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Emergency department bottlenecks
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The Misuse and Abuse of Emergency Medical Services
The 9-1-1 emergency dispatcher, dispatches a call to the local fire department. “55 year- old male, chest pains, has been having chest pains for the last couple hours.” The department responds to the call, as they would any call. This is the 4th time this week they have been called out to the same old man, with the same complaints. These patients are known as the “frequent flyer’s”, they received this nick-name from constantly calling EMS personal, when deemed not appropriate. Some of these patients call everyday, and every fire station has that several individuals who gives them a purpose daily. This is a problem in the Emergency Medical Service field and seems to be growing out of control.
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A lot of the time, a “frequent flyer” will call out for emergency medical services, receive care inside their homes, and then refuse transport to hospital. The base-pay for a ride to hospital on an ambulance, is $400 dollars. That is starting, if the emergency medical services personal administrate medicine or treatment, the cost can rise up to $5,000 dollars. For patients that do not have medical insurance, this tab is picked up by tax payers. The National Fire Protection Association tracks all 9-1-1 calls annually, said fire departments nationwide responded to about 15.7 million total medical aid calls in 2008. Using that data, the National Academies of Emergency Dispatch, said about 20% of the calls are classified as non life-threatening and don't require a paramedic (Kavilanz). The ethical duty of any emergency medical services personal is to respond to any call without any judgment. Departments everywhere will always respond to a skinned knee, just as fast as they will respond to a school shooting. This is, not only adding additional stress on the medic squad, but it is distracting emergency medical services personal from focusing on potential actual life-threatening …show more content…
Many other communities jumped in and started similar programs, and also has a huge decrease in non-emergency calls.
Most of the time people who are super users and call 9-1-1 all the time, are just lonely with mental health issues, they want companionship so these programs are designed for those people. Companies like these will take a huge load off the firefighters and paramedics, they can have more time to train and answer life-threatening emergency calls instead of wasting hours transporting the same old man who calls everyday about his migraine. This will also save tax-payers millions of dollars. Emergency medical services is a very high stressful job, and if there is anyway they can reduce the stress, it would be to implement these programs in all
I found your post interesting, having worked in an emergency department during my paramedic years. In my career as a nurse working in a clinic on occasion we must send a patient to the emergency department. I always call to speak with the charge nurse to provide report prior to just sending the patient, often I am on hold for greater than 15 minutes. This often results in the patient arriving at the ER before I can give report. Adding to this the charge nurse on more than one occasion is calling me on another line to ask why the patient it there! However, from past experience I do know how busy the ER can be at any given time.
911 operators are the beginning to every emergency others are faced with and also hold a huge role in getting these situations resolved, but there are many misconceptions and stereotypes that argue the difficulty in their field of work. Stereotypes have been around since the 19th century and were brought about to characterize a certain group of people in which the way they behave, intending for it to represent the group as a whole. A misconception derives from stereotypes but, more often than not the misconceptions show not to be true for those certain groups of people. Stereotypes and misconceptions are brought upon naturally, and one will even stereotype others without realizing it. Being a 911 operator is a job where you sit at a desk
Realistically, they very well could be going to someone who has had a persistent cough for 3 weeks and decided tonight was the night that they should be checked out in the emergency room. Unfortunately, the abuse and misuse of the emergency medical system (EMS) is one that exists but can have terrible outcomes and consequences if not changed soon. This problem is not just an issue for the patients waiting on care, but it also affects the hospitals and the emergency workers alike.
The development of legislation is not the end of policy issue, usually it’s only the beginning. As these laws are implemented, there are always situations where the law or a specific policy may run into a situation where it is challenged by the public. This is true even when it comes to legislation that is meant to mitigate the worst case scenario. In this post I will be discussing a case that ended in personal tragedy for one family.
But for the patients best interest it is vital for the paramedics to transport the patient to hospital for further investigation and continuity of care.
Trzeciak, S. & Rivers, E. (2003). Emergency department overcrowding in the United States: An emerging threat to patient safety and public health. Emergency Medicine Journal, 20, 402−405. doi: 10.1136/emj.20.5.402
Emergency care has always been an important part of history all over the world. It has been said that medical assistance has been around and prevalent since as far back as 1500 B.C. Around the 1700’s is when EMS systems first began to experience large advancements, and ever since then, the field continues to grow and improve every year.
First, if patients have to pay for medical care, currently publicly funded, many families will avoid going to the doctor endangering their health. Researchers found that user charges implemented in Saskatchewan in 1968 and abolished seven years later reduced the annual use of
The term “failure to rescue” refers to a clinical scenario where hospital doctors, nurses, or caregivers fail to recognize symptoms. Responders do not respond adequately to clinical signs that would prevent harm (Morse, 2008, p.2). Dr. Jeffery H. Silber, Director of the Center for Health Outcomes and Policy Research, first coined the term “failure to rescue” in the 1990’s. He characterized the matrix of institutional and individual errors that contribute to patient deaths as “failure to rescue” (Aleccia, 2008). Since 1990, it has been well documented patients usually exhibit signs and symptoms of impending cardiac or respiratory arrest 6-8 hours before an arrest (Schein, Hazday, Pena, Ruben, & Spring, 1990). Buist, Bernard, Nguyen, Moore, and Anderson’s (2004) research reported similar findings. They found patients had documented clinically abnormal signs and symptom prior to arrest (Buist, et al., 2004). When certain abnormal signs and symptoms are identified early, critical bedside consultat...
In the event of a disaster, EMS and other professional must be prepared to come together and help each other provide care to help the victims and their families. EMS develops response plans, policies, and procedures that provides guidelines and prepares EMS for any emergencies that arise ("POSITIONING AMERICA’S EMERGENCY HEALTH CARE SYSTEM TO RESPOND TO ACTS OF TERRORISM."). Training makes perfect is what some people would say, Disaster EMS medicine also uses that saying as they test their disaster medical response plans through periodic exercises with the local, state and federal levels ("POSITIONING AMERICA’S EMERGENCY HEALTH CARE SYSTEM TO RESPOND TO ACTS OF TERRORISM.").Disaster EMS medicine includes many different departments from all over the world. Training is also now including the Viper system to allow communication from county to county and state to state in case of a catastrophic event that requires immediate action. 9/11 was a major terrorist attack that changed the world’s perspective and showed the world how unprepa...
Healthcare services have been on the rise for over 10 years now. According to a 2012 consumer alert, the industry provided $2.26 trillion in payments for more than four billion health insurance benefit claims in the year 2011(Fraud in Health Care). The bulk of the claims and the mainstream of fraud and abuse stem from the Medicare system professionals, who are knowledgeable about the process and persuade new clients into handing over their pertinent information in hopes of deception and illegitimate claims. Multiple and double billing, fraudulent prescriptions, are some of the major flaws in this organization that has made the healthcare services industry curdle. (AGHAEGBUNA, 2011) This is a non-violet crime and is often committed by very educated people including business people, hospital, doctors, and administrators.
Several years ago, I was getting out of my vehicle in the busy parking lot where I worked. I slipped on ice, my legs went in opposite directions and I fell hard on my right kneecap. While I was laying on the ice, a man walked up and asked “Are you okay? Do you need help?’ Through my tears, I said yes that I needed help and he just walked away. I eventually found my phone in my purse and called a co-worker who I knew was already inside. Luckily, I worked across the street from the hospital and a member of the rescue squad saw me laying in the parking lot and ran over to help. I was eventually transported to the hospital across the street and found out that I had broken my kneecap. “LaTane and Darley (1970) developed a five-step tree that describes how people decide whether to intervene in an emergency.” (Aronson, Wilson, Akert & Sommers, 2016). The five steps include: (1) Notice the event, (2) Interpret the event as an emergency, (3) Assume responsibility, (4) know appropriate form of assistance, (5) and Implement decision. (Aronson et al., 2016). It was obvious that the first man that asked if I needed assistance noticed me laying on the ground and interpreted the event as an emergency, but is appears that he did not want to assume responsibility. Even though he asked if I was okay and needed help, it seems that he never actually called
Weinick, R. M., Burns, R. M. & Mehrotra, A. (Sept 2010). ‘Many emergency Department visits could be managed at urgent care centers and retail clinics’. Chevy Chase, 29(9), 1630-37.
As EMS providers, I know that we see things that human eyes were never created to see, and we must deal with it. Physically, mentally, socially and spiritually. One of those outlets to express ourselves is social media, and when someone is hurting they will lash out. That usually is when someone is going to get in trouble. What is the difference with someone in public safety posting something on a social media site or us reading the I not an Ambulance driver series … or enjoying a public safety photo art created by Daniel Sundahl. To me the only difference is the intended readers?
When most people hear “First Aid” they think of the little white box with the red logo on it containing Band-Aids, gauze, tape, bug bite sticks, and antibiotic cream. However Webster’s Dictionary defines first aid as “the emergency care or treatment given to an ill or injured person before regular medical aid can be obtained”. That being said “First Aid” is not to be confused with “First Responder” whom is a trained paramedic who is able to administer CPR, medication, perform intubation, IV fluids, and a multitude of other medical tasks that any bystander or even a CPR certified civilian is unable to perform.