that1emsguy

[that1emsguy]

That's exactly what it's like at my part time job. Rural EMS can be such a drag.

I love the term “activate EMS” because I imagine like, at the station, the medics/EMTs are just in a completely comatose state on the couch or whatever and once someone calls 911 they’re just like

“EMS ACTIVATED”

[that1emsguy]

Transfer, transfer, will you pay?

Spoiler alert: this is an opinion. Medical necessity. This necessary evil is so freaking abused that private ambulances are committing Medicare fraud on the regular. We are going to hospital settings, at a RN or physician’s request, to take patient A back to the nursing home or to a larger hospital. They provide us with a Medical Necessity form that says the patient needs to be transported via ambulance due to… things like bed confinement, ALOC, higher level of care, for definite diagnoses, services not provided by the current hospital, etc. Lets say for a certain example they want someone taken back to a nursing home via ambulance. They say in their report the person is bred confined, document they are bed confined, and fill out the necessity as such. When you make contact with said patient, you assess them as alert and oriented x4, they are in 0/10 pain(subjective, I know) and they easily get up and ambulate themselves to the cot EMS provides. The medical necessity states THEY AREN’T SUPPOSED TO BE ABLE TO DO THIS. You obviously can’t, or at least shouldn’t, document that they DIDN’T, so you have basically just witnessed and documented a case of a hospital lying to an insurance agency about a patient who doesn’t need to be transported by ambulance. This is obviously not so simple and easy of an argument because the are often more factors at play, but this is actually happening a lot, and it can be argued that not only is this fraud and abuse of the insurance systems, but also an abuse of EMS providers and their own systems. The implications of

I know that in many circles, private EMS providers are viewed as the bastard children of emergency services, but this is something that affects many services. What can we do to mitigate this? Do you think it is an abuse of the system? How far do you think the implications, if you think there are any, can go?

[that1emsguy]

Hello There

I am an EMT-B who has worked in EMS for four years(celebrated my anniversary on March 20th with a nice long 24 hour shift!), and have worked for five different ambulance services, four of which I am still employed at. Crazy hours, you say? I work a minimum of 96 a week! I am a representative of my fellow employees at my full time service, and a vocal advocate of workers in EMS being treated fairly and with respect at all the others. I’ve worked with a diverse cast of characters, from the jaded two or three decade veterans who have seen things that will make your blood curdle to the new guys who don’t know what they’re getting into, and everyone in between. I call them characters because I have not found an English word to describe human beings who are as excited, yet horrified, to be working in a environment that can, at any time, maim, injure, infect, excite, enthrall, addict, and scar one for life. My old, codgery EMT instructor put it best, “EMS is 90% soul sucking boredom, 10% sheer terror.”

That being said, my mission statement for this blog is three simple and direct goals.

First, share stories, legally, that don’t break HIPPAA laws. The stories of victory, defeat, the joy and the grotesque, the learning experiences, and most importantly, the calls that make EMRs, EMTs, Paramedics, and flight nurse go, “WTF?”  Wild stories, crazy calls, and black humor are a part of what makes the career worth it. It’s our duty to keep the tradition of cracking jokes at the expense of drug seekers, hoarders, crazy cat ladies and frequent flyers alive. 

Yes, I said dooty. 

Share thoughts, feelings, advice, and techniques to help others improve their skill set. Whether this is through sharing a story and saying, “Well, this was a difficult intubation, but I managed to secure it by...” or just sharing a how-to on how to legally protect yourself from a combative psych patient, or even just asking for advice on how to write a better PCR narrative, it can be shared here. I encourage it. 

Last but not least, this is a blog where I will discuss advocacy of EMS rights. We work a very difficult job, and more often than not it is for less than minimum wage, with terrible benefits, few days off, and not a lot of attention on our physical, mental, and emotional well being. A lot of communities, especially rural areas, don’t really treat EMS services or ambulance personnel as the vital piece of infrastructure they are. Work for a private service who treats turnover ratios like an inevitability instead of a problem that can be fixed? Talk to me about it.