Stupid EMS question

[Llwellyn]

Ok... this morning on my way to work, I heard EMS dispatched (first responder engine and an ALS transport) to the Sajak Pavilion at AAMC for heart problems. The building is less than 200 feet from the hospital! Do you mean to tell me that people who are providing medical care in the pavilion cannot help a cardiac patient, and that they don't have the ability to move a patient to a trauma/monitored bed all on the hospital's resources? Are these people treating patients in this pavilion not doctors and nurses? Why can't a doctor trained in trauma or cardiac respond from their ER? I would think that they could have the patient from the pavilion to the ER before the engine or medic even got out of the station... and they really should be able to!

Can any of you people that run with the county (or any other, really) tell me why this is necessary?

 

[bwhite]

Heard something like this dispatch for the Carroll Co Gen Hosp ER about 2 years ago.
Kinda interesting because you heard a couple of units go to another TG and do a "what?".
I didn't hear any more, but, sure hit me as bizzare.

 

[tbnmaster]

Interesting post. When I used to live in North Dakota, if someone had problems (requiring EMS) EVEN IN THE ACTUAL HOSPITAL, they had to dispatch the paramedics. Nobody could actually call to the ER and request a medic to a certain area of the hospital. They had to dial 911 from within the hospital and EMS had to be dispatched (from the ER). Never made a lot of sense to me. Maybe it's a paperwork kind of deal. Something where they need certain documentation of calls.

 

[blinddog50]

It's probably all about the money and gov. bureaucracy.
They charge a goodly amount for sending an ambulance.
Plus if they have the same rules there that they do in Charlotte a fireman that arrives at a location first even though trained as a paramedic is limited as to what life saving procedures he can apply.
EMS is the only ones allowed to apply these treatments.

Local government pissing contests......aren't they great!

 

[rescue161]

Well, in every hospital I've ever worked in (4 hospitals and 14 years), including the one I work for now, we have a code system. It's pretty much standard across the board (JCAHO).

Code Blue is called for cardiac arrest.

Every hospital will have it's own system for initiating a Code Blue, but ours goes like this:

1. Patient goes down (MI, TIA, etc.).

2. Staff picks up closest phone and dials X3699 (different for each installation).

3. X3699 rings at Quarterdeck. Staff verifies the legitamacy of the code and gets location and any other information.

4. Overhead announcement made including whether the patient is adult or pediatric.

5. Code Team is paged via our digital paging system.

6. Code is not secured until the doctor in charge of the code calls it.

I see no reason for someone to have to call 911 for an outside agency to respond to a hospital. Apparently, JCAHO needs to pay a visit to said hospital to review their code system.

 

[BoxAlarm187]

In the county where I work as a career firefighter, we have a number of hospitals that we respond to regularly for medical calls. Everything from pedestrians struck in the parking lot to medical emergencies in the doctor's offices located within the hospital are routine. It generally involves assessing the patient, taking precautions necessary, placing them on the stretcher, and wheeling it over to the ER without even loading them in the ambulance. Yes, it does get aggrevating sometimes, but we can't deny them service!

As for Blinddog's post, our agency does not charge for any fire or EMS services, so money is not a motivating factor in our case.

 

[jf222]

Every patient deserves proper care - so yes, an ambulance will be called to the accident in front of the hospital or to the doctor's office across the street - according to proper EMS regulations - you don't carry or walk the patient to the ER

 

[BoxAlarm187]

jf222, if you're directing your response to my post, you'll notice that I said "in the parking lot" and "doctor's offices located within the same hospital." I don't think that anyone on here would argue that a doctor's office across the street or an MVA on the public roadway is going to be a little different than a patient that is 25 yards from the ER in the SAME BUILDING.

I've been doing EMS long enough to know that we don't walk or carry patients to the ER. Speaking of that, I don't know that I have ever "carried" a patient over the age of four anywhere.

 

[andrew_m]

Here in Las Cruces, NM, ems gets called sometimes to the medical building behind the hospital. That building even has a walkway right into the hospital. But I guess they have to follow the rules and everything.

 

[scover5555]

Being a former police officer and first responder all I can say is it all comes down to "liability" and "what if"

 

[troymail]

This is VERY common. There are numerous places where the doct's office is in the same building or just a stone's throw away from the ER door. Fire/medics get dispatched.

There have even been cases where a lower level provider unit (BLS ambulance) has transported a patient to the ER and the patient suddenly has chest pains or some other condition that requires advanced intervention.... so, the BLS unit sometimes has to request that an ALS unit be dispatched because the hospital has no cardiac monitor available or are just otherwise really busy.

At one time, the ER at BWMC (formerly NAH) even had fire department providers "stationed" in the ER to "watch" patients (supplement the ER staff) because the ER was so overwhelmed. Without these people, tranport units would be tied up there for hours [to be honest, I don't know all of the details behind it - I just witnessed this situation].

Other statements are true ... and the same reason why 911 can't tell you no - liability.

 

[Llwellyn]

Thanks for the replies; I assumed it was a standard-of-care or liability issue but wanted to check. It still seems like a tremendous waste of resources to have both an engine company and an ALS transport unit tied up for an incident that's basically in the hospital already... but I guess the protocols exist for good reason.

 

[ResQguy]

??? The Sajak Pavilion doors are almost a 1/4 mile on foot from the ED entrance of AAMC. Not to mention its on the other side of Medical Parkway, which is a 2 lane street exiting from US Rt.50. It may look close on a map, but try to move a cardiac patient that far in a wheelchair or a hospital bed and see how far you get. Now, I don't know the exact policy for AAMC regarding their 'scoop and run' boundaries, but the Sajak Pavilion certainly is far enough away for a 911 response. Hospital staff are not set up for field response. Their "crash carts" and defibrillators are not meant for outdoor use. Plus, the local AACoFD ALS unit is at 121 Jennifer Rd. Oh, and forget about a health system increasing their standard of care in an outpatient facility, it likely requires an amended "Certificate of Need".

 

[Llwellyn]

That's the answer I was looking for. The title of my original post, "Stupid EMS question" wasn't meant as "a stupid act by EMS" it was meant as "I'm not a responder, this seems odd, please explain this EMS". I realized after my last post it sounded a bit hostile, when I really was just curious.

I don't believe that M40 was in quarters for the call, I believe another ALS unit got the call, but I do understand your points... thanks for responding.