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Administrative, EMS, Patient Care, Politics

Patient – Defined. Wrong, but defined.

I nearly had a stroke the other morning.

As I came into work I was notified that our local EMS Agency, the agency tasked with telling me what I can and can’t do as a Paramedic, has added a new sentence into a policy that makes it nearly impossible to believe they know what they are doing anymore.

I’ve been to the meetings where these policy changes are discussed and most are suggested by an ED doc upset something happened once out of 115,000 calls for service.


In our policy that defines what is required to document a patient contact, there were 2 bullet points that gave guidance as to who was a patient, since if you have a patient you must complete a primary and secondary assessment (including ECG and BGL), identify illness or injury, treat said illness or injury and offer transport.

Those two bullet points were:

  1. Anyone who requests medical evaluation. That makes perfect sense to me.  They want us here, we’re here.
  2. Anyone who, based on practitioner impression, requires assessment or intervention.  Makes sense again, altered consciousness, folks who need us but can’t ask for us by name.

That’s all we really needed.  Either they want us or, if they were able to ask for us, they would.


Nope, now nestled inbetween sanity is insanity.  A new bullet point is included…

  1. Remains unchanged
  2. Any person for who assistance was summoned by a third party.
  3. Remains unchanged.

Do not adjust your TV sets.  Yes, the new policy states that a patient exists if a third party believes they are in need of assistance.   This means that, LEGALLY, there is a “patient” at every single 911 call regardless of the condition of the person in question.  If you sneeze and someone in a passing Lexus calls 911, I’m required to assess you and get a refusal signature.

We’ve fallen down more than a few rungs on this one and, so far, I can’t get anyone in the agency to reply as to why this was changed.  All I can figure is that they’re gearing up to start charging a response fee (Which is almost as stupid as the new definition of patient) and now delays units clearing calls where the caller was wrong (more often than right) which impacts the system.

And all for what?  So we can stay out of service longer to document how the 911 caller is not on scene and the man who sneezed is not giving consent for an unnecessary medical procedure and refuses to sign my form?


It’s almost 2018 too.

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One Comment

  1. Tom l December 29, 2017 7:40 pm

    Not to mention the “patient” will be forced to pay for the AMA/PDT. So if u want to piss someone off, just called an ambulance for them and say they appear sick… it will set them back a few hundred bucks

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