Man dies after misdiagnosis from EMTs

[Guest alsfirefighter]

50-65...excellent post brother and very well said.

Deaming a call BLS is not what I am talking about. Paramedics are at a minimum and I am lucky enough to always be on a bus where a paramedic rides with me. Now I would hope i would not have to explain what it means to be EMS. I couldnt agree more with your "boarderline" principle always going ALS as that is the smart things to do, but i also know that we let the MD's make the diagnosis and we do our job of transporting to the hospital. Maybe you operate differently and if that works for you then great.

404...I'm not sending jabs your way, and I just wanted to point that out. I do have to say that I still do not know what you mean by "act like EMS." I would hope that most Paramedics operate the way I stated. Our job goes well beyond just transporting to the hospital. BLS or ALS. I can understand being if your a BLS provider you might not have the same aspects into the decisions Paramedics make. But in either role, we are there to make an impact on the patient condition, to sometimes be a patient advocate. Paramedics make field diagnosis to lead them in the right treatment direction(s) to take. Whether that just be routine medical care, medication administration and so on. I aim to reassure them, to either reverse the event that is taking place or to counteract them or give treatments aimed at buying time until better detailed treatment at the ED can be done, to reduce door to door time with certain medical conditions and if all else fails to reduce the symptoms they are experiencing. Transportation is just one aspect of the phases of care we deliver and I often when teaching discuss how sometimes that is a critical "treatment" choice. The MD will make his diagnosis, it might be more detailed then what I need to do in the field. But I have to get my impression and choose the right treatment modality. At the most "being EMS" for me is sometimes not getting into direct specifics of conditions that a MD might do, but in the end I have to have a general impression, ensure that what I'm seeing and the decision of treatment I will make match up.

[ckroll 101]

Excellent post 50-65.

Second, I, too, was bothered by the phrasing "act like EMS". "Act like....." carries with it the connotation of pretense, that one either isn't or doesn't.

We 'are' EMS.

When following protocols either as a volunteer EMT or paid paramedic, then in the eyes of the law, we are an extension of an MD that is medical control. These are privileges to which certification entitles us so long as we maintain the standard of care.

If we do not, we lose the privilege. These are MINIMUM standards and it is up to us, professionally, ethically to bring as much as we can to every patient. Any health care provider who does not cross the threshhold of a home asking him/her self "What is the most I can do to help this person?" is doing a disservice to the patient, to fellow providers, and is missing the opportunity get full enjoyment out of what he/she is doing.

Someone noticed once that I had been issued a work shirt that did not have a paramedic patch on it. My reply was that if everyone didn't know I was a paramedic when I walked in, then shame on me. It's not a patch, it's who I am.

If one takes pride in the profession, then it stings when fellow providers fail, it stings when bystanders and family accuse us of having no conscience, it stings when we lose faith in each other. Someone noted that the difference between a doctor and a medic was what took a doctor 8 years education, 2 hours with a patient, three blood tests and an Xray to do, a medic could do in 30 seconds. [in context they were making fun of medics.] And sometimes we get it wrong. It's important that when we get it wrong that it's for good reasons, not that we didn't care enough to get it right.