Thursday, August 22, 2013

I want your opinion

I have a question and really want to hear from all of you.

Currently, the state of Minnesota defines a health officer as:

Health officer.

"Health officer" means:
(1) a licensed physician;
(2) a licensed psychologist;
(3) a licensed social worker;
(4) a registered nurse working in an emergency room of a hospital;
(5) a psychiatric or public health nurse as defined in section 145A.02, subdivision 18;
(6) an advanced practice registered nurse (APRN) as defined in section 148.171, subdivision 3;
(7) a mental health professional providing mental health mobile crisis intervention services as described under section 256B.0624; or
(8) a formally designated member of a prepetition screening unit established by section 253B.07.

I have been of the opinion that the list should also include paramedics.
That would facilitate the medic writing a transport hold on scene and taking the patient to a hospital. There have been some concerns about the MD's agreeing over the phone, because then you need to ensure that the patient is seen by that MD. Triage and bed space in a large ED with multiple providers doesn't always make that realistic. And some MD are unsure if it is appropriate to agree to a hold over the phone without really seeing the patient.

So, would it make an impact in your job if paramedics could sign the hold form? How?
On your first day of work, would you have been able to make that decision?
Recognizing that much of the state is served by EMS providers trained to the EMT level, should they be included in the definition?
Remember, I am not governor so I am not making any campaign promises, I just want to know what you think.


Unknown said...

I think it would be valuable, however I fear that it would make Law Enforcement less likely to do that role. I work in multiple systems and feel that it would be good overall for the patient.

Not sure day 1 I would have picked the right cases, but after a few months, I believe it is reasonable to think that we could place the proper criteria around the hold.

Unknown said...
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Unknown said...
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Unknown said...

I think it is a good idea. However, just looking at the logistics, I think we would have to take a closer look at how we document. Possibly offering a class to help us write an air tight report. Each hold needs to be reviewed by QA. Also we would be subject to the same regulations as peace officers and health officers. We definitely would need a tab in programs that deal with holds much like signatures.

I think overall it would help legitimize EMS and help push the profession forward. Police are still needed for protection, valuable assistance, and advice. They could verify what we were seeing on scene and be a witness. Knowing how society reacts I think initially we might see some court cases arise from the change.


wittyone said...

Paul, I'm coming into this a little late but, would have to agree with you that having EMS personnel added to the list of providers. Most peace officers look to us for an exam and then base their Transport Hold off of that interaction.

A LE officer on thier first day may have to write the hold but their FTO is with them and then the new person would be with a partner with experience.

There may have to be a line drawn however on who in EMS can sign a Hold. Just like other parts of the medical field there is a hierarchy.