Re: [texasems-L]Diversion Notification

January 8, 2006

I agree Mike, and the regional DSHS office here does too.

The main thing they look

at is: " as long as no ALS interventions have been performed

the BLS can take over

without Abandonment being an issue.

Myron EMT-B/Coord. SAEC

On Sun, 8 Jan 2006 06:27:25 -0600

Mike wrote:

> ARGH!

>

> This is one of the most common frustrations I have. You

>do NOT have

> to transfer care to someone of " equal training. " You

>have to transfer

> care to someone able to take care of the patient. In

>this case if the

> patients are stable and the CNA is capable of

>recognizing " oh, this

> guy looks worse " and call the RN for the ER they're

>ALREADY IN, that

> seems legit. Now, I'd be worried as the ER admin that

>I'm liable for

> the care provided (or not provided) by these CNA's due

>to EMTALA and

> the fact that the patient has presented to my ER. In

>many cases if

> the ER is full and making you wait, dropping the patient

>with the

> triage nurse works wonders. One or two ALS patients

>dropped in

> triage, IV's, reports and all will change things...

>

> Anyhow, if my MICU rolls up on a major accident and

>calls for mutual

> aid, and a BLS truck arrives, I can transfer a patient

>that only needs

> BLS interventions from the care of me or my partner, a

>paramedic, to

> the BLS crew. That's not abandonment. In some cases,

>it's probably

> not abandonment even if they DO need ALS care, if

>someone else needs

> it MORE - in that case, you're just handing them off for

>transport.

>

> Abandonment means leaving the patient without the

>ability to get care.

> It does not mean ensuring the provider you leave them

>with can

> perform every skill you can, else many RN's wouldn't be

>able to take

> patients from medics who can administer paralytics and

>perform

> intubations...

>

> </rant>

>

> Mike :/

>

>> salvador capuchino wrote: But

>>these CNAs are hired by the ambulance company to

>> relieve medics at the hospital when they are going to

>> hold the medics for a long time.

>> I was under the impression that the CNAs were hospital

>>staff; thank you for clarifying that. It seems, then,

>>that the ambulance service is willing to aid and abet

>>patient abandonment, in fact facilitating that by hiring

>>the CNAs! That makes communication between a hospital RN

>>and a non-hospital CNA; even poorer than normal.

>>

>> Unless the ambulance service is under the impression

>>that the transfer of care is to a person of equal

>>training.... the phrase " warm body " comes to mind.

>>

>> " The true soldier fights not because he hates what is in

>>front of him, but because he loves what is behind him. " -

>> GK Chesterton

>>

>> ---------------------------------

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January 8, 2006