Date Archives: 22-Aug-2013

Question: In the BLS Standards I found in Section 1, General Standard of Care, Directive H. Patient Transport, the following statement in subsection 1 "in the absence of direction, transport to the closest or most appropriate hospital emergency unit capable of providing the medical care apparently required by the patient." So one question I have is the trauma patient, if they needed care above the capabilities of the closest hospital emergency unit, do we transport the patient to the closest hospital emergency unit that has these capabilities?

Question: My question is in regards when a crew has a positive STEMI result on a cardiac ischemia call. I noticed that on these types of calls there has been incidents where patients have been going in lethal dysrhythmias as crews are trying to deliver the patient to the cath lab. Most recently I was at a hospital and as a crew was entering the elevator the patient went into V-Tach and there was a delay to defibrillating because the crew had to attach the defib pads.

I noticed myself when entering the cath lab the first thing the staff does before even accepting the patient and allowing crews to disconnect the cardiac monitor is attach defib pads. Due to the high mortality rates (5%) of STEMI patients transported by EMS and the time it takes to attach the defib pads when the patient enters the lethal rhythm, would it be wise to attach the defib pads on positive STEMI patients during transport(even though they have not gone VSA) to decrease the time to defibrillated the patient if in fact the patient enters the letahal rhythm.

Question: Would SWORBHP ever consider putting a system in place for medics to learn the in hospital diagnosis of patients they transported. There are times when we transport patients and never learn what was causing them to present as they did. I think it would be beneficial to learn what the cause of the patient's condition in those instances for our own improvement and growth. I understand it would be unreasonable to do this for every patient but it would not be difficult to set up a flagging system to tag specific interesting calls. A system similar to the follow up after a ROSC may be a model to base it on.