Re: GCS=7-Overdose possible Haldol and Dilantin-Were not Accepting

[Guest guest]

Hey look...I got a promotion!!!

Dr. Wiseman...but ya'll can call me

GCS=7-Overdose possible Haldol and Dilantin-Were

> not

> >Accepting

> >

> >

> >> Yes thats right the county hospital in County refused my

> >> patient with the above title. I called in my ems report to the er,

> and

> >> was told by the er charge nurse that since we had a TDCJ inmate we

> >> should go to Our contracted hospital or Sealy, roughly 2.5 hours

> >> from Huntsville. I explained that HMH was the nearest hospital from

> >> our pick-up approx 5 miles and he informed me they were on critical

> >> care diversion. Funny they don't have a level with the State for the

> >> Trauma Registry, nor do they particpate in any of the Trauma Regional

> >> plan. They do however like to brush us off since we carry TDCJ

> >> Inmates. Anyone have any suggestions?

> >>

> >> CREMSMEDIC

> >>

> >>

> >>

> >>

> >>

[Guest guest]

Whether caring for an inmate or a civilian, we are still obligated to provide

the same care under our protocols including your destination determination

protocol. Critical inmates should be taken to the most appropriate facility

including trauma patients being transported to Trauma Centers.

As for the use of air transportation, I have personally transported several

inmates by air from both the Huntsville and Sugarland areas, the requirement is

that TDCJ send an officer with the inmate and that additional officers or

hospital security be available to assist the TDCJ officer at the receiving

facility, however not every flight program has aircrafts that are large enough

to facilitate a guard.

Regards,

, LP, NREMT-P

Flight Paramedic

Memorial Hermann Life Flight

Houston, Texas

GCS=7-Overdose possible Haldol and Dilantin-Were not

Accepting

> Yes thats right the county hospital in County refused my

> patient with the above title. I called in my ems report to the er, and

> was told by the er charge nurse that since we had a TDCJ inmate we

> should go to Our contracted hospital or Sealy, roughly 2.5 hours

> from Huntsville. I explained that HMH was the nearest hospital from

> our pick-up approx 5 miles and he informed me they were on critical

> care diversion. Funny they don't have a level with the State for the

> Trauma Registry, nor do they particpate in any of the Trauma Regional

> plan. They do however like to brush us off since we carry TDCJ

> Inmates. Anyone have any suggestions?

>

> CREMSMEDIC

>

>

>

>

>

[Guest guest]

Whether caring for an inmate or a civilian, we are still obligated to provide

the same care under our protocols including your destination determination

protocol. Critical inmates should be taken to the most appropriate facility

including trauma patients being transported to Trauma Centers.

As for the use of air transportation, I have personally transported several

inmates by air from both the Huntsville and Sugarland areas, the requirement is

that TDCJ send an officer with the inmate and that additional officers or

hospital security be available to assist the TDCJ officer at the receiving

facility, however not every flight program has aircrafts that are large enough

to facilitate a guard.

Regards,

, LP, NREMT-P

Flight Paramedic

Memorial Hermann Life Flight

Houston, Texas

GCS=7-Overdose possible Haldol and Dilantin-Were not

Accepting

> Yes thats right the county hospital in County refused my

> patient with the above title. I called in my ems report to the er, and

> was told by the er charge nurse that since we had a TDCJ inmate we

> should go to Our contracted hospital or Sealy, roughly 2.5 hours

> from Huntsville. I explained that HMH was the nearest hospital from

> our pick-up approx 5 miles and he informed me they were on critical

> care diversion. Funny they don't have a level with the State for the

> Trauma Registry, nor do they particpate in any of the Trauma Regional

> plan. They do however like to brush us off since we carry TDCJ

> Inmates. Anyone have any suggestions?

>

> CREMSMEDIC

>

>

>

>

>

[Guest guest]

CREMSMedic,

So what did you do with the patient? Ya know, in the EMS business

sometimes stuff just hits the proverbial fan & we have to deal with

it. ER staff should expect the same. One respondent to your post was

correct in that you could have simply ignored the diversion... " 10-9?

HMH, you're breaking up...not able to copy...I repeat: eta 5 minutes,

over " ...Once the patient is in their ER, EMTALA says they must treat

the patient.

I wonder- what exactly is critical care divert? Does that mean the ER

is presently overhelmed, or are there no ICU beds available?

The fact that the patient is a TDCJ inmate should never have been an

issue- transport of critical inmates to the nearest appropriate

facility is very common.

You might have gone 20 miles to ETMC Trinity, or 35 miles to Conroe,

but if I were you- 5 minutes away, I'd have continued on to HMH- but

certainly not 114 miles further to UTMB. My reasoning: A hospital

should notify all area EMS agencies when they go to divert status,

including yours, if that was your nearest ER. If they failed to that,

that's their mistake- they shouldn't wait until EMS is 5 minutes out

and then notify them. When you checked enroute to HMH, your dispatch

would have advised you of HMH's diversion status...if they had been

notified. If the divert status had just occured- at that very moment,

then they should expect that there may be an ambulance or two

currently enroute to their ER that they will have to deal with. Also

interesting is that you were initially told that " since you have a

TDCJ inmate...you explained 5 min eta, and only then did they advise

of divert status. I wonder if a review of their patient load vs their

capabilities at that time would have justified patient diversion, or

were you simply being (as you said) " brushed off " .

On another note- whether the inmate was a murderer or a pickpocket-

TDCJ always provides an armed guard (two?)to accompany the patient,

and they remain with the patient at all times. My experience is that

the patient remains in restraints during transport, and is secured to

the bedrail while in the ER.

It is kinda funny, as you said, that they have no trauma level

designation, even though they seem to have the capabilities of a

level 3 facility. Wonder why that is?

Last time I went to Conroe, it looked like a mini Ben Taub. I

maintained care of my patient, on our stretcher, in the triage area

outside the ER for about 20 minutes (alongside 4 other EMS crews &

their patients). I could see the hectic ER staff scurrying around

trying to get their patients dealt with so they could accomodate the

incoming patients- but they weren't diverting them away. When they

noticed I was administering Valium IV for my patient's recurring

seizures, they got us in pretty quick.

Ron Mason

TMR Centerville

A medic's favorite color? Pink (blue is bad)

And speaking of ER's- my favorite ER? ETMC Crockett (level 3) The

staff is superb- competent, aggressive, positive attitudes,

respectful and supportive of EMS, and never complain about receiving

patients.

> Yes thats right the county hospital in County refused my

> patient with the above title. I called in my ems report to the er,

and

> was told by the er charge nurse that since we had a TDCJ inmate we

> should go to Our contracted hospital or Sealy, roughly 2.5

hours

> from Huntsville. I explained that HMH was the nearest hospital from

> our pick-up approx 5 miles and he informed me they were on critical

> care diversion. Funny they don't have a level with the State for the

> Trauma Registry, nor do they particpate in any of the Trauma

Regional

> plan. They do however like to brush us off since we carry TDCJ

> Inmates. Anyone have any suggestions?

>

> CREMSMEDIC

[Guest guest]

I've noticed that HMH's ER has a tendency to fill up.. fast.

Sometime so bad that you'll wait in the ER waiting room with

possible fractures for 5 hours before you get to go get X-Ray's, and

most of the time, they've only had ONE doctor on shift, taking care

of 10+ patients at a time. I was told by a nurse at ETMC-Crockett

that ETMC has a contract with TDCJ that it will be used in emergency

situations. I've been at ETMC's ER serveral times when inmates come

in from Huntsville. The best thing to do was to turn around and take

them to ETMC-Crockett. Though ETMC-Trinity is closer, (no offense to

anyone on here), but its not exactly the best ER in Texas. There's

been numerous complaints in the Trinity newspaper about it.. and

still continues to be. Crockett is much better.

-Matt Kuhl

> Yes thats right the county hospital in County refused my

> patient with the above title. I called in my ems report to the er,

and

> was told by the er charge nurse that since we had a TDCJ inmate we

> should go to Our contracted hospital or Sealy, roughly 2.5

hours

> from Huntsville. I explained that HMH was the nearest hospital from

> our pick-up approx 5 miles and he informed me they were on critical

> care diversion. Funny they don't have a level with the State for

the

> Trauma Registry, nor do they particpate in any of the Trauma

Regional

> plan. They do however like to brush us off since we carry TDCJ

> Inmates. Anyone have any suggestions?

>

> CREMSMEDIC