Jun 08 2009

Death of emergency patient due to paramedic shift end

Unbelievable. Incredible. There are not enough exclamations to describe the kind of reaction an ordinary person would have to the story of a paramedic who put his own needs before that of a critically ill person.

Of course, the decision might not have been his, thus an investigation is pending.  But, regardless of the authority who demanded that the paramedic end his shift, his first moral priority should have been for the welfare of the patient he was carrying.  Though paramedics may not be bound by the Hippocratic oath, they essentially agree to similar codes of ethical conduct.

Imagine a doctor, in the middle of a life-saving code, deciding to go off shift.  That just wouldn’t happen, not unless some extraordinary circumstances where another doctor is available and can take over immediately.  In this case, a paramedic is called to transport a stroke patient to the hospital.  He takes a detour to the ambulance station so that he can go off shift and another driver takes the patient to the hospital, where he ends up dying because he did not receive treatment immediately. 

Now, you might argue that the patient would have died anyway.  But, is that the way we should trivialise someone’s life.  There was a possibility that he could have been saved had intervention taken place in the recommended time frame.  As such, the patient arrived at the hospital outside of the time frame.  (Remember the Natasha Richardson case.)  The driver could have been excused for going off-shift had a driver been available along the way to the hospital, rather than off the route.

So, what was the motive for choosing to go off-shift rather than completing his route then returning to the ambulance station?  Was there a demand for him to turn in?  Or, did he just feel that his duty ended at such and such a time?  Should you be in the emergency health field if you only want to work your shift and forget about it?  What happened to overtime in cases of emergency?  Surely, exceptions to limiting pay exists in such cases.  It costs more in the long-run when you become too tight-fisted to allow for flexibility in shift work hours.

Mar 19 2009

Should helmets be compulsory on snow/ice?

Natasha Richardson’s death has highlighted an important issue with regards to head injuries. Most of us think of head injuries in relation to bike accidents, whether motorcycles or bicycles, because they are the most frequent injuries we hear about. In fact, helmets are required by law for motorcyclists. And most serious bicyclists wear helmets – they are required to in competition. Of course, parents also urge their children to wear helmets on bikes, especially when they are new bike-riders.

But what about other sports. We know that American football requires helmets. In baseball, players wear helmets when they are batting or catching. Ice hockey requires helmets. Children learning to ice skate are encouraged to wear helmets, though adults are hardly ever asked to do so. Yet, figure skaters would never dream of putting on a helmet, even those in the beginning stages.

It has been many years since I went on the slopes, but back then, I don’t recall anyone ever wearing a helmet. But over the years, apparently, some skiers and snowboarders have taken to wearing helmets. It is not a universally accepted practice, however. Yet, head injuries on snow/ice are just as dangerous as concrete. And those slopes can become very icy after many people have trampled on them.

Richardson’s injury initially appeared to be minor, but now it has proved to be fatal. It is quite tragic and it begs the question of how many people have suffered through similar accidents but did not get the media attention because they were not celebrities? Should helmets now be required? Will it help? This question cannot be answered by studies, but if helmets can be shown to prevent serious head injuries, then the answer should be a resounding ‘yes’.  But creating a mandate to make helmet-wearing compulsory would take a lot of time and money.  The best solution for now would be to strongly encourage the use of helmets in cases where head injuries are not only serious but frequent.  The public need to be aware of the potential for injuries.  The helmet industry may see a surge in sales following this incident.