RE: (unknown)

[Guest guest]

It is also a violation of the " White " act.

Atwell Rasmussen, Ph.D., REMTP

Lieutenant, Education and Training

Greenville County Emergency Medical Services

301 University Ridge, Suite 1100

Greenville, SC 29601

Re: (unknown)

HIPPA clarifies how much patient information is too much patient

information in

a public format. Obviously, dispatch relaying that a patient has a

communicdisease over a transmission that can be intercepted by the public is

a

possible violation of HIPPA. Why dispatch that a patient has a communicable

disease? Standard precautions and a detailed history should be a normal

aspect

of patient care. We all need to get past the " Scarlet Letter " syndrome.

-mikey

RaaEMS605@... wrote:

> In a message dated 8/16/01 8:25:55 AM Pacific Daylight Time,

> steve_dralle@... writes:

>

> > That is not the understanding I have, I have been told by my EMD

> > colleagues that they are not authorized to send that information to the

> > crews by any method.

> >

> > Steve Dralle

> >

> >

>

> Just as information, I know of one EMS service in the Dallas/Fort Worth

area

> that dispatches there units and if the patient is known to have Aids, HIV,

or

> other communicable disease have a code for it such as " Code 27 " . They

seem

> to work well using that system.

>

>

[Guest guest]

HIPPA clarifies how much patient information is too much patient information in

a public format. Obviously, dispatch relaying that a patient has a

communicdisease over a transmission that can be intercepted by the public is a

possible violation of HIPPA. Why dispatch that a patient has a communicable

disease? Standard precautions and a detailed history should be a normal aspect

of patient care. We all need to get past the " Scarlet Letter " syndrome.

-mikey

RaaEMS605@... wrote:

> In a message dated 8/16/01 8:25:55 AM Pacific Daylight Time,

> steve_dralle@... writes:

>

> > That is not the understanding I have, I have been told by my EMD

> > colleagues that they are not authorized to send that information to the

> > crews by any method.

> >

> > Steve Dralle

> >

> >

>

> Just as information, I know of one EMS service in the Dallas/Fort Worth area

> that dispatches there units and if the patient is known to have Aids, HIV, or

> other communicable disease have a code for it such as " Code 27 " . They seem

> to work well using that system.

>

>

[Guest guest]

but them figuring it out and *legally* being able to figure it out should be the

differentiator. You *should not* be held liable if you took steps to encrypt

the data beyond a reasonable legal standard, which is most likely defined

somewhere by the wireless data industry. I'd talk to a wireless data rep

(motorola is probably a good starting point), and of course, your attorney for

your service.

A determinant is a code that contains health information. Are determinants over

the air considered illegal by this instructor?

Mike

Re: (unknown)

In a message dated 8/16/01 8:25:55 AM Pacific Daylight Time,

steve_dralle@... writes:

> That is not the understanding I have, I have been told by my EMD

> colleagues that they are not authorized to send that information to the

> crews by any method.

>

> Steve Dralle

>

>

Just as information, I know of one EMS service in the Dallas/Fort Worth area

that dispatches there units and if the patient is known to have Aids, HIV,

or

other communicable disease have a code for it such as " Code 27 " . They seem

to work well using that system.

[Guest guest]

12 stories up in highrise apartments. caller relays history of TB, not relayed

to crew. crew arrives, unknowing, and has to go *back down* to the unit for

face masks they don't carry on their persons as part of standard PPE.

That's one reason... <g>

IMHO, more information is better. Of course, the caveat is more *legally

transmitted* information is better for *this* discussion.

Mike

Re: (unknown)

HIPPA clarifies how much patient information is too much patient information

in

a public format. Obviously, dispatch relaying that a patient has a

communicdisease over a transmission that can be intercepted by the public is a

possible violation of HIPPA. Why dispatch that a patient has a communicable

disease? Standard precautions and a detailed history should be a normal

aspect

of patient care. We all need to get past the " Scarlet Letter " syndrome.

-mikey

RaaEMS605@... wrote:

> In a message dated 8/16/01 8:25:55 AM Pacific Daylight Time,

> steve_dralle@... writes:

>

> > That is not the understanding I have, I have been told by my EMD

> > colleagues that they are not authorized to send that information to the

> > crews by any method.

> >

> > Steve Dralle

> >

> >

>

> Just as information, I know of one EMS service in the Dallas/Fort Worth area

> that dispatches there units and if the patient is known to have Aids, HIV,

or

> other communicable disease have a code for it such as " Code 27 " . They seem

> to work well using that system.

>

>

[Guest guest]

but the key here is - can the transmission be *legally* intercepted? MDT's

encode data, and it's illegal to decode it unless you're the intended recipient

(or have a warrant). It's not a violation if you could *say* it to someone you

were standing next to (who's working with you), just because you " transmit " it,

as long as you take reasonable, prudent precatutions against interception and

promulgation of the data. Coming from the computer side of the fence, the

infrastructure exists to make this *easily* done. RIM Technologies has some

great little units that can do this, and they use encryption that's based

against your own organization's server(s). Your voice is a method of wireless

transmission, too - are we considering talking to your partner illegal wireless

transmissions, too?

Mike

Re: (unknown)

HIPPA clarifies how much patient information is too much patient

information in

a public format. Obviously, dispatch relaying that a patient has a

communicdisease over a transmission that can be intercepted by the public is

a

possible violation of HIPPA. Why dispatch that a patient has a communicable

disease? Standard precautions and a detailed history should be a normal

aspect

of patient care. We all need to get past the " Scarlet Letter " syndrome.

-mikey

RaaEMS605@... wrote:

> In a message dated 8/16/01 8:25:55 AM Pacific Daylight Time,

> steve_dralle@... writes:

>

> > That is not the understanding I have, I have been told by my EMD

> > colleagues that they are not authorized to send that information to the

> > crews by any method.

> >

> > Steve Dralle

> >

> >

>

> Just as information, I know of one EMS service in the Dallas/Fort Worth

area

> that dispatches there units and if the patient is known to have Aids, HIV,

or

> other communicable disease have a code for it such as " Code 27 " . They

seem

> to work well using that system.

>

>

[Guest guest]

Comments inline...

Re: (unknown)

Thank you Mike,

What exactly are you going to do differently knowing this information enroute

as opposed to when you get on scene? IF you are told this info on the patient's

who volunteer it over the phone (and probably when you arrive on scene

too)...what about the scores of patient's who don't tell you until later in the

call IF at all?

M> Knowing more is better than knowing less, or nothing at all. If they

give the information over the phone, it should be relayed to the crew(s)

responding in a responsible, protected manner whenever possible. IMHO.

One issue of giving out this information (as well as myriads of other

information such as " patient is ETOH " or " patient has no real complaints " , etc)

is it pre-disposes health care providers treatments. And with communicable

diseases, if it consciously or subconsciously predisposes your treatment, then

you are opening up a liability issue of discrimination.

M> Not really. Just because I know someone is TB+ doesn't mean they won't

get a breathing treatment if they are also having an asthma attack. But it does

change my mindset on using a HEPA filtration mask for me.

I agree certain information is necessary such as a chief complaint, type of

call, and potential threats (guns, knives, baseball bats, etc) where we would

delay entry until PD arrives, but I cannot nor could I ever understand why we

need to know about communicable diseases prior to arrival.

M> Communicable diseases have different methods of transmission. If I

have a long journey into a scene (up 12 flights of stairs in a dilapadated

apartment slum), I'd rather know more ahead of time so I can bring the right

gear (and the counter-arguement is " When you know you're going there, take

everything! " but that's not always possible, and rarely effective).

Additionally, it may influence how early I call for additional help... but you

are right - it should not (and I can honestly say does not) affect treatment

decisions, complete assessments or patient management.

Body Substance Isolation procedures must be used consistantly to be effective.

If you only use the equipment when you are told of a disease...again you are at

risk with many other patients who never tell you. It is like body armor, works

great if you wear it on EVERY call all the time....doesn't work too great when

you only put it on when the dispatcher tells you that there was a shooting or

stabbing....

M> Are you telling me that you wear gloves, eye protection, a HEPA mask

and full gown on every call you make? BSI gear is like anything else - you use

what you need for the situation. I don't think I need to wear a face mask every

call... but won't hesitate to don gloves for every call. It's about what's

appropriate... and an all or nothing approach is rarely appropriate.

Just my thoughts...

Dudley

[Guest guest]

Unless the scene is contaminated in such a way that the responding crews

should not approach without special equipment, information about known or

suspected communicable diseases is superfluous and should not be transmitted.

BSI techniques must be used religiously, no matter what the call.

E. Gandy, JD, LP

EMS Professions Program

Tyler Junior College

Tyler, TX

[Guest guest]

Even if they *illegally* figure it out, they can be prosecuted, but that is not

a defense for you or your service from a civil suit when the patients health

history is made public. As far as using determinants, as long as they are not

specifically about a communicable disease, and are vague stating just the nature

of the call such as diabetic, or chest pain, they are okay. Privacy issues are

somewhat stricter when it comes to communicable diseases.

Re: (unknown)

In a message dated 8/16/01 8:25:55 AM Pacific Daylight Time,

steve_dralle@... writes:

> That is not the understanding I have, I have been told by my EMD

> colleagues that they are not authorized to send that information to the

> crews by any method.

>

> Steve Dralle

>

>

Just as information, I know of one EMS service in the Dallas/Fort Worth

area

that dispatches there units and if the patient is known to have Aids, HIV,

or

other communicable disease have a code for it such as " Code 27 " . They

seem

to work well using that system.

[Guest guest]

It's not necessarily the transmission of the information that is the illegal

part. It's what the person you are transmitting the information will or

won't do because of the information received..

Will the fact that the person responding to the patient act any differently

in dealing with the patient? Will the normal care of that patient be lacking

something secondary to the knowledge that was illegally transmitted. The

safest policy to adopt is one that allows the patient the opportunity to

divulge any information they feel is necessary to the responding crew.

The fact remains that no matter how the information is relayed; rather it be

by radio, telephone, pager, MDT, signals, codes, or by smoke signals is view

under the law as a violation of that patients rights, and places the person

who transmitted it, the person that receives it, and the agency involved in

a litigious position.

Best bet....Take universal precautions on all patients and treat every

patient as if they have a possible communicable disease until proven

otherwise!

-Thom Seeber

[Guest guest]

Mike,

What happens when the caller is a neighbor who heard a " thump' and you climb

up 12 stories WITHOUT your masks....the patient is conscious and you find out

that they have TB from the patient......you still have to go all the way back

downstairs and get your masks.....that is why they are called " Personal "

protection and should be carried on your PERSON all the time.

We all have room for shears, penlights, badges, pins, patches, flags, belts,

boots, KNIVES, tape, hemostats, L-scopes, etc on our person....why don't we

carry other such pertinent info on our person ONLY when dispatch tells us we

need to.

I have to laugh...is there truly anyone on this list who has NEVER complained

about the quality of the dispatch they receive; laughing at the mistakes and

errors they make and saying " boy, they never get it right " ....but then we

depend upon dispatch to tell us WHEN to take PPE precautions.....seems kinda

odd to me.

Dudley

[Guest guest]

Dispatcher Point of view. We do receive info such as HIV or AIDS and such

over the phone. But due to previous law suites setting the standard we

cant give this info out over the radio or cell phone. We cant even flag an

address in the CAD system because once a call comes in and that info is

transferred to the call then it is public record. As a responder I

understand the need for this info but we are faced with certain legal

restrictions also.

Frederick

Odessa Emergency Communications

[Guest guest]

Or they could comply with the law and have the appropriate ppe readily

available. Bat belt with small pouch to carry mask, etc.

Atwell Rasmussen, Ph.D., REMTP

Lieutenant, Education and Training

Greenville County Emergency Medical Services

301 University Ridge, Suite 1100

Greenville, SC 29601

Fw: (unknown)

Resending...

Re: (unknown)

HIPPA clarifies how much patient information is too much patient

information in

a public format. Obviously, dispatch relaying that a patient has a

communicdisease over a transmission that can be intercepted by the public

is a

possible violation of HIPPA. Why dispatch that a patient has a

communicable

disease? Standard precautions and a detailed history should be a normal

aspect

of patient care. We all need to get past the " Scarlet Letter " syndrome.

-mikey

RaaEMS605@... wrote:

> In a message dated 8/16/01 8:25:55 AM Pacific Daylight Time,

> steve_dralle@... writes:

>

> > That is not the understanding I have, I have been told by my EMD

> > colleagues that they are not authorized to send that information to

the

> > crews by any method.

> >

> > Steve Dralle

> >

> >

>

> Just as information, I know of one EMS service in the Dallas/Fort Worth

area

> that dispatches there units and if the patient is known to have Aids,

HIV, or

> other communicable disease have a code for it such as " Code 27 " . They

seem

> to work well using that system.

>

>

[Guest guest]

Jimmie,

According to Rule 157.11 (Requirements for EMS Provider License) Section (i):

" At least the following equipment and supplies shall be present on each

in-service vehicle and on, or immediately available for, each response-ready

vehicle at all times:

1 BLS:

(M) Automatic External Defibrillator (AED) or equivalent;

Under 2 ALS it says " all required BLS equipment " and 3 MICU " cardiac

monitor/defibrillator (in lieu of AED) " .

SO, yes all ambulances in the state of Texas must have defib capabilities

irregardless of license level.

Dudley Wait

[Guest guest]

I believe it is. I thought I was wrong once, However I was mistaken.

Henry

" Jimmie West Jr. " wrote:

>

>

>

> I have question and thought that someone here would know the correct

> answer.

> I need to know is it a TDH requirement that an ambulance whether it is

>

> transfer or 911 carry either a monitor or an AED.

> I've been told that is was and wasn't a requirement what is the rule.

>

> _________________________________________________________________

> Get your FREE download of MSN Explorer at

> http://explorer.msn.com/intl.asp

>

>

>

[Guest guest]

Joe,

There are lots of sites on the web that you can go to to listen to heart

sounds. Just do a google.com search for " heart sounds " and you'll get to

some of them. Also there are available tapes that you can buy from various

people. The problem is that they are presented in the abstract, and it's

hard to hook them up to a patient that you see in the field. Also, the

problems with noise in the background and so forth are always maddening.

My best advice is for you to try and hook up with a good internist or

cardiologist and ask them to let you follow them around and do rounds with

them. Many docs would welcome the opportunity to teach you in that way. Go

to the telemetry floor and listen to as many hearts as you can. Ask the ER

docs to let you listen to their patients and teach you. Some may question

why, as a paramedic student you would need to practice this, but that may be

your opening to get them to listen to you. The ultimate answer is " to have

the knowledge. " Knowledge for it's " own sake " as we say in Texas is not a

bad thing to have.

The old docs who practiced before the advent of ECGs, echocardiograms,

cathlabs, and such, could diagnose many conditions just by listening. They

could find the PMI (point of maximum impulse), and distinguish between

clicks, murmers, split sounds, and so forth. Many docs now can't do that

because they rely upon the diagnostic bells and whistles.

Good luck in your quest for knowledge. Let me know how I can help you.

Gene

[Guest guest]

RIGHT BACK TOO YA JO!! THANKS HON. YOU GUYS ARE THE BEST!!!

HUGS

SHARON

(unknown)

SOME OF YOU MAY NEED THIS MORE THAN OTHERS BUT WE CAN ALL USE ONE. LUV

YA JO

Just to say we love ya!!!

HUG CERTIFICATE

            Please Send Back

If I could catch a rainbow

I would do it Just for you

And share with you Its beauty

On the days You're feeling blue

If I could build a mountain

You could call Your very own

A place to find serenity

A place to be alone

If I could Take your troubles

I would toss them In the sea

But all these things I'm finding

Are impossible for me

I cannot build a mountain

Or catch a rainbow fair

But let me be What I know best

A friend That's always there

This is a Hug Certificate!!

Send One to All of Your Friends You Think Deserve A Hug.

Send This to Your Friends Including The

Person Who Sent It To You!

If you receive this back 1 Time - Open Up! Find More Friends

If you receive this back 2 Times - You Are Off to a good start.

If you receive this back 3 Times - You Are a Good Friend

If you receive this back 4 Times - You Are Popular If you receive this

back 5 Times or More - - - - There are Angels Watching Over You

                              

http://community.webtv.net/jowaca/JOSFAVORITEPICTURES

[Guest guest]

JO SO FUNNY!!!HOW YA DOING HON?

HUGS

SHARON

(unknown)

There was a midget down in Texas who complained to his buddy that his

testicles ached almost all the time. As he was always complaining about

his problem, his friend finally suggested that he go to the doctor to

see what could be done to relieve the problem.

The midget took his advice and went to the doctor and told him what

the problem was. The doctor told him to drop his pants and he would have

a look.

The midget dropped his pants. The doctor put him up onto the

examining table and started to examine him. The doc put one finger under

his left testicle and told the midget to turn his head and cough, the

usual method to check for hernia.

" Aha! " mumbled the doc and putting his finger under the right

testicle, he asked the midget to cough again. " Ahhha!' " said the doctor

and reached for his surgical scissors.

Snip, snip, snip, snip on the right side then snip, snip,   snip,

snip, on the left side. The midget was so scared he was afraid to look,

but noted with amazement that the sniping did not hurt.   The doctor

then told the midget to pull up his pants to see   if they still

ached. The midget was absolutely delighted as he walked around the doc's

office and discovered his testicles were no longer aching. " Gee, Doc,

what did you do? " he asked. The doc replied, " I cut two inches off the

tops of your cowboy boots. "

                              

http://community.webtv.net/jowaca/JOSFAVORITEPICTURES

[Guest guest]

Hi! I am 12 days post UAE, and was wondering about others' experience

with relief of symptoms. I really don't have a lot of relief yet; my

problems were bloating, bowel and bladder problems. Am I being

impatient? I still feel like I have to urinate often, especially when

moving around. Can anyone share ideas? THanks, Diane

Dawn Nagar wrote:

>

> Hello my name is Dawn and I have recently been diagnosed with uterine

> fibroids I am 26 years old and I have been having complications for two

> months now. I have been having heavy bleeding and pain. My doctor has

> suggested taking progesteron and birth control pills to stop the bleeding,

> she has also done 2 D & C procedures to try to stop the bleeding. Are there

> any safe removal procedures? And what are the chances of conceiving after

> removal? Has anyone had a UAE and conceived? Thanks for your help

> Dawn

>

> _________________________________________________________________

> Send and receive Hotmail on your mobile device: http://mobile.msn.com

>

>

>

[Guest guest]

Give it more time. Antibiotics really screw up my digestive tract. I was

horribly bloated and constipated after the procedure.

Ginny

Re: (unknown)

> Hi! I am 12 days post UAE, and was wondering about others' experience

> with relief of symptoms. I really don't have a lot of relief yet; my

> problems were bloating, bowel and bladder problems. Am I being

> impatient? I still feel like I have to urinate often, especially when

> moving around. Can anyone share ideas? THanks, Diane

>

[Guest guest]

Give it more time. Antibiotics really screw up my digestive tract. I was

horribly bloated and constipated after the procedure.

Ginny

Re: (unknown)

> Hi! I am 12 days post UAE, and was wondering about others' experience

> with relief of symptoms. I really don't have a lot of relief yet; my

> problems were bloating, bowel and bladder problems. Am I being

> impatient? I still feel like I have to urinate often, especially when

> moving around. Can anyone share ideas? THanks, Diane

>

[Guest guest]

Hi Diane, I'm 2 months post UAE and had the bladder problems. Some

here have reported almost immediate relief, but for me it was

gradual. Over about 3 weeks I guess, until I noticed I was only

getting up once a night, and then it was usually if something else

woke me up 1st. Didn't experience the other problems so much, so

can't help you there. Hope that helps.

Christy

> >

> > Hello my name is Dawn and I have recently been diagnosed with

uterine

> > fibroids I am 26 years old and I have been having complications

for two

> > months now. I have been having heavy bleeding and pain. My doctor

has

> > suggested taking progesteron and birth control pills to stop the

bleeding,

> > she has also done 2 D & C procedures to try to stop the bleeding.

Are there

> > any safe removal procedures? And what are the chances of

conceiving after

> > removal? Has anyone had a UAE and conceived? Thanks for your help

> > Dawn

> >

> > _________________________________________________________________

> > Send and receive Hotmail on your mobile device:

http://mobile.msn.com

> >

> >

> >

[Guest guest]

Hi Diane, I'm 2 months post UAE and had the bladder problems. Some

here have reported almost immediate relief, but for me it was

gradual. Over about 3 weeks I guess, until I noticed I was only

getting up once a night, and then it was usually if something else

woke me up 1st. Didn't experience the other problems so much, so

can't help you there. Hope that helps.

Christy

> >

> > Hello my name is Dawn and I have recently been diagnosed with

uterine

> > fibroids I am 26 years old and I have been having complications

for two

> > months now. I have been having heavy bleeding and pain. My doctor

has

> > suggested taking progesteron and birth control pills to stop the

bleeding,

> > she has also done 2 D & C procedures to try to stop the bleeding.

Are there

> > any safe removal procedures? And what are the chances of

conceiving after

> > removal? Has anyone had a UAE and conceived? Thanks for your help

> > Dawn

> >

> > _________________________________________________________________

> > Send and receive Hotmail on your mobile device:

http://mobile.msn.com

> >

> >

> >

[Guest guest]

Hi Diane, I'm 2 months post UAE and had the bladder problems. Some

here have reported almost immediate relief, but for me it was

gradual. Over about 3 weeks I guess, until I noticed I was only

getting up once a night, and then it was usually if something else

woke me up 1st. Didn't experience the other problems so much, so

can't help you there. Hope that helps.

Christy

> >

> > Hello my name is Dawn and I have recently been diagnosed with

uterine

> > fibroids I am 26 years old and I have been having complications

for two

> > months now. I have been having heavy bleeding and pain. My doctor

has

> > suggested taking progesteron and birth control pills to stop the

bleeding,

> > she has also done 2 D & C procedures to try to stop the bleeding.

Are there

> > any safe removal procedures? And what are the chances of

conceiving after

> > removal? Has anyone had a UAE and conceived? Thanks for your help

> > Dawn

> >

> > _________________________________________________________________

> > Send and receive Hotmail on your mobile device:

http://mobile.msn.com

> >

> >

> >

[Guest guest]

i am having a myomectomy in a few weeks for my fibroids and i do not have half

the problems you seem to be having. they just cause me pain which i can

tolerate but in october i had a miscarriage which the doc thinks the fibroids

could of been a contributing factor.

infertility is always a risk and even hysterectomy once they go in if there is

heavy bleeding during the surgery but i have no #'s on that.

i understand there is a process called UAE -uterine arterial embolism -

something like that where they try and shrink the fibroid by cutting off the

blood supply.

good luck'

lisa

(unknown)

Hello my name is Dawn and I have recently been diagnosed with uterine

fibroids I am 26 years old and I have been having complications for two

months now. I have been having heavy bleeding and pain. My doctor has

suggested taking progesteron and birth control pills to stop the bleeding,

she has also done 2 D & C procedures to try to stop the bleeding. Are there

any safe removal procedures? And what are the chances of conceiving after

removal? Has anyone had a UAE and conceived? Thanks for your help

Dawn

_________________________________________________________________

Send and receive Hotmail on your mobile device: http://mobile.msn.com

[Guest guest]

i am having a myomectomy in a few weeks for my fibroids and i do not have half

the problems you seem to be having. they just cause me pain which i can

tolerate but in october i had a miscarriage which the doc thinks the fibroids

could of been a contributing factor.

infertility is always a risk and even hysterectomy once they go in if there is

heavy bleeding during the surgery but i have no #'s on that.

i understand there is a process called UAE -uterine arterial embolism -

something like that where they try and shrink the fibroid by cutting off the

blood supply.

good luck'

lisa

(unknown)

Hello my name is Dawn and I have recently been diagnosed with uterine

fibroids I am 26 years old and I have been having complications for two

months now. I have been having heavy bleeding and pain. My doctor has

suggested taking progesteron and birth control pills to stop the bleeding,

she has also done 2 D & C procedures to try to stop the bleeding. Are there

any safe removal procedures? And what are the chances of conceiving after

removal? Has anyone had a UAE and conceived? Thanks for your help

Dawn

_________________________________________________________________

Send and receive Hotmail on your mobile device: http://mobile.msn.com