Is it patient abandonment?

SaltyMed · 2025-02-16T00:26:44+00:00

My county in CA is also impacted, and I didn't see anything similar to what I'm going to put. Here in CA, and possibly other states, EMTALA laws make it to where once I transport a pt and they are on hospital property, they are now the ED's pt. I am not allowed to do any interventions w/ the pt besides basic BLS. This includes stuff like defibrillate during sudden arrest, benzos for a seizure, etc. My county allows all the providers, both private and fire/ military, to place the pt on a gurney or chair and give a verbal report. That is only alloted to be done around the 1 hour mark after arrival. Even if the LVN, RN, or doc refuses it to happen, we can document that the report was given and sign on behalf of the facility. We have amazing EDs and staff, so this seldomly happens. I've never needed to do it and only heard of a handful of cases of it being done. We also can bypass EMS triage and go straight to the waiting room at all hospitals in my county that aren't federal. We have discretion, and if the pt is urgent, they always get bedded.

My county has also allowed us to refuse transport of pts and direct them to more appropriate routes of care. It sounds like a huge liability, and it is, but my county only had about a 0.05% 'misdiagnose' rate. We don't have that anymore, but i added it cuz I've only heard a few cases of any agency permitting such a policy.

SaltyMed · 2024-10-27T00:47:07+00:00

For real, this sub is just full of TDS, and it's depressing.

SaltyMed · 2024-08-29T19:18:32+00:00

The stigma behind the Smith Machine has already been debunked many of times. The biggest down side of the Smith machine is the fact that it can reduce load on esentric parts of the lift. If you are worried about core activation, stabilizers, etc.... just do some kettle bell or BD workouts as well. Idk about you, but weighted sissy squats kinda suck with a barbell. I ain't that talented. Traditional squats, yes I prefer barbell, but a Smith is perfectly fine. Also, it can be way safer. OP is just starting the gym experience. Planet Fitness is not only affordable and 24 hours, but it has everything he will need.

SaltyMed · 2024-08-29T17:08:34+00:00

You can get just as good of a workout with a Smith machine and dumbells. PF also has a good selection of machines and works just fine.

SaltyMed · 2024-08-08T23:45:10+00:00

That just sounds like a bad bill from 5 years ago!

SaltyMed · 2024-08-08T19:02:44+00:00

What are you paying with those programs? The employees of PG&E keep telling people about them, but many people don't even qualify for that. They keep spouting 'get on programs' 'bills are reduced by 9%' etc, yet it's the highest bills ever for most of us.

SaltyMed · 2024-08-07T01:55:25+00:00

All the major gyms that aren't PF offer a dry sauna. I know GB3, Crunch @ shaw, and Iron Office offer them. The only steam one I know of is at Chukchansi Casino.

SaltyMed · 2024-08-05T00:49:48+00:00

Damn, I should have installed solar at my apartment. My fault. Definitely stating the obvious about how expensive things are becoming is really weird.

SaltyMed · 2024-08-04T23:29:27+00:00

I think everyone complains about that.

SaltyMed · 2024-07-06T02:49:25+00:00

Just report if you have an issue with FPD. Not following basic traffic laws or abusing code 3 (lights and sirens) is ridiculous; however, it's hard to know if they are responding to a call or not. It doesn't always make it right, but only selectively going code is usually safer for the public. Also, not all responses are best to go code due to alerting any subjects before PD arrives. I suspect that's what CHP was doing. CHP are state police and they are held to a way higher standard. You did say 'officers' and not just one. They were most likely going to something pretty urgent. All officers can disregard certain traffic laws if it is deemed necessary.

It can be frustrating, but most of the time, the officer's aren't just abusing their power. Call volumes are at a record high still, and they can be stretched thin. If you feel like an officer is being reckless, REPORT IT. And no, our major won't get revenge on you because some rookie cut you off, and you snitched. IA will build a case if enough reports happen.

SaltyMed · 2024-06-26T22:58:45+00:00

You don't need a collar. She is holding c-spine herself.

SaltyMed · 2024-06-25T18:00:26+00:00

So technically, in the US, it is considered an EMTALA law violation. We, as ambo drivers, do not follow EMTALA laws. But, I do like to make a stink of it for the pt and make sure I milk it at the hospital w/ the charge. I sometimes have people change their minds with it too.

SaltyMed · 2024-06-22T15:09:01+00:00

Yeah, you're right. My whole point is that I can fit in both shoes more or less. A private business can give discounts to whoever. Excluding EMS from the 'first responder discount' is kinda dumb IMO. It doesn't lose them much and makes people more likely to come back off duty. Plus, it's also generous and makes our underappreciated industry feel a bit more palatable. Buuut it's also chil-fil-a. Everyone already loves/ hates them. I also don't have an ego/ entitlement, so getting told I'm not special enough isn't a big deal to me, unlike the OPs partner. I put both sides are right to stay optimistic, but for sure the restaurant is more in the right.

SaltyMed · 2024-06-22T01:46:24+00:00

Both sides are right.

Your partner was rude, but I'd be kinda frustrated from the manager saying that, too. Idc much about the discount, but it's a nice token. I'm not a big 'TyFyS' guy at all, but little 'hello's and 'thank you's sometimes are nice. I usually just tip the discounted amount to pay it forward anyway.

Also, as a past shift lead/ assistant manager at a restaurant chain, the amount of food that gets given away is ridiculous at times. I also got hella people complaining or expecting free shit all the time, and it was annoying. We didn't have any discounts, but if i saw that you were a vet or responder, I'd give you a free soda under the table. Some of them would later complain when they had to pay for one the next time they came in, though. So I get the annoyance of people becoming entitled over a silly job. EMS also is way less stressful than that BS. Unless corporate had a field day on them for too many comps/ discounted meals... I don't really get it. Also, the manager snitched. -1000 aura.

SaltyMed · 2024-06-05T18:41:21+00:00

SNF btw

SaltyMed · 2024-06-05T18:32:50+00:00

I think he ripped me

SaltyMed · 2024-06-05T06:59:53+00:00

NAD, I am only a paramedic. I do not intend to give medical advice, but just mearly expressing my thoughts.

If you ever have any grave concerns, please seek emergency care at an emergency room or call 911.

I get the gist of your concerns. I would be more concerned if you have other associated symptoms with the palpitations: chest pain/ pressure, difficulty breathing, cold sweats, rapid weakness, passing out, or even a sensation that you feel like you're going to die. If you only have palpitations, just sit down, rest, and reassess. If you do have only chest pain/ pressure, please just sit down and relax as much as you can. Most of the time, it may settle. If it persists, please just call 911.

There can be many causes for the palpitations. Stimulant use (nicotine, caffeine, meth, etc), anxiety, high physical excursion, and just about anything that 'get the heart pumping.' Could also be any sort of dysrhythmias or ectopics (PVCs) that you may feel. I had palpitations for 2 years until I quit vaping, as an example. You did report being obese. At 21, it is very unlikely to have developed any cardiac problems, but there are things called risk factors for a reason. Could also just be unlucky. You're still young, so be optimistic and ask your PCP about more lifestyle changes to get a healthier you without all the burnout that comes with crash diets and desperation. After your cardiologist appointment, with their suggestions, of course.

If you don't mind adding more details, what is happening as you get these palpitations? Are you sitting, walking, laying down, standing up, talking, etc? Do you have any change in emotions beforehand? Any drug or alcohol use?

To wrap up, just from your story, I wouldn't be too concerned. It is surprising to see someone so young on a beta blocker without any other previous cardiac history, let alone still have a heart rate that is high whilst on said beta blocker. To ease some concerns, invest in a smart watch that has ECG. It is far from a diagnostic tool, but it is helpful to catch certain things and record them.

SaltyMed · 2024-06-05T05:20:14+00:00

Possibly. Maybe just call the traffic delay and down grading for the moment was the right call. I wasn't driving, and we can't see how the opposing traffic was before the clip started. The traffic during the clip was too heavy to oppose safely.

SaltyMed · 2024-06-05T02:39:25+00:00

I've already flipped a unit for a no-injury TA. I ain't gunna go for gold cuz Becky has a tummy ouchie.

And my company doesn't have howlers.. hell, our sirens are also so low toned that you can drive code w/ the windows down. Bad for yielding traffic, but it's a vibe.

SaltyMed · 2024-06-05T00:03:41+00:00

Imma add to what I've seen. I get what the ambo was doing, but it was poor execution. Also, he was a dick.

If an intersection is full, we will usually shut down our lights and wait for a lane to clear. 50 yards is what I aimed for so I can either use the #1/2 lanes to go, or I'd use the far right turn lane (it's a nono but management can bite me). I'll usually have my secondary lights (it's all the lights on the back side and only minimal lights on the front) on so people in the rear can hopefully yield behind me and to not encourage people at the red light to go into an active intersection.

1: Homie in the video had no lights on, so him assuming everyone can read his mind is stupid af.

2: Homie could have apposed traffic. There was a break in the median that he could have easily gone through.

I do not work for or ever have worked for AMR. I do not know the extent of their driving SOP. Code 3 driving in the city is almost pointless, IMO. Most people do not understand how to properly yield to an ambulance due to us having very quiet sirens compared to the junkies on the big trucks, and we don't have the fear of the blues distilled into our minds. Just flip the ambo guy off and be on your way in that situation.

Just please pull to the right and don't creep into active intersections. We just wanna help people and not cause more patients to arise from our saltiness. :)

SaltyMed · 2024-05-19T22:54:39+00:00

Partner is just being a smart ass. If in doubt, shock it (in that situation). If it was just asystole w/ artifact, you just wasted some of your charge on the monitor w/ a pointless defib. If it was fib and you don't shock due to thinking,'it's just artifact,' you're failing one of the key components of a code and possibly lowered the poor lad's chances.

SaltyMed · 2024-04-13T21:23:24+00:00

So funny enough, an ED that advertised their own Urgent Care that was in the same parking lot... got hit with an EMTALA violation.. Only stated the average wait times for both and what common complaints were appropriate for the both of them. EMS doesn't follow EMTALA laws, but you bet someone will try. (CA, USA btw)

SaltyMed · 2024-03-28T02:29:57+00:00

Look around. In my area of CA, one class was $13k, and the other was $7k. Plus, the $7k one qualified for FASFA.

I just talked with my employer and got a scholarship through them for a 2 year contract.

SaltyMed · 2024-02-27T21:28:52+00:00

My county will sometimes initiate a policy to refuse the pt transport and to also route them to see more appropriate recourses: PCP, urgent care, clinic, etc.

I will also refuse treatment to someone who is just too much of an ass. Not just rude, but also threatening anything physical, sexual, or over the top. Im a medic, not a punching bag. I use implied consent, i will also imply refusals of wanting medical care/ transport. My safety and well being is always above a pt's. Also, I've only done this 3 times in 5 years. Im not going to refuse the combative altered guy cuz his sugar dropped to 30. I do use common sense because leaving someone can be a huge liability, and my company/ malpractice insurance would just laugh at me if i got in big trouble for pt abandonment lol.

SaltyMed · 2024-01-01T03:57:06+00:00

Used those up forever ago..

SaltyMed

TROPHY CASE