Prehospital Archives

I am currently working on a patient that gets admitted to OSH for medical reasons. Two days later while doing therapy falls from chair and dx with a fx from the fall. Patient is then transferred to our facility for treatment 3 days after injury at OSH. For scene provider would I want to choose walk-in as patient was in facility at time of injury? For admission date would it be the date and time of injury, anything done prior to injury would be voided?

We recommend using walk-in as the scene provider and recording the time of injury as the admission date/time. This allows for abstraction to really begin with the injury/fall and not with their initial admission at the referring facility.

The data element “Was patient extricated?” states that extrication is defined as any action that disentangles or frees from entrapment or delays in transport. Is there a time frame the registry should go by when determining a delay in transport?

There is no specific timeframe. While intent is to document if there is a delay, there does not need to be a delay to report extrication.

If a patient is given pre hospital Ketamine, would you answer the question in the clinical tab, yes to chemically sedated, I would like to ask the same question for chemically paralyzed if such medication is given such as Rocuronium? There has been discussion that these drugs do not stay in the patients system for very long.

The PTOS Manual provides examples of common paralyzing drugs under the Paralyzing Drugs data element. Rocuronium is included within these examples. Under GCS qualifiers, I recommend Rocuronium be recorded as a paralyzing drug and Ketamine be recorded under sedation. Note that each of these agents has a slightly different duration of action (as you mention), …

Continue reading “If a patient is given pre hospital Ketamine, would you answer the question in the clinical tab, yes to chemically sedated, I would like to ask the same question for chemically paralyzed if such medication is given such as Rocuronium? There has been discussion that these drugs do not stay in the patients system for very long.”

I’m looking for direction regarding a case that was seen post MVA and left AMA prior to imaging results. He was called back to the ED and transferred out for care. He initially was brought in direct from scene of MVA by EMS. His second visit, where he was transferred out to higher level of care, he was brought in by EMS from home. How do I address the EMS data?

It sounds like you have two separate encounters here. The first, I’m assuming, is nonPTOS as the patient most likely left AMA prior to meeting a portion of the inclusion criteria (i.e. LOS). The second encounter should be captured as a separate trauma record that will be PTOS. Information about the injury itself will remain …

Continue reading “I’m looking for direction regarding a case that was seen post MVA and left AMA prior to imaging results. He was called back to the ED and transferred out for care. He initially was brought in direct from scene of MVA by EMS. His second visit, where he was transferred out to higher level of care, he was brought in by EMS from home. How do I address the EMS data?”

When a patient is a transfer in from another facility and are being transferred by helicopter (ambulance drives patient and helicopter crew to LZ from referring facility) what set of vital signs do you use, the first set when the patient leaves the hospital or the fist set when the helicopter takes off from LZ?

You are to record the first assessment of each vital sign after the patient leaves the facility.

Please clarify the x-rays at referring facilities. If patient has a hip x-ray, there isn’t a specific code under the BW0 anatomical regions. Do you want us to use the BW01ZZZ for abdomen and pelvis or the BQ0 code that is specifically hip?

If the x-ray is for the hip specifically, I recommend using the BQ0 code. If it is a diagnostic x-ray that is of the entire pelvis that happened to identify a hip injury, that is when I would use the BW01ZZZ code. If you would like to send over the documentation you have, we can …

Continue reading “Please clarify the x-rays at referring facilities. If patient has a hip x-ray, there isn’t a specific code under the BW0 anatomical regions. Do you want us to use the BW01ZZZ for abdomen and pelvis or the BQ0 code that is specifically hip?”

If patient had a head CT at the non-acute care hospital but not at our facility, how do we answer “did PT receive CT during resusc”?

You may enter 1, yes. It sounds like you have documentation from the non-acute care hospital. If this is the case, you will enter 2, no, for is this a transfer patient element. But you will then enter 1, yes, for documentation available from outside facility on the Referring Facility tab.

If a patient is injured at home, goes to a non-acute care hospital by private vehicle, then is transferred into our hospital is the scene the patient’s home or the hospital?

For PTOS, the scene is the scene of injury. Therefore, it would be the patient’s home.

Please help me understand how to answer the Transport Provider question for this scenario. ALS on scene requested Life Flight. Life Flight arrives to a Landing Zone destination. ALS drives to landing zone with patient on board to meet Life Flight. Life Flight crew decides to board the ALS Ambulance and ride in that vehicle to the hospital. The helicopter was not used to transport the patient to the hospital. Please help me understand how to answer the Transport Provider question.

I recommend recording 3 – Ambulance/Helicopter Rendezvous as the Scene Provider and 1 – Ambulance as the Transport Provider. This may look a little strange so I also recommend that you utilize the Memo to include a note regarding this scenario (be sure to exclude any provider or patient identifiers from this free-text section). Life …

Continue reading “Please help me understand how to answer the Transport Provider question for this scenario. ALS on scene requested Life Flight. Life Flight arrives to a Landing Zone destination. ALS drives to landing zone with patient on board to meet Life Flight. Life Flight crew decides to board the ALS Ambulance and ride in that vehicle to the hospital. The helicopter was not used to transport the patient to the hospital. Please help me understand how to answer the Transport Provider question.”

I have a patient transferred from a hospital by ambulance to us however during transport patient had a seizure and called for a helicopter to transport the rest of the way would we record this as ambulance/helicopter rendezvous or just helicopter?

This would meet ambulance/helicopter rendezvous, as both provided part of the transport from the referring facility to you.