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Giving packed red blood cells in the prehospital phase of care... a good idea?

Tim Noonan noonantim at ymail.com
Sat Apr 7 20:49:49 BST 2012

Marty Munro, 

The case you are referring to is about taking too much time on scene, which resulted in a delay in providing ALS care (pacing, which might have saved the patient's life). That is the claim.

Not 7 minutes on scene.

Call received 12:53:22
Crew notified 12:53:36
En route to call 12:53:36
Arrived scene 12:55:48
Depart scene 13:13:32
Arrived hospital 13:17:10
Chasczewski et al v. 52809 Ontario Inc. et al, 2011 ONSC 999 (CanLII)

Date: 2011-05-26 
Docket: 88400/97 
URL: http://canlii.ca/t/flqcv 
Citation: Chasczewski et al v. 52809 Ontario Inc. et al, 2011 ONSC 999 (CanLII), <http://canlii.ca/t/flqcv> retrieved on 2012-02-15 
You are bringing up a case that is completely irrelevant. 

If you cannot start an IV/IO en route to the hospital, then EMS may not be the job for you.

This is just one case out of how many transports in Canada? Your chances of being sued do not appear to be worth mentioning.

If misunderstood and irrelevant legal considerations are what you worry about, you should consider the exciting world of of the chartered accountant.

Tim Noonan.

> From: Marty Munro <marty_munro at yahoo.ca>
>To: Trauma-List [TRAUMA.ORG] <trauma-list at trauma.org> 
>Sent: Friday, April 6, 2012 6:06 PM
>Subject: Re: Giving packed red blood cells in the prehospital phase of care... a good idea?
>Mr. Richey, while I believe you make some sound points, I am curious as to how you ventilate, suction and initiate an I.V. or I.O. all by yourself en route to the hospital? While preparing your I.V. equipment you are still able to ventilate and suction? That's pretty impressive. 
>Yes, one could argue that by not having the transfusin in the field, the patient didn't get the best possible care. However, that lawsuit would be on the service provider, and not the individual medics since if the procedure didn't exist, they can't be expected to perform it. Personally, I couldn't care less if my employer gets sued as long as there is no possible way for me to be sued or lose my job. And if the fault is on the employer for not providing a procedure, then one cannot fault the medics. You say that I am being paranoid, however, I can tell you that there is a case here in Ontario currently where two paramedics are being sued from an incident that happened in 1996. It was not a trauma, it was a medical that involved a third degree heart block. At that time, advanced life support units were very scarce in Ontario and therefore, pacing and pharmacolical intervention was not available at this time. The medics had an on-scene time of 7 minutes,
>and the time from their arrival at the residence to the time they arrived to the hospital was a total of 17 minutes. Yet, the court has stated that these medics took too long on scene, which caused the patient's death, and that the lawsuit should procede. Seven minutes from the time of arrival on scene, getting themselves and equipment inside, assessment, stair chair and then departure was seven minutes. I think that's pretty damn good. Yet, the courts say it is not. The more procedures we do as medics, the more risk there is for lawsuits. And I am not a physician, I cannot bill for each procedure. Do the wages go up for paramedics as more skills are given? No, of course not. 
>I realize that this post was meant to argue the medical side of providing blood, however, as a paramedic, I do not think that it is a good idea practically. 

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