Guest guest Posted December 19, 2007 Report Share Posted December 19, 2007 More from the " oopsie " incident. Looks like the SAFD PR efforts are improving, albeit slightly. -Wes Ogilvie, MPA, JD, LP -Austin, Texas  Controversy over woman left for dead Web Posted: 12/19/2007 01:02 AM CST Chasnoff and Lomi Kriel Express-News The injury looked grave. Part of the front-seat passenger's skull had caved in after a head-on collision on Loop 410. McLaughlin, a truck driver who said he witnessed the wreck and rushed to the aid of its victims, crouched beside the mangled Honda Accord and talked to the injured woman, 23-year-old a , until a police officer arrived. had been moaning, McLaughlin said. " I said, 'Sir, that girl in the front seat is messed up bad. She needs help,' " he recalled. Yet it was precisely that injury — coupled with an apparent lack of a pulse — that led paramedics to abandon , believing her dead, and instead rush two other victims with non-life-threatening injuries to Army Medical Center, Fire Chief Hood said on Tuesday. was actually alive — a detail discovered more than an hour later by a medical examiner's investigator called to the scene to examine her body. Paramedics again were called, and was taken to Army Medical Center, on Sunday, more than two hours after the early morning wreck. She died at the hospital Monday afternoon. The paramedics' decision to abandon in the wreckage in near freezing temperatures — compounded by Hood's refusal to apologize for the incident at a news conference Monday — has stoked outrage among some. Tuesday, in an interview with the Express-News editorial board, Hood said he regretted not saying he was " sorry for the family. " Although he conceded that Sunday's misdiagnosis " could possibly have been a mistake, " Hood defended the judgment of the four paramedics who abandoned after checking her pulse. Cold weather can mask vital signs, he said, and victims can continue breathing after they are brain dead. " The body is designed, basically, to function without a brain, " he said. " Bodies make noises, bodies move, bodies will sit up on you. Gordon, a professor of medicine at the University of Texas Health Science Center at San , said up to 60 percent of patients who gasp are not alive. Typically, he said, the gasp is the result of a spinal reflex. Hood and Gordon, who has authorized the standard medical operating procedure for the city's Fire Department for more than two decades, said medical privacy laws constrained them from detailing what exactly led paramedics to believe was dead. But Gordon said national standards prevent medical providers from resuscitating patients if they meet criteria classifying them as an " obvious death on arrival. " And on Tuesday, Hood said publicly for the first time that, " by all intents and purposes, (the paramedics) thought () was dead. " " She presented as deceased to them, " Hood said, adding that paramedics, " when they checked, she had no pulse. " According to the current operating procedure, which Gordon updated last year, patients fall into the category of " obvious death on arrival " if they have " no measurable vital signs, " such as a heart beat or pulse, and meet one of four criteria: rigor mortis; when the blood pools to the lowest level of gravity; decapitation, incineration or visual massive trauma; or if the body is decomposed. " Visual massive trauma " refers to injuries severe enough for a layperson to think they might cause death, such as " part of a V-6 engine sitting in the middle of your chest, " Gordon said. According to McLaughlin, suffered a major head injury. " I knew that if she didn't get help right away, she might not make it, " he said, adding, " My opinion, I think they should have paid more attention to her. " A police officer familiar with the incident said he told paramedics at least twice that was still breathing. " They kept telling everybody, 'No, she's not. ... She'll die in a few minutes,' " said the officer, who requested anonymity because he is not authorized to speak about the case. If there's any question about whether a patient meets the required criteria for resuscitation, paramedics are required to call their medical director for an opinion. Gordon, who is the medical director for the city's Fire Department, declined to say whether he was called in 's accident. But typically, he offers such opinions on a daily basis, he said. It is very rare for someone to be classified as an " obvious DOA " and then return to life, he said, but it has happened. Over the past 20 years, San has recorded two other such incidents, Hood said Tuesday. The four paramedics involved in Sunday's incident have been with the department for several years, with the least experienced having worked as a medic for nearly six years. Officials declined to release their names on Tuesday, but said the other three have served in their roles for six years, seven years and 12 years. None was disciplined for the incident and each is expected to return to work this week, Hood said. Still, the incident remains under investigation, he said, and will force the department to review its policies. " We need to figure out what to do to avoid this, " he said. " Customers in San need to have faith in their department. " was one of three people inside the Accord when a Pontiac G5 veered into an oncoming lane on Loop 410, striking the Accordshortly before 4 a.m. The driver of the Pontiac, Ann Ybarra, 28, was taken to a hospital after complaining of back pain. She has been charged with intoxication manslaughter and her bond set at $50,000. A jail official said she had posted bail, but was awaiting an ankle monitor so that she could be released. 's friends — Shaner, 22, the Accord's driver, and back seat passenger Amber , 22— suffered serious but non-life-threatening injuries. ________________________________________________________________________ More new features than ever. Check out the new AOL Mail ! - http://webmail.aol.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 19, 2007 Report Share Posted December 19, 2007 So when I was taught EMS and learned to be an instructor nothing in that informed me to disregard a patient if they were still breathing. Obvious signs of injury mean there is no pulse, no B/P, no respiration's, a head is missing, a hole is in the middle of the chest, or some other type of injury not consistent with life. Severe head injury is not one of the criteria especially if the patient is still breathing. Perhaps someone should have thought to check a carotid pulse? Another black eye for EMS across Texas and the Nation. FYI: There was an article in the Amarillo Globe News about First Responders from the Air Force Base in New Mexico that are not allowed to do Intubations due to 3 incidents in the last month for tearing the trachea. Where are we going these days in EMS??????? Wes Ogilvie wrote: More from the " oopsie " incident. Looks like the SAFD PR efforts are improving, albeit slightly. -Wes Ogilvie, MPA, JD, LP -Austin, Texas  Controversy over woman left for dead Web Posted: 12/19/2007 01:02 AM CST Chasnoff and Lomi Kriel Express-News The injury looked grave. Part of the front-seat passenger's skull had caved in after a head-on collision on Loop 410. McLaughlin, a truck driver who said he witnessed the wreck and rushed to the aid of its victims, crouched beside the mangled Honda Accord and talked to the injured woman, 23-year-old a , until a police officer arrived. had been moaning, McLaughlin said. " I said, 'Sir, that girl in the front seat is messed up bad. She needs help,' " he recalled. Yet it was precisely that injury — coupled with an apparent lack of a pulse — that led paramedics to abandon , believing her dead, and instead rush two other victims with non-life-threatening injuries to Army Medical Center, Fire Chief Hood said on Tuesday. was actually alive — a detail discovered more than an hour later by a medical examiner's investigator called to the scene to examine her body. Paramedics again were called, and was taken to Army Medical Center, on Sunday, more than two hours after the early morning wreck. She died at the hospital Monday afternoon. The paramedics' decision to abandon in the wreckage in near freezing temperatures — compounded by Hood's refusal to apologize for the incident at a news conference Monday — has stoked outrage among some. Tuesday, in an interview with the Express-News editorial board, Hood said he regretted not saying he was " sorry for the family. " Although he conceded that Sunday's misdiagnosis " could possibly have been a mistake, " Hood defended the judgment of the four paramedics who abandoned after checking her pulse. Cold weather can mask vital signs, he said, and victims can continue breathing after they are brain dead. " The body is designed, basically, to function without a brain, " he said. " Bodies make noises, bodies move, bodies will sit up on you. Gordon, a professor of medicine at the University of Texas Health Science Center at San , said up to 60 percent of patients who gasp are not alive. Typically, he said, the gasp is the result of a spinal reflex. Hood and Gordon, who has authorized the standard medical operating procedure for the city's Fire Department for more than two decades, said medical privacy laws constrained them from detailing what exactly led paramedics to believe was dead. But Gordon said national standards prevent medical providers from resuscitating patients if they meet criteria classifying them as an " obvious death on arrival. " And on Tuesday, Hood said publicly for the first time that, " by all intents and purposes, (the paramedics) thought () was dead. " " She presented as deceased to them, " Hood said, adding that paramedics, " when they checked, she had no pulse. " According to the current operating procedure, which Gordon updated last year, patients fall into the category of " obvious death on arrival " if they have " no measurable vital signs, " such as a heart beat or pulse, and meet one of four criteria: rigor mortis; when the blood pools to the lowest level of gravity; decapitation, incineration or visual massive trauma; or if the body is decomposed. " Visual massive trauma " refers to injuries severe enough for a layperson to think they might cause death, such as " part of a V-6 engine sitting in the middle of your chest, " Gordon said. According to McLaughlin, suffered a major head injury. " I knew that if she didn't get help right away, she might not make it, " he said, adding, " My opinion, I think they should have paid more attention to her. " A police officer familiar with the incident said he told paramedics at least twice that was still breathing. " They kept telling everybody, 'No, she's not. ... She'll die in a few minutes,' " said the officer, who requested anonymity because he is not authorized to speak about the case. If there's any question about whether a patient meets the required criteria for resuscitation, paramedics are required to call their medical director for an opinion. Gordon, who is the medical director for the city's Fire Department, declined to say whether he was called in 's accident. But typically, he offers such opinions on a daily basis, he said. It is very rare for someone to be classified as an " obvious DOA " and then return to life, he said, but it has happened. Over the past 20 years, San has recorded two other such incidents, Hood said Tuesday. The four paramedics involved in Sunday's incident have been with the department for several years, with the least experienced having worked as a medic for nearly six years. Officials declined to release their names on Tuesday, but said the other three have served in their roles for six years, seven years and 12 years. None was disciplined for the incident and each is expected to return to work this week, Hood said. Still, the incident remains under investigation, he said, and will force the department to review its policies. " We need to figure out what to do to avoid this, " he said. " Customers in San need to have faith in their department. " was one of three people inside the Accord when a Pontiac G5 veered into an oncoming lane on Loop 410, striking the Accordshortly before 4 a.m. The driver of the Pontiac, Ann Ybarra, 28, was taken to a hospital after complaining of back pain. She has been charged with intoxication manslaughter and her bond set at $50,000. A jail official said she had posted bail, but was awaiting an ankle monitor so that she could be released. 's friends — Shaner, 22, the Accord's driver, and back seat passenger Amber , 22— suffered serious but non-life-threatening injuries. __________________________________________________________ More new features than ever. Check out the new AOL Mail ! - http://webmail.aol.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 In a message dated 20-Dec-07 08:41:39 Central Standard Time, rick.moore@... writes: Is this a sad situation, yes it is, but 4 highly trained long term paramedics made a decision based on the training, knowledge and protocols that they utilize every day. Oh one other factor to the decision, THEY WERE THERE, the rest of us were not. We all know that the news media is not the best source of information and that they frequently get things wrong or slant them in an unfavorable way. Rick, while I understand where you are coming from, I'm disappointed that, after the other patients were trainsported (using FR personnel from the FD if needed to assist), that the Lead Medic (i.e., triage officer) evidently didn't go back to reasess the last victim...Just as important, who was the Incident Commander on scene who didn't make sure that the last victim had been rechecked? How can I be relatively sure that wasn't done? The established detail that the victim was still alive enough over an hour later when the coroner's officer got there to be extricated and transported. I've done enough operational/field medicine in the past to know how much of a SNAFU situation you can have in that kind of a mess (add in a dark night; wet, freezing weather; a Huey; and a torn down coat, and I've been there....)...but I'll wait for the after action report and the investigation before I go further. ck S. Krin, DO FAAFP **************************************See AOL's top rated recipes (http://food.aol.com/top-rated-recipes?NCID=aoltop00030000000004) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 Apparently you have never been taught how to handle an MCI then. An MCI is any incident that has more than 2 victims and this incident had at least 4. During the course of an MCI someone is charged with triage and that person's responsibility is to assign priority to those who will receive treatment. A black or blue tag (depending on the system) indicates that the patients injuries appear to be incompatible with life and the resources available on scene can be better utilized treating and transporting those who will benefit from treatment. " perhaps someone should have thought to check a carotid pulse " . How do you know they didn't? I have seen TV news coverage of the car and the brunt of the damage is to the right front, where this victim was sitting. Mangled car, victim position, prolonged extrication potential all could have an affect on the assessment of the patient. Is this a sad situation, yes it is, but 4 highly trained long term paramedics made a decision based on the training, knowledge and protocols that they utilize every day. Oh one other factor to the decision, THEY WERE THERE, the rest of us were not. We all know that the news media is not the best source of information and that they frequently get things wrong or slant them in an unfavorable way. Instead of considering this " another black eye for EMS across Texas " , let's support our fellow medics, who just like us make decisions based on field assessments in dangerous situations in split second real time. We should look at this as a learning experience and for sure those of us with a DSHS patch (regardless of color) should stop Monday morning quarterbacking based on news reports, rumor and innuendo. There is not one of us who has not been placed in a similar situation and only by the grace of god did we make the right decision. My suggestion to this list is that the next person to post negative comments about these San Paramedics, be the person that has NEVER made a bad decision or error while treating a patient. Rick , RN,LP College Station ________________________________ From: texasems-l [mailto:texasems-l ] On Behalf Of Danny Sent: Thursday, December 20, 2007 1:38 AM To: texasems-l Subject: Re: The latest from San .... So when I was taught EMS and learned to be an instructor nothing in that informed me to disregard a patient if they were still breathing. Obvious signs of injury mean there is no pulse, no B/P, no respiration's, a head is missing, a hole is in the middle of the chest, or some other type of injury not consistent with life. Severe head injury is not one of the criteria especially if the patient is still breathing. Perhaps someone should have thought to check a carotid pulse? Another black eye for EMS across Texas and the Nation. FYI: There was an article in the Amarillo Globe News about First Responders from the Air Force Base in New Mexico that are not allowed to do Intubations due to 3 incidents in the last month for tearing the trachea. Where are we going these days in EMS??????? Wes Ogilvie <ExLngHrn@... <mailto:ExLngHrn%40aol.com> > wrote: More from the " oopsie " incident. Looks like the SAFD PR efforts are improving, albeit slightly. -Wes Ogilvie, MPA, JD, LP -Austin, Texas  Controversy over woman left for dead Web Posted: 12/19/2007 01:02 AM CST Chasnoff and Lomi Kriel Express-News The injury looked grave. Part of the front-seat passenger's skull had caved in after a head-on collision on Loop 410. McLaughlin, a truck driver who said he witnessed the wreck and rushed to the aid of its victims, crouched beside the mangled Honda Accord and talked to the injured woman, 23-year-old a , until a police officer arrived. had been moaning, McLaughlin said. " I said, 'Sir, that girl in the front seat is messed up bad. She needs help,' " he recalled. Yet it was precisely that injury  coupled with an apparent lack of a pulse  that led paramedics to abandon , believing her dead, and instead rush two other victims with non-life-threatening injuries to Army Medical Center, Fire Chief Hood said on Tuesday. was actually alive  a detail discovered more than an hour later by a medical examiner's investigator called to the scene to examine her body. Paramedics again were called, and was taken to Army Medical Center, on Sunday, more than two hours after the early morning wreck. She died at the hospital Monday afternoon. The paramedics' decision to abandon in the wreckage in near freezing temperatures  compounded by Hood's refusal to apologize for the incident at a news conference Monday  has stoked outrage among some. Tuesday, in an interview with the Express-News editorial board, Hood said he regretted not saying he was " sorry for the family. " Although he conceded that Sunday's misdiagnosis " could possibly have been a mistake, " Hood defended the judgment of the four paramedics who abandoned after checking her pulse. Cold weather can mask vital signs, he said, and victims can continue breathing after they are brain dead. " The body is designed, basically, to function without a brain, " he said. " Bodies make noises, bodies move, bodies will sit up on you. Gordon, a professor of medicine at the University of Texas Health Science Center at San , said up to 60 percent of patients who gasp are not alive. Typically, he said, the gasp is the result of a spinal reflex. Hood and Gordon, who has authorized the standard medical operating procedure for the city's Fire Department for more than two decades, said medical privacy laws constrained them from detailing what exactly led paramedics to believe was dead. But Gordon said national standards prevent medical providers from resuscitating patients if they meet criteria classifying them as an " obvious death on arrival. " And on Tuesday, Hood said publicly for the first time that, " by all intents and purposes, (the paramedics) thought () was dead. " " She presented as deceased to them, " Hood said, adding that paramedics, " when they checked, she had no pulse. " According to the current operating procedure, which Gordon updated last year, patients fall into the category of " obvious death on arrival " if they have " no measurable vital signs, " such as a heart beat or pulse, and meet one of four criteria: rigor mortis; when the blood pools to the lowest level of gravity; decapitation, incineration or visual massive trauma; or if the body is decomposed. " Visual massive trauma " refers to injuries severe enough for a layperson to think they might cause death, such as " part of a V-6 engine sitting in the middle of your chest, " Gordon said. According to McLaughlin, suffered a major head injury. " I knew that if she didn't get help right away, she might not make it, " he said, adding, " My opinion, I think they should have paid more attention to her. " A police officer familiar with the incident said he told paramedics at least twice that was still breathing. " They kept telling everybody, 'No, she's not. ... She'll die in a few minutes,' " said the officer, who requested anonymity because he is not authorized to speak about the case. If there's any question about whether a patient meets the required criteria for resuscitation, paramedics are required to call their medical director for an opinion. Gordon, who is the medical director for the city's Fire Department, declined to say whether he was called in 's accident. But typically, he offers such opinions on a daily basis, he said. It is very rare for someone to be classified as an " obvious DOA " and then return to life, he said, but it has happened. Over the past 20 years, San has recorded two other such incidents, Hood said Tuesday. The four paramedics involved in Sunday's incident have been with the department for several years, with the least experienced having worked as a medic for nearly six years. Officials declined to release their names on Tuesday, but said the other three have served in their roles for six years, seven years and 12 years. None was disciplined for the incident and each is expected to return to work this week, Hood said. Still, the incident remains under investigation, he said, and will force the department to review its policies. " We need to figure out what to do to avoid this, " he said. " Customers in San need to have faith in their department. " was one of three people inside the Accord when a Pontiac G5 veered into an oncoming lane on Loop 410, striking the Accordshortly before 4 a.m. The driver of the Pontiac, Ann Ybarra, 28, was taken to a hospital after complaining of back pain. She has been charged with intoxication manslaughter and her bond set at $50,000. A jail official said she had posted bail, but was awaiting an ankle monitor so that she could be released. 's friends  Shaner, 22, the Accord's driver, and back seat passenger Amber , 22 suffered serious but non-life-threatening injuries. __________________________________________________________ More new features than ever. Check out the new AOL Mail ! - http://webmail.aol.com <http://webmail.aol.com> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 I have not only been taught, I do it on a regular basis. I have triaged more than 8 patients at one time; with at least two of those patients critical. Appearances are everything. The appearance of this incident and others that seem to be misshandled on a daily basis are cause for alarm and action to stop them. " Four long term paramedics made a decision based on training, knowledge, and protocols. " I will go with the protocols aspect but don't try to cover up inadequate treatment with that argument. There is something for support of our fellow medics, but we should also be the ones to call a cat a cat and not a donkey. Negative comments are what allow us as a profession to see where our downfalls may be and correct them before they become a permanent ill fated treatment regime. Noone enjoys criticism, but there are days that it is needed so that we may continue to do the best job possible. These are my feelings not only as a fellow paramedic, but also as a manager of EMS personnel. Have I made mistakes? Yes I have. It is a sad but true reality that we learn from our mistakes. We Hope. Let's learn from the mistake so that it does not happen again. Things happen but don't look the other way just because it is convenient. We are tasked with the assistance and ultimate survival of many that come into contact with us, let's not loose that simple reality nor the understanding that it is a great responsibility not to be take lightly. " , Rick " wrote: Apparently you have never been taught how to handle an MCI then. An MCI is any incident that has more than 2 victims and this incident had at least 4. During the course of an MCI someone is charged with triage and that person's responsibility is to assign priority to those who will receive treatment. A black or blue tag (depending on the system) indicates that the patients injuries appear to be incompatible with life and the resources available on scene can be better utilized treating and transporting those who will benefit from treatment. " perhaps someone should have thought to check a carotid pulse " . How do you know they didn't? I have seen TV news coverage of the car and the brunt of the damage is to the right front, where this victim was sitting. Mangled car, victim position, prolonged extrication potential all could have an affect on the assessment of the patient. Is this a sad situation, yes it is, but 4 highly trained long term paramedics made a decision based on the training, knowledge and protocols that they utilize every day. Oh one other factor to the decision, THEY WERE THERE, the rest of us were not. We all know that the news media is not the best source of information and that they frequently get things wrong or slant them in an unfavorable way. Instead of considering this " another black eye for EMS across Texas " , let's support our fellow medics, who just like us make decisions based on field assessments in dangerous situations in split second real time. We should look at this as a learning experience and for sure those of us with a DSHS patch (regardless of color) should stop Monday morning quarterbacking based on news reports, rumor and innuendo. There is not one of us who has not been placed in a similar situation and only by the grace of god did we make the right decision. My suggestion to this list is that the next person to post negative comments about these San Paramedics, be the person that has NEVER made a bad decision or error while treating a patient. Rick , RN,LP College Station ________________________________ From: texasems-l [mailto:texasems-l ] On Behalf Of Danny Sent: Thursday, December 20, 2007 1:38 AM To: texasems-l Subject: Re: The latest from San .... So when I was taught EMS and learned to be an instructor nothing in that informed me to disregard a patient if they were still breathing. Obvious signs of injury mean there is no pulse, no B/P, no respiration's, a head is missing, a hole is in the middle of the chest, or some other type of injury not consistent with life. Severe head injury is not one of the criteria especially if the patient is still breathing. Perhaps someone should have thought to check a carotid pulse? Another black eye for EMS across Texas and the Nation. FYI: There was an article in the Amarillo Globe News about First Responders from the Air Force Base in New Mexico that are not allowed to do Intubations due to 3 incidents in the last month for tearing the trachea. Where are we going these days in EMS??????? Wes Ogilvie <ExLngHrn@... <mailto:ExLngHrn%40aol.com> > wrote: More from the " oopsie " incident. Looks like the SAFD PR efforts are improving, albeit slightly. -Wes Ogilvie, MPA, JD, LP -Austin, Texas  Controversy over woman left for dead Web Posted: 12/19/2007 01:02 AM CST Chasnoff and Lomi Kriel Express-News The injury looked grave. Part of the front-seat passenger's skull had caved in after a head-on collision on Loop 410. McLaughlin, a truck driver who said he witnessed the wreck and rushed to the aid of its victims, crouched beside the mangled Honda Accord and talked to the injured woman, 23-year-old a , until a police officer arrived. had been moaning, McLaughlin said. " I said, 'Sir, that girl in the front seat is messed up bad. She needs help,' " he recalled. Yet it was precisely that injury  coupled with an apparent lack of a pulse  that led paramedics to abandon , believing her dead, and instead rush two other victims with non-life-threatening injuries to Army Medical Center, Fire Chief Hood said on Tuesday. was actually alive  a detail discovered more than an hour later by a medical examiner's investigator called to the scene to examine her body. Paramedics again were called, and was taken to Army Medical Center, on Sunday, more than two hours after the early morning wreck. She died at the hospital Monday afternoon. The paramedics' decision to abandon in the wreckage in near freezing temperatures  compounded by Hood's refusal to apologize for the incident at a news conference Monday  has stoked outrage among some. Tuesday, in an interview with the Express-News editorial board, Hood said he regretted not saying he was " sorry for the family. " Although he conceded that Sunday's misdiagnosis " could possibly have been a mistake, " Hood defended the judgment of the four paramedics who abandoned after checking her pulse. Cold weather can mask vital signs, he said, and victims can continue breathing after they are brain dead. " The body is designed, basically, to function without a brain, " he said. " Bodies make noises, bodies move, bodies will sit up on you. Gordon, a professor of medicine at the University of Texas Health Science Center at San , said up to 60 percent of patients who gasp are not alive. Typically, he said, the gasp is the result of a spinal reflex. Hood and Gordon, who has authorized the standard medical operating procedure for the city's Fire Department for more than two decades, said medical privacy laws constrained them from detailing what exactly led paramedics to believe was dead. But Gordon said national standards prevent medical providers from resuscitating patients if they meet criteria classifying them as an " obvious death on arrival. " And on Tuesday, Hood said publicly for the first time that, " by all intents and purposes, (the paramedics) thought () was dead. " " She presented as deceased to them, " Hood said, adding that paramedics, " when they checked, she had no pulse. " According to the current operating procedure, which Gordon updated last year, patients fall into the category of " obvious death on arrival " if they have " no measurable vital signs, " such as a heart beat or pulse, and meet one of four criteria: rigor mortis; when the blood pools to the lowest level of gravity; decapitation, incineration or visual massive trauma; or if the body is decomposed. " Visual massive trauma " refers to injuries severe enough for a layperson to think they might cause death, such as " part of a V-6 engine sitting in the middle of your chest, " Gordon said. According to McLaughlin, suffered a major head injury. " I knew that if she didn't get help right away, she might not make it, " he said, adding, " My opinion, I think they should have paid more attention to her. " A police officer familiar with the incident said he told paramedics at least twice that was still breathing. " They kept telling everybody, 'No, she's not. ... She'll die in a few minutes,' " said the officer, who requested anonymity because he is not authorized to speak about the case. If there's any question about whether a patient meets the required criteria for resuscitation, paramedics are required to call their medical director for an opinion. Gordon, who is the medical director for the city's Fire Department, declined to say whether he was called in 's accident. But typically, he offers such opinions on a daily basis, he said. It is very rare for someone to be classified as an " obvious DOA " and then return to life, he said, but it has happened. Over the past 20 years, San has recorded two other such incidents, Hood said Tuesday. The four paramedics involved in Sunday's incident have been with the department for several years, with the least experienced having worked as a medic for nearly six years. Officials declined to release their names on Tuesday, but said the other three have served in their roles for six years, seven years and 12 years. None was disciplined for the incident and each is expected to return to work this week, Hood said. Still, the incident remains under investigation, he said, and will force the department to review its policies. " We need to figure out what to do to avoid this, " he said. " Customers in San need to have faith in their department. " was one of three people inside the Accord when a Pontiac G5 veered into an oncoming lane on Loop 410, striking the Accordshortly before 4 a.m. The driver of the Pontiac, Ann Ybarra, 28, was taken to a hospital after complaining of back pain. She has been charged with intoxication manslaughter and her bond set at $50,000. A jail official said she had posted bail, but was awaiting an ankle monitor so that she could be released. 's friends  Shaner, 22, the Accord's driver, and back seat passenger Amber , 22 suffered serious but non-life-threatening injuries. __________________________________________________________ More new features than ever. Check out the new AOL Mail ! - http://webmail.aol.com <http://webmail.aol.com> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 Respectfully, I thought the definition of MCI was any event that exceeded your service's capabilities. Are we saying that SAFD can't handle an incident with 2+ patients? -Wes Ogilvie Re: The latest from San .... So when I was taught EMS and learned to be an instructor nothing in that informed me to disregard a patient if they were still breathing. Obvious signs of injury mean there is no pulse, no B/P, no respiration's, a head is missing, a hole is in the middle of the chest, or some other type of injury not consistent with life. Severe head injury is not one of the criteria especially if the patient is still breathing. Perhaps someone should have thought to check a carotid pulse? Another black eye for EMS across Texas and the Nation. FYI: There was an article in the Amarillo Globe News about First Responders from the Air Force Base in New Mexico that are not allowed to do Intubations due to 3 incidents in the last month for tearing the trachea. Where are we going these days in EMS??????? Wes Ogilvie <ExLngHrn@... <mailto:ExLngHrn%40aol.com> > wrote: More from the " oopsie " incident. Looks like the SAFD PR efforts are improving, albeit slightly. -Wes Ogilvie, MPA, JD, LP -Austin, Texas  Controversy over woman left for dead Web Posted: 12/19/2007 01:02 AM CST Chasnoff and Lomi Kriel Express-News The injury looked grave. Part of the front-seat passenger's skull had caved in after a head-on collision on Loop 410. McLaughlin, a truck driver who said he witnessed the wreck and rushed to the aid of its victims, crouched beside the mangled Honda Accord and talked to the injured woman, 23-year-old a , until a police officer arrived. had been moaning, McLaughlin said. " I said, 'Sir, that girl in the front seat is messed up bad. She needs help,' " he recalled. Yet it was precisely that injury  coupled with an apparent lack of a pulse  that led paramedics to abandon , believing her dead, and instead rush two other victims with non-life-threatening injuries to Army Medical Center, Fire Chief Hood said on Tuesday. was actually alive  a detail discovered more than an hour later by a medical examiner's investigator called to the scene to examine her body. Paramedics again were called, and was taken to Army Medical Center, on Sunday, more than two hours after the early morning wreck. She died at the hospital Monday afternoon. The paramedics' decision to abandon in the wreckage in near freezing temperatures  compounded by Hood's refusal to apologize for the incident at a news conference Monday  has stoked outrage among some. Tuesday, in an interview with the Express-News editorial board, Hood said he regretted not saying he was " sorry for the family. " Although he conceded that Sunday's misdiagnosis " could possibly have been a mistake, " Hood defended the judgment of the four paramedics who abandoned after checking her pulse. Cold weather can mask vital signs, he said, and victims can continue breathing after they are brain dead. " The body is designed, basically, to function without a brain, " he said. " Bodies make noises, bodies move, bodies will sit up on you. Gordon, a professor of medicine at the University of Texas Health Science Center at San , said up to 60 percent of patients who gasp are not alive. Typically, he said, the gasp is the result of a spinal reflex. Hood and Gordon, who has authorized the standard medical operating procedure for the city's Fire Department for more than two decades, said medical privacy laws constrained them from detailing what exactly led paramedics to believe was dead. But Gordon said national standards prevent medical providers from resuscitating patients if they meet criteria classifying them as an " obvious death on arrival. " And on Tuesday, Hood said publicly for the first time that, " by all intents and purposes, (the paramedics) thought () was dead. " " She presented as deceased to them, " Hood said, adding that paramedics, " when they checked, she had no pulse. " According to the current operating procedure, which Gordon updated last year, patients fall into the category of " obvious death on arrival " if they have " no measurable vital signs, " such as a heart beat or pulse, and meet one of four criteria: rigor mortis; when the blood pools to the lowest level of gravity; decapitation, incineration or visual massive trauma; or if the body is decomposed. " Visual massive trauma " refers to injuries severe enough for a layperson to think they might cause death, such as " part of a V-6 engine sitting in the middle of your chest, " Gordon said. According to McLaughlin, suffered a major head injury. " I knew that if she didn't get help right away, she might not make it, " he said, adding, " My opinion, I think they should have paid more attention to her. " A police officer familiar with the incident said he told paramedics at least twice that was still breathing. " They kept telling everybody, 'No, she's not. ... She'll die in a few minutes,' " said the officer, who requested anonymity because he is not authorized to speak about the case. If there's any question about whether a patient meets the required criteria for resuscitation, paramedics are required to call their medical director for an opinion. Gordon, who is the medical director for the city's Fire Department, declined to say whether he was called in 's accident. But typically, he offers such opinions on a daily basis, he said. It is very rare for someone to be classified as an " obvious DOA " and then return to life, he said, but it has happened. Over the past 20 years, San has recorded two other such incidents, Hood said Tuesday. The four paramedics involved in Sunday's incident have been with the department for several years, with the least experienced having worked as a medic for nearly six years. Officials declined to release their names on Tuesday, but said the other three have served in their roles for six years, seven years and 12 years. None was disciplined for the incident and each is expected to return to work this week, Hood said. Still, the incident remains under investigation, he said, and will force the department to review its policies. " We need to figure out what to do to avoid this, " he said. " Customers in San need to have faith in their department. " was one of three people inside the Accord when a Pontiac G5 veered into an oncoming lane on Loop 410, striking the Accordshortly before 4 a.m. The driver of the Pontiac, Ann Ybarra, 28, was taken to a hospital after complaining of back pain. She has been charged with intoxication manslaughter and her bond set at $50,000. A jail official said she had posted bail, but was awaiting an ankle monitor so that she could be released. 's friends  Shaner, 22, the Accord's driver, and back seat passenger Amber , 22 suffered serious but non-life-threatening injuries. __________________________________________________________ More new features than ever. Check out the new AOL Mail ! - http://webmail.aol.com <http://webmail.aol.com> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 You miss the entire point of my post. I fully agree that IF it is proven, by someone other than the press and uninformed public opinion, that these medics provided " inadequate treatment " then yes we should act. I have no problems calling a cat a cat, but I won't do it until someone other than a news reporter proves to me that it is a cat. Negative comments do not allow us to see where our downfalls may be, constructive criticism via a tried and true performance improvement program do that. All negative comments do is create false liability and give EMS a black eye. I submit to you Mr. that if you were involved in this incident you would crave a responsible investigation from your service and DSHS, not press driven rumor and innuendo. Rick ________________________________ From: texasems-l [mailto:texasems-l ] On Behalf Of Danny Sent: Thursday, December 20, 2007 9:17 AM To: texasems-l Subject: RE: The latest from San .... I have not only been taught, I do it on a regular basis. I have triaged more than 8 patients at one time; with at least two of those patients critical. Appearances are everything. The appearance of this incident and others that seem to be misshandled on a daily basis are cause for alarm and action to stop them. " Four long term paramedics made a decision based on training, knowledge, and protocols. " I will go with the protocols aspect but don't try to cover up inadequate treatment with that argument. There is something for support of our fellow medics, but we should also be the ones to call a cat a cat and not a donkey. Negative comments are what allow us as a profession to see where our downfalls may be and correct them before they become a permanent ill fated treatment regime. Noone enjoys criticism, but there are days that it is needed so that we may continue to do the best job possible. These are my feelings not only as a fellow paramedic, but also as a manager of EMS personnel. Have I made mistakes? Yes I have. It is a sad but true reality that we learn from our mistakes. We Hope. Let's learn from the mistake so that it does not happen again. Things happen but don't look the other way just because it is convenient. We are tasked with the assistance and ultimate survival of many that come into contact with us, let's not loose that simple reality nor the understanding that it is a great responsibility not to be take lightly. " , Rick " <rick.moore@... <mailto:rick.moore%40triadhospitals.com> > wrote: Apparently you have never been taught how to handle an MCI then. An MCI is any incident that has more than 2 victims and this incident had at least 4. During the course of an MCI someone is charged with triage and that person's responsibility is to assign priority to those who will receive treatment. A black or blue tag (depending on the system) indicates that the patients injuries appear to be incompatible with life and the resources available on scene can be better utilized treating and transporting those who will benefit from treatment. " perhaps someone should have thought to check a carotid pulse " . How do you know they didn't? I have seen TV news coverage of the car and the brunt of the damage is to the right front, where this victim was sitting. Mangled car, victim position, prolonged extrication potential all could have an affect on the assessment of the patient. Is this a sad situation, yes it is, but 4 highly trained long term paramedics made a decision based on the training, knowledge and protocols that they utilize every day. Oh one other factor to the decision, THEY WERE THERE, the rest of us were not. We all know that the news media is not the best source of information and that they frequently get things wrong or slant them in an unfavorable way. Instead of considering this " another black eye for EMS across Texas " , let's support our fellow medics, who just like us make decisions based on field assessments in dangerous situations in split second real time. We should look at this as a learning experience and for sure those of us with a DSHS patch (regardless of color) should stop Monday morning quarterbacking based on news reports, rumor and innuendo. There is not one of us who has not been placed in a similar situation and only by the grace of god did we make the right decision. My suggestion to this list is that the next person to post negative comments about these San Paramedics, be the person that has NEVER made a bad decision or error while treating a patient. Rick , RN,LP College Station ________________________________ From: texasems-l <mailto:texasems-l%40yahoogroups.com> [mailto:texasems-l <mailto:texasems-l%40yahoogroups.com> ] On Behalf Of Danny Sent: Thursday, December 20, 2007 1:38 AM To: texasems-l <mailto:texasems-l%40yahoogroups.com> Subject: Re: The latest from San .... So when I was taught EMS and learned to be an instructor nothing in that informed me to disregard a patient if they were still breathing. Obvious signs of injury mean there is no pulse, no B/P, no respiration's, a head is missing, a hole is in the middle of the chest, or some other type of injury not consistent with life. Severe head injury is not one of the criteria especially if the patient is still breathing. Perhaps someone should have thought to check a carotid pulse? Another black eye for EMS across Texas and the Nation. FYI: There was an article in the Amarillo Globe News about First Responders from the Air Force Base in New Mexico that are not allowed to do Intubations due to 3 incidents in the last month for tearing the trachea. Where are we going these days in EMS??????? Wes Ogilvie <ExLngHrn@... <mailto:ExLngHrn%40aol.com> <mailto:ExLngHrn%40aol.com> > wrote: More from the " oopsie " incident. Looks like the SAFD PR efforts are improving, albeit slightly. -Wes Ogilvie, MPA, JD, LP -Austin, Texas  Controversy over woman left for dead Web Posted: 12/19/2007 01:02 AM CST Chasnoff and Lomi Kriel Express-News The injury looked grave. Part of the front-seat passenger's skull had caved in after a head-on collision on Loop 410. McLaughlin, a truck driver who said he witnessed the wreck and rushed to the aid of its victims, crouched beside the mangled Honda Accord and talked to the injured woman, 23-year-old a , until a police officer arrived. had been moaning, McLaughlin said. " I said, 'Sir, that girl in the front seat is messed up bad. She needs help,' " he recalled. Yet it was precisely that injury  coupled with an apparent lack of a pulse  that led paramedics to abandon , believing her dead, and instead rush two other victims with non-life-threatening injuries to Army Medical Center, Fire Chief Hood said on Tuesday. was actually alive  a detail discovered more than an hour later by a medical examiner's investigator called to the scene to examine her body. Paramedics again were called, and was taken to Army Medical Center, on Sunday, more than two hours after the early morning wreck. She died at the hospital Monday afternoon. The paramedics' decision to abandon in the wreckage in near freezing temperatures  compounded by Hood's refusal to apologize for the incident at a news conference Monday  has stoked outrage among some. Tuesday, in an interview with the Express-News editorial board, Hood said he regretted not saying he was " sorry for the family. " Although he conceded that Sunday's misdiagnosis " could possibly have been a mistake, " Hood defended the judgment of the four paramedics who abandoned after checking her pulse. Cold weather can mask vital signs, he said, and victims can continue breathing after they are brain dead. " The body is designed, basically, to function without a brain, " he said. " Bodies make noises, bodies move, bodies will sit up on you. Gordon, a professor of medicine at the University of Texas Health Science Center at San , said up to 60 percent of patients who gasp are not alive. Typically, he said, the gasp is the result of a spinal reflex. Hood and Gordon, who has authorized the standard medical operating procedure for the city's Fire Department for more than two decades, said medical privacy laws constrained them from detailing what exactly led paramedics to believe was dead. But Gordon said national standards prevent medical providers from resuscitating patients if they meet criteria classifying them as an " obvious death on arrival. " And on Tuesday, Hood said publicly for the first time that, " by all intents and purposes, (the paramedics) thought () was dead. " " She presented as deceased to them, " Hood said, adding that paramedics, " when they checked, she had no pulse. " According to the current operating procedure, which Gordon updated last year, patients fall into the category of " obvious death on arrival " if they have " no measurable vital signs, " such as a heart beat or pulse, and meet one of four criteria: rigor mortis; when the blood pools to the lowest level of gravity; decapitation, incineration or visual massive trauma; or if the body is decomposed. " Visual massive trauma " refers to injuries severe enough for a layperson to think they might cause death, such as " part of a V-6 engine sitting in the middle of your chest, " Gordon said. According to McLaughlin, suffered a major head injury. " I knew that if she didn't get help right away, she might not make it, " he said, adding, " My opinion, I think they should have paid more attention to her. " A police officer familiar with the incident said he told paramedics at least twice that was still breathing. " They kept telling everybody, 'No, she's not. ... She'll die in a few minutes,' " said the officer, who requested anonymity because he is not authorized to speak about the case. If there's any question about whether a patient meets the required criteria for resuscitation, paramedics are required to call their medical director for an opinion. Gordon, who is the medical director for the city's Fire Department, declined to say whether he was called in 's accident. But typically, he offers such opinions on a daily basis, he said. It is very rare for someone to be classified as an " obvious DOA " and then return to life, he said, but it has happened. Over the past 20 years, San has recorded two other such incidents, Hood said Tuesday. The four paramedics involved in Sunday's incident have been with the department for several years, with the least experienced having worked as a medic for nearly six years. Officials declined to release their names on Tuesday, but said the other three have served in their roles for six years, seven years and 12 years. None was disciplined for the incident and each is expected to return to work this week, Hood said. Still, the incident remains under investigation, he said, and will force the department to review its policies. " We need to figure out what to do to avoid this, " he said. " Customers in San need to have faith in their department. " was one of three people inside the Accord when a Pontiac G5 veered into an oncoming lane on Loop 410, striking the Accordshortly before 4 a.m. The driver of the Pontiac, Ann Ybarra, 28, was taken to a hospital after complaining of back pain. She has been charged with intoxication manslaughter and her bond set at $50,000. A jail official said she had posted bail, but was awaiting an ankle monitor so that she could be released. 's friends  Shaner, 22, the Accord's driver, and back seat passenger Amber , 22 suffered serious but non-life-threatening injuries. __________________________________________________________ More new features than ever. Check out the new AOL Mail ! - http://webmail.aol.com <http://webmail.aol.com> <http://webmail.aol.com <http://webmail.aol.com> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 MCI exceeds your services capabilities to handle that incident. I do not know the status of other SAFD units at the time. It is conceivable that there were not other units readily available for that incident without compromising care or response to multiple other incidents within the same timeframe. Rick ________________________________ From: texasems-l [mailto:texasems-l ] On Behalf Of Wes Ogilvie Sent: Thursday, December 20, 2007 9:24 AM To: texasems-l Subject: Re: The latest from San .... Respectfully, I thought the definition of MCI was any event that exceeded your service's capabilities. Are we saying that SAFD can't handle an incident with 2+ patients? -Wes Ogilvie Re: The latest from San .... So when I was taught EMS and learned to be an instructor nothing in that informed me to disregard a patient if they were still breathing. Obvious signs of injury mean there is no pulse, no B/P, no respiration's, a head is missing, a hole is in the middle of the chest, or some other type of injury not consistent with life. Severe head injury is not one of the criteria especially if the patient is still breathing. Perhaps someone should have thought to check a carotid pulse? Another black eye for EMS across Texas and the Nation. FYI: There was an article in the Amarillo Globe News about First Responders from the Air Force Base in New Mexico that are not allowed to do Intubations due to 3 incidents in the last month for tearing the trachea. Where are we going these days in EMS??????? Wes Ogilvie <ExLngHrn@... <mailto:ExLngHrn%40aol.com> <mailto:ExLngHrn%40aol.com> > wrote: More from the " oopsie " incident. Looks like the SAFD PR efforts are improving, albeit slightly. -Wes Ogilvie, MPA, JD, LP -Austin, Texas  Controversy over woman left for dead Web Posted: 12/19/2007 01:02 AM CST Chasnoff and Lomi Kriel Express-News The injury looked grave. Part of the front-seat passenger's skull had caved in after a head-on collision on Loop 410. McLaughlin, a truck driver who said he witnessed the wreck and rushed to the aid of its victims, crouched beside the mangled Honda Accord and talked to the injured woman, 23-year-old a , until a police officer arrived. had been moaning, McLaughlin said. " I said, 'Sir, that girl in the front seat is messed up bad. She needs help,' " he recalled. Yet it was precisely that injury  coupled with an apparent lack of a pulse  that led paramedics to abandon , believing her dead, and instead rush two other victims with non-life-threatening injuries to Army Medical Center, Fire Chief Hood said on Tuesday. was actually alive  a detail discovered more than an hour later by a medical examiner's investigator called to the scene to examine her body. Paramedics again were called, and was taken to Army Medical Center, on Sunday, more than two hours after the early morning wreck. She died at the hospital Monday afternoon. The paramedics' decision to abandon in the wreckage in near freezing temperatures  compounded by Hood's refusal to apologize for the incident at a news conference Monday  has stoked outrage among some. Tuesday, in an interview with the Express-News editorial board, Hood said he regretted not saying he was " sorry for the family. " Although he conceded that Sunday's misdiagnosis " could possibly have been a mistake, " Hood defended the judgment of the four paramedics who abandoned after checking her pulse. Cold weather can mask vital signs, he said, and victims can continue breathing after they are brain dead. " The body is designed, basically, to function without a brain, " he said. " Bodies make noises, bodies move, bodies will sit up on you. Gordon, a professor of medicine at the University of Texas Health Science Center at San , said up to 60 percent of patients who gasp are not alive. Typically, he said, the gasp is the result of a spinal reflex. Hood and Gordon, who has authorized the standard medical operating procedure for the city's Fire Department for more than two decades, said medical privacy laws constrained them from detailing what exactly led paramedics to believe was dead. But Gordon said national standards prevent medical providers from resuscitating patients if they meet criteria classifying them as an " obvious death on arrival. " And on Tuesday, Hood said publicly for the first time that, " by all intents and purposes, (the paramedics) thought () was dead. " " She presented as deceased to them, " Hood said, adding that paramedics, " when they checked, she had no pulse. " According to the current operating procedure, which Gordon updated last year, patients fall into the category of " obvious death on arrival " if they have " no measurable vital signs, " such as a heart beat or pulse, and meet one of four criteria: rigor mortis; when the blood pools to the lowest level of gravity; decapitation, incineration or visual massive trauma; or if the body is decomposed. " Visual massive trauma " refers to injuries severe enough for a layperson to think they might cause death, such as " part of a V-6 engine sitting in the middle of your chest, " Gordon said. According to McLaughlin, suffered a major head injury. " I knew that if she didn't get help right away, she might not make it, " he said, adding, " My opinion, I think they should have paid more attention to her. " A police officer familiar with the incident said he told paramedics at least twice that was still breathing. " They kept telling everybody, 'No, she's not. ... She'll die in a few minutes,' " said the officer, who requested anonymity because he is not authorized to speak about the case. If there's any question about whether a patient meets the required criteria for resuscitation, paramedics are required to call their medical director for an opinion. Gordon, who is the medical director for the city's Fire Department, declined to say whether he was called in 's accident. But typically, he offers such opinions on a daily basis, he said. It is very rare for someone to be classified as an " obvious DOA " and then return to life, he said, but it has happened. Over the past 20 years, San has recorded two other such incidents, Hood said Tuesday. The four paramedics involved in Sunday's incident have been with the department for several years, with the least experienced having worked as a medic for nearly six years. Officials declined to release their names on Tuesday, but said the other three have served in their roles for six years, seven years and 12 years. None was disciplined for the incident and each is expected to return to work this week, Hood said. Still, the incident remains under investigation, he said, and will force the department to review its policies. " We need to figure out what to do to avoid this, " he said. " Customers in San need to have faith in their department. " was one of three people inside the Accord when a Pontiac G5 veered into an oncoming lane on Loop 410, striking the Accordshortly before 4 a.m. The driver of the Pontiac, Ann Ybarra, 28, was taken to a hospital after complaining of back pain. She has been charged with intoxication manslaughter and her bond set at $50,000. A jail official said she had posted bail, but was awaiting an ankle monitor so that she could be released. 's friends  Shaner, 22, the Accord's driver, and back seat passenger Amber , 22 suffered serious but non-life-threatening injuries. __________________________________________________________ More new features than ever. Check out the new AOL Mail ! - http://webmail.aol.com <http://webmail.aol.com> <http://webmail.aol.com <http://webmail.aol.com> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 Another black eye to EMS? Too often the black eye in EMS comes from EMS and from those who relish in the mistakes of others and cannot wait to offer their opinion on it. Unfortunately, this listserve, which can serve better purposes, is a forum for this. Don, Tyler =========================================================== This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you received this message in error, or are not the named recipient(s), please notify the sender and delete this e-mail from your computer. ETMC has implemented secure messaging for certain types of messages. For more information about our secure messaging system, go to: http://www.etmc.org/mail/ Thank you. =========================================================== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 Don't be so quick to misjudge the news media. It is often their stories that " open the bag " on a problem. They do this with some extravigant wording at times, but this is what people will read. Who would have been the ones to report this incident as being somewhat questionable, you?, me?; I don't think so. The crazy thing is that there are people watching and it sucks that we get caught with our pants down at the most inopportune moments. And I would submit also that if it were me involved in this incident the last thing I would want would be an investigation. I would feel really crapy, wonder what happened, am I doing what I need to be doing, and how do I keep it from happening in the future. " , Rick " wrote: You miss the entire point of my post. I fully agree that IF it is proven, by someone other than the press and uninformed public opinion, that these medics provided " inadequate treatment " then yes we should act. I have no problems calling a cat a cat, but I won't do it until someone other than a news reporter proves to me that it is a cat. Negative comments do not allow us to see where our downfalls may be, constructive criticism via a tried and true performance improvement program do that. All negative comments do is create false liability and give EMS a black eye. I submit to you Mr. that if you were involved in this incident you would crave a responsible investigation from your service and DSHS, not press driven rumor and innuendo. Rick ________________________________ From: texasems-l [mailto:texasems-l ] On Behalf Of Danny Sent: Thursday, December 20, 2007 9:17 AM To: texasems-l Subject: RE: The latest from San .... I have not only been taught, I do it on a regular basis. I have triaged more than 8 patients at one time; with at least two of those patients critical. Appearances are everything. The appearance of this incident and others that seem to be misshandled on a daily basis are cause for alarm and action to stop them. " Four long term paramedics made a decision based on training, knowledge, and protocols. " I will go with the protocols aspect but don't try to cover up inadequate treatment with that argument. There is something for support of our fellow medics, but we should also be the ones to call a cat a cat and not a donkey. Negative comments are what allow us as a profession to see where our downfalls may be and correct them before they become a permanent ill fated treatment regime. Noone enjoys criticism, but there are days that it is needed so that we may continue to do the best job possible. These are my feelings not only as a fellow paramedic, but also as a manager of EMS personnel. Have I made mistakes? Yes I have. It is a sad but true reality that we learn from our mistakes. We Hope. Let's learn from the mistake so that it does not happen again. Things happen but don't look the other way just because it is convenient. We are tasked with the assistance and ultimate survival of many that come into contact with us, let's not loose that simple reality nor the understanding that it is a great responsibility not to be take lightly. " , Rick " <rick.moore@... <mailto:rick.moore%40triadhospitals.com> > wrote: Apparently you have never been taught how to handle an MCI then. An MCI is any incident that has more than 2 victims and this incident had at least 4. During the course of an MCI someone is charged with triage and that person's responsibility is to assign priority to those who will receive treatment. A black or blue tag (depending on the system) indicates that the patients injuries appear to be incompatible with life and the resources available on scene can be better utilized treating and transporting those who will benefit from treatment. " perhaps someone should have thought to check a carotid pulse " . How do you know they didn't? I have seen TV news coverage of the car and the brunt of the damage is to the right front, where this victim was sitting. Mangled car, victim position, prolonged extrication potential all could have an affect on the assessment of the patient. Is this a sad situation, yes it is, but 4 highly trained long term paramedics made a decision based on the training, knowledge and protocols that they utilize every day. Oh one other factor to the decision, THEY WERE THERE, the rest of us were not. We all know that the news media is not the best source of information and that they frequently get things wrong or slant them in an unfavorable way. Instead of considering this " another black eye for EMS across Texas " , let's support our fellow medics, who just like us make decisions based on field assessments in dangerous situations in split second real time. We should look at this as a learning experience and for sure those of us with a DSHS patch (regardless of color) should stop Monday morning quarterbacking based on news reports, rumor and innuendo. There is not one of us who has not been placed in a similar situation and only by the grace of god did we make the right decision. My suggestion to this list is that the next person to post negative comments about these San Paramedics, be the person that has NEVER made a bad decision or error while treating a patient. Rick , RN,LP College Station ________________________________ From: texasems-l <mailto:texasems-l%40yahoogroups.com> [mailto:texasems-l <mailto:texasems-l%40yahoogroups.com> ] On Behalf Of Danny Sent: Thursday, December 20, 2007 1:38 AM To: texasems-l <mailto:texasems-l%40yahoogroups.com> Subject: Re: The latest from San .... So when I was taught EMS and learned to be an instructor nothing in that informed me to disregard a patient if they were still breathing. Obvious signs of injury mean there is no pulse, no B/P, no respiration's, a head is missing, a hole is in the middle of the chest, or some other type of injury not consistent with life. Severe head injury is not one of the criteria especially if the patient is still breathing. Perhaps someone should have thought to check a carotid pulse? Another black eye for EMS across Texas and the Nation. FYI: There was an article in the Amarillo Globe News about First Responders from the Air Force Base in New Mexico that are not allowed to do Intubations due to 3 incidents in the last month for tearing the trachea. Where are we going these days in EMS??????? Wes Ogilvie <ExLngHrn@... <mailto:ExLngHrn%40aol.com> <mailto:ExLngHrn%40aol.com> > wrote: More from the " oopsie " incident. Looks like the SAFD PR efforts are improving, albeit slightly. -Wes Ogilvie, MPA, JD, LP -Austin, Texas  Controversy over woman left for dead Web Posted: 12/19/2007 01:02 AM CST Chasnoff and Lomi Kriel Express-News The injury looked grave. Part of the front-seat passenger's skull had caved in after a head-on collision on Loop 410. McLaughlin, a truck driver who said he witnessed the wreck and rushed to the aid of its victims, crouched beside the mangled Honda Accord and talked to the injured woman, 23-year-old a , until a police officer arrived. had been moaning, McLaughlin said. " I said, 'Sir, that girl in the front seat is messed up bad. She needs help,' " he recalled. Yet it was precisely that injury  coupled with an apparent lack of a pulse  that led paramedics to abandon , believing her dead, and instead rush two other victims with non-life-threatening injuries to Army Medical Center, Fire Chief Hood said on Tuesday. was actually alive  a detail discovered more than an hour later by a medical examiner's investigator called to the scene to examine her body. Paramedics again were called, and was taken to Army Medical Center, on Sunday, more than two hours after the early morning wreck. She died at the hospital Monday afternoon. The paramedics' decision to abandon in the wreckage in near freezing temperatures  compounded by Hood's refusal to apologize for the incident at a news conference Monday  has stoked outrage among some. Tuesday, in an interview with the Express-News editorial board, Hood said he regretted not saying he was " sorry for the family. " Although he conceded that Sunday's misdiagnosis " could possibly have been a mistake, " Hood defended the judgment of the four paramedics who abandoned after checking her pulse. Cold weather can mask vital signs, he said, and victims can continue breathing after they are brain dead. " The body is designed, basically, to function without a brain, " he said. " Bodies make noises, bodies move, bodies will sit up on you. Gordon, a professor of medicine at the University of Texas Health Science Center at San , said up to 60 percent of patients who gasp are not alive. Typically, he said, the gasp is the result of a spinal reflex. Hood and Gordon, who has authorized the standard medical operating procedure for the city's Fire Department for more than two decades, said medical privacy laws constrained them from detailing what exactly led paramedics to believe was dead. But Gordon said national standards prevent medical providers from resuscitating patients if they meet criteria classifying them as an " obvious death on arrival. " And on Tuesday, Hood said publicly for the first time that, " by all intents and purposes, (the paramedics) thought () was dead. " " She presented as deceased to them, " Hood said, adding that paramedics, " when they checked, she had no pulse. " According to the current operating procedure, which Gordon updated last year, patients fall into the category of " obvious death on arrival " if they have " no measurable vital signs, " such as a heart beat or pulse, and meet one of four criteria: rigor mortis; when the blood pools to the lowest level of gravity; decapitation, incineration or visual massive trauma; or if the body is decomposed. " Visual massive trauma " refers to injuries severe enough for a layperson to think they might cause death, such as " part of a V-6 engine sitting in the middle of your chest, " Gordon said. According to McLaughlin, suffered a major head injury. " I knew that if she didn't get help right away, she might not make it, " he said, adding, " My opinion, I think they should have paid more attention to her. " A police officer familiar with the incident said he told paramedics at least twice that was still breathing. " They kept telling everybody, 'No, she's not. ... She'll die in a few minutes,' " said the officer, who requested anonymity because he is not authorized to speak about the case. If there's any question about whether a patient meets the required criteria for resuscitation, paramedics are required to call their medical director for an opinion. Gordon, who is the medical director for the city's Fire Department, declined to say whether he was called in 's accident. But typically, he offers such opinions on a daily basis, he said. It is very rare for someone to be classified as an " obvious DOA " and then return to life, he said, but it has happened. Over the past 20 years, San has recorded two other such incidents, Hood said Tuesday. The four paramedics involved in Sunday's incident have been with the department for several years, with the least experienced having worked as a medic for nearly six years. Officials declined to release their names on Tuesday, but said the other three have served in their roles for six years, seven years and 12 years. None was disciplined for the incident and each is expected to return to work this week, Hood said. Still, the incident remains under investigation, he said, and will force the department to review its policies. " We need to figure out what to do to avoid this, " he said. " Customers in San need to have faith in their department. " was one of three people inside the Accord when a Pontiac G5 veered into an oncoming lane on Loop 410, striking the Accordshortly before 4 a.m. The driver of the Pontiac, Ann Ybarra, 28, was taken to a hospital after complaining of back pain. She has been charged with intoxication manslaughter and her bond set at $50,000. A jail official said she had posted bail, but was awaiting an ankle monitor so that she could be released. 's friends  Shaner, 22, the Accord's driver, and back seat passenger Amber , 22 suffered serious but non-life-threatening injuries. __________________________________________________________ More new features than ever. Check out the new AOL Mail ! - http://webmail.aol.com <http://webmail.aol.com> <http://webmail.aol.com <http://webmail.aol.com> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 I refer you to Mr. Elbert's post which preceded this post. Rick ________________________________ From: texasems-l [mailto:texasems-l ] On Behalf Of Danny Sent: Thursday, December 20, 2007 9:43 AM To: texasems-l Subject: RE: The latest from San .... Don't be so quick to misjudge the news media. It is often their stories that " open the bag " on a problem. They do this with some extravigant wording at times, but this is what people will read. Who would have been the ones to report this incident as being somewhat questionable, you?, me?; I don't think so. The crazy thing is that there are people watching and it sucks that we get caught with our pants down at the most inopportune moments. And I would submit also that if it were me involved in this incident the last thing I would want would be an investigation. I would feel really crapy, wonder what happened, am I doing what I need to be doing, and how do I keep it from happening in the future. " , Rick " <rick.moore@... <mailto:rick.moore%40triadhospitals.com> > wrote: You miss the entire point of my post. I fully agree that IF it is proven, by someone other than the press and uninformed public opinion, that these medics provided " inadequate treatment " then yes we should act. I have no problems calling a cat a cat, but I won't do it until someone other than a news reporter proves to me that it is a cat. Negative comments do not allow us to see where our downfalls may be, constructive criticism via a tried and true performance improvement program do that. All negative comments do is create false liability and give EMS a black eye. I submit to you Mr. that if you were involved in this incident you would crave a responsible investigation from your service and DSHS, not press driven rumor and innuendo. Rick ________________________________ From: texasems-l <mailto:texasems-l%40yahoogroups.com> [mailto:texasems-l <mailto:texasems-l%40yahoogroups.com> ] On Behalf Of Danny Sent: Thursday, December 20, 2007 9:17 AM To: texasems-l <mailto:texasems-l%40yahoogroups.com> Subject: RE: The latest from San .... I have not only been taught, I do it on a regular basis. I have triaged more than 8 patients at one time; with at least two of those patients critical. Appearances are everything. The appearance of this incident and others that seem to be misshandled on a daily basis are cause for alarm and action to stop them. " Four long term paramedics made a decision based on training, knowledge, and protocols. " I will go with the protocols aspect but don't try to cover up inadequate treatment with that argument. There is something for support of our fellow medics, but we should also be the ones to call a cat a cat and not a donkey. Negative comments are what allow us as a profession to see where our downfalls may be and correct them before they become a permanent ill fated treatment regime. Noone enjoys criticism, but there are days that it is needed so that we may continue to do the best job possible. These are my feelings not only as a fellow paramedic, but also as a manager of EMS personnel. Have I made mistakes? Yes I have. It is a sad but true reality that we learn from our mistakes. We Hope. Let's learn from the mistake so that it does not happen again. Things happen but don't look the other way just because it is convenient. We are tasked with the assistance and ultimate survival of many that come into contact with us, let's not loose that simple reality nor the understanding that it is a great responsibility not to be take lightly. " , Rick " <rick.moore@... <mailto:rick.moore%40triadhospitals.com> <mailto:rick.moore%40triadhospitals.com> > wrote: Apparently you have never been taught how to handle an MCI then. An MCI is any incident that has more than 2 victims and this incident had at least 4. During the course of an MCI someone is charged with triage and that person's responsibility is to assign priority to those who will receive treatment. A black or blue tag (depending on the system) indicates that the patients injuries appear to be incompatible with life and the resources available on scene can be better utilized treating and transporting those who will benefit from treatment. " perhaps someone should have thought to check a carotid pulse " . How do you know they didn't? I have seen TV news coverage of the car and the brunt of the damage is to the right front, where this victim was sitting. Mangled car, victim position, prolonged extrication potential all could have an affect on the assessment of the patient. Is this a sad situation, yes it is, but 4 highly trained long term paramedics made a decision based on the training, knowledge and protocols that they utilize every day. Oh one other factor to the decision, THEY WERE THERE, the rest of us were not. We all know that the news media is not the best source of information and that they frequently get things wrong or slant them in an unfavorable way. Instead of considering this " another black eye for EMS across Texas " , let's support our fellow medics, who just like us make decisions based on field assessments in dangerous situations in split second real time. We should look at this as a learning experience and for sure those of us with a DSHS patch (regardless of color) should stop Monday morning quarterbacking based on news reports, rumor and innuendo. There is not one of us who has not been placed in a similar situation and only by the grace of god did we make the right decision. My suggestion to this list is that the next person to post negative comments about these San Paramedics, be the person that has NEVER made a bad decision or error while treating a patient. Rick , RN,LP College Station ________________________________ From: texasems-l <mailto:texasems-l%40yahoogroups.com> <mailto:texasems-l%40yahoogroups.com> [mailto:texasems-l <mailto:texasems-l%40yahoogroups.com> <mailto:texasems-l%40yahoogroups.com> ] On Behalf Of Danny Sent: Thursday, December 20, 2007 1:38 AM To: texasems-l <mailto:texasems-l%40yahoogroups.com> <mailto:texasems-l%40yahoogroups.com> Subject: Re: The latest from San .... So when I was taught EMS and learned to be an instructor nothing in that informed me to disregard a patient if they were still breathing. Obvious signs of injury mean there is no pulse, no B/P, no respiration's, a head is missing, a hole is in the middle of the chest, or some other type of injury not consistent with life. Severe head injury is not one of the criteria especially if the patient is still breathing. Perhaps someone should have thought to check a carotid pulse? Another black eye for EMS across Texas and the Nation. FYI: There was an article in the Amarillo Globe News about First Responders from the Air Force Base in New Mexico that are not allowed to do Intubations due to 3 incidents in the last month for tearing the trachea. Where are we going these days in EMS??????? Wes Ogilvie <ExLngHrn@... <mailto:ExLngHrn%40aol.com> <mailto:ExLngHrn%40aol.com> <mailto:ExLngHrn%40aol.com> > wrote: More from the " oopsie " incident. Looks like the SAFD PR efforts are improving, albeit slightly. -Wes Ogilvie, MPA, JD, LP -Austin, Texas  Controversy over woman left for dead Web Posted: 12/19/2007 01:02 AM CST Chasnoff and Lomi Kriel Express-News The injury looked grave. Part of the front-seat passenger's skull had caved in after a head-on collision on Loop 410. McLaughlin, a truck driver who said he witnessed the wreck and rushed to the aid of its victims, crouched beside the mangled Honda Accord and talked to the injured woman, 23-year-old a , until a police officer arrived. had been moaning, McLaughlin said. " I said, 'Sir, that girl in the front seat is messed up bad. She needs help,' " he recalled. Yet it was precisely that injury  coupled with an apparent lack of a pulse  that led paramedics to abandon , believing her dead, and instead rush two other victims with non-life-threatening injuries to Army Medical Center, Fire Chief Hood said on Tuesday. was actually alive  a detail discovered more than an hour later by a medical examiner's investigator called to the scene to examine her body. Paramedics again were called, and was taken to Army Medical Center, on Sunday, more than two hours after the early morning wreck. She died at the hospital Monday afternoon. The paramedics' decision to abandon in the wreckage in near freezing temperatures  compounded by Hood's refusal to apologize for the incident at a news conference Monday  has stoked outrage among some. Tuesday, in an interview with the Express-News editorial board, Hood said he regretted not saying he was " sorry for the family. " Although he conceded that Sunday's misdiagnosis " could possibly have been a mistake, " Hood defended the judgment of the four paramedics who abandoned after checking her pulse. Cold weather can mask vital signs, he said, and victims can continue breathing after they are brain dead. " The body is designed, basically, to function without a brain, " he said. " Bodies make noises, bodies move, bodies will sit up on you. Gordon, a professor of medicine at the University of Texas Health Science Center at San , said up to 60 percent of patients who gasp are not alive. Typically, he said, the gasp is the result of a spinal reflex. Hood and Gordon, who has authorized the standard medical operating procedure for the city's Fire Department for more than two decades, said medical privacy laws constrained them from detailing what exactly led paramedics to believe was dead. But Gordon said national standards prevent medical providers from resuscitating patients if they meet criteria classifying them as an " obvious death on arrival. " And on Tuesday, Hood said publicly for the first time that, " by all intents and purposes, (the paramedics) thought () was dead. " " She presented as deceased to them, " Hood said, adding that paramedics, " when they checked, she had no pulse. " According to the current operating procedure, which Gordon updated last year, patients fall into the category of " obvious death on arrival " if they have " no measurable vital signs, " such as a heart beat or pulse, and meet one of four criteria: rigor mortis; when the blood pools to the lowest level of gravity; decapitation, incineration or visual massive trauma; or if the body is decomposed. " Visual massive trauma " refers to injuries severe enough for a layperson to think they might cause death, such as " part of a V-6 engine sitting in the middle of your chest, " Gordon said. According to McLaughlin, suffered a major head injury. " I knew that if she didn't get help right away, she might not make it, " he said, adding, " My opinion, I think they should have paid more attention to her. " A police officer familiar with the incident said he told paramedics at least twice that was still breathing. " They kept telling everybody, 'No, she's not. ... She'll die in a few minutes,' " said the officer, who requested anonymity because he is not authorized to speak about the case. If there's any question about whether a patient meets the required criteria for resuscitation, paramedics are required to call their medical director for an opinion. Gordon, who is the medical director for the city's Fire Department, declined to say whether he was called in 's accident. But typically, he offers such opinions on a daily basis, he said. It is very rare for someone to be classified as an " obvious DOA " and then return to life, he said, but it has happened. Over the past 20 years, San has recorded two other such incidents, Hood said Tuesday. The four paramedics involved in Sunday's incident have been with the department for several years, with the least experienced having worked as a medic for nearly six years. Officials declined to release their names on Tuesday, but said the other three have served in their roles for six years, seven years and 12 years. None was disciplined for the incident and each is expected to return to work this week, Hood said. Still, the incident remains under investigation, he said, and will force the department to review its policies. " We need to figure out what to do to avoid this, " he said. " Customers in San need to have faith in their department. " was one of three people inside the Accord when a Pontiac G5 veered into an oncoming lane on Loop 410, striking the Accordshortly before 4 a.m. The driver of the Pontiac, Ann Ybarra, 28, was taken to a hospital after complaining of back pain. She has been charged with intoxication manslaughter and her bond set at $50,000. A jail official said she had posted bail, but was awaiting an ankle monitor so that she could be released. 's friends  Shaner, 22, the Accord's driver, and back seat passenger Amber , 22 suffered serious but non-life-threatening injuries. __________________________________________________________ More new features than ever. Check out the new AOL Mail ! - http://webmail.aol.com <http://webmail.aol.com> <http://webmail.aol.com <http://webmail.aol.com> > <http://webmail.aol.com <http://webmail.aol.com> <http://webmail.aol.com <http://webmail.aol.com> > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 Don's comments are correct, we should all listen. > > > > > Another black eye to EMS? Too often the black eye in EMS comes from EMS and > from those who relish in the mistakes of others and cannot wait to offer > their opinion on it. Unfortunately, this listserve, which can serve better > purposes, is a forum for this. > > Don, Tyler > > =========================================================== > This message is confidential, intended only > for the named recipient(s) and may contain > information that is privileged or exempt from > disclosure under applicable law. If you are > not the intended recipient(s), you are notified > that the dissemination, distribution or copying > of this message is strictly prohibited. If you > received this message in error, or are not the > named recipient(s), please notify the sender > and delete this e-mail from your computer. > > ETMC has implemented secure messaging for > certain types of messages. For more information > about our secure messaging system, go to: > > http://www.etmc.org/mail/ > > Thank you. > =========================================================== > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 I do not relish in the mistakes of others, but I have seen too many times where we choose to give only lip service to a problem rather than to correct it. Who should correct the mistakes of our profession? Should it be the men and women of the profession, or someone from the outside who would only make things worse? Don Elbert wrote: Another black eye to EMS? Too often the black eye in EMS comes from EMS and from those who relish in the mistakes of others and cannot wait to offer their opinion on it. Unfortunately, this listserve, which can serve better purposes, is a forum for this. Don, Tyler =========================================================== This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you received this message in error, or are not the named recipient(s), please notify the sender and delete this e-mail from your computer. ETMC has implemented secure messaging for certain types of messages. For more information about our secure messaging system, go to: http://www.etmc.org/mail/ Thank you. =========================================================== Danny L. Owner/NREMT-P PETSAR INC. (Panhandle Emergency Training Services And Response) Office Fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 I'll respectfully suggest that if EMS cannot clean up its own problems (Face it, we do have some issues to resolve.), that someone else will. Unfortunately, this incident could be the instance where the citizens pick up the pitchforks and torches and demand someone to " do something! " EMS doing " something " will invariably be better than the Legislature (who still isn't sure what an ambulance is) doing something. There's an old saying in law that bad cases make for bad law.? This could easily become one of these " bad cases. " -Wes Ogilvie, MPA, JD, LP -Austin, Texas RE: The latest from San .... I do not relish in the mistakes of others, but I have seen too many times where we choose to give only lip service to a problem rather than to correct it. Who should correct the mistakes of our profession? Should it be the men and women of the profession, or someone from the outside who would only make things worse? Don Elbert wrote: Another black eye to EMS? Too often the black eye in EMS comes from EMS and from those who relish in the mistakes of others and cannot wait to offer their opinion on it. Unfortunately, this listserve, which can serve better purposes, is a forum for this. Don, Tyler =========================================================== This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you received this message in error, or are not the named recipient(s), please notify the sender and delete this e-mail from your computer. ETMC has implemented secure messaging for certain types of messages. For more information about our secure messaging system, go to: http://www.etmc.org/mail/ Thank you. =========================================================== Danny L. Owner/NREMT-P PETSAR INC. (Panhandle Emergency Training Services And Response) Office Fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 Wes With all of your vast amount of EMS experience, I thank you for your comments! > > > > > > I'll respectfully suggest that if EMS cannot clean up its own problems (Face > it, we do have some issues to resolve.), that someone else will. > > Unfortunately, this incident could be the instance where the citizens pick > up the pitchforks and torches and demand someone to " do something! " > > EMS doing " something " will invariably be better than the Legislature (who > still isn't sure what an ambulance is) doing something. > > There's an old saying in law that bad cases make for bad law.? This could > easily become one of these " bad cases. " > > -Wes Ogilvie, MPA, JD, LP > > -Austin, Texas > > RE: The latest from San .... > > I do not relish in the mistakes of others, but I have seen too many times > where we choose to give only lip service to a problem rather than to correct > it. > Who should correct the mistakes of our profession? Should it be the men and > women of the profession, or someone from the outside who would only make > things worse? > > Don Elbert wrote: > Another black eye to EMS? Too often the black eye in EMS comes from EMS and > from those who relish in the mistakes of others and cannot wait to offer > their opinion on it. Unfortunately, this listserve, which can serve better > purposes, is a forum for this. > > Don, Tyler > > =========================================================== > This message is confidential, intended only > for the named recipient(s) and may contain > information that is privileged or exempt from > disclosure under applicable law. If you are > not the intended recipient(s), you are notified > that the dissemination, distribution or copying > of this message is strictly prohibited. If you > received this message in error, or are not the > named recipient(s), please notify the sender > and delete this e-mail from your computer. > > ETMC has implemented secure messaging for > certain types of messages. For more information > about our secure messaging system, go to: > > http://www.etmc.org/mail/ > > Thank you. > =========================================================== > > Danny L. > Owner/NREMT-P > PETSAR INC. > (Panhandle Emergency Training Services And Response) > Office > Fax > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 Wes, The problem is at this point we are the citizens with the pitchforks and torches. EMS doing something is waiting for all the information to be gathered then constructively acting to revise protocols, pass laws or whatever the situation calls for to come to a reasonable solution. Knee-jerk solutions never work appropriately and often make things worse, yet we seem to be jerking knees all over the EMS community without complete information. Rick ________________________________ From: texasems-l [mailto:texasems-l ] On Behalf Of Wes Ogilvie Sent: Thursday, December 20, 2007 9:54 AM To: texasems-l Subject: Re: The latest from San .... I'll respectfully suggest that if EMS cannot clean up its own problems (Face it, we do have some issues to resolve.), that someone else will. Unfortunately, this incident could be the instance where the citizens pick up the pitchforks and torches and demand someone to " do something! " EMS doing " something " will invariably be better than the Legislature (who still isn't sure what an ambulance is) doing something. There's an old saying in law that bad cases make for bad law.? This could easily become one of these " bad cases. " -Wes Ogilvie, MPA, JD, LP -Austin, Texas RE: The latest from San .... I do not relish in the mistakes of others, but I have seen too many times where we choose to give only lip service to a problem rather than to correct it. Who should correct the mistakes of our profession? Should it be the men and women of the profession, or someone from the outside who would only make things worse? Don Elbert <delbert@... <mailto:delbert%40etmc.org> > wrote: Another black eye to EMS? Too often the black eye in EMS comes from EMS and from those who relish in the mistakes of others and cannot wait to offer their opinion on it. Unfortunately, this listserve, which can serve better purposes, is a forum for this. Don, Tyler =========================================================== This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you received this message in error, or are not the named recipient(s), please notify the sender and delete this e-mail from your computer. ETMC has implemented secure messaging for certain types of messages. For more information about our secure messaging system, go to: http://www.etmc.org/mail/ <http://www.etmc.org/mail/> Thank you. =========================================================== Danny L. Owner/NREMT-P PETSAR INC. (Panhandle Emergency Training Services And Response) Office Fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 Ahhhhh, professional integrity, brotherly love, and the holiday spirit. Just makes me all gushy inside. Miles wrote: Wes With all of your vast amount of EMS experience, I thank you for your comments! > > > > > > I'll respectfully suggest that if EMS cannot clean up its own problems (Face > it, we do have some issues to resolve.), that someone else will. > > Unfortunately, this incident could be the instance where the citizens pick > up the pitchforks and torches and demand someone to " do something! " > > EMS doing " something " will invariably be better than the Legislature (who > still isn't sure what an ambulance is) doing something. > > There's an old saying in law that bad cases make for bad law.? This could > easily become one of these " bad cases. " > > -Wes Ogilvie, MPA, JD, LP > > -Austin, Texas > > RE: The latest from San .... > > I do not relish in the mistakes of others, but I have seen too many times > where we choose to give only lip service to a problem rather than to correct > it. > Who should correct the mistakes of our profession? Should it be the men and > women of the profession, or someone from the outside who would only make > things worse? > > Don Elbert wrote: > Another black eye to EMS? Too often the black eye in EMS comes from EMS and > from those who relish in the mistakes of others and cannot wait to offer > their opinion on it. Unfortunately, this listserve, which can serve better > purposes, is a forum for this. > > Don, Tyler > > =========================================================== > This message is confidential, intended only > for the named recipient(s) and may contain > information that is privileged or exempt from > disclosure under applicable law. If you are > not the intended recipient(s), you are notified > that the dissemination, distribution or copying > of this message is strictly prohibited. If you > received this message in error, or are not the > named recipient(s), please notify the sender > and delete this e-mail from your computer. > > ETMC has implemented secure messaging for > certain types of messages. For more information > about our secure messaging system, go to: > > http://www.etmc.org/mail/ > > Thank you. > =========================================================== > > Danny L. > Owner/NREMT-P > PETSAR INC. > (Panhandle Emergency Training Services And Response) > Office > Fax > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 : I don't deny that my EMS experience may not be as vast as others on this list. (Such as you.) However, I've got significant experience in law, government, and the political process. I can assure you that those insights may well be appropriate right now. -Wes Ogilvie, MPA, JD, LP -Attorney at Law/Licensed Paramedic -Austin, Texas RE: The latest from San .... > > I do not relish in the mistakes of others, but I have seen too many times > where we choose to give only lip service to a problem rather than to correct > it. > Who should correct the mistakes of our profession? Should it be the men and > women of the profession, or someone from the outside who would only make > things worse? > > Don Elbert wrote: > Another black eye to EMS? Too often the black eye in EMS comes from EMS and > from those who relish in the mistakes of others and cannot wait to offer > their opinion on it. Unfortunately, this listserve, which can serve better > purposes, is a forum for this. > > Don, Tyler > > =========================================================== > This message is confidential, intended only > for the named recipient(s) and may contain > information that is privileged or exempt from > disclosure under applicable law. If you are > not the intended recipient(s), you are notified > that the dissemination, distribution or copying > of this message is strictly prohibited. If you > received this message in error, or are not the > named recipient(s), please notify the sender > and delete this e-mail from your computer. > > ETMC has implemented secure messaging for > certain types of messages. For more information > about our secure messaging system, go to: > > http://www.etmc.org/mail/ > > Thank you. > =========================================================== > > Danny L. > Owner/NREMT-P > PETSAR INC. > (Panhandle Emergency Training Services And Response) > Office > Fax > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 Fair enough.? Mea culpa. Allow me to " revise and extend " my remarks as my attorney colleagues in Congress do.? LOL I'll say that, if the media's allegations are true, we may need to fix some things.? Unfortunately, perception is often reality - and that's what the public sees and thinks.? While this is a " public " email list, I'd argue that most of us on this list have at least some understanding of EMS and are going to " Monday Morning Quarterback " anything like this.? It's the nature of a profession.?? Attorneys do the same when we flub up, even if it's just to say " there but for the grace of God go I. " ? More typically, in any profession or group, the first sentiment is all too often, " What was that idiot thinking? " Regardless, SAFD's chief's comments in the media sure aren't helping.? It might behoove him to let his PIO, the city's PIO, and/or the city attorney help him a bit with his statements to the press. -Wes Ogilvie, MPA, JD, LP -Attorney at Law/Licensed Paramedic -Austin, Texas RE: The latest from San .... I do not relish in the mistakes of others, but I have seen too many times where we choose to give only lip service to a problem rather than to correct it. Who should correct the mistakes of our profession? Should it be the men and women of the profession, or someone from the outside who would only make things worse? Don Elbert <delbert@... <mailto:delbert%40etmc.org> > wrote: Another black eye to EMS? Too often the black eye in EMS comes from EMS and from those who relish in the mistakes of others and cannot wait to offer their opinion on it. Unfortunately, this listserve, which can serve better purposes, is a forum for this. Don, Tyler =========================================================== This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you received this message in error, or are not the named recipient(s), please notify the sender and delete this e-mail from your computer. ETMC has implemented secure messaging for certain types of messages. For more information about our secure messaging system, go to: http://www.etmc.org/mail/ <http://www.etmc.org/mail/> Thank you. =========================================================== Danny L. Owner/NREMT-P PETSAR INC. (Panhandle Emergency Training Services And Response) Office Fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 Wes, You have a point, but since you do not have all of the information, your opinions do nothing but tear our profession apart, and serve to hurt people. Lets use the list server as a building block for EMS instead of a hangman's noose. I would venture to say, all of us need to remember someone died, that's the important factor at this point. Not government control, legal insight, or knee jerk reaction because of fear of a law suit. Lets all look internally at how we can correct our own short comings, then share those ideas on this list server, instead of gathering around to throw stones at fellow paramedic/firefighters who have to wake up tomorrow and still be faced with the fact they made a mistake. I have made mistake, as has everyone else reading this, lets support not destroy. Respectfully > > > > > : > > I don't deny that my EMS experience may not be as vast as others on this > list. (Such as you.) > > However, I've got significant experience in law, government, and the > political process. > > I can assure you that those insights may well be appropriate right now. > > -Wes Ogilvie, MPA, JD, LP > -Attorney at Law/Licensed Paramedic > -Austin, Texas > > RE: The latest from San .... > > > > I do not relish in the mistakes of others, but I have seen too many times > > where we choose to give only lip service to a problem rather than to > correct > > it. > > Who should correct the mistakes of our profession? Should it be the men > and > > women of the profession, or someone from the outside who would only make > > things worse? > > > > Don Elbert wrote: > > Another black eye to EMS? Too often the black eye in EMS comes from EMS > and > > from those who relish in the mistakes of others and cannot wait to offer > > their opinion on it. Unfortunately, this listserve, which can serve better > > purposes, is a forum for this. > > > > Don, Tyler > > > > =========================================================== > > This message is confidential, intended only > > for the named recipient(s) and may contain > > information that is privileged or exempt from > > disclosure under applicable law. If you are > > not the intended recipient(s), you are notified > > that the dissemination, distribution or copying > > of this message is strictly prohibited. If you > > received this message in error, or are not the > > named recipient(s), please notify the sender > > and delete this e-mail from your computer. > > > > ETMC has implemented secure messaging for > > certain types of messages. For more information > > about our secure messaging system, go to: > > > > http://www.etmc.org/mail/ > > > > Thank you. > > =========================================================== > > > > Danny L. > > Owner/NREMT-P > > PETSAR INC. > > (Panhandle Emergency Training Services And Response) > > Office > > Fax > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 Here goes guys from the old coon ass on the water. First of all I truly feel bad for the lady that died and her family. It is terrible to lose a family member under any conditions. Here is what I think is really going on here on the list in regards to this incident. Each and everyone of us are offering up viewpoints that may differ in our perspective but yet it still points in the same direction. That direction is inward to ourselves. Each and everyone of us know that this call could have been ours and we could have been the paramedic involved. For what ever reason it was not determined that the lady was still alive. Just thinking about us being involved in a scenario like this scares the hell out of me and it should all of you. This is a very unfortunate incident that the folks down in San will have to iron out. Keep in mind the only folks we have control over is ourselve or our departments if that is what we do. What can we learn from this? We can learn that the possibility exist for this to happen and take measures to prevent it from happening to us or one of our patients. Lets move on to another subject if you will. If you are a person that prays, offer up a prayer for the patient, the family, the paramedics involved and for the folks in San who will have to work through this issue. Henry RE: The latest from San .... > > I do not relish in the mistakes of others, but I have seen too many times > where we choose to give only lip service to a problem rather than to correct > it. > Who should correct the mistakes of our profession? Should it be the men and > women of the profession, or someone from the outside who would only make > things worse? > > Don Elbert wrote: > Another black eye to EMS? Too often the black eye in EMS comes from EMS and > from those who relish in the mistakes of others and cannot wait to offer > their opinion on it. Unfortunately, this listserve, which can serve better > purposes, is a forum for this. > > Don, Tyler > > =========================================================== > This message is confidential, intended only > for the named recipient(s) and may contain > information that is privileged or exempt from > disclosure under applicable law. If you are > not the intended recipient(s), you are notified > that the dissemination, distribution or copying > of this message is strictly prohibited. If you > received this message in error, or are not the > named recipient(s), please notify the sender > and delete this e-mail from your computer. > > ETMC has implemented secure messaging for > certain types of messages. For more information > about our secure messaging system, go to: > > http://www.etmc.org/mail/ > > Thank you. > =========================================================== > > Danny L. > Owner/NREMT-P > PETSAR INC. > (Panhandle Emergency Training Services And Response) > Office > Fax > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 I have been reading about this incident for the last couple of days and considering a reply. I had a situation where a patient presented with rigor, no pulse, no breathing, and flat line on the monitor in multiple leads. The patient was checked by multiple paramedics and all had the same finding. Fifteen minutes after we had called for the JP, the wife tells us she thinks he is breathing. He was, survived to the hospital. He went through a whole battery of test and nothing found. He was released from the hospital and died later that day in spite of our efforts. The man upstairs was well at work in this patient. I know we have all made mistakes in our careers. Everything at this point is purely guessing. I think that we need to let the investigation take place and then see what comes out of it. I have been in their shoes of these medics and seconded guessed myself like you would not believe. We are convicting them before the evidence is in. They are also hearing the things that are discussed here. I have them in my prayers, I know what they are going through. >>> Danny 12/20/2007 10:04 AM >>> Ahhhhh, professional integrity, brotherly love, and the holiday spirit. Just makes me all gushy inside. Miles wrote: Wes With all of your vast amount of EMS experience, I thank you for your comments! > > > > > > I'll respectfully suggest that if EMS cannot clean up its own problems (Face > it, we do have some issues to resolve.), that someone else will. > > Unfortunately, this incident could be the instance where the citizens pick > up the pitchforks and torches and demand someone to " do something! " > > EMS doing " something " will invariably be better than the Legislature (who > still isn't sure what an ambulance is) doing something. > > There's an old saying in law that bad cases make for bad law.? This could > easily become one of these " bad cases. " > > -Wes Ogilvie, MPA, JD, LP > > -Austin, Texas > > RE: The latest from San .... > > I do not relish in the mistakes of others, but I have seen too many times > where we choose to give only lip service to a problem rather than to correct > it. > Who should correct the mistakes of our profession? Should it be the men and > women of the profession, or someone from the outside who would only make > things worse? > > Don Elbert wrote: > Another black eye to EMS? Too often the black eye in EMS comes from EMS and > from those who relish in the mistakes of others and cannot wait to offer > their opinion on it. Unfortunately, this listserve, which can serve better > purposes, is a forum for this. > > Don, Tyler > > =========================================================== > This message is confidential, intended only > for the named recipient(s) and may contain > information that is privileged or exempt from > disclosure under applicable law. If you are > not the intended recipient(s), you are notified > that the dissemination, distribution or copying > of this message is strictly prohibited. If you > received this message in error, or are not the > named recipient(s), please notify the sender > and delete this e-mail from your computer. > > ETMC has implemented secure messaging for > certain types of messages. For more information > about our secure messaging system, go to: > > http://www.etmc.org/mail/ > > Thank you. > =========================================================== > > Danny L. > Owner/NREMT-P > PETSAR INC. > (Panhandle Emergency Training Services And Response) > Office > Fax > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 I'm in complete agreement that we need not hang any medics out to dry until all the facts are known and that the hanging is the responsibility of their employer, not those of us on the list serve. I'm sure those medics are probably questioning themselves much harder and deeper than any individual ever could. That said; let me throw in a thought from " back in the old days " mentality. (Prior to having advanced protocols, lots of fancy treatment possibilities and wonderful communications with medical control.) At one particular service we worked every CPR all the way to the hospital, even when we knew in our hearts that the patient wasn't going to make it and that we were, in effect, having a very good practicum lesson. We did the same thing for trauma unless it was really, really obvious that they were dead. (No it wasn't a good use of resources, but we were a low/medium volume system at that time.) Why would we do that you ask? Because we knew we were also treating the family members the patient was leaving behind. For their mental health, we worked the patient so that they knew that everything that could have been done was done for their loved one. (For CPR calls, it also meant that " Uncle Bob " died at the hospital not in the Lazy-Boy in the living room.) In a case like the one in San that may have meant we did a ground transport instead of flying the patient. But to the family members and by standers on the scene they saw patient care. It may not have changed patient outcomes, but it did do a lot for the comfort of the loved ones and reputation of that particular EMS system. Barry Barry Sharp, MSHP, CHES Program Coordinator Tobacco Prevention & Control Texas Dept. of State Health Services Barry.Sharp@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 If I read the stuff right this incident had 3 Patients and there were 4 Medics. I also assume other EMS system folks were on a scene like this. If those numbers are right how does this classify as an MCI by any measure? Louis N. Molino, Sr., CET FF/NREMT-B/FSI/EMSI Owner and President of LNM Emergency Services Consulting Services (LNMECS) Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant LNMolino@... (Cell Phone) (IFW/TFW/FSS Office) (IFW/TFW/FSS Fax) The comments contained in this E-mail are the opinions of the author and the author alone. I in no way ever intend to speak for any person or organization that I am in any way whatsoever involved or associated with unless I specifically state that I am doing so. Further this E-mail is intended only for its stated recipient and may contain private and or confidential materials retransmission is strictly prohibited unless placed in the public domain by the original author. **************************************See AOL's top rated recipes (http://food.aol.com/top-rated-recipes?NCID=aoltop00030000000004) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 Here, here. I agree with Henry. This scenario is giving me those nightmares, you know, those nightmares. The ones you leave 911 in the first place for. Those rehashing, 'what if " , " what did I forget " nightmares, I am sure many of us have had. I truely feel for everyone involved in this. From the patient, the family and the paramedics who were on scene. Let us find enlightenment through re-education. Penny Engelking, LP > > Here goes guys from the old coon ass on the water. > > First of all I truly feel bad for the lady that died and her family. It is > terrible to lose a family member under any conditions. > > Here is what I think is really going on here on the list in regards to > this incident. > > Each and everyone of us are offering up viewpoints that may differ in our > perspective but yet it still points in the same direction. That direction is > inward to ourselves. Each and everyone of us know that this call could have > been ours and we could have been the paramedic involved. For what ever > reason it was not determined that the lady was still alive. Just thinking > about us being involved in a scenario like this scares the hell out of me > and it should all of you. This is a very unfortunate incident that the folks > down in San will have to iron out. Keep in mind the only folks we > have control over is ourselve or our departments if that is what we do. What > can we learn from this? We can learn that the possibility exist for this to > happen and take measures to prevent it from happening to us or one of our > patients. Lets move on to another subject if you will. If you are a person > that prays, offer up a prayer for the patient, the family, the paramedics > involved and for the folks in San who will have to work through this > issue. > > Henry > RE: The latest from San .... > > > > I do not relish in the mistakes of others, but I have seen too many > times > > where we choose to give only lip service to a problem rather than to > correct > > it. > > Who should correct the mistakes of our profession? Should it be the men > and > > women of the profession, or someone from the outside who would only make > > things worse? > > > > Don Elbert <delbert@... <delbert%40etmc.org>> wrote: > > Another black eye to EMS? Too often the black eye in EMS comes from EMS > and > > from those who relish in the mistakes of others and cannot wait to offer > > their opinion on it. Unfortunately, this listserve, which can serve > better > > purposes, is a forum for this. > > > > Don, Tyler > > > > =========================================================== > > This message is confidential, intended only > > for the named recipient(s) and may contain > > information that is privileged or exempt from > > disclosure under applicable law. If you are > > not the intended recipient(s), you are notified > > that the dissemination, distribution or copying > > of this message is strictly prohibited. If you > > received this message in error, or are not the > > named recipient(s), please notify the sender > > and delete this e-mail from your computer. > > > > ETMC has implemented secure messaging for > > certain types of messages. For more information > > about our secure messaging system, go to: > > > > http://www.etmc.org/mail/ > > > > Thank you. > > =========================================================== > > > > Danny L. > > Owner/NREMT-P > > PETSAR INC. > > (Panhandle Emergency Training Services And Response) > > Office > > Fax > > > > Quote Link to comment Share on other sites More sharing options...
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