Here we go again!

Another installment from T&G reporter Tom K-Y.

http://www.telegram.com/apps/pbcs.dll/article?AID=/20090719/NEWS/907190373/


Here's the comments as of 2100 last night.
http://www.telegram.com/apps/pbcs.dll/section?Category=reader_comments&article_ID=907190373&WT_article_headline=EMT censures spur action - -

UMass Memorial makes changes
Reader Comments

EMT's and paramedics handle hundreds of calls a week. Many of these are people who refuse to take care of themselves. They are overweight, don't take their meds as prescribed smoke and wait till the very last minute to call for an ambulance. When the EMT's get there they give them a hard time about going to the hospital, they lie about their symptoms and medical history and then expect these guys to risk their health carrying an obese person down 3 flights of stairs. Lets give these guys the benefit of the doubt as we see in the article there are always two sides. I cant believe how much this rag of a newspaper loves bashing cops, firemen, and EMT's. You know what they say if you cant do write for the T & G.
-J

Mr EMT, If you got the balls to sign your name, I got one of those stickers. If not, shut up.
-wormtown medic

Boston Medic: Poor you! Patients you transport do not THANK YOU?? Hmm, maybe because they are very ill, in pain, terrified, sick or dying! The one time I was transported, I may have said thank you, but I do not recall, I only remember the pain and recovering from emergency surgery afterward. Take pride in your job and quit whining.
-Thank you?

West Coast Rich -- UMassMemorial Healthcare was once The University of Massachusetts Medical Center, which was a state-owned institution.At some point -- someone else will have to supply the dates, but not recently -- the hospital was privatized. In the late 1990s it merged with another Worcester Hospital, Memorial Hospital (once known as Central Massachusetts Medical Center).The resulting, non-profit organization is UMassMemorial Healthcare. It's composed of several area community hospitals and a large teaching hospital affiliated with the state medical school (which remains a public institution).UMass University Campus is the region's only tertiary care center and Level 1 Trauma Center, and houses the LifeFlight air medical service, and UMassMemorial/Worcester EMS, the city's contracted 911 EMS provider and the successor to the city's ambulance service that was once run by the city DPH.
-On the EA


Hey Mr. EMT -- you can probably guess where you can go find that sticker.BTW, those stickers haven't been around for years, and they were a national phenomenon. Run a Google Image search and you'll find them in some interesting places. They weren't our creation and they haven't been around forever. Find something else to gripe about....
-On the EA

now you really have my curiosity up. about three people have said it's private. No one has yet said who owns this company. It's a simple question for someone to answer.Who is the owner resposible for the management, hiring, firing, training, etc?
-west coast rich

I have been in both sides shoes, as a patient twice and with patients needing transport. Both times when it was me as the patient there wasn't a need to be carried, but the EMT's asked me to, they were polite and understanding that I was safe to walk, yet both times I let them put me on the stretcher. I have also been with people in need that didn't want to be carried and they needed to be carried.I can see where any emergency worker is in a tough position dealing with a person in need and respecting that persons free will vs. everyone involved safety.A lot of you have raised valid points, some of you well I won't address those comments... To all of you until you have been in BOTH these situations please don't judge the patient or the emergency personal, there can be stress, concern, sometimes confusion and anger. All emergency workers regardless of training and experience find themselves making judgement calls that need to be in everyone's best interests, that isn't always going to be easy and they aren't always going to be right but WHAT'S IMPORTANT WHEN WE NEED THEM THEY ARE THERE!
-Been in these peoples shoes!


U Mass Memorial Hospital IS privately owned. Only the medical school is run by the state.I see the paramedics every day when they come into our emergency room and know how intelligent, hard-working and compassionate they are. I consider them the unsung heroes of Worcester's first responders. It seems like the other guys get all the positive press while difficult, life-saving work the paramedics routinely do is rarely acknowledged.
-at last


where can i get one of those 'got shoes' bumper stickers?
-mr.emt


TO all the haters,Just like Police and firefighters, Worcester EMS have a very tough job. I would love to see some of you live a day in a paramedics shoes. You would go home crying from all the things they see and do. 10 complaints!!? that is not alot of complaints. I believe I am a healthy person and when I get pains any where I don't complain and call 911 for the medics. I have an idea stop crying and work through it. Just because you don't feel good is not a good enough reason to get a ride to the hospital by a (delivery person) as one clown stated. 'your job is not to diagnose the problem, it is to transport them' Ha that comment is a joke! The next time that guy needs to be 'transported' for chest pains (Medics don't diagnose anything, Don't hook up your EKG, don't check his oxygen level, Don't check his blood pressure' Just transport him!!!!! and let the Doctor diagnose him when he is already dead in the back of the ambulance because all the medics do is transport!!!!For the Rocket scientist, There is a reason you only have very limited training in first aid and medical responses! With that comment your common sense is limited too! You're the guy that probably chases radio calls and thinks you're a medic! Enjoy flipping burgers!!Just another one way liberal article!!
-65

And the woman who complained had no memory of the event. But her neighbor 'thinks' she walked.
-wormtown medic

You're right -- WEMS IS a privatized service.Which means the City of Worcester gets one of the best EMS services in the nation absolutely free of charge.You don't have to pay our salaries, our retirements, our worker's comp when we get injured. You don't have to contribute to the Worc County Retirement System or 111F for when we get hurt.
-On the EA


I did a google search on the ems program. It says that it is run by UMASS Memorial which, appears to make it a state program. Who do you think owns this?
-west coast rich

None of these medics deserves to be fired.All four are exemplary employees and are the kind of medic you want coming through your door when you're critically ill.In fact, the female complainant mentioned in the story went so far as to track medics Humphrey and Feeney down in the weeks after they saved her life to thank them, tearfully, for, well, saving her life.She also put up a tribute to both medics on her social networking site.Of course, I'm sure it's just a coincidence that said tribute disappeared right after Caywood's first article appeared in April, about a year after her 'incident.'It's also interesting that none of this appeared in the newspaper article.I'd be interested to compare today's Caywood piece to the 'confidential' report filed by the state compliance coordinator.Something tells me they'd be close enough to count as plagiarism, were that something newspapers cared about anymore...
-And You Thought It Ended With Ken Powers


Dear 'Do Your Own Job'EMT's and medicas ABSOLUTELY have to have MDs orders.... it called medical direction. Yes they have to do assessments but they DO NOT diagnose. And anytime an RN questions a paramedic or eludes you are not up there with the almighty we are classified as 'BUTT WIPERS' etc.. This is why some paramedics dont get the respect they deserve. As for this case, there are many facts not mentioned. UMass is #1 in the state #2 in the COUNTRY for surviving a heart attack and you can start by thanking the paramedics who look at the patients EKG and notice they may be having a heart attack. This allows for the pt to go directly to the cath lab. Time is muscle. The EMTs and Paramedics have a very difficult job and for what they are exposed to are grossly underpaid. T&G should be supporting the wonderful resources of this city and not reporting such an irresponsible story!!!
-Another RN


WEMS is a privatized EMS Service.
-It is a privatized EMS Service


I can solve this problem in four words:'Privatize your EMT sevice'
-west coast rich


Worcester EMS is now an even better organization due to this case. They have taken drastic measures and will continue to keep an closer eye on the cowboys that bring a bad name to the majority good medics here trying to do the most good.Now stop bickering and name calling. Its currently 72 degrees and sunny. Walk away from the PC.
-Massachusetts Medic


I totally agree with the comments referring to the fact that there is no safe,rapid way to extricate a morbidly obese pt out of a structure. Until then, we will have to rely on the old fashioned way. These few providers seem to have made a mistake. Lessons learned,improvements implemented. lets move on! To the 95% of the talking heads commenting here and there who have never carried a 400+ lb person down 3 flights of stairs that are only 36' wide(if youre lucky), in a 100+ yr old building,(with no street numbers) with rotting stairs,little or no lighting, on a 95 degree day. Or better yet,same scenario but in February when the outside stairs have 30' of snow piled high and still--no lights on. Oh yeah--add the oxygen tank around your neck, the heart monitor slung over your partners back, and an IV bag lodged somewhere. And then, once you get to the hospital, no thank you from said pt. So to all of those who are taking potshots at WEMS or another 'ambulance driver' (i prefer ambulance attendant or gurneyperson myself) you should keep your thoughts to yourself. Or better yet---schedule a night shift ride along and walk up a flight or two or 10 in our boots.
-Boston Medic


Hmmm, ok 10 complaints in 2 years out of approximately 60,000 calls. Something seems fishy here, it also appears that UMass maintains an excellent staff of EMT's and paramedics, some with existing problems. How about firing these people??? Are these people state employees??? That would make senses, as we know any level of government can screw up as much as they want and still have a job. All these people should have been fired including the mangers, what a joke!!! Great reporting on this, keep the heat on until all these people are fired and never allowed to be EMT's or paramedics again in any state!!!
-mike81m


-You put your foot in your mouth, you should follow your own advice. I doubt you know much more about this case than what you read in the article. I would never defend someone's inappropriate treatment of a patient.I agree that there appears to be a deriliction of duty but that is if you assume the word of the patient and reporter as gospel. There is only one side of the story presented here. Articles like this are what 'undermines the respect and prestige deserved by those EMS providers who operate according to those standards and are worthy to be called life savers.'
-wormtown medic


A wise person once said 'it is better to remain silent and be thought a fool than to open one's mouth and remove all doubt.' Some of you would do well to heed that advice.The issue here is a number of people, and I think it a small number, within WEMS have been derelict in their duty. Whether you like it or not, that is the phrase used to describe someone who has a duty to act according to set guidelines and principles and fails to do so. It is absolutely true, EMS workers whether private, municipal, fire based or otherwise save lives. They do so when they are able to apply their cognitive and psychomotor skills in accordance with standing orders, protocols, and standard operating procedures within their scope of practice.The poster calling yourself 'Do your own job', no one within EMS operates without the supervision of a Dr. In the EMS world they are called a Medical Director. An EMT whether Basic, Intermediate, or Paramedic cannot take any action without the approval of a competent medical authority. They receive this direction through 1) state protocols, 2) standing orders, 3) direct contact through Worcester CMED or via telephone.Take away the name of the company and the names of the two EMTs in this article and look solely at the scenario. The actions taken were inappropriate and would be a good case study for what not to do on an EMS call.Those who advocate for people based solely on their particular occupation rather than on the adherence to high ethical and professional standards have a very hollow case. Anyone who claims to be an EMS provider and tries to justify the improper actions of people who did not follow proper procedures only further serves to erode the public's confidence in a vitally needed service in addition to proving the ignorance of the author. It also undermines the respect and prestige deserved by those EMS providers who operate according to those standards and are worthy to be called life savers.
-You put your foot in your mouth


Whoa, this is a tough room to be a dead horse in. A rehash of old news. A fine piece of muckraking there Mr. Caywood. You will probably be the only one cashing in on this article. I work at WEMS and know the truth, one of the calls was reviewed at M&M rounds shortly after the incident and the medics were commended. Someone isn't being entirely truthful, I wonder who. The reason you didn't talk to the medics involved is because we are bound by regulations that prohibit us from sharing a patient's medical information, not because we didn't want to. These same regulations prohibit people ridng along as observers or I would invite you to come see how we really work. Ask The Center for Cardiovascular Excellance at UMass how we do with cardiac patients and you will be blown away. Ask your own Mr. Nemeth how we do, I'm sure he will back us too. Go ask about us at WoMag, go to any emergency room in the city, that is where you will find your pattern of behavior. Not in the minority of complaints or the biased view of a state investigator.
-wormtown medic


To Do Your Own Job,You're a little bit too sensitive! You say, 'Do your own job and stopping trying to comment on things you do not know about.' Yet you tell me to do what I do best 'wiping butts'. You are clueless to what I do everyday. Listen, I know that EMTs are highly trained, skilled medical progessionals just like me. Aren't we all on the same team here with the same goal of providing the best care to our patients within the scope of our own practice? Yes, when a patient rolls into the ER with chest pain, I do count on the EMT for report. My point was you are NOT qualified to diagnose the problem. Neither is a nurse. Only a doctor can diagnose.RN
-RN


I appreciate all the lives saved by these dedicated servants in our community. I for one can not thank you enough, not because I have used this service, but I work at UMMS and see the fruits of your labors. You are special men and women.
-EMT's do their best, Thank You so Much


M -- don't get ahead of yourself big fella. On a typical shift in Worcester, we move, carry, transport and otherwise move to the hospital AT LEAST 3 to 4 400+ pound patients per truck per shift (that's in addition to the 12 to 20 calls we already do on a typical 12-hour shift). They ALL get treated with dignity and respect, no matter the toll their treatment (some of whom go multiple times per month) takes on our backs and legs and arms. As I write this I can think immediately of a half-dozen regular patients who top 650 pounds, and a couple approaching 800. We are sympathetic to their condition, and if you asked them would tell you that we do everything we can to spare them embarrassment, up to and including sacrificing our own health and, potentially, careers. I have to wonder what compassion YOU have for the several medics per year forced to go out on extended medical disability with significant back injuries incurred while moving the morbidly obese?My guess is probably none.The morbidly obese are probably the single greatest challenge to street EMS right now, as no equipment exists to move them that guarantees the safety of the patient, and the crews working on them, while also facilitating a speedy exit in the case of acute emergency.Many patients have simply physically exceeded the existing technology, and that's a problem no matter whether you work on the streets of Worcester, Boston, Bumbleyville or NYC.
-On the EA


To the RN, Rocket Scientist and Others who do not and will never know the job that EMS do. To the RN you need orders from the MD to do your job, these EMTP have to do their assessment and determine the best treatment for the patient, without a Dr telling them what to do. These men and women say lives everyday and never read that on the front page of the T&G(unless they were fire personnel). Ms or Mr. RN just keep doing what you do best... WIPING BUTTS!!!!Rocket Scientist, I would welcome you to go to a house and carry an OBESE patient down 3 stairs never mind 3 flights, or 10 stairs. EMT's need to get the patient to the ambulance as time is so crucial especially cardiac patient and when your on scene time takes 30+ minutes to get this patient care, that is what causes damage. Having a patient walk so they can treat them ASAP is what matters. The others who stated 'A patient's Past History (P under the SAMPLE method) is only one part of the equation. You need to do a proper primary and secondary and get all of the information and put it in context to properly treat the patient.' Well I'm glad that you did your studying and can memorize. But can you use the skill that these men and women do daily?My mother has COPD and many other medical issues have had WEMS at her house on many accounts. I have witness them talking my mother into going to the hospital because she thinks it's just her anxiety. Due to them getting my mother out to their ambulance to treat her as fast as they can, they have walked my mother (who is overweight) down stair to do so. I thank them everyday that the talked her into going to the hospital and I know if the medic brought in a stair chair, cot or whatever she would change her mind and not go to the hospital, because she is embarrassed and feels that would bring more attention to her by bystanders. Do your own job and stopping trying to comment on things you do not know about.Thank you WEMS
-Do Your Own Job


Now that a potential cash settlement is involved for the 'victims' here, I'd like to say that when I was having chest pain, EMS made me walk down 7 flights of stairs, then go back up to get the stretcher they left behind. Then they made me walk down the stairs again with one of them on my back. Then they made me drive the ambulance to the hospital myself while they napped in the back. They made me hook up my own paddles to my chest and shock myself because they thought I was fine. Then they made me pull the ambulance over at a nearby tavern and made me sit there while they went in and drank on the job for over an hour. Then they billed me for damage done to the ambulance as I knicked the bumper backing it into the hospital parking space. Finally they dropped me at the back door of the ER and slapped me in the face before speeding away in the truck. I think I should be compensated. Doesn't matter that I'm 800 pounds and live on the 22nd floor. (How do I get upstairs if I can't get down?) Doesn't matter that I didn't want to go to the hospital and was combative and drunk when they showed up to transport me. Doesn't matter that they continued to act professional when I was acting like a five year old. I hit the jackpot when I actually did have a heart attack as it gave me the means to be financially compensated for inadequate treatment. It makes my other 753 calls to EMS for chest pain all worth it. WEMS- we love you, you know that we in the hospital couldn't do our jobs without you. You are all tremendous in what you do despite the garbage pay. Keep your heads up, all of you WEMS medics, this too shall pass.
-Grow up

Massachusetts EMS - You said your largest patient was over 600 lbs and you did not carry 'that'. Is a large person beneath the dignity of being referred to as 'her' or 'him'? I would not expect you to carry someone that large if they were able to walk down the stairs - but I would expect them to be treated with dignity and compassion. Your response makes me think you didn't have either of those for your largest patient.
-m

I work with the Umass medics every week and see the job they do. These are skilled, professional people doing a great job under difficult circumstances. Patients sometimes refuse to be carried, patients sometimes walk despite being warned of the danger, patients are sometimes less than cooperative. If the medics were to carry every patient that they transported the city would soon be without medics. Injuries would claim the vast majority of them. I think some of the critics are unaware of the volume of calls the medics respond to and the nature of many of these calls. It would be an understatement to say that some members of the public may not be aware of what constitutes a medical emergency. The people calling for help are most likely experiencing a true emergency or believe themselves to be but there is a huge difference between chest pain and a sore hand, say. Both patients may insist that they be transported and both may actually be transported but does any one think both should be carried down three flights via stair chair? The medics involved with Mr. Rondeau clearly made the wrong decision and were punished. Adjustments have been and continue to be made to the sytem. Designing protocols so broadly that all patients need to be carried is more about avoiding lawsuits than treating patients. Let's not blame the medics as a whole because as a whole they're doing a great job.
-Siding with the medics


Please comment only on the article.
-Lindy


My husband had need of the Worcester EMS on multiple occassions, and on every occassion they, the fire department and police department, arrived quickly and were very kind and professional. I am sorry for the other's losses however I can say that each and every time I had the occassion, and very stresful occassions that they arrived they took charge, knew what to do and listened to the specific needs that my husband had.
-Lo


Methinks Mr. Markiewicz smells a payday.
-Max Pixel


To Massachusetts EMS,Don't forget you'te an EMT. NOT an MD. You are not qualified to diagnose a patient. Your job is to get the patient to the hospital so the proper tests and diagnosis can be made. Patients with cardiac symptoms are to be 'ruled out' for an MI.
-RN


Massachusetts EMS Says: 'The thing is, if any one of you spent time in the field, you'd understand that a patient can actually say the wrong thing that makes you believe the situation isn't as bad as once thought. You could call in a chest tightness and by the time I get there, you tell me you have a history of anxiety attacks and that this feels like the same thing all over again. That comment just aided in putting any cardiac assumptions secondary to anxiety.'Massachusetts EMS, this is an ignorant statement and clearly shows you don't understand the purpose of a primary and secondary survey, a basic tenant of your job. A patient's Past History (P under the SAMPLE method) is only one part of the equation. You need to do a proper primary and secondary and get all of the information and put it in context to properly treat the patient.And by the way, anxiety is usually caused by stress. People under stress have been known to have heart attacks. I will add that anxiety symptoms are very similar to cardiac symtoms and what I've been taught and learned through my experience is that you treat for the worse case scenario. It is a 'ruled out process'.All you did is just make a negative case against yourself as an EMS provider by showing your ignorance. Your 'if any of you spent anytime in the field' statement clearly shows you're one of those people who thinks 'forget everything you learned in training, this is how we do it in the field' people.The fact of the matter is that the protocol, and this is not just in Massachusetts either, is that the patient is transported by the EMS people on a suitable tool for that purpose (stretcher, backboard, stairchair, whatever), to the ambulance. It is NEVER acceptable to make a patient walk to the ambulance if your transporting them. Stop making excuses for improper treatment. The public is counting on you to get it right.
-You put your foot in your mouth


So here we again. How about the Telegram does an article as to how many calls a year WEMS does, and how people abuse the '911 Cab' in the City. How about the state investigates the number of lives that they save every year ? How about Steve Haynes,again no call back,what was his reprimant for the last time this happened ? Enough is enough all you pencil pushers from the state need to hit the road again I am sure it has been a while and some of you have no EMS backround hmmmm amazing
-Dw


This article states that the patient who died, Mr. Rondeau, walked down 3 flights of stairs. It then goes on to state another female patient walked down a 'flight of 10 stairs'. Why does it fail to mention just how many stairs Mr. Markiewicz walked down when it was so specific with the amount of stairs the female patient walked down? Could be Mr. Markiewicz is exagerrating how many stairs his front steps have? Perhaps the reporter didn't get that fact from Mr. Markiewicz in his telephone interview.
-just sayin


Ok, first of all - not even the reporter who wrote this one-sided story knows exactly what went on that day. Seems he neglected to tell you one patient was over 400lbs. The other patient needs to get their story straight, it even states that the reason these cases are still being investigated is due to the patient and EMS story discrepancies. EMS personnel CANNOT carry everyone. My largest pt was 613lbs and I sure didn't carry that. It took 6 EMTs and 4 Firefighters to strap him to a backboard and slide him down the stairs. Took us 36 minutes to get him out of a 5th floor apartment. He had shortness of breath and coded by the time we pulled into the ER parking lot. You going to site me for taking to long on that one too? Let's time you.I also have words for the 'rocket scientist.' If you had bothered to read the article thoroughly, you would have understood that the line stating that the paramedics were 'trying to cover it up,' had nothing to do with these two patients. It was referring to the article that preceeded this one a few months back. Idiot.The thing is, if any one of you spent time in the field, you'd understand that a patient can actually say the wrong thing that makes you believe the situation isn't as bad as once thought. You could call in a chest tightness and by the time I get there, you tell me you have a history of anxiety attacks and that this feels like the same thing all over again. That comment just aided in putting any cardiac assumptions secondary to anxiety. I'm sure if the reporter had bothered to tell you how long these crews were onscene assessing their patients, the story would somehow have a different tone. The problem is, not ALL of the facts were reported. And since I was a journalist before I went into the medical field, I can hoestly tell you that selling papers, ESPECIALLY in a rough economy, will always trump factual accuracy. You just sell more papers when you have to apologize for the errors...
-Massachusetts EMS


Rocket Scientist, wake up and smell the agenda. This happended 22 months ago and just NOW makes the front page, right after a law suit was filed? This guy is jumping on the bandwagon because he smells a payday. If he was that concerned about the care he received he would have been all over this BEFORE he saw that there was a $lawsuit$ brewing.
-captain obvious


I have to get my two cents worth in here...when I was having exacerbated COPD and could not breathe easily, I was also walked out to the ambulance as well, bare-footed, in the slushy February snow.
-Sharon

I just wanted to thank the men and women of the Umass EMS system. I am no one special, when I was hurt and needed emergency medical attention,the paramedics who responded treated me like I was somebody. Thank you for making a bad situation that much better for me as well as all of the other people you have helped over the years.
-Ahhhh Worcester, we're almost there!


Obviously they knew they screwed up if they were trying to cover up their mistakes. It was not a witch hunt.Nice try.
-a Rocket Scientist


we as a americans are fat lazy people, god forbid you get some exercise and eat healthy so you don't have to worry about someone carrying you down a flight of stairs.
-silly goose

So we are talking 3-4 calls out of 30,000.... We had better get to the bottom of this!! In the meantime lets bash all paramedics, second guess all of their experience and insist that anyone who calls an ambulance be carried no matter how trivial the complaint or dangerous the staircase.
-enough already

Well, Rocket Scientist, if you knew what a witch hunt was, and had half a brain and could put two and two together and figure out why certain complaints lie dormant for two years, and aren't lodged until AFTER a front page hit job by this newspaper appeared in April, with the attendant threat of a multi-million dollar lawsuit, you'd probably come to the conclusion that you shouldn't believe everything you read in the paper...but then again, you already admitted you're no rocket scientist....
-On the EA


I have very limited training in first aid and medical responses....but it doesn't take a rocket scientist to figure out that if someone is complaining of chest pains and possibly having a heart attack....you don't make them exert themselves by walking down stairs.I don't see how they figure $500,000 worth of technology will fix what common sense should already tell you.
-a rocket scientist