Comments on: Are We the Gatekeepers to the Emergency Healthcare System? – EMS 2.0

By: We Oughta Look In to This – EMS 2.0 | Life Under the Lights

We Oughta Look In to This – EMS 2.0 | Life Under the Lights — Wed, 08 Jun 2011 13:18:19 +0000

[...] Are We the Gatekeepers to the Emergency Healthcare System? EMS 2.0 [...]

By: Primary Care Paramedics? I think it’s time | Life Under the Lights

Primary Care Paramedics? I think it’s time | Life Under the Lights — Thu, 28 Oct 2010 11:18:46 +0000

[...] while back, I wrote the piece “Did I do Good?” regarding what I think EMS 2.0 should become. I think that Paramedics should be educated and [...]

By: EMS 2.0 as Explained to My Brother | Life Under the Lights

EMS 2.0 as Explained to My Brother | Life Under the Lights — Wed, 26 May 2010 19:18:28 +0000

[...] the conversation, I brought up the scenario that I used to write the post: “Are We the Gatekeepers to the Emergency Healthcare System?” (Unofficially titled, “Did I do g… and explained to him how I evaluated a patient in a nursing home, performed a full assessment on [...]

By: The Gate Keeper

The Gate Keeper — Mon, 25 Jan 2010 03:47:32 +0000

You did as I would have done and maybe a little more. I deal with these types of situations quite often and have developed a little rule that I apply when deciding how the patient is to be triaged.

If they know WHO they are, WHERE they are, HOW they are, and WHY I'm standing there…they call the shots. Now, obviously I have to use some common sence when the patient may not be fully aware of their condition or the extent of their “injury”, and I will not hesitate to encourage further evaluation if it is warrented.

I seem to remember something about consent to treat and that other thing…..kidnapping I believe it is, that we must take into consideration. I do wish the facility staff understood those rules we have to play by before they start demanding that we transport because of their “policy” or just because the doctor said so.

By: Medic999

Medic999 — Mon, 25 Jan 2010 01:24:30 +0000

Again Chris, completely agree with everything you say, however, here is the real humdinger!

I dont think this is enough for EMS 2.0. Yup it is a great start, but it is ultimately relying on the patient saying that they do not want to go.

EMS 2.0 should and will allow the assessing paramedic to do his/her full assessment, and then once all findings are complete make a clinical decision as to whether the patient requires further care at another facility.

The big step is to chance from asking the patient if they want to go to hospital, to instead, informing them that there is no clinical need for them to attend the ER at that moment in time. Not only is that a huge jump for the US systems of providing pre-hopsital care, but it will also be an ennormous jump for the paramedic actually delivering the care!

It will come though eventually, wont it?

By: The Gate Keeper

The Gate Keeper — Sun, 24 Jan 2010 23:47:32 +0000

You did as I would have done and maybe a little more. I deal with these types of situations quite often and have developed a little rule that I apply when deciding how the patient is to be triaged.

By: Medic999

Medic999 — Sun, 24 Jan 2010 21:24:30 +0000

By: Medic999

Medic999 — Sun, 24 Jan 2010 19:24:30 +0000

By: “Controversal” EMT Training | Firegeezer

“Controversal” EMT Training | Firegeezer — Sat, 23 Jan 2010 15:48:41 +0000

[...] Should I incorporate the discussion about EMS 2.0 as articulated by Chris Kaiser in Life Under The Lights? [...]

By: the Happy Medic

the Happy Medic — Fri, 22 Jan 2010 17:24:17 +0000

The MD doesn't even enter into it in my opinion. If the patient wants to stay and I have no reason to take them, they stay plain and simple. We already have this option, it's just legally filed under Patient Declines Transport.
The facility can only override the patient's wishes if they have medical power of attorney (at least in this state).
Sounds like the poor woman fell asleep in the chair. I think we need to change the name of your facility to Not-all-that-skilled.
EMS 2.0 would give you the ability to not only leave her there, but notify the MD and the facility manager as to the condition and disposition through a central network. You know, the one they currently use to bill and refuse care.

Keep it going CK.