WAS967

So for sheer cya why not just RMA them. Now you have a half ass PCR with a list of names and DOBs n them... No exam on them or any other detailed information about the event... And for some odd ball reason it goes to court and the ambulance chafing lawyer asks why you didn't d a full assessment on there client(s). The RMA would only help in this situation to fully cover you from the fear of something happening.

Because an RMA is for patients. If they don't meet any of the aforementioned criteria of being a "patient" then there is no RMA to be done, plain and simple. If your agency has a policy that you do an RMA on everyone regardless, then so be it....RMA everyone. And the resulting report with names and DOBs is hardly half-assed. If it goes to court and they ask why I didn't assess their client I have documentation saying I made contact with them and they denied injury. Fact of the matter is, you can get sued for anything now-a-days. But I'm not going to start forcing people with no injuries to go through a long drawn out process (often in the cold because no ambulance can get there in a reasonable time) of an RMA when none is needed.

Does having a dialog now make them a patient?

If you pull up to a fender bender and everyone says they are okay and just need a police report, are they now patients?

Where in the other hand writing no patient found states that you went to the MVA and found no patients and that the matter was being handled by the police. Simple done. The police report shows who was there thus to link who was involved in the accident. If something hurt or they felt the need for being treated it now rests on them to call again or seek other medical treatment.

My report would show the same and just shows that an effort was made to ensure that everyone was okay and that medical care was offered and they declined. Unlike some providers I have seen who don't even bother to get out of the truck.

Recently this has come up at my job. When is someone a patient? If 6 cars bounce off each other minor damage too all vehicles and no one is complaining of anything, note everyone is up of the vehicles and walking around. Are they all patients? Is a PCR writtien as no patient found with the name of all the individuals that were asked if they were patients? What is the proper way?

The policy of your primary agency stipulates that a person is a patient if any of these three items are met:

1) The person requested medical assistance. (Either directly or indirectly)

2) The person appears ill or injured (subject to good clinical judgement).

3) There is a mechanism of injury that raises enough suspicion in the providers mind that injury could result (this obviously is open to large amount of interpretation).

Out of sheer CYA, if I roll up on an MVC that involves 6 parties and all of them state they are okay, I grab names and DOBs so that if later on down the road someone turns around and claims I never offered them assistance I have it documented that I made contact with all involved and they denied injury at that time.

It was also mentioned in Mike's recent SEMO/SEMAC notes that Intubation is STILL in the NYS AEMT curriculum.

"While not included in the National EMS Educational Standards, ET was included in the NY AEMT curriculum, apparently a holdover from the EMT-Intermediate level of care. This revelation both surprised and perplexed those at the meeting. Several regions have not include intubation in their AEMT protocols; the Bureau maintains that material in a curriculum must be taught and tested, regardless of regional authorizations of practice."

IF you read the NY Post article it says at the end that the patient was transported by an ambulette. The luxury ambulance wasnt even involved.

Kinda makes you wonder.....if YOUR local dispatch center is disabled, what backups can you failover to?

Completely missing the point.

I actually got your point. I was being a smart ass. Note the winkey.

Any billing "soft" or "Hard" is illegal in a fire district based EMS in NYS.

Wasn't there legislation in the works in Albany to fix that?

Company I used to work for was based in CT. Had a CON for NY. Sent an ambulance to NY with a CT plate. Someone complained. NYS DOH told them to go squat and that if the company wanted to, they could sue. So no, you don't have to be NY Registered/Tagged to be NYS DOH certified.

Reverse case however I think is not correct. For CT as an example. NY Based agency operates several units in CT. I believe in order for them to get their CT trucks certed in CT they had to get CT registrations/tags. The CT certification process is far more annoying than NY IMHO. You not only have to prove need (similar to a CON) on an agency basis, but on a per UNIT basis. Said agency only had one truck certified for CT and was regularly pulling the NY truck from over into CT for 911 jobs. Someone in CT got their panties in a pinch and complained so the agency had to petition for an additional certified CT truck with CT EMS.

Gotta love those political hoops.

Actually, they don't have to carry band-aids. It's not part 800.

So nobody here knows why MLSS was there.

Got it.

Wedge nailed it. Charlie will be sorely missed by all who EVER worked with him.

So I was watching news 12 just now and either they were using old news footage and making it look like it was live or my eyes doth did just see a MLSS box ambulance in New Rochelle as part of the Presidential motorcade. Yes/No/Maybe/None-of-the-above?

Too bad Physio doesn't have a monitor the size of the LP20 that we can use in the field. The LP12/15 is heavy compared to what I would expect in this day of electronic miniaturization.

There are agencies still using LP10s? Can they be retrofitted to be biphasic?

I'd love to play with a Zoll X series. I've heard so many good things. The idea of something lighter than the boat anchor of an LP15 seems a huge plus.

To the best of my knowledge: WEMS IS a private ambulance service but unlike MLSS/Transcare/etc WEMS is a not-for-profit organization. Just like any of the hospitals that participate in the Stellaris Network (also not-for-profit), WEMS can accept donations (tax deductible for the donor) of equipment, funds, and (wo)manpower.

Regardless, there is nothing that says you can't give money or equipment to a FOR PROFIT company. It's just not as advantageous however since it's not generally tax deductible.

Date: 12/3/2013
Time: Now

Incident Type: Chimney Fire with Extension into the structure
Location: 386 Dogtail Corners Rd, Dover, NY MAP

District: Dover (Dutchess County), NY
Units: 36-12, 36-13, 36-45, 36-71, 54-14, 54-31, Wassaic 31, Gaylordsville and Sherman Tankers,

Description: Initially reported as a chimney fire. Upgraded to second alarm of fire.

0434 - Fire appears to be knocked down.

0435 - Cutting exterior, checking for extension.

Nebulized narcan works. Why don't we do it? Who the hell knows.

Resps of 12 and Sat 97% on R/A? Leave em alone. I'd rather take an obtunded person into the ER and let them manage the problem in a controlled environment than risk crew safety by waking up an opiate junky and have them start swinging in an small enclosed box.

But will I be able to talk to dispatch on a portable or will 60 continue to tell me "You're not making it on the portable, please switch to your mobile" (And impossibility when you are in the midst of patient care and/or quite a bit away from mobile).

I've said it before and I'll say it again, the communication system in Westchester sucks. Love the dispatchers (most of em anyway) but they are overwhelmingly busy and understaffed, the policies in place suck and bind their hands in many ways, and the radio "system" is a patchwork of stupidity. If Dutchess had a trunked radio system it would be my Nirvana. </rant>

Would now be a good time to point out that the DOH mandate for "vaccine or mask" doesn't seem to apply to EMS providers?

NYS V&T Section 114-b. "Emergency Operation. The operation, or parking, of an authorized emergency vehicle, when such

I was about to ask how we'd meet Part 800.24(a) but it only mentions the need to carry a device capable of carrying a second recumbent patient. It doesn't seem to say that said patient need to be able to be carried in the ambulance at the same time as the first. Hmmm.

You can only carry 7 in the gun. Carry more magazines. =) And technically you aren't allowed to CCW in NYC anyway unless LEO or other special conditions (from my understanding). [Links for clarification appreciated]

Will this be accessible for use to agencies outside of Yonkers? If so, great! If not, I give it six months before one is sitting outside DES in Valhalla.

I was wondering if this was the one Chief Volk mentioned at a recent regional meeting. My guess is DES is getting one as well. Will be good to have for nursing/assisted living evacuations like the Westledge or Atria Ossining evacs.

If you want to be technical, EMS people aren't professionals in the strictest sense of the definition of the term. There was discussion of this same thing in relation to nurses in my transitions class. Wierd huh?

http://en.wikipedia.org/wiki/Professional#Definition

Everett is indeed a very good leader. Good command of scenes, and good morale booster for the whole department. I look forward to seeing the new BRAT in person.