Any Paramedics/EMTs/Firefighters?

[lanchefan1]

[quote]GrindOverMatter wrote:

[quote]Uncle Gabby wrote:

[quote]Derek542 wrote:

[quote]Uncle Gabby wrote:

[quote]Derek542 wrote:
I hire the ones who are tired of riding a box and lifting 400 pound land mammals. [/quote]

So anybody with + 6 weeks of experience?[/quote]

Its all about the age and the person. I do occupational medicine. Its not hard medicine but you cant be an asshole. Most of this is working for Exxon, Marathon, BP and others. I have taken some new grads, but those were a little older already. 20 year old new Paramedic I discourage them from trying to work for us. They need experience in the field.[/quote]

I was just making a joke about how quickly one gets tired of moving the land beasts. Some people get tired of the box pretty fast too. It’s not the stressful calls either that burns them out but the taxi rides. The traumas and strokes and what not make it worth while, but you don’t want to sit around wishing that some wrecks their car, at least I don’t.[/quote]

Yeah, my goal with this career is to get in and get dirty for 5 years or so and then maybe find something with an easier 9 to 5 type schedule as an instructor or something similar, I see a lot of older medics who are all beat up and burnt out from doing it too long. I also have some pretty lofty bodybuilding goals I’d like to accomplish before just training to stay In shape. I envision some rough times precontest with this line of work down the road

[/quote]

Hmmm interesting career goal.

I got away form the 9-5 grind, and I never looked back. After being on shift work I couldn’t imagine going back to a soul sucking day job.

I’m afforded many days off, the ability to trade time with other fire fighters and a ton of vacation (just took the month of July off).

We run ALS medic units (we are dual role on a fire scene and are active in structure fires). Yeah we have our frequent flyers, we have huge people we have to lift. But the attitude is what makes it a career, I’ve been involved in delivering babies, meeting people that the last time I saw them they didn’t have a pulse.

I learned something awhile ago from another fire fighter that he feels is what makes this more than a job

1. Do your job
2. Treat people right
3. Give all out effort
4. Have an all in attitude

[Uncle_Gabby]

I would describe a taxi ride as when someone calls 911 because they want to go to the ER for something that’s not an emergency. Examples:

1. Grandpa’s 87 years old and has been feeling weak for the last few weeks. We check his vital signs and they’re all fine, but the family wants him to be transported to the ER for further evaluation. They’re going to follow along behind in the van. Could they just give him a ride? Yes. Do they think he’s going to drop dead in the next 45 minutes and need life support? Probably not. One of us is just going to sit in the back with him and take his blood pressure a few times.

What it boils down to is they’re worried, and don’t want to wait to get him in to see his regular doctor. If they drive him up to the ER themselves they will probably have to sit around in the waiting room a while and they don’t want to spend any more time on this than they really have to.

2. A 23 year old female was in a motor vehicle accident the day before yesterday. She went to the ER that day, was diagnosed with a forearm fracture, her arm was put in a cast, she was given a bottle of pills for the pain and sent home. It’s 11:30 at night and her arm hurts and the pills “didn’t do anything” and she wants to go back to the ER to get checked out.

You don’t have to be a rocket scientist to figure out that her boyfriend sold the pills the ER gave her, and she wants to get more. For him to sell.

3. A 47 year old female has a toothache. She went to the ER 2 days ago. They gave her pain pills and sent her home. She wants to go back because “they got to do something.”

4. A 55 year old female who feels sick. We take her vital signs and she has a temperature of 99.3. Also she threw up once a couple of hours ago and thinks she might be dehydrated.

5. A 23 year old male fell off the porch and cut his forearm on some broken glass. We clean and examine his cuts, and there is no glass in them. They aren’t very deep and probably don’t need stitches. We bandage his wounds, but he wants to go to the ER to be checked out.

This is 80% of our calls. I’m not even going to go into the fakers. Some agencies are pretty aggressive about refusing transport and even charging people with abuse of the 911 system. Some of them we just take, like grandpa. The family might not take him up there themselves, he might not be able to see his regular doctor till next week, and if he kicked the bucket in the meantime we might be held liable.

[GrindOverMatter]

[quote]Uncle Gabby wrote:
I would describe a taxi ride as when someone calls 911 because they want to go to the ER for something that’s not an emergency. Examples:

1. Grandpa’s 87 years old and has been feeling weak for the last few weeks. We check his vital signs and they’re all fine, but the family wants him to be transported to the ER for further evaluation. They’re going to follow along behind in the van. Could they just give him a ride? Yes. Do they think he’s going to drop dead in the next 45 minutes and need life support? Probably not. One of us is just going to sit in the back with him and take his blood pressure a few times.

What it boils down to is they’re worried, and don’t want to wait to get him in to see his regular doctor. If they drive him up to the ER themselves they will probably have to sit around in the waiting room a while and they don’t want to spend any more time on this than they really have to.

2. A 23 year old female was in a motor vehicle accident the day before yesterday. She went to the ER that day, was diagnosed with a forearm fracture, her arm was put in a cast, she was given a bottle of pills for the pain and sent home. It’s 11:30 at night and her arm hurts and the pills “didn’t do anything” and she wants to go back to the ER to get checked out.

You don’t have to be a rocket scientist to figure out that her boyfriend sold the pills the ER gave her, and she wants to get more. For him to sell.

3. A 47 year old female has a toothache. She went to the ER 2 days ago. They gave her pain pills and sent her home. She wants to go back because “they got to do something.”

4. A 55 year old female who feels sick. We take her vital signs and she has a temperature of 99.3. Also she threw up once a couple of hours ago and thinks she might be dehydrated.

5. A 23 year old male fell off the porch and cut his forearm on some broken glass. We clean and examine his cuts, and there is no glass in them. They aren’t very deep and probably don’t need stitches. We bandage his wounds, but he wants to go to the ER to be checked out.

This is 80% of our calls. I’m not even going to go into the fakers. Some agencies are pretty aggressive about refusing transport and even charging people with abuse of the 911 system. Some of them we just take, like grandpa. The family might not take him up there themselves, he might not be able to see his regular doctor till next week, and if he kicked the bucket in the meantime we might be held liable.

[/quote]
Haha yeah fairly accurate, people here in rural Canada aren’t that bad though typically, I’d say calls like that were about half of the calls I experienced as a student

[GrindOverMatter]

[quote]Uncle Gabby wrote:
I would describe a taxi ride as when someone calls 911 because they want to go to the ER for something that’s not an emergency. Examples:

1. Grandpa’s 87 years old and has been feeling weak for the last few weeks. We check his vital signs and they’re all fine, but the family wants him to be transported to the ER for further evaluation. They’re going to follow along behind in the van. Could they just give him a ride? Yes. Do they think he’s going to drop dead in the next 45 minutes and need life support? Probably not. One of us is just going to sit in the back with him and take his blood pressure a few times.

What it boils down to is they’re worried, and don’t want to wait to get him in to see his regular doctor. If they drive him up to the ER themselves they will probably have to sit around in the waiting room a while and they don’t want to spend any more time on this than they really have to.

2. A 23 year old female was in a motor vehicle accident the day before yesterday. She went to the ER that day, was diagnosed with a forearm fracture, her arm was put in a cast, she was given a bottle of pills for the pain and sent home. It’s 11:30 at night and her arm hurts and the pills “didn’t do anything” and she wants to go back to the ER to get checked out.

You don’t have to be a rocket scientist to figure out that her boyfriend sold the pills the ER gave her, and she wants to get more. For him to sell.

3. A 47 year old female has a toothache. She went to the ER 2 days ago. They gave her pain pills and sent her home. She wants to go back because “they got to do something.”

4. A 55 year old female who feels sick. We take her vital signs and she has a temperature of 99.3. Also she threw up once a couple of hours ago and thinks she might be dehydrated.

5. A 23 year old male fell off the porch and cut his forearm on some broken glass. We clean and examine his cuts, and there is no glass in them. They aren’t very deep and probably don’t need stitches. We bandage his wounds, but he wants to go to the ER to be checked out.

This is 80% of our calls. I’m not even going to go into the fakers. Some agencies are pretty aggressive about refusing transport and even charging people with abuse of the 911 system. Some of them we just take, like grandpa. The family might not take him up there themselves, he might not be able to see his regular doctor till next week, and if he kicked the bucket in the meantime we might be held liable.

[/quote]
Haha yeah fairly accurate, people here in rural Canada aren’t that bad though typically, I’d say calls like that were about half of the calls I experienced as a student

[EmilyQ]

[quote]Uncle Gabby wrote:

[quote]EmilyQ wrote:

[quote]Uncle Gabby wrote:

[quote]EmilyQ wrote:

[quote]Uncle Gabby wrote:

[quote]EmilyQ wrote:
As someone who calls on that particular taxi when dealing with crisis calls or working with kids too volatile to be in a caretaker’s car, I appreciate that you’re there. The cops as well. I was covering a crisis pager a couple of weeks ago and had to have a guy picked up.

I know it’s tedious, but it’s needed and valued.[/quote]

No, that’s not what I’m talking about. Those are legitimate calls. [/quote]

Oh! I would have said that they’re often gray area (chronic suicide threateners, many of them, of questionable legitimacy as emergencies. . .the “tedious” I was referring to). I was just saying that as one of the people charged with their care them I’m glad there are people to call.

Who are you talking about?

[/quote]

That would be a very long rant. I’ll come back to it when I have time, but right now I’m at my part-time job.

For the record I have far more patience for the silly “attempted suicides” than most of my colleagues. You cannot leave a fellow human being in certain conditions, even when it is of their own making.
[/quote]

I work with a number of these frequent flyers and have a great deal of sympathy. No one wants to be at the mercy of quick-firing emotions that are too strong (or the host too weak) to regulate. They also view themselves as many other people do - as utterly incompetent human beings - which is a source of agony.

“Of their own making,” yes and no. I lean more toward no. It’s almost like emotional amnesia - they genuinely can’t remember on any real level that these thoughts and behaviors bite them in the ass every single time.

I’m also acutely aware that eventually, working in the field I do, someone will suicide. It is statistically likely to be one of the frequent gesturers.

Sucks. I was being sincere when I said “tedious.” But it’s also heartbreaking. [/quote]

I was not talking about the genuinely mentally ill when I say of their own making. Some people have dug themselves into a pretty deep hole through drug and alcohol abuse. Sometimes the drugs started as prescriptions for genuine hurts, but the patient lets them take over their life. A lot of people will become suicidal when they realize how deep that hole has gotten.

I would also rank obesity and the maladies associated with it as of someone’s own making.

I’m working EMS tomorrow, and if we’re not busy I’ll try to describe the average taxi ride.
[/quote]

Same people, in my view. No properly built human being wants to live like that. Generally speaking, in order to stop the drug abuse or eating disordered behavior, they’re going to have to address underlying mental health issues.

Because patience and long term thinking aren’t qualities the typical train wreck-type has in abundance, addressing the mental illness without reverting to self-sabotaging behaviors is tough.

It took me a while to really wrap my head around how genuinely helpless these people feel, how impossibly out of reach living as you or I do seems to them. And they’re probably right about that. They will never sleep in the kind of clean, fluffy bed I do or have the kind of satisfaction I do in closing my computer at the end of the work day. They weren’t given the tools you or I were. They’re as feeble in their own way as someone with cerebral palsy.

It’s heartbreaking, particularly when they genuinely try, but fail, over and over again.

[EmilyQ]

[quote]Uncle Gabby wrote:
I would describe a taxi ride as when someone calls 911 because they want to go to the ER for something that’s not an emergency. Examples:

1. Grandpa’s 87 years old and has been feeling weak for the last few weeks. We check his vital signs and they’re all fine, but the family wants him to be transported to the ER for further evaluation. They’re going to follow along behind in the van. Could they just give him a ride? Yes. Do they think he’s going to drop dead in the next 45 minutes and need life support? Probably not. One of us is just going to sit in the back with him and take his blood pressure a few times.

What it boils down to is they’re worried, and don’t want to wait to get him in to see his regular doctor. If they drive him up to the ER themselves they will probably have to sit around in the waiting room a while and they don’t want to spend any more time on this than they really have to.

2. A 23 year old female was in a motor vehicle accident the day before yesterday. She went to the ER that day, was diagnosed with a forearm fracture, her arm was put in a cast, she was given a bottle of pills for the pain and sent home. It’s 11:30 at night and her arm hurts and the pills “didn’t do anything” and she wants to go back to the ER to get checked out.

You don’t have to be a rocket scientist to figure out that her boyfriend sold the pills the ER gave her, and she wants to get more. For him to sell.

3. A 47 year old female has a toothache. She went to the ER 2 days ago. They gave her pain pills and sent her home. She wants to go back because “they got to do something.”

4. A 55 year old female who feels sick. We take her vital signs and she has a temperature of 99.3. Also she threw up once a couple of hours ago and thinks she might be dehydrated.

5. A 23 year old male fell off the porch and cut his forearm on some broken glass. We clean and examine his cuts, and there is no glass in them. They aren’t very deep and probably don’t need stitches. We bandage his wounds, but he wants to go to the ER to be checked out.

This is 80% of our calls. I’m not even going to go into the fakers. Some agencies are pretty aggressive about refusing transport and even charging people with abuse of the 911 system. Some of them we just take, like grandpa. The family might not take him up there themselves, he might not be able to see his regular doctor till next week, and if he kicked the bucket in the meantime we might be held liable.
[/quote]

Wow! This is shocking. I had no idea.

[Derek542]

[quote]EmilyQ wrote:

[quote]Uncle Gabby wrote:
I would describe a taxi ride as when someone calls 911 because they want to go to the ER for something that’s not an emergency. Examples:

1. Grandpa’s 87 years old and has been feeling weak for the last few weeks. We check his vital signs and they’re all fine, but the family wants him to be transported to the ER for further evaluation. They’re going to follow along behind in the van. Could they just give him a ride? Yes. Do they think he’s going to drop dead in the next 45 minutes and need life support? Probably not. One of us is just going to sit in the back with him and take his blood pressure a few times.

What it boils down to is they’re worried, and don’t want to wait to get him in to see his regular doctor. If they drive him up to the ER themselves they will probably have to sit around in the waiting room a while and they don’t want to spend any more time on this than they really have to.

2. A 23 year old female was in a motor vehicle accident the day before yesterday. She went to the ER that day, was diagnosed with a forearm fracture, her arm was put in a cast, she was given a bottle of pills for the pain and sent home. It’s 11:30 at night and her arm hurts and the pills “didn’t do anything” and she wants to go back to the ER to get checked out.

You don’t have to be a rocket scientist to figure out that her boyfriend sold the pills the ER gave her, and she wants to get more. For him to sell.

3. A 47 year old female has a toothache. She went to the ER 2 days ago. They gave her pain pills and sent her home. She wants to go back because “they got to do something.”

4. A 55 year old female who feels sick. We take her vital signs and she has a temperature of 99.3. Also she threw up once a couple of hours ago and thinks she might be dehydrated.

5. A 23 year old male fell off the porch and cut his forearm on some broken glass. We clean and examine his cuts, and there is no glass in them. They aren’t very deep and probably don’t need stitches. We bandage his wounds, but he wants to go to the ER to be checked out.

This is 80% of our calls. I’m not even going to go into the fakers. Some agencies are pretty aggressive about refusing transport and even charging people with abuse of the 911 system. Some of them we just take, like grandpa. The family might not take him up there themselves, he might not be able to see his regular doctor till next week, and if he kicked the bucket in the meantime we might be held liable.
[/quote]

Wow! This is shocking. I had no idea. [/quote]

I remember one call when I was working as an ER Nurse. Swear to all that is good. This was the call from the Medic.

“I have a 23 year old female being transported with a burn to bottom lip secondary to using a crack pipe.”

[Uncle_Gabby]

[quote]EmilyQ wrote:

[quote]Uncle Gabby wrote:

[quote]EmilyQ wrote:

[quote]Uncle Gabby wrote:

[quote]EmilyQ wrote:

[quote]Uncle Gabby wrote:

[quote]EmilyQ wrote:
As someone who calls on that particular taxi when dealing with crisis calls or working with kids too volatile to be in a caretaker’s car, I appreciate that you’re there. The cops as well. I was covering a crisis pager a couple of weeks ago and had to have a guy picked up.

I know it’s tedious, but it’s needed and valued.[/quote]

No, that’s not what I’m talking about. Those are legitimate calls. [/quote]

Oh! I would have said that they’re often gray area (chronic suicide threateners, many of them, of questionable legitimacy as emergencies. . .the “tedious” I was referring to). I was just saying that as one of the people charged with their care them I’m glad there are people to call.

Who are you talking about?

[/quote]

That would be a very long rant. I’ll come back to it when I have time, but right now I’m at my part-time job.

For the record I have far more patience for the silly “attempted suicides” than most of my colleagues. You cannot leave a fellow human being in certain conditions, even when it is of their own making.
[/quote]

I work with a number of these frequent flyers and have a great deal of sympathy. No one wants to be at the mercy of quick-firing emotions that are too strong (or the host too weak) to regulate. They also view themselves as many other people do - as utterly incompetent human beings - which is a source of agony.

“Of their own making,” yes and no. I lean more toward no. It’s almost like emotional amnesia - they genuinely can’t remember on any real level that these thoughts and behaviors bite them in the ass every single time.

I’m also acutely aware that eventually, working in the field I do, someone will suicide. It is statistically likely to be one of the frequent gesturers.

Sucks. I was being sincere when I said “tedious.” But it’s also heartbreaking. [/quote]

I was not talking about the genuinely mentally ill when I say of their own making. Some people have dug themselves into a pretty deep hole through drug and alcohol abuse. Sometimes the drugs started as prescriptions for genuine hurts, but the patient lets them take over their life. A lot of people will become suicidal when they realize how deep that hole has gotten.

I would also rank obesity and the maladies associated with it as of someone’s own making.

I’m working EMS tomorrow, and if we’re not busy I’ll try to describe the average taxi ride.
[/quote]

Same people, in my view. No properly built human being wants to live like that. Generally speaking, in order to stop the drug abuse or eating disordered behavior, they’re going to have to address underlying mental health issues.

Because patience and long term thinking aren’t qualities the typical train wreck-type has in abundance, addressing the mental illness without reverting to self-sabotaging behaviors is tough.

It took me a while to really wrap my head around how genuinely helpless these people feel, how impossibly out of reach living as you or I do seems to them. And they’re probably right about that. They will never sleep in the kind of clean, fluffy bed I do or have the kind of satisfaction I do in closing my computer at the end of the work day. They weren’t given the tools you or I were. They’re as feeble in their own way as someone with cerebral palsy.

It’s heartbreaking, particularly when they genuinely try, but fail, over and over again. [/quote]

I think this is a chicken and egg question a lot of times. Did they turn to drugs and alcohol because they are broken, or did drugs and alcohol do the breaking? I live and work in a small town and know many of these people and their families. Often it is the latter.

[Uncle_Gabby]

[quote]Derek542 wrote:

[quote]EmilyQ wrote:

[quote]Uncle Gabby wrote:
I would describe a taxi ride as when someone calls 911 because they want to go to the ER for something that’s not an emergency. Examples:

1. Grandpa’s 87 years old and has been feeling weak for the last few weeks. We check his vital signs and they’re all fine, but the family wants him to be transported to the ER for further evaluation. They’re going to follow along behind in the van. Could they just give him a ride? Yes. Do they think he’s going to drop dead in the next 45 minutes and need life support? Probably not. One of us is just going to sit in the back with him and take his blood pressure a few times.

What it boils down to is they’re worried, and don’t want to wait to get him in to see his regular doctor. If they drive him up to the ER themselves they will probably have to sit around in the waiting room a while and they don’t want to spend any more time on this than they really have to.

2. A 23 year old female was in a motor vehicle accident the day before yesterday. She went to the ER that day, was diagnosed with a forearm fracture, her arm was put in a cast, she was given a bottle of pills for the pain and sent home. It’s 11:30 at night and her arm hurts and the pills “didn’t do anything” and she wants to go back to the ER to get checked out.

You don’t have to be a rocket scientist to figure out that her boyfriend sold the pills the ER gave her, and she wants to get more. For him to sell.

3. A 47 year old female has a toothache. She went to the ER 2 days ago. They gave her pain pills and sent her home. She wants to go back because “they got to do something.”

4. A 55 year old female who feels sick. We take her vital signs and she has a temperature of 99.3. Also she threw up once a couple of hours ago and thinks she might be dehydrated.

5. A 23 year old male fell off the porch and cut his forearm on some broken glass. We clean and examine his cuts, and there is no glass in them. They aren’t very deep and probably don’t need stitches. We bandage his wounds, but he wants to go to the ER to be checked out.

This is 80% of our calls. I’m not even going to go into the fakers. Some agencies are pretty aggressive about refusing transport and even charging people with abuse of the 911 system. Some of them we just take, like grandpa. The family might not take him up there themselves, he might not be able to see his regular doctor till next week, and if he kicked the bucket in the meantime we might be held liable.
[/quote]

Wow! This is shocking. I had no idea. [/quote]

I remember one call when I was working as an ER Nurse. Swear to all that is good. This was the call from the Medic.

“I have a 23 year old female being transported with a burn to bottom lip secondary to using a crack pipe.”[/quote]

I don’t often actually laugh out loud but that was a good one!

[Uncle_Gabby]

It is also my opinion that number 4&5 probably suffer from some kind of mental illness. Not one tthehat has been or even would be diagnosed by a professional. But whatever you would call a pathetic cross of entitlement and lack of self-reliance. And I’m talking about people who live in nice homes, with decent jobs.

[kpsnap]

[quote]Uncle Gabby wrote:
I would describe a taxi ride as when someone calls 911 because they want to go to the ER for something that’s not an emergency. Examples:

1. Grandpa’s 87 years old and has been feeling weak for the last few weeks. We check his vital signs and they’re all fine, but the family wants him to be transported to the ER for further evaluation. They’re going to follow along behind in the van. Could they just give him a ride? Yes. Do they think he’s going to drop dead in the next 45 minutes and need life support? Probably not. One of us is just going to sit in the back with him and take his blood pressure a few times.

What it boils down to is they’re worried, and don’t want to wait to get him in to see his regular doctor. If they drive him up to the ER themselves they will probably have to sit around in the waiting room a while and they don’t want to spend any more time on this than they really have to.

This is 80% of our calls. I’m not even going to go into the fakers. Some agencies are pretty aggressive about refusing transport and even charging people with abuse of the 911 system. Some of them we just take, like grandpa. The family might not take him up there themselves, he might not be able to see his regular doctor till next week, and if he kicked the bucket in the meantime we might be held liable.
[/quote]
Agencies are aggressive about refusing transport for cases like the above because ambulance transporters cannot legally bill Medicare for such transports. Does your agency present patients with an ABN in such situations? Do you bill these? Write them off? Curious here. . .

[Uncle_Gabby]

[quote]kpsnap wrote:

[quote]Uncle Gabby wrote:
I would describe a taxi ride as when someone calls 911 because they want to go to the ER for something that’s not an emergency. Examples:

1. Grandpa’s 87 years old and has been feeling weak for the last few weeks. We check his vital signs and they’re all fine, but the family wants him to be transported to the ER for further evaluation. They’re going to follow along behind in the van. Could they just give him a ride? Yes. Do they think he’s going to drop dead in the next 45 minutes and need life support? Probably not. One of us is just going to sit in the back with him and take his blood pressure a few times.

What it boils down to is they’re worried, and don’t want to wait to get him in to see his regular doctor. If they drive him up to the ER themselves they will probably have to sit around in the waiting room a while and they don’t want to spend any more time on this than they really have to.

This is 80% of our calls. I’m not even going to go into the fakers. Some agencies are pretty aggressive about refusing transport and even charging people with abuse of the 911 system. Some of them we just take, like grandpa. The family might not take him up there themselves, he might not be able to see his regular doctor till next week, and if he kicked the bucket in the meantime we might be held liable.
[/quote]
Agencies are aggressive about refusing transport for cases like the above because ambulance transporters cannot legally bill Medicare for such transports. Does your agency present patients with an ABN in such situations? Do you bill these? Write them off? Curious here. . . [/quote]

Not sure about billing, I’m just a peon. Billing is only a part of the equation. We are pretty rural so every transport equals 2 1/2 to 3 hours that an ambulance and it’s crew is not available for an actual emergency. If a unit has to come from another agency that adds another 20-30 minutes to the response time.

Sometimes a supervisor comes out and talks the patient into finding a ride to the ER. In more blatant cases they threaten to charge them with abuse of the 911 system. Sometimes we just go ahead and take them.

[Derek542]

[quote]kpsnap wrote:

[quote]Uncle Gabby wrote:
I would describe a taxi ride as when someone calls 911 because they want to go to the ER for something that’s not an emergency. Examples:

1. Grandpa’s 87 years old and has been feeling weak for the last few weeks. We check his vital signs and they’re all fine, but the family wants him to be transported to the ER for further evaluation. They’re going to follow along behind in the van. Could they just give him a ride? Yes. Do they think he’s going to drop dead in the next 45 minutes and need life support? Probably not. One of us is just going to sit in the back with him and take his blood pressure a few times.

What it boils down to is they’re worried, and don’t want to wait to get him in to see his regular doctor. If they drive him up to the ER themselves they will probably have to sit around in the waiting room a while and they don’t want to spend any more time on this than they really have to.

This is 80% of our calls. I’m not even going to go into the fakers. Some agencies are pretty aggressive about refusing transport and even charging people with abuse of the 911 system. Some of them we just take, like grandpa. The family might not take him up there themselves, he might not be able to see his regular doctor till next week, and if he kicked the bucket in the meantime we might be held liable.
[/quote]
Agencies are aggressive about refusing transport for cases like the above because ambulance transporters cannot legally bill Medicare for such transports. Does your agency present patients with an ABN in such situations? Do you bill these? Write them off? Curious here. . . [/quote]
Every state is different Ksnap.

[kpsnap]

[quote]Derek542 wrote:

[quote]kpsnap wrote:

[quote]Uncle Gabby wrote:
I would describe a taxi ride as when someone calls 911 because they want to go to the ER for something that’s not an emergency. Examples:

1. Grandpa’s 87 years old and has been feeling weak for the last few weeks. We check his vital signs and they’re all fine, but the family wants him to be transported to the ER for further evaluation. They’re going to follow along behind in the van. Could they just give him a ride? Yes. Do they think he’s going to drop dead in the next 45 minutes and need life support? Probably not. One of us is just going to sit in the back with him and take his blood pressure a few times.

What it boils down to is they’re worried, and don’t want to wait to get him in to see his regular doctor. If they drive him up to the ER themselves they will probably have to sit around in the waiting room a while and they don’t want to spend any more time on this than they really have to.

This is 80% of our calls. I’m not even going to go into the fakers. Some agencies are pretty aggressive about refusing transport and even charging people with abuse of the 911 system. Some of them we just take, like grandpa. The family might not take him up there themselves, he might not be able to see his regular doctor till next week, and if he kicked the bucket in the meantime we might be held liable.
[/quote]
Agencies are aggressive about refusing transport for cases like the above because ambulance transporters cannot legally bill Medicare for such transports. Does your agency present patients with an ABN in such situations? Do you bill these? Write them off? Curious here. . . [/quote]
Every state is different Ksnap. [/quote]
Medicare is a national program. The rules defining medical necessity for Medicare patients desiring ambulance transport are the same for all. Google “Medicare ambulance coverage.” There is a government booklet dedicated to the topic. It is illegal to bill Medicare for transports when the patient’s health will not be endangered if he/she is transported by other means.

[Uncle_Gabby]

[quote]kpsnap wrote:

[quote]Derek542 wrote:

[quote]kpsnap wrote:

[quote]Uncle Gabby wrote:
I would describe a taxi ride as when someone calls 911 because they want to go to the ER for something that’s not an emergency. Examples:

1. Grandpa’s 87 years old and has been feeling weak for the last few weeks. We check his vital signs and they’re all fine, but the family wants him to be transported to the ER for further evaluation. They’re going to follow along behind in the van. Could they just give him a ride? Yes. Do they think he’s going to drop dead in the next 45 minutes and need life support? Probably not. One of us is just going to sit in the back with him and take his blood pressure a few times.

What it boils down to is they’re worried, and don’t want to wait to get him in to see his regular doctor. If they drive him up to the ER themselves they will probably have to sit around in the waiting room a while and they don’t want to spend any more time on this than they really have to.

This is 80% of our calls. I’m not even going to go into the fakers. Some agencies are pretty aggressive about refusing transport and even charging people with abuse of the 911 system. Some of them we just take, like grandpa. The family might not take him up there themselves, he might not be able to see his regular doctor till next week, and if he kicked the bucket in the meantime we might be held liable.
[/quote]
Agencies are aggressive about refusing transport for cases like the above because ambulance transporters cannot legally bill Medicare for such transports. Does your agency present patients with an ABN in such situations? Do you bill these? Write them off? Curious here. . . [/quote]
Every state is different Ksnap. [/quote]
Medicare is a national program. The rules defining medical necessity for Medicare patients desiring ambulance transport are the same for all. Google “Medicare ambulance coverage.” There is a government booklet dedicated to the topic. It is illegal to bill Medicare for transports when the patient’s health will not be endangered if he/she is transported by other means.

[/quote]

You’re probably right, and I’m sure it’s the same for Medicaid as well. That keeps the honest conscientious people from abusing the system.

[Derek542]

[quote]kpsnap wrote:

[quote]Derek542 wrote:

[quote]kpsnap wrote:

[quote]Uncle Gabby wrote:
I would describe a taxi ride as when someone calls 911 because they want to go to the ER for something that’s not an emergency. Examples:

1. Grandpa’s 87 years old and has been feeling weak for the last few weeks. We check his vital signs and they’re all fine, but the family wants him to be transported to the ER for further evaluation. They’re going to follow along behind in the van. Could they just give him a ride? Yes. Do they think he’s going to drop dead in the next 45 minutes and need life support? Probably not. One of us is just going to sit in the back with him and take his blood pressure a few times.

What it boils down to is they’re worried, and don’t want to wait to get him in to see his regular doctor. If they drive him up to the ER themselves they will probably have to sit around in the waiting room a while and they don’t want to spend any more time on this than they really have to.

This is 80% of our calls. I’m not even going to go into the fakers. Some agencies are pretty aggressive about refusing transport and even charging people with abuse of the 911 system. Some of them we just take, like grandpa. The family might not take him up there themselves, he might not be able to see his regular doctor till next week, and if he kicked the bucket in the meantime we might be held liable.
[/quote]
Agencies are aggressive about refusing transport for cases like the above because ambulance transporters cannot legally bill Medicare for such transports. Does your agency present patients with an ABN in such situations? Do you bill these? Write them off? Curious here. . . [/quote]
Every state is different Ksnap. [/quote]
Medicare is a national program. The rules defining medical necessity for Medicare patients desiring ambulance transport are the same for all. Google “Medicare ambulance coverage.” There is a government booklet dedicated to the topic. It is illegal to bill Medicare for transports when the patient’s health will not be endangered if he/she is transported by other means.

[/quote]
You are correct sorry my mind was more on Medicaid. Due to the fact the transport issues probably fall on this more, but again I have been out of ER for 8 years now.
Most Medicare if not all have secondary coverage I would imagine that is who is getting charged

[Derek542]

[quote]kpsnap wrote:

[quote]Derek542 wrote:

[quote]kpsnap wrote:

[quote]Uncle Gabby wrote:
I would describe a taxi ride as when someone calls 911 because they want to go to the ER for something that’s not an emergency. Examples:

1. Grandpa’s 87 years old and has been feeling weak for the last few weeks. We check his vital signs and they’re all fine, but the family wants him to be transported to the ER for further evaluation. They’re going to follow along behind in the van. Could they just give him a ride? Yes. Do they think he’s going to drop dead in the next 45 minutes and need life support? Probably not. One of us is just going to sit in the back with him and take his blood pressure a few times.

What it boils down to is they’re worried, and don’t want to wait to get him in to see his regular doctor. If they drive him up to the ER themselves they will probably have to sit around in the waiting room a while and they don’t want to spend any more time on this than they really have to.

This is 80% of our calls. I’m not even going to go into the fakers. Some agencies are pretty aggressive about refusing transport and even charging people with abuse of the 911 system. Some of them we just take, like grandpa. The family might not take him up there themselves, he might not be able to see his regular doctor till next week, and if he kicked the bucket in the meantime we might be held liable.
[/quote]
Agencies are aggressive about refusing transport for cases like the above because ambulance transporters cannot legally bill Medicare for such transports. Does your agency present patients with an ABN in such situations? Do you bill these? Write them off? Curious here. . . [/quote]
Every state is different Ksnap. [/quote]
Medicare is a national program. The rules defining medical necessity for Medicare patients desiring ambulance transport are the same for all. Google “Medicare ambulance coverage.” There is a government booklet dedicated to the topic. It is illegal to bill Medicare for transports when the patient’s health will not be endangered if he/she is transported by other means.

[/quote]
Now that I think about it is Medicare run like Medicaid? It is national FUNDED but not managed. The state manages and each state runs it different and their money is “reimbursed” according to how much they follow the rules.

[kpsnap]

[quote]Derek542 wrote:

[quote]kpsnap wrote:

[quote]Derek542 wrote:

[quote]kpsnap wrote:

[quote]Uncle Gabby wrote:
I would describe a taxi ride as when someone calls 911 because they want to go to the ER for something that’s not an emergency. Examples:

1. Grandpa’s 87 years old and has been feeling weak for the last few weeks. We check his vital signs and they’re all fine, but the family wants him to be transported to the ER for further evaluation. They’re going to follow along behind in the van. Could they just give him a ride? Yes. Do they think he’s going to drop dead in the next 45 minutes and need life support? Probably not. One of us is just going to sit in the back with him and take his blood pressure a few times.

What it boils down to is they’re worried, and don’t want to wait to get him in to see his regular doctor. If they drive him up to the ER themselves they will probably have to sit around in the waiting room a while and they don’t want to spend any more time on this than they really have to.

This is 80% of our calls. I’m not even going to go into the fakers. Some agencies are pretty aggressive about refusing transport and even charging people with abuse of the 911 system. Some of them we just take, like grandpa. The family might not take him up there themselves, he might not be able to see his regular doctor till next week, and if he kicked the bucket in the meantime we might be held liable.
[/quote]
Agencies are aggressive about refusing transport for cases like the above because ambulance transporters cannot legally bill Medicare for such transports. Does your agency present patients with an ABN in such situations? Do you bill these? Write them off? Curious here. . . [/quote]
Every state is different Ksnap. [/quote]
Medicare is a national program. The rules defining medical necessity for Medicare patients desiring ambulance transport are the same for all. Google “Medicare ambulance coverage.” There is a government booklet dedicated to the topic. It is illegal to bill Medicare for transports when the patient’s health will not be endangered if he/she is transported by other means.

[/quote]
Now that I think about it is Medicare run like Medicaid? It is national FUNDED but not managed. The state manages and each state runs it different and their money is “reimbursed” according to how much they follow the rules. [/quote]
Medicare is a national program. Rules are the same for all. Medicaid is state run and varies widely. Boring shit. But something I know a fair bit about since I am an administrator for a fire department.

[Derek542]

[quote]kpsnap wrote:

[quote]Derek542 wrote:

[quote]kpsnap wrote:

[quote]Derek542 wrote:

[quote]kpsnap wrote:

[quote]Uncle Gabby wrote:
I would describe a taxi ride as when someone calls 911 because they want to go to the ER for something that’s not an emergency. Examples:

1. Grandpa’s 87 years old and has been feeling weak for the last few weeks. We check his vital signs and they’re all fine, but the family wants him to be transported to the ER for further evaluation. They’re going to follow along behind in the van. Could they just give him a ride? Yes. Do they think he’s going to drop dead in the next 45 minutes and need life support? Probably not. One of us is just going to sit in the back with him and take his blood pressure a few times.

What it boils down to is they’re worried, and don’t want to wait to get him in to see his regular doctor. If they drive him up to the ER themselves they will probably have to sit around in the waiting room a while and they don’t want to spend any more time on this than they really have to.

This is 80% of our calls. I’m not even going to go into the fakers. Some agencies are pretty aggressive about refusing transport and even charging people with abuse of the 911 system. Some of them we just take, like grandpa. The family might not take him up there themselves, he might not be able to see his regular doctor till next week, and if he kicked the bucket in the meantime we might be held liable.
[/quote]
Agencies are aggressive about refusing transport for cases like the above because ambulance transporters cannot legally bill Medicare for such transports. Does your agency present patients with an ABN in such situations? Do you bill these? Write them off? Curious here. . . [/quote]
Every state is different Ksnap. [/quote]
Medicare is a national program. The rules defining medical necessity for Medicare patients desiring ambulance transport are the same for all. Google “Medicare ambulance coverage.” There is a government booklet dedicated to the topic. It is illegal to bill Medicare for transports when the patient’s health will not be endangered if he/she is transported by other means.

[/quote]
Now that I think about it is Medicare run like Medicaid? It is national FUNDED but not managed. The state manages and each state runs it different and their money is “reimbursed” according to how much they follow the rules. [/quote]
Medicare is a national program. Rules are the same for all. Medicaid is state run and varies widely. Boring shit. But something I know a fair bit about since I am an administrator for a fire department.[/quote]
That is why I asked Snap. I have been out of the loop on that now for about 8 years.

[DoubleDuce]

[quote]Uncle Gabby wrote:
I would describe a taxi ride as when someone calls 911 because they want to go to the ER for something that’s not an emergency. Examples:

1. Grandpa’s 87 years old and has been feeling weak for the last few weeks. We check his vital signs and they’re all fine, but the family wants him to be transported to the ER for further evaluation. They’re going to follow along behind in the van. Could they just give him a ride? Yes. Do they think he’s going to drop dead in the next 45 minutes and need life support? Probably not. One of us is just going to sit in the back with him and take his blood pressure a few times.

What it boils down to is they’re worried, and don’t want to wait to get him in to see his regular doctor. If they drive him up to the ER themselves they will probably have to sit around in the waiting room a while and they don’t want to spend any more time on this than they really have to.

2. A 23 year old female was in a motor vehicle accident the day before yesterday. She went to the ER that day, was diagnosed with a forearm fracture, her arm was put in a cast, she was given a bottle of pills for the pain and sent home. It’s 11:30 at night and her arm hurts and the pills “didn’t do anything” and she wants to go back to the ER to get checked out.

You don’t have to be a rocket scientist to figure out that her boyfriend sold the pills the ER gave her, and she wants to get more. For him to sell.

3. A 47 year old female has a toothache. She went to the ER 2 days ago. They gave her pain pills and sent her home. She wants to go back because “they got to do something.”

4. A 55 year old female who feels sick. We take her vital signs and she has a temperature of 99.3. Also she threw up once a couple of hours ago and thinks she might be dehydrated.

5. A 23 year old male fell off the porch and cut his forearm on some broken glass. We clean and examine his cuts, and there is no glass in them. They aren’t very deep and probably don’t need stitches. We bandage his wounds, but he wants to go to the ER to be checked out.

This is 80% of our calls. I’m not even going to go into the fakers. Some agencies are pretty aggressive about refusing transport and even charging people with abuse of the 911 system. Some of them we just take, like grandpa. The family might not take him up there themselves, he might not be able to see his regular doctor till next week, and if he kicked the bucket in the meantime we might be held liable.
[/quote]

And it’s even worse when you take 2 hours out of your life starting at 4AM to go “help” one of these as a volunteer when you still have to go to work. As bad as it is I started filtering calls I responded to based on what the call sounded like. And working in a small area you get to know the people who just call for a ride to the ER.