That being said, our protocols are non-existent. I am in the process of “repairing” them and I keep getting frustrated at some of the errors, or even worse, oversights. 

Today, I found that there is no needle thoracostomy protocol, no combitube protocol, and no needle cric protocol. Those wouldn’t be a big deal, if they weren’t things we didn’t ALREADY have in our trucks….

SO… I spent today doing surgery on a dead horse so I could beat it some more.

That was up until we found the Chicco Cortina Travel System. The Cortina system is by far my favorite option out there. It does come with a price though… Nearly 300 bucks. For this price, you get a stroller, car seat with infant pad, and a quick release base. The base is ESSENTIAL to a good car seat experience, and a stroller that accepts your car seat with an actual quick release latch is a must too.

The Cortina uses the same buckles to latch into the base as it does to hook into the stroller. This allows you to get the seat in and out with very little effort. Just my style……

The system is one of the heavier options out there–that being said, it has one of the highest safety ratings and I figure that part of that comes from the weight of the quality materials. Many seats feel like toys, and this one certainly does not.

The stroller is a great all around system. It is convertible so it works with both the car seat and as a stand alone stroller. It has a large basket to hold a diaper bag under the seat, as well as a cup holder and tray for the parents. It has a removable tray with cupholders for baby too. The removable feature hasn’t been used by us yet… But I already know how vital it will be! The stroller has shocks on all four wheels with about 1.5 inches of travel–enough to stop the bouncing heads. My only complaint here is that the storage under the seat isn’t very accessible when the seat is in the down position so that you can use the car seat in the stroller. You have to put the bag in FIRST, then the seat.

The base can be fastened into the car using car seat clips or the seat belt. I love the clips. You can put it in the car in 2 minutes, with a quick pull strap to get it tight.

The seat uses a quick pull strap to get the straps tight. You feel like you’re going to squish the kid, but it does get it snug! My only complaint about the car seat is the visor, which could be a little bigger as in the car it often lets a lot of sun in the boy’s face.

All in all I think this system was well worth the bling. It offers me peace of mind when it comes to safety and is easy enough to set up that you don’t have to worry about the poor ‘ling screaming out too long…

The pros:

• Ease of use

1. easy to put in/take out of car
2. easy to put in stroller
3. easy to adjust straps for the ‘ling
4. easy to set base in car

• construction
• storage
• easy clean

Cons:

• price
• weight
• stroller does not fold down as small a I’d like
• poor storage when using car seat in stroller

Luckily when I work weekend shifts I get to have them come to the station and hang out while I’m here. They come during the week, but our schedules usually makes that last only an hour or so. Being away from my wife was hard enough… being away from Asher is a whole different ball of wax…

I never realized just how much I’d love that little guy… I miss you guys…

Wish me luck…

HIPAA seeks to do a few things. It was designed to make healthcare coverage “portable”. This means that pre-existing conditions would no longer be excluded in new insurance policies–so long as the patient had insurance up until the new insurance went into effect.

Further, the standardization of electronic records keeping and claims management was a large target of this bill–and this is where the primary concerns of HIPAA come into effect. With this the Federal Government realized the potential for abuse of patient information and created the security standards that we have all grown to fear.

With that, it is important to understand who is obligated to abide by HIPAA. It has always been percieved that EVERYONE that is around a patient is a “covered entity”–in that anyone on a scene had to follow HIPAA policies. This is NOT the case though.

In EMS the “covered entities” are simple. Any “health care provider” (it could be said that pretty much anyone at a scene is a health care provider–in one aspect or another) who submits information electronically–whether for billing or reporting purposes.

This means that a fire department that has paramedics but does not transport or bill the patient, or file electronic reports is NOT a covered entity and does NOT have to follow HIPAA privacy guidelines or standards. That being said–you are very likely required to meet a state healthcare privacy law’s standards, which usually have higher standards than HIPAA.

Not so complicated, eh?

Now the question is… what is Protected Health Information.

“PHI is a subset of IIHI, or individually identifiable health information. That obviously include information with the patient’s identity still attached. But it also includes information where it would be possible to discern the identity of the individual by virtue of some indirerct means. If it’s reasonably likely that someone could identify the individual from the information you’re using or disclosing, then you’re using or disclosing IIHI, which means you’re using or disclosing PHI, which means you’re violating HIPAA (unless it’s a use or disclosure for an allowed purpose, like treatment).”–Jeff Drummond at Jackson Walker Law.

This means that in reality, it is very difficult to tell a “war story” without disclosing HIPAA protected information. Because of this, Jeff recomends that medbloggers fictionalize the story. Change everything but concept. You can even keep the details pretty close, assuming you change it so that your reader can not identify the character in your story.

SO… you’re story about a 23 year old white female becomes a story about a 31 year old Hispanic male(unless female is essential to your story). Your story about a 12 year old Asian boy’s parents becomes one about a 10 year old Australian’s parents.

Get it? Now, if you can tell a story(that makes sense) without disclosing ANY PHI, then you are safe. Details of the event, such as age, race, description, treatment, and/or location mean that you could easily be crossing the dreaded HIPAA line…

Remember–Just because you are NOT violating HIPAA, you have both a code of ethics and State Privacy Laws to keep in mind when disclosing any patient information.

Sources:
EMAIL from Jeff Drummond at JW.com(hipaablog.blogspot.com)

http://www.cms.hhs.gov/HealthInsReformforConsume/03_FiveStepstoUnderstandingHIPAA.asp

http://www.merginet.com/index.cfm?searched=/admin_management/legal/HIPAAPrivacy.cfm

http://www.merginet.com/index.cfm?pg=legal&fn=privacyviolation

http://www.hipaaps.com/main/background.html

Give the app a try to see if it works for you. Let me know what you think about this idea and give me a shout about when might work for you!

Courtesy Shock is a hybridization of everything that is EMS. From cookbook medicine to drunks and nut jobs… This blog is about it all!

I am a 25 year old white guy in the upper Mid West living the dream as a medic, husband, and now a father.

My beautiful wife and I live in my hometown, where I work for The Little Ambulance that Could. We have a 2 month old son, 3 dogs, and several fish. 

I couldn’t be more of a dork–from computers to my aquarium. I also happen to be a gadget whore…

Today is just another day… But it is going to be a great one!

from my ABOUT ME page.

“But their in asystole…?”

Give ‘em a Courtesy Shock–Just one for the Road!

A “Courtesy Shock” is when you give someone a little medicine that we KNOW won’t help them, but for some reason do it anyways on the off chance that the laws of medicine, physics, and probability all have faild us. This blog is a continuation of my previous ventures in blogging and a step towards my NEW journey as a blogger.

I have many goals that I hope to bring forward here–Sit back. Listen up. Enjoy the ride.

Watch out though… I might just give ya a courtesy shock….