True Story…
The dispatch information was updated before we had even rolled our rig out onto the pad. Eye injury, no serious symptoms. Jodie shut down the lights and I informed dispatch that we’d be responding non-emergent.
Up stairs and inside the small two bedroom apartment, Samantha, our patient, was waiting on the couch, holding a hot compress to her swollen right eyelid. Mom worked calmly in the kitchen finishing diner for her other two children. Alan, Samantha’s father sat on the edge of his seat next to his daughter in a state of barely containable anxiety.
He had recently arrived home from work and his wife had informed him of the apparent infection in Samantha’s right eye. One look and he was on the phone to us. Now he breathed rapidly as he fumbled through a list of questions. What caused it? Could it damage her vision? Could she lose her eye? Could she go blind?
I cleared the engine to go back in service and sat down next to him. Over the next ten minutes we both explained what pink-eye was and how to take care of it. We talked about hot-compresses and how contagious the bacteria was going to be. We reviewed the typical course for such and infection. How to prevent it in the other kids. How likely it was that one of them already had it. And we discussed his plan for morning. (It involved asking a neighbor to drive them to a near-by clinic.)
Alan called 911 for pink-eye. And…(This part is bound to be controversial, depending on what kind of system you work in.) I never offered to take him to the emergency room. And he never asked.
Read This Entire Literary Masterpiece…
Physical restraint techniques and procedures are a subject of debate and controversy in EMS. Few agencies have taken the time and energy to research and develop a comprehensive restraint guideline for field providers to follow.
When violent or aggressive patients show up (and they always do) EMT’s are left to fend for themselves. In these situations we take on a great deal of risk, both personal and legal, to bring the patient safely to the hospital.
I’ve had my share of both good and bad take-downs. When things go well the call transitions smoothly from the street to the hospital. The patient stays protected, the prehospital personnel stay safe and everyone goes back in service happy.
When things go badly people get hurt, patient care gets compromised and everyone ends up writing a lot of paperwork. In the worst cases you may end up sitting across from your patient in a courtroom explaining why you made the decisions that you made.
Here are some tips to help make your next patient restraint scenario go smoothly. Follow these guidelines and you’ll reduce the possibility of ever having to explain your actions. If you do end up needing to justify your decisions, you can take comfort in the fact that these gudeliness give you a rock solid foundation of compassionate, patient centered care.
Read This Entire Literary Masterpiece…
Steve Valdez only wanted to cash a check. In retrospect it seems so simple. The check was written to him from his wife’s account at Bank of America. He had two forms of ID, both with photos. The address on the drivers license was the same as the ID on the check (printed by Bank of America.) Bank of America thought differently.
Here’s the rub. B of A has a written policy that states if you don’t have an account at their bank you need to leave a thumbprint. You’ve probably seen those by now. Either you dab your thumb in an ink blotter or you use the fancy thumb scanner. But Steve Valdez doesn’t have any arms. And based on his inability to make a mark with his non-existent thumb, B of A refused to cash the check.
Clearly the bank representative thought that following the rules was the safest option. Instead of considering the needs of the customer, interjecting common sense into the matter, taking on a wee bit of personal risk on behalf of the individual being served and making a simple accommodation, the bank manager stuck to her guns. Rules are rules. And now the story has been picked up by the AP news wire and it’s everywhere.
Don’t laugh. It could happen to you. We all operate under multiple sets of rules and regulations from our written protocols to our national scope of practice to our organizations policy manual. We all are expected to apply a set of pre-established rules to our jobs in EMS. The question is how we perceive those rules. Do they trump basic common sense?
Do the prohibit us from acting in the patients best interest? When are we allowed to forgo the rules? If we decide it’s only in emergencies … well, were bound to encounter a lot of those.
Read This Entire Literary Masterpiece…
Sure you communicate with your patient, but do you make connections? The difference may sound like 
semantics … but it’s not. The difference is extraordinary.
Do you remember James Burke? He was the plucky, dry humored narrator of the 1970s BBC TV series “Connections”. James would begin each episode with some historical event like the invention of the catapult and show how it was related to the way we make billiard balls or some other impossible sounding connection. His message was simple and profound. The big idea was that we are interconnected in ways that are complex and impossible to predict. Reality doesn’t flow forward in a perfect linear timeline. An intricate web of human connections drive history and innovation forward.
Without one minor connection another crucial event becomes impossible. Alter one seemingly insignificant event and you change the course of history.
There is something vital in the way we are interconnected. When we connect, we change each other in ways that we can’t predict. If we simply communicate with our patients and coworkers but never reach out across that gap and connect with them, our work can become dull and routine. On the other side of the gap the patient / caregiver / human relationship is far more fulfilling.
If that sounds worthwhile, let me give you a few tips for making conscious connections with your patient.
Read This Entire Literary Masterpiece…
… It could happen to you
That’s what EMT Paul Casson of the Bronx is learning. On New Years Eve, Paul was waiting to drop off a five 
year old child at Lincoln Hospital. Per investigators, Paul got tired of waiting, so he decided to forge a signature on his run sheet and leave the child behind.
Apparently the child had non-life threatening injuries and Paul figured someone would be by shortly to take care of him. Now Paul is being charged with endangering the welfare of a child. Here’s the crazy part.
If he’s convicted, this guy could spend the next seven years in prison thinking about what it means to be an advocate for your patient. The good news is that most of us don’t need laws to tell us to take good care of people and protect them. But Paul’s story is certainly a good reminder.
Read This Entire Literary Masterpiece…
