crcocr1

I think what is evident based on all our posts is that EMS to Hospital communications/reports largely are regional in nature. The basics are left to the handout and supplemented by the clinical rotations in hospitals. Perhaps the DOH would benefit for having a set list of expectations while undergoing the 10 hours or so of clinical rotation time for EMTs. EMTs then could be aware what the hospitals that they likely work in or near expect in a hospital report, including the bare minimum basics taught through a handout given in an EMT class. Insofar as "initals", the benefit for many commercial and even municipal providers seems to be that if hospital registration has that information up front, the EMS provider can obtain a facesheet and get paid for their services easier than relying on patient given information, which we should know may or may not be entirely accurate. It has its benefits and drawbacks, serves very little clinical purpose (outside of perhaps age and sex of patient), but may provide a friendlier atmosphere between EMS and hospital (if the hospital wants the information in a radio report).

I also would agree but in actuality, barring gross negligence in care, the EMT can be sued successfully for negligent documentation and for negligent transportation. Personally, I find documentation to be the hallmark of good clinical care; however, in the end, it also marks the beginning of CYA philsophy. A little pull to protect the EMT might be warranted, with some homework and the addition of one to two hours tops to go over that documentation. In the alternative, perhaps a field training requirement for new EMTs, or another alternative to make sure the EMT is learning and the patient is recieving quality care.

Negligent Documentation and Transportation are the two areas where most EMTs find themselves in the middle of a legal case yet it is often breezed over by most classes with the adage "If you didn't write it, you didn't do it." Speaking legally, there is more to it than "If you didn't write it, you didn't do it." Documentation matters to the health care providers whom you turn over care as well as to law enforcement officials. As a prosecutor, I have used documentation in domestic violence cases and simple assault cases. As a hospital worker, I have seen docs review documentation when there is a discrepency between one person's account to an injury and their initial presentation to the ER. If New York State took this portion of the EMT class more seriously and adopted a much more practical method to teaching Documentation as CFFD suggests, we all would be better served. To make that change happen, I would be more than happy to assist in any way permissible.

mstrang1, on 06 Aug 2013 - 10:47 AM, said: The issue isn't one of ADHD being overdiagnosed but rather a need for medication and the stigmas attached thereto. I have ADD-Inattentive and can tell you that it is a real disorder that can be managed with medication/appropriate training. Without my medication (at times), I would have had great difficulty in law school despite the fact that the medications made me tired as I was unable to focus, driven to distractability by the air in the room, the lights, and the smallest sound. Since law school, I have practiced as a criminal defense attorney and prosecutor handled a multitude of cases. The separate issues raised by your comment, however, is: (1) Is it appropriately diagnosed or diagnosed for the sake of convenience; and (2) if it is appropriately diagnosed with an appropriate extensive assessment by a neuropsychiatrist, is it something missed years ago (such as tumors being diagnosed as CVAs in the 1950s etc. etc. due to a lack of testing/proper knowledge at the time). The more appropriate question raised regarding the topic is does the mental illness have a profound effect on the job allowing for discrimination at the workplace? (physically handicapped individual wanting to be a firefighter being the classic example)

The interesting part of this scenario is the EMT, if part of a municipal fire agency, could be held liable under a federal 1983 for any harm due to the EMT's actions for acting under color of law to deprive an individual of a civil right (assuming if fits within the "shock the conscience" exception or the many carved exceptions to allow for a 1983 suit). Even if not part of a muncipal agency, the issue of medical neglect/malpractice would otherwise rear its ugly head even with protections under the Article 800 of the Public Health Law (allowing immunity for EMTs and Paramedics so long as not grossly negligent). Of course, the liability would be fact dependent and more details would be needed for an attorney, judge, jury, etc. This comment dovetails any employment law violation by his/her partner who may be affected by the discrimination.

Yes, but are you a "badge banger"?

I just had an interesting thought- Isn't a reporter who works the police fire ems beat a buff themselves? Reading the article makes me think what exactly is a buff whacker etc? ( I think badge banger is fairly obvious.) To me a buff is someone who appreciates anothers work, respectful to their work, and merely a booster A whacker is someone who takes it too far, has a scanner and tries to help out a scenes putting everyone in danger, and harms the view of the work someone does by not responding to requests to stay away when not needed or wanted I do agree with your assessment as I think obssessed would have been better than buff. (I think the word usage is. Similar to how some mos use the word bus than ambulance. Not a perfect analogy but doesn't help either in an mci situation).

Where's the disorderly conduct on the part of the videographer? Assuming there is no further evidence that we haven't seen, I don't see any evidence the videographer caused a public disturbance or inconvenience, nor did he disobey a lawful order by law enforcement. (The order that he could not video was not lawful as the law allows people to video and photograph in public areas.) Thus, no charge would lie under PL 240.20, a mere violation. Further since there was no physical inteference with firefighting operations, there likely would be no charge for Obstruction of Government Activity or Obstruction of Firefighting Operations under Article 195 of the Penal Law, a misdemeanor. If the videographer had a dashboard light and is not authorized to have it, then there might be a charge for that offense. Assuming Florida has a similar statutory scheme and absent any evidence that the videographer was impersonating a public servant (i.e. pointed to the dashboard light and said I'm a firefighter), I don't see anything that would subject him to any criminal charges. Further there is no violation of HIPAA or privacy as the videographer does not have any PHI of the patient. Ironically, the captain was causing a public disturbance that caused a crowd to gather and could be crimiinally liable for disorderly conduct, harassment, and possibly attempted assault for the pushing but to what end? I think the captain should remain professional at all times even if he doesn't like someone with a video camera over his shoulder or use a truck to block the area from sight if it could be safely done. I'm curious what else could be done to keep both FD and the videographer happy with minimal effort. Its a world we live in and will continue to live in barring the enactment of new laws that comport with federal and state constitutions.

Like the poster immediately before you, I'm hoping we are missing something and the press should have stated a paramedic was in the back of the ambulance. However, generally speaking, the Emergency Medical Treatment and Active Labor Act (EMTALA) requires a hospital only to provide a screening and stabilizing treatment to the best of its ability. In this case, the local community hospital may not have the capabilities to fully stabilize the patient and therefore provided advanced care to its ability and then recommended the transfer of the patient to definitive care at a secondary or tertiary facility. In which case, absent a state statute, regulation or case law within that state to the contrary, the hospital transferred the the patient to the ambulance to provide that definitive care and the ambulance would have been transporting a critical patient requiring a lights and siren approach. Further, a nurse is not required, and in some states, may not have the authority to perform any care in the back of an ambulance, depending on state statute. Of course, this analysis is mere speculation as we don't have the benefit of all the facts, only the media slant placed upon a portion of those facts available to the media.

Based on all that has been discussed, I would have to agree with those individuals who said to arrest based on the Aggravated Unlicensed Operation, search the person's grabbable area (which is different from many states where you can search the car even if you ask the person to step out of vehicle), and later conduct an inventory search of the vehicle. I think many departments have the policy of vouchering ammo from the gun itself and see no legal impediment to doing so for safety reasons. In NYC, with DATs, the person would be cuffed, searched for any contraband on his/her person, and then brought to precinct for issuance of a DAT. Insofar as the "if an officer is informed of a concealed carry permit, whether it be verbally or visualizing a license, does this give him/her the right to search and seizure or the need to physically exam the weapon or weapons on said license," I think it gives the officer the right to exam the weapon to see if the person is properly licensed. Outside of the inventory search, I don't see a need to examine the magazine unless it is an arrest for CPW as it would be a search covered under the fourth amendment. The decline to prosecute on this case could be due to any number of reasons, including lack of prosecutorial merit, if the Columbia County District Attorney thinks prosecuting under the SAFE ACT would be unduly harsh and improper.

Anyone can file a lawsuit. The question about medical marijuana is too fact dependent to reach any sort of fair answer. The American with Disabilities acts makes a number of reasonable accomodations depending on the job for which you are employed. If, however, being subtance free is required due to the nature of your employment (FF, PD, etc.), then a lawsuit may or may not be successful. In sum, in my humble opinion, the question is too open ended to reach any acceptable answer.

First of all, it depends on how the statute on DUI or DWI/DWAI is construed in those states. In New York, Driving while Ability Impaired by Drugs (VTL1192.4) only requires the defendant to be impaired by ANY extent by a drug and be driving at time of stop/arrest. Law enforcement often utilizes a urine or blood test to prove that a drug was in one's body at the time someone was driving. In some areas, a blood or urine test may not be needed if the person exhibits signs of intoxication by drug, the drug if found in the person's vehicle, and an expert witness can testify as to the effects manifesting itself in the person's body. This methodology may be utilized if a defendant refuses the urine/blood test and a search warrant is not obtained to seize the blood. From an earlier post: "Though I wonder what the impact of legalization is on drug testing for employment, particularly considering the discrepancy between federal and state law regarding marijuana. Can an employer fire you for failing a drug test if the drug is legalized in that state because the drug is federally illegal?Though I wonder what the impact of legalization is on drug testing for employment, particularly considering the discrepancy between federal and state law regarding marijuana. Can an employer fire you for failing a drug test if the drug is legalized in that state because the drug is federally illegal?" The mere fact that something is legal to use does not necessarily mean that an employer cannot ban it as a condition of employment, by law or by contract. By federal regulation, transit workers for instance cannot have more than 0.02 Blood Alcohol Content in their system and be working. Further, a private company can mandate no drug use as a condition of employment. If the potential applicant feels that this is an unfair obligation, the applicant can withdraw their application or, if they feel that they are being the victim of some discrimination, file a lawsuit (cause of action) in the appropriate court. Of course, the nature of the discrimination would have to be compellling to win such a suit/action (i.e. reasonable religious reasons, etc.). Nothing in this post should be construed as legal advice. For legal advice, please see your local bar association.

The issue rests on bioethics, law, and common sense. First and foremost, what type of message is sent by an EMS provider carrying a weapon, such as a pistol, onto a scene with a person needing medical assistance? Has the EMS agency that allows its providers to carry such a weapon considered potential liability issues if the weapon is drawn or negligently used, at a minimum? Has the EMS provider considered the chilling effect it may have on a patient being honest and candor in a medical assessment? Second, what if any effect will the law have on those EMS providers who chose to carry while on duty? If the agency bills Medicare/Medicaid, it may be violating Medicare/Medicaid guidelines. See 42 CFR 482.13(f) (CMS does not consider the use of weapons in the application of restraint as safe appropriate health care interventions. We consider the term "weapons" to include pepper spray, mace, nightsticks, Tazers, cattle prods, stun guns, pistols and other such devices. Security staff may carry weapons as allowed by hospital policy and state and federal law. The use of weapons by security staff is considered as a law enforcement use and not a health care intervention.) Third, what will be next on this slippery slope? Will EMS Providers next carry handcuffs that may hurt a patient? These points seem salient when EMS providers traditionally were thought as a safe haven/sanctuary from the world, so that patients, no matter what type of class (law enforcement, suspect, etc), may heal without interference from society. Of course, these comments are not to construed as saying that patients do not get abusive, violent, or otherwise dangerous. However, when a patient presented in an abusive or aggressive manner, solid training would dictate the involvement of law enforcement as a protective measure, for both the EMS provider and the patient.

My apologies--Piinsky lives in Third Department, decision rendered in Fourth. My statement however remains the same. Only binding in Rochester / Buffalo area then. The other interesting observation is that the decision was based on the defendant moving for summary judgment. The fire department still can win at trial, fact depending, if they decide not to settle the case. Definitely a interesting posting...

The decision mentioned within the article was rendered in the Third Judicial Department (Central New York and Albany). It therefore is not binding on the First (Bronx, Manhattan), Second (Long Island, Rest of New York City, Westchester, Putnam and Dutchess), and Fourth (Rochester and Buffalo area) Departments. With that in mind, I'm curious if the Manilus (sp?) Fire Department is appealing the ruling to the Court of Appeals, whose decision is binding on the whole state. In short form, I'd heed the articles comments but don't shred your SOPs yet!