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Sat Jun 11 20:12:06 BST 2005

-----Original Message-----
From: Ronald Gross <Rgross at harthosp.org>

> "the practical matter is that we simply can not be measured against what happens 4, 5, 6, 10 days later." <

Sorry Jeff - in fact, what you do (or don't do) in the pre-hospital setting often WILL directly affect the patients 4,5,6,10 days later - IF they live that long.  To use your analogy, if you take the kickoff at the 10, run around with no forward movement, and get tackled in the endzone - YOUR endzone - the other team gets the points.  In the patient's case, however, the "other team" is a guy with long black robes and a schythe, and he will end up showing his face 4,5,6,10 days after the tackle - if he waits that long.
RIG
-------------------------

Sure.  A bad decision by me will adversely affect outcomes, and the example you give is the obvious (though at the extreme end of the spectrum)  one.  But the difference is that you can work around bad decisions by me... if I'm in error, you've got more work to do, but it's not the same as if I do my job perfectly and you screw up.  There's nothing I can do if you screw up.    

Assuming of course that the patient makes it to the ER alive.  

I'm all for the team concept, honest... but just as you can't be held liable for a bad outcome if I waste 30 minutes on the scene and bring you a dead patient, nor can EMS be held responsible for a patient that gets a nosocomial infection on day 7 and dies, despite the best EMS care.

Best, 

Jeff Brosius
Paramedic, etc.
Phoenix

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