Years ago I had a conversation with a surgeon at our facility. He was unhappy that a seriously injured trauma patient came to our facility after a MVC. ‘These patients shouldn’t come here Ed, they should go to a trauma center!’
Fair enough; we aren’t a trauma center. Not a Level I, not a Level II or III; not even a level 0.5! But we are the only hospital in a large rural county, and the closest, largest facility for portions of a few other counties nearby. The nearest hospital with neurosurgery and thoracic surgery is at least 30 minutes further away.
The problem is, torn blood vessels, crushed spleens, collapsed lungs, swollen brains don’t look at the clock, and cars aren’t designed to wreck only near trauma centers, any more than assailants shoot and stab people only within proximity of appropriate care. (It rather defeats the purpose of attempted murder, you know. )
Recently, my partner had the same conversation with the same surgeon. The patient had been shot twice and was hypotensive. ‘These patients shouldn’t come here!’ We understand, the conditions may not be ideal and trauma is, to be quite honest, fraught with medical and legal peril. Read more »
*This blog post was originally published at edwinleap.com*
The Sudden Cardiac Arrest Foundation has held a “You Can Save a Life” video awareness contest, in which participants were invited to submit videos that raise awareness of cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs). The 2010 grand prize winner is “Paramedic Rap” by 911 Emergency ROCKsponse, a college team that uses humor to get your attention about sudden cardiac arrest:
Although it happened a few weeks ago, I only recently learned of the “retirement” of the blog called “Medic999” by EMS social media superstar Mark Glencourse who works in the United Kingdom. I only learned of Mark and his blog (which was recognized as the 2009 Fire/EMS Blog of the Year) in the past few months in association with the hugely popular Chronicles of EMS project (see the first episode on video here).
In stating why he was stopping his blog, unfortunately, I find similar thoughts being shared by the medical colleagues I know about why people either stop blogging or don’t ever start in the first place:
I find it a shame that the reason for this blog ending is the general lack of understanding of blogging and social media. I feel that I have promoted best practice, shared my passion for the job that I do, and hopefully have shown all readers what it is that makes EMS and those that devote their lives to it so special.
However, there still remains a general unease about social media and blogging in the health service. Read more »
I was about to leave work a few nights ago when EMS was dispatched to a 10-50, which is a motor vehicle accident.
Enough years in emergency care and that tone makes your radar, but doesn’t create much of a blip. Many of those crashes have EMS arrive, only to discover no injuries. Some have patients transported, with minor problems that lead to their speedy evaluation and discharge from our ER. A few have serious, life-threatening injuries. They take all our speed, skill and attention to save life and limb. And often, require transfer to other facilities.
But this last call was none of those. Around 1AM the radio traffic crackled back to dispatch (which we could hear in the emergency department): “Probable Signal Nine.” Signal Nine means the victim is dead at the scene. Not “Dead On Arrival” (DOA) at the hospital, but no hospital necessary.
I knew the paramedics were finished when they asked dispatch to call for the coroner. And my heart sank a little. For all that a multi-trauma is work, I’d rather do it anytime than have someone die, and someone learn of the death. Read more »
*This blog post was originally published at edwinleap.com*
It turns out calling 911 isn’t free. Imagine that. 911 communications may actually cost you money. People who pay taxes aren’t the only ones who are fitting the bill anymore. In some places ambulances are charging fat surcharges for the extra equipment necessary for the ambulance ride? How much does an ambulance ride cost if you are morbidly obese? How does an extra $500 in addition to the base rate. But even people who don’t require extra equipment will have to start paying extra for the right to make the call to 911 communications. How much extra? How much will calling 911 cost in Tracy, California? Well, if you want to pay a $48 per year fee, you can call 911 communications centers as many times as you want. But if you don’t want to pay the fee, how does $300 per call sound. If you’re having a stroke, calling 911 communications may just cost you your arm and your leg.
That’s right. $300 to call 911 communications for an emergency. Or perhaps the problem is too many people are calling for nonemergency reasons. If you can’t get the frequent abusers who show up at the hospital by ambulance for nonemergent problems to stop calling 911, maybe you can collect their $300 by garnishing their welfare and disability checks.
At some point, our country is going to have to stop excusing the actions of the economic tax abusers and start implementing personal responsibility with real consequences that hold folks accountable for their actions. I think charging a fee is an excellent deterant to unnecssary abuse of a system that is overwhelmed with nonurgent convenience care.
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