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Mobile technology is playing an ever more central role in the emergency services today and in some cases can enhance the performance of the emergency professional. Paramedics need to be able to rely on technology to help them seamlessly attend patient needs, access information, record Electronic Patient Report Forms, and send and receive data, transfer diagnosis and other critical details to their destination hospital in any condition, and from any location. Services like Scottish Ambulance Service (SAS) are already using rugged devices from the global designer and manufacturer of rugged mobile devices, Getac, designs devices specifically for critical field performance. Focus on Mobile Technology Mobile technology when using gloves or if it’s wet, or with gloves and styluses. For added security, the laptop also offers multi-factor authentication as well as capacitive fingerprint touch technology. It is resistant to dust and water ingress, three foot drops, plus it has features that support ambulance work, such as a hotswappable battery, giving more than enough battery to support a full day’s shift. The laptop has the footprint of a business notebook but with the features of a full-rugged device, providing a combination of design, performance and versatility. Getac has just launched its latest laptop, the S410, a semi-rugged device which includes a number of features that allow emergency crews to focus on mission-critical tasks, without worrying about reliability and performance. The S410 provides the latest technologies, processors and connectivity features for improved RF coexistence and comes complete with Windows 10 support for faster and more reliable data speeds. Getac’s LumiBond technology provides a high-visibility, sunlightreadable touchscreen that works The S410 offers the functionality and reliability that the emergency services can depend upon. Tested, reliable, dependable, empowering medical professionals can do what they are trained to: save human lives. If you would like to discuss any aspect of your rugged computing solution requirements, call: 01952 207 221 e-mail: Sales-Getac-UK@getac.com or visit: www.getac.co.uk 72 Spring 2016 | Ambulancetoday
Thijs Gras’ Letter from Amsterdam Isn’t it Time that Patients Take Responsibility as Well? Below our thoughtful and thought-provoking Dutch correspondent, Thijs Gras, explains the high level of legal responsibility for the patient assumed by Dutch ambulance nurses every time they go on-shift. He also asks whether or not now is the time we should finally also make patients legally responsible for co-operating with the ambulance nurse or paramedic so they can actually provide them with the high levels of patient-care that they rightly expect… but without harassment or interference! In our work we should always strive for the best in caring for a patient. This is pretty obvious - so obvious that it has almost become a hollow sentence. We know that in practice there is tension, especially when patients’ interests and colleagues’ interests are conflicting. For example, a delay of several seconds when one takes over the call of another ambulance in order to prevent them doing overtime. Will the patient notice this? No. Will he or she suffer damage from this? I would say ‘no’ to this too. Maybe those seconds make it possible to take a crossing more smoothly so you make up for it. More serious are the cases where the team disagrees about how to handle a case. Luckily this is not very common. We all know we should not discuss these things in front of a patient. In our Dutch system we have a nurse and a driver, so it is clear who is medically responsible and whose decision in patient care is final. Judicially, the patient has a lot of power in our country. We are obliged to inform the patient about what we are going to do and in the end the patient decides if he is treated or transported and he or she can even indicate the hospital where he or she wants to go to. Of course there are some limits, for example because that hospital lacks the facilities or is too far away. We respect people who have indicated that they do not want to be resuscitated. These always present precarious situations and in those cases our family doctor system really helps. Patients have spoken beforehand to their doctor who generally knows the situation well and can safely tell us to stop the resuscitation attempt. We also refrain from setting IV’s if a patient really opposes it even though it deprives him or her from effective analgesia. In quite a number of cases we just advise the patients and we do not transport them to the hospital. This happens in about 25- 30% of cases and this percentage is rising. The cause of this is still not clear: do people call more often? Is this due to the use of triage systems in the control room? There are a few possibilities: we were really not necessary at all (for example a young girl with abdominal pain due to her periods), we may give treatment on the scene (reviving a diabetic with glucose), we may advise people to call or visit their family doctor or we may advise them to go to the hospital with their own means of transport. In all of these cases, legally we are on thin ice because we were the last medical professionals to have seen the patient and until the next professional makes contact with the patient; this means we are responsible. But let us not only talk about the patients’ rights, but also about his duties. I think more attention is needed on this aspect of patient care. First of all the patient is obliged to let us help him or her. This is sometimes quite tricky with people under the influence of alcohol, drugs or mental disorders. Then it would certainly help if he or she is polite to us. We do not deserve swearing and cursing while we help someone. And then there is the following of our advice. Who is to blame when we instructed a non-drunken, well behaved person to go to the A&E department himself and he does not do this but suffers from damage as a result? I would say it is not the ambulance crew. Who is to blame when the control room instructed a caller to call his family doctor, but he decides to wait and gets into trouble because an inflammation that could have been tackled earlier now gets the chance to do more harm? I would say it is not the control room dispatcher, though legally (according to Dutch laws) he is. It is time to write in the law something about patient duties. These involve not only behaviour, but also listening well to ambulance personnel and doing something with the advice given. If the patient refuses this, that is his or her own decision and it is his or her responsibility. For with rights come duties, with power comes responsibility. That goes for us ambulance people, but also for patients. If the doctor says you should stop smoking and you refuse this, your next heart attack cannot be blamed on the doctor. Tell Thijs what you think about this article by emailing him at: thijsgras@upcmail.nl This edition of Ambulance Today goes out to all 25 Dutch Ambulance Regions courtesy of Procentrum PROCENTRUM - LEARN TO FEEL THE DRIVE www.procentrum.eu Spring 2016 | Ambulancetoday 73 3
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