anyone to make the assumption that I am blaming Nurses, Doctors, PAs, Paramedics or EMT's solely. This is an issue that we must all evaluate and correct. We are a team. We may not work for the same company but we all work for the patient. Let's do our part. If we all improve ourselves, then the patient benefits. Nurses, if you feel the patient was cared for inappropriately, contact your supervisor and have them address the incident. EMS personnel, do the right thing. Don't be surprised when you receive a complaint and don't whine about someone else taking note of you not doing your job properly. We are human, we are subject to make mistakes. We must learn not only from our mistakes but also from others we have seen. A mistake by us may be a wheelchair for our patient. Adequate triage and transport may be their ticket to walking out of the hospital and living without a disability.
The topic I want to discuss is the famous line by nurses all around: "Why did you bring them here? This isn't a trauma center". Now I must say that all hospitals do not operate on the assumption that they cannot care for trauma patients. Their are a sporadic few that don't complain when you bring a trauma patient to an Emergency Room. However, it is much more common to hear this complaint. I understand that sometimes it may be a little taxing to take care of a patient with a traumatic injury. They call it an Emergency Room because it is equipped to handle medical emergencies. Yes, some are better equipe than others. I do understand that some patients have been inappropriately transported to a hospital that is not equipped to handle surgical intervention for a critical trauma patient. What I don't understand is the automatic assumption prior to evaluating a patients condition that the injuries require a trauma center to intervene. I have seen many complaints about the condition being to critical only to find out that the patient was discharged 2 hours later with a minor injury. I don't think that some health care providers understand our level of training and our ability to triage patients. I can appreciate the fact that some Medics are burned out or just plain lazy. But I cannot accept that it is assumed that the Paramedic on shift today is substandard because the Paramedic that worked yesterday made a poor decision.
I know that most ER's are overwhelmed with high volumes of patients at times. I understand that many times staffing is an issue. Patient care comes first. Part of patient care is instilling confidence in the patient that we can handle their condition. If a patient hears either of us complaining about the fact that they may not be at the appropriate facility then they have every right to believe that they are not at the right facility. ED staff please refrain from automatically assuming the patient has not been properly triaged and the proper facility chosen. EMS staff please refrain from being lax in your assessments. Please don't be too lazy to transport your patient to a designated trauma center if their condition warrants transport to the proper facility.
I don't want anyone to make the assumption that I am blaming Nurses, Doctors, PAs, Paramedics or EMT's solely. This is an issue that we must all evaluate and correct. We are a team. We may not work for the same company but we all work for the patient. Let's do our part. If we all improve ourselves, then the patient benefits. Nurses, if you feel the patient was cared for inappropriately, contact your supervisor and have them address the incident. EMS personnel, do the right thing. Don't be surprised when you receive a complaint and don't whine about someone else taking note of you not doing your job properly. We are human, we are subject to make mistakes. We must learn not only from our mistakes but also from others we have seen. A mistake by us may be a wheelchair for our patient. Adequate triage and transport may be their ticket to walking out of the hospital and living without a disability.
Thursday, November 19, 2009
New on the Blog scene
I am new to the world of Blogging. I have not read Blogs until the past week. I will be posting content related to the Emergency Medical field. I look forward to posting content and I look forward to your comments. Hope to learn from others. If you have any blogging tips sned them my way.
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