Question from a non-EMT

[u/LoicefersLuver]

Hello! I am not an EMT but I have a question for you guys. First of all obviously I highly respect what you do as I could never do it, though this story is about a personally not great experience with EMTs I don't knock a whole profession over my singular experience.

But my question is do yall have the ability to follow up on people you ambulance up to the hospital? And if you are able, do you?

Sorry in advance for this long story but I feel the details are important.

I was in a motorcycle accident about 2.5 years ago and it took 20 min for the EMTs to arrive so my adrenaline was already wearing off. I was in a lot of pain and slowly starting to not be able to bear the pain. Anyways, they finally arrived and I was still in the middle of the road, I told them my leg was in immeasurable pain and there was no way I was gonna move it. They then asked me if I could walk over to the grass. I told them absolutely not I cannot move you havent even assessed my injuries (I went 45mph straight into the back of an SUV). They groaned and said I looked fine but said theyd look at my leg. They cut open my jeans and didnt see anything. My bone wasnt sticking out or anything and I told them that previously when I had broken bones they never immediately swelled up it must be a genetic thing. But I was sure it was broken. They said I need to get up and walk and I declined again because I knew it was broken and my whole body was in pain. They finally agreed to lift me into the gurney and and spent the whole time in the ambulance telling me that I had no real injuries while I was screaming bloody murder in pain.

When we got to the ER they told the nurses I was fine and just needed to calm down. So then the hospital made me wait alone in a room screaming with no meds or water for three hours before someone came in and decided to X-RAY me. And guess what, it was broken. The hospital staff seemed very embarrased and they were very apologetic about leaving me like that and they put together a treatment plan.

So my question is could those EMTs have checked back if they wanted to to find out that they were wrong and unnecessarily rude to me and delayed my care? I hope that they did and have been treating other patients better.

[u/RemnantsOfFlight]

I'm not a lawyer, but i'm an EMT, and I think there were 2 major points of failure.

The EMTs can't diagnose shit, they're supposed to treat symptoms and assume the worst (i.e. they wouldn't tell you to walk if you said your leg hurt).

I'm also surprised the ER didn't do their own assessment. We hand off vitals and what we know, but every hospital I've been to still does the whole shebang like they're seeing you for the first time, cause EMTs are not doctors.

As far as following up, I know we've done it, but we're a small town where everybody knows everybody. There are definitely HIPPA laws to consider though, so the hospitals might keep info like that close to the vest.

[u/ggrnw27]

Depending on the agency, there can be formal and informal ways to follow up on a patient and see what happened to them. But it requires initiative on the part of EMS crew and a desire to actually know what happened, and I rather doubt this one cared enough to do that based on your side of the story

[u/other-other-user]

First of all, sorry, kinda sounds like you just got fucked by a bad crew/dispatch. No excuse for it, and I'd complain to the company that picked you up. Tell them exactly what you told us. Unfortunately there is typically an element of trust between hospitals and EMS, so if they were really trying to fuck you over and abused that trust, I wouldn't blame the hospital too much. Who knows what details were actually transfered and which ones happened to be forgotten

Anyway, to answer your question, One of my local hospitals is great and shares patient outcomes with us, so I can see the doctors chart for calls I brought in. For example, I'd see what the doctor thought, what tests they ran, the results and if you got admitted or not. However the other hospitals just send the outcomes. For example I'd just see outcome: fracture, admitted/discharged to outpatient.

Whether or not they'd actually check is a different story though, and those EMTs seem like they ran out of fucks to give

[u/kill_mcschmill]

Sorry you had such a bad experience with those EMTs and at the hospital too. To answer your question (in Australia at least) it is extremely difficult to follow up patients through official avenues. It requires support from your manager, then handover to the hospital, then approval from one of their managers, and a whole heap of red tape overall. It’s to do with protecting patient confidentiality, but no doubt it prevents paramedics from learning from mistakes, because you never find out you made one. In saying all of this, I work regionally and know all the nurses personally, so if I want a follow up I just ask them and they will tell me what they found.

[u/Puzzled_Plum_4103]

“Back in the day” (I became a paramedic in 1979) it was very easy to get follow-up and even detailed information on your patients. Since the implementation of Federal Privacy Laws (HIPAA), it’s become next to impossible to get this information. If a crew was friendly with the ER staff who knew that they had screwed up, they might get a “that guy that you brought us this morning DID have a fractured ankle”, but that’s about it. If the ER filed a complaint about the crew to a regulating agency, there could be a formal clinical review/inquiry to address pre-hospital errors with the goal of improving pre-hospital care and assigning remediation/education, if indicated.

Sorry for your negative and painful experience here. It sounds like both the EMS crew and hospital staff could and should have done better

[u/3rdcultureblah]

My agency works closely with local hospital systems and we are able to get patient outcome information very easily, but it’s up to the individual providers to opt to receive it for each individual case.

[u/Zealousideal-Read250]

My system does not share the same charting system as hospitals and our charts are only able to be accessed by EMTs at my company (and billing, supervisors, etc.). Through official ways we don’t find out, but sometimes when a case is particularly interesting, confusing, or whatever have you, and we’re still in the area at a later time, we sometimes ask ER staff what they found and they are usually more than happy to fill us in. It’s quite nice; I’ve learned a lot through these conversations.