EMS abandonment? - page 3
last week an outlying county ems crew brought in an elderly male with the c/c of chest pain. the charge nurse sent them to a room but all the staff nurses were in other rooms and didn't go into the... Read More
Dec 18, '06Joined: Jul '06; Posts: 1,394; Likes: 217OP, why would it fall on you? It seems to me that the MD would be in trouble.
I wonder, too, if EMT's were aware of and communicated the ST elevation.
Where was Charge Nurse? Did the nurse whose room the pt was put in know she had a new pt? And that the pt had CP?
I think you need to check policy with your ER manager so there is absolutely no doubt about whose responsibility this sort of thing is.
Dec 19, '06Occupation: trauma er Specialty: 8 year(s) of experience in emergency ; Joined: Jul '06; Posts: 32; Likes: 89thanks for the feedback.
the assigned nurse was with an infant in resp distress being transferred to a peds hospital.
i was triaging another chest pain pt who had come in just prior to the one in question.
the charge nurse was doing whatever charge nurses do.
i don't know exactly what was said during the ems incode and a run sheet wasn't left so i don't know if there was an emt-p on the bus
Dec 20, '06Occupation: registered nurse Specialty: 11 year(s) of experience in ER, telemetry ; Joined: Oct '05; Posts: 230; Likes: 43In the hospital I work at, all of our ER techs are EMTs. We have a few CNAs but they function strictly as CNAs. Our EMTs are authorized by our hospital admin to take report on ER pts, as well as perform all the basic triaage tasks, such as initial EKGs, IVs, blood draws, ISTAT lab draws. We have a 42 bed ER with 2 doctors on at a given time. We may have multiple critical pts in the dept at one time. The doctor signing the run sheet is not necessarily the doc seeing the given pt. The role of the nurse in my dept is to order necessary labs/xrays/ekgs per protocols and need. If the pt is unstable, the doctor then is informed and sees the pt stat. Our doctors do not do EKGs or place pts on cardiac monitors, so to leave a cardiac pt in a room without being monitored, without a primary nurse or EMT (someone who will start taking care of the pt) aware of pts condition and status is neglectful. When tranferring a stable, worked up pt to a tele floor, we can not leave the pt in the room until a nurse has arrived to take over care, i.e. continue to monitor the pt. In a perfect world, all the docs would pitch in and help with triaging pts, do Ekgs, place foleys, start IVs, but it hasn't happened in my ER yet.
Dec 20, '06Specialty: Rotor EMS, Ped's ICU, CT-ICU, ; Joined: Jul '05; Posts: 213; Likes: 12Quote from swtoothHospital policy is definitely the legal standard.It also does not matter what the HOSPTIAL POLICY is it is a legal standard for EMS personnel and has nothing to do with a hopsital policy. Legally EMS personell are responsible for transfering patient care and report to a person that is equal or higher level, so that should be an nurse or physician unless the techs are at the paramedic level.
EMTALA has policies and suggestions on these issues, and sometimes the policies are as vaguely defined as "health care provider" without defining what level of licensure that provider must have, followed by a policy saying that the hospitals must follow their own policy if they have one (i.e. hospital policy may say a report has to be given to a physician, or specifically to the RN assigned to that room). AND, if the hospital violates their own policy, they can be considered in violation of EMTALA.
OTOH, it would be hard for a hospital to implement their own policy over a completely seperate institution such as a ambulance company.