That paramedic's certification will be pulled. How does a paramedic make a determination like that? All heartburn has to be treated as a cardiac unless it is established by a physician as being otherwise. Nurses know that and paramedics are taught that. Let this be a lesson to all health care providers, but also to those who have heartburn. MI vs. GI has a basic protocol in an Emergency Room under monitored circumstances and should not be a pre-hospital assessment. Heartburn is a cardiac warning!
he had chest pains and diff breathing and they didn't suspect something was wrong??
it'll be a he said, she said argument in the end, but more than likely they medic(s) will lose their licenses. hope there was some very detailed paperwork written up.
i get posts deleted for joking around and its called monday morning quarterbacking...you guys have these members of the DCFD tried and hung already...monday morning quarterbacking??? so you believe everything in the news now...as gotum said i'm sure the DCFD pre-hospital care report will indicate he didn't want to go, RMA'd and that was it. Ever try to pursade a macho 39 year to go to hospital because he may die? You get the reaction of yea ok, i'm gonna have a heart attack, i'm 39..only 70 year old have heart attacks. Let's give our brothers in DC a shot first.
I wasn't saying I believed everything the news report said. There was probably an RMA involved...no mention of that in the news though. That's why I said I hoped they had some very detailed paperwork and a witness that wasn't a family member...
the news claims they took a set of "normal" vital signs. i wonder if they did an EKG. im not ALS, but i would imagine at that point there would have been an irregular heart rhythm. can someone shed some light on that?
as much as i support our own and distrust the news, i am curious about the fact that heartburn and antacid was brought up. if the paramedics were convincing him to take transport in the hospital for a possible cardiac, why was there any mention of heartburn?
its in the legal system now, and im sure it will end up a mess. my thoughts go out to both the family and the responders caught in this debacle. everything will be questioned and questioned again...
I work in DC area... Talked to a buddy who is DC Fire/EMS... They did a 4 lead EKG, and took V/S.. But we all know you can have a normal EKG and still be infracting...
Also they were both FF/EMTs on Amb. 30 and Paramedic Engine Co. #30 with a FF/Paramedic on board...
Sounds like the poo pooed the patient into an RMA. or just left without getting one...
Whatever happened this will be a PR nightmare...... when a patient calls always better to just take them to the ER,, a lot less ppw in the end.
If they got the rma, then everything should be ok.. But what I don't understand, if u take the time to do an ekg.. Why not transport?? Where I am, by the time als puts that stuff on we are @ the hospital
IF they did all that I would like to think they documented the fact it was ama. Also with a case like this if the Pt. wants to rma/ama call medcom and have him/her speak to them. Just another way of C.Y.A.
First off, Gunsnhoses is right. We are hearing one side. Lets wait and hope they acted correctly.
Secondly, it depends how RMA's are done. They may be handled differently down there than in NY. signal21, can you go into how its done?
Third, an RMA is not the be all end all. if you tell a patient who is having chest pains a load of BS (not saying this happened here but just making an example) and get the RMA, are you really in the clear. doubt it when all the info comes out.
It may take longer to get to a hospital in DC than here, where we are 2 mins from a hospital no matter where u are. Plus, having driven down there, I saw a bus goin lights and not moving. just stuck in traffic.
i dunno, i hope these two paramedics, who probably have extensive training wouldnt be so stupid as to leave the house without an RMA. That is pure criminal even if the guy had a stubbed toe.
like most cases with first responders and the news, the truth will come out one day, i doubt we are hearing the full story.
Since we don't know the other side of the story, it's tough to know what really happened.
This case aside, I have always felt that the RMA is the most dangerous position that EMS get put into. Being the last medically trained person to see a patient and have them not go the hospital is simply a powder keg of potential problems and liability. Contrary to popular belief, the RMA is the most important PCR in regards to documentation.
If they got the rma, then everything should be ok.. But what I don't understand, if u take the time to do an ekg.. Why not transport?? Where I am, by the time als puts that stuff on we are @ the hospital
where i am from, ALS can do 90% of what the hospitals can, and catheterization is in the 10% of what they cant. this guy could be having an inferior wall MI and they wouldnt have known.
obvioulsy this guy and his family didnt deem himself to be in that much danger, they didnt call 911 back and they didnt drive to the hospital themselves.
this is a tragedy, and should be treated as such. Just because you called 911 doesnt mean everything is well and good, you have to take steps towards helping out also. If you want to go, dont sign the paper, and make sure that you call 911 back and tell them what happened.
According to DC Protocols, "Explain the risks and possible consequences of not seeking medical care ..... Encourage to patient to reconsider transport ... etc .
Pretty cut and dried, and I'm not trying to bang out our DC brothers, but from what the family said, it sounds like they were convinced he was fine and talked out of going.
Also DC Fire/EMS runs and Engine with only 1 Paramedic on it,, so there was only 1 medic and 2 EMT's at the scene.
We explain to the patient about it. It can be used to refuse spinal immobilization, care, treatment, transport or all services.
They then sign it, you put the date,incident location, your name and ID#. Give them the pink little nice copy, and go on your merry way. Back to the firehouse to staff the engine.
More Information
Paramedics make fatal misdiagnosis
Linear Mode
