Practical EMS
My mission is to use the stories we all have in emergency medicine to encourage and uplift you where you are. EMT, Paramedic, nurse, PA, NP or physician. Emergency medicine is a very difficult specialty with unique challenges, and it calls us all to be better than the average person in order to stay healthy for our patients, our families and own mental wellness. I want to connect with EMS crews, fire crews, ER RN's, ER techs and new ER advanced practice providers to better understand their current struggles. I also want to bridge the gap between prehospital medicine and the emergency department and to encourage those seeking to become an advanced practice provider. Disclaimer: All Practical EMS content is opinion only. It is unaffiliated with any company or organization and does not represent any company or organization that Aaron currently works for or has worked for in the past. No content should be taken as medical advice.
Practical EMS
98 | Fire paramedics and medical director panel | Assessing capacity | Suicidal patients | Involving medical control
New panel: Fire officer/paramedic John, fire paramedic Jason, retired fire paramedic Terry and EMS medical director Kash
How to determine capacity and how this differs from competency
This becomes critical when doing refusals – when the patient decides not to be transported – a very high liability part of EMS
This is different than AAOX4
Capacity is very situational and specific, competency is determined by a judge
We determine capacity:
They must communicate a clear choice, an understanding of their current situation, understanding the risks and benefits of refusing or accepting care
Suicidal thoughts mean the patient does not have the capacity to makes decisions for that particular aspect of their care
Back when I first started in EMS, we would routinely force a suicidal patient to go to the hospital. The current culture puts EMS crew safety as a higher priority. Meaning, if we don’t have the support of law enforcement, we are not going to force patients against their will to get a mental health evaluation
We talk about our relationship and reliance on our mental health evaluators
Documenting these difficult cases involving suicidality and capacity can be tough
One of the current challenges is assuring cooperation between EMS and PD to help safely transport a patient with suicidality but that is also a potential danger to providers
Involving medical control is critical in these difficult situations, especially with technological changes decreasing the difficulty
When in doubt, just make the consult
EMS trained physicians improve our ability to do our jobs as more and more emergency medicine physicians get this training, it can only benefit us
Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics
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Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.