Guest guest Posted March 27, 2003 Report Share Posted March 27, 2003 What would I do? I would consult with Mister Gandy. seems like a big hairy mess. > Scenario: > > EMS carries a patient who is properly nasally intubated as confirmed by CO2 > monitoring, breath sounds, chest rise and fall, pulse oxymetry, and so > forth, to hospital ER. > > ER physician says s/he must intubate the patient orally, as a nasotracheal > intubation is not adequate. Paramedics and respiratory therapy people try to > reason with the physician but s/he insists on intubating orally. At one > point s/he uses the laryngoscope to visualize the tube and says, " I can't > intubate. There's a tube in the trachea. " > > Physician pulls the tube, then is unable to re-intubate the patient. Patient > pronounced dead. > > What should be done about this by the Paramedics? Anything? > > Gene Gandy > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2003 Report Share Posted March 27, 2003 Make sure you already got a signature from the ER nurse.......cover your nametag....walk away quickly...... Just kidding... 'TJ' Hatfield EMT-P " I would rather you call me and not need me, than need me and not call me. " quem di diligunt What would you do? > Scenario: > > EMS carries a patient who is properly nasally intubated as confirmed by CO2 > monitoring, breath sounds, chest rise and fall, pulse oxymetry, and so > forth, to hospital ER. > > ER physician says s/he must intubate the patient orally, as a nasotracheal > intubation is not adequate. Paramedics and respiratory therapy people try to > reason with the physician but s/he insists on intubating orally. At one > point s/he uses the laryngoscope to visualize the tube and says, " I can't > intubate. There's a tube in the trachea. " > > Physician pulls the tube, then is unable to re-intubate the patient. Patient > pronounced dead. > > What should be done about this by the Paramedics? Anything? > > Gene Gandy > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2003 Report Share Posted March 27, 2003 wegandy1938@... wrote: > > ...s/he uses the laryngoscope to visualize the tube and says, " I can't > intubate. There's a tube in the trachea. " > > Physician pulls the tube, then is unable to re-intubate the patient. Gene, please tell me this is our first " Joke Of The Day, " and not an actual scenario! Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2003 Report Share Posted March 27, 2003 On Fri, 28 Mar 2003 00:33:31 EST wegandy1938@... writes: > Scenario: ... > At one point s/he uses the laryngoscope to visualize the tube and says, " I > can't intubate. There's a tube in the trachea. " > > Physician pulls the tube, then is unable to re-intubate the patient. > Patient pronounced dead. > > What should be done about this by the Paramedics? Anything? Make sure all the paperwork is together, and write down every witnesses name. Hopefully, your Medical Director swings more weight than this " Double O Doc " (You know, like Bond, 007 .. has a license to kill); Get them in on it early, before any M & M committee bollocks things up. In other words.. let it be a Clash of the Titans, but give your Titan enough airtight info they can run with it. If your MD won't touch it, consider a new MD. " There are countless ways of attaining greatness, but any road to reaching one's maximum potential must be built on a bedrock of respect for the individual, a commitment to excellence, and a rejection of mediocrity. " - Buck Rodgers Larry RN NREMTP Nurse, Teacher, Medic Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 28, 2003 Report Share Posted March 28, 2003 lanelson1@... wrote: > Get them in on it early, before any M & M committee bollocks things up. Larry makes an excelllent point which applies not just to this situation, but to all controversies. He who gets his story in first will usually be considered right. It doesn't matter who is actually right or wrong. He who reports it second must have been hiding something. I think they teach that in EMS management school somewhere. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 28, 2003 Report Share Posted March 28, 2003 Gene, If this situation was to play out, the first thing to do would be to make damn sure your paperwork was immaculate! Nothing saves you better then great documentation, second you should contact your Medical Director ASAP. In some communities he/she may have quite abit of pull, in some they may not, either way, he/she can address this with the ED doc as a peer, then hopefully help this physician understand what they did wrong and help then correct it. The ultimate goal I would have would be to reeducate this physician so that this scenario didn't play out again. What we all want is good patient care. Take Care, Wiseman What would you do? > Scenario: > > EMS carries a patient who is properly nasally intubated as confirmed by CO2 > monitoring, breath sounds, chest rise and fall, pulse oxymetry, and so > forth, to hospital ER. > > ER physician says s/he must intubate the patient orally, as a nasotracheal > intubation is not adequate. Paramedics and respiratory therapy people try to > reason with the physician but s/he insists on intubating orally. At one > point s/he uses the laryngoscope to visualize the tube and says, " I can't > intubate. There's a tube in the trachea. " > > Physician pulls the tube, then is unable to re-intubate the patient. Patient > pronounced dead. > > What should be done about this by the Paramedics? Anything? > > Gene Gandy > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 28, 2003 Report Share Posted March 28, 2003 i'd do nothing ...the doc is the top of the food chain. just like the rest of us they learn from mistakes. have you tried asking diplomaticly the reason for wanting oral intubation??? > Scenario: > > EMS carries a patient who is properly nasally intubated as confirmed by CO2 > monitoring, breath sounds, chest rise and fall, pulse oxymetry, and so > forth, to hospital ER. > > ER physician says s/he must intubate the patient orally, as a nasotracheal > intubation is not adequate. Paramedics and respiratory therapy people try to > reason with the physician but s/he insists on intubating orally. At one > point s/he uses the laryngoscope to visualize the tube and says, " I can't > intubate. There's a tube in the trachea. " > > Physician pulls the tube, then is unable to re-intubate the patient. Patient > pronounced dead. > > What should be done about this by the Paramedics? Anything? > > Gene Gandy > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 28, 2003 Report Share Posted March 28, 2003 Gene Would " At one point s/he uses the laryngoscope to visualize the tube and says, " I can't intubate. There's a tube in the trachea. " be a " clue " ? L. What would you do? Scenario: EMS carries a patient who is properly nasally intubated as confirmed by CO2 monitoring, breath sounds, chest rise and fall, pulse oxymetry, and so forth, to hospital ER. ER physician says s/he must intubate the patient orally, as a nasotracheal intubation is not adequate. Paramedics and respiratory therapy people try to reason with the physician but s/he insists on intubating orally. At one point s/he uses the laryngoscope to visualize the tube and says, " I can't intubate. There's a tube in the trachea. " Physician pulls the tube, then is unable to re-intubate the patient. Patient pronounced dead. What should be done about this by the Paramedics? Anything? Gene Gandy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 26, 2003 Report Share Posted May 26, 2003 turn and leave if you are smart. go out side and shake your head. go to the office and say a few nasty words. notify your medical control supervisor and let hime/her handle it from there untill they contact you back. david What would you do? Scenario: EMS carries a patient who is properly nasally intubated as confirmed by CO2 monitoring, breath sounds, chest rise and fall, pulse oxymetry, and so forth, to hospital ER. ER physician says s/he must intubate the patient orally, as a nasotracheal intubation is not adequate. Paramedics and respiratory therapy people try to reason with the physician but s/he insists on intubating orally. At one point s/he uses the laryngoscope to visualize the tube and says, " I can't intubate. There's a tube in the trachea. " Physician pulls the tube, then is unable to re-intubate the patient. Patient pronounced dead. What should be done about this by the Paramedics? Anything? Gene Gandy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 27, 2003 Report Share Posted May 27, 2003 There are avenues within the hospital that you may take if you like. Usually the administrator or the head Medical Resident. Dr.'s usually have bosses too within the hospital. Danny L. Owner/NREMT-P Panhandle Emergency Training Services And Response (PETSAR) Office FAX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 27, 2003 Report Share Posted May 27, 2003 There are avenues within the hospital that you may take if you like. Usually the administrator or the head Medical Resident. Dr.'s usually have bosses too within the hospital. Danny L. Owner/NREMT-P Panhandle Emergency Training Services And Response (PETSAR) Office FAX Quote Link to comment Share on other sites More sharing options...
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