Last On: 2:49AM, 6 Jan 10
Joshua D. Hartman
  • Male
  • Englewood, NJ
  • United States
  • Paramedic/EMT-I/EMT-D
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Joshua D. Hartman's Discussions

First things First: Is the Patient "Sick" or "Not Sick"?
18 Replies

I have for years tried to impart a concept upon my colleagues, the concept I call ‘sick’ vs. ‘not sick.’ Recently I found the need to reintroduce the importance of this determination as well as the…Continue

Started this discussion. Last reply by Joe Paczkowski Jan 1, 2010.

 

Joshua D. Hartman's Page

Latest Activity

Joshua D. Hartman commented on Marty Turvey's group CCEMTP
"I am interested in putting together a CCEMTP class for my ALS group. Does anyone know of a group willing to take this course on the road?"
Jan 5, 2010
Joe Paczkowski replied to Joshua D. Hartman's discussion First things First: Is the Patient "Sick" or "Not Sick"?
"First off, if I cut it out, it's because I agree with it... I would argue that, ideally, a paramedic should be present on all emergency calls. In all but the most rural of rural of areas, emergency departments that utilize PAs and NPs still…"
Jan 1, 2010
Neil White replied to Joshua D. Hartman's discussion First things First: Is the Patient "Sick" or "Not Sick"?
"This is of interest to me because I am part of a group looking at a similar theme for nursing assistants at the local hospital, in recognising when a patient on the ward is deteriorating and when to alert the nurse/doctor... Our national patient…"
Jan 1, 2010
Joe Paczkowski replied to Joshua D. Hartman's discussion First things First: Is the Patient "Sick" or "Not Sick"?
"I think that there is a point where pigeon holing becomes important and it's more important the less you are able to intervene. If you're pigeon holing a patient as being "sick" with a condition that you can't readily…"
Jan 1, 2010
Neil White replied to Joshua D. Hartman's discussion First things First: Is the Patient "Sick" or "Not Sick"?
"What I guess I'm trying to establish is that a sick (critically ill/potentially critically ill) person can present without an OMG 1-2 minute general impression and it may only be 15 minutes down the line when vital signs and a basic physical…"
Jan 1, 2010
Joshua D. Hartman replied to Joshua D. Hartman's discussion First things First: Is the Patient "Sick" or "Not Sick"?
"Sick vs. not sick does not mean that the not sick patient does not deserve our attention and care. It means that we have identified this person as not one which will require additional resources and the rapid assessment and treatmen that is required…"
Jan 1, 2010
Neil White replied to Joshua D. Hartman's discussion First things First: Is the Patient "Sick" or "Not Sick"?
"Some of the issues ring true for practice here, and like Maria Von Trap the beginning is a good place to start...and education although a broken record is where we have to start. What prevents the EMT-B from going nuclear? Thats going to be a…"
Jan 1, 2010
Joe Paczkowski replied to Joshua D. Hartman's discussion First things First: Is the Patient "Sick" or "Not Sick"?
"Several things can cause a "ZOMG, patient going to ER. Lights/sirens, call paramedics, place NRB" without concern to what's actually wrong with a patient. Some things come to mind: 1. Education (yea, yea... I'm a broken…"
Dec 31, 2009
Daved van Stralen replied to Joshua D. Hartman's discussion First things First: Is the Patient "Sick" or "Not Sick"?
"Moving a patient between sick and not sick is a process. I like your point as diagnosis is a process, not an event. My concern with confirmation bias is that once we make our decision we unconsciously look for information that supports that decision…"
Dec 31, 2009
Joe Paczkowski replied to Joshua D. Hartman's discussion First things First: Is the Patient "Sick" or "Not Sick"?
"On going assessment. The thing with deciding a patient is "not sick" is that just because a patient is "not sick" based on either the current situation and information available doesn't mean that as the assessment progresses…"
Dec 31, 2009
Daved van Stralen replied to Joshua D. Hartman's discussion First things First: Is the Patient "Sick" or "Not Sick"?
"Once you have identified that the patient is "not sick" how do you identify if you are wrong? Availability is a decision making bias that the first thing we think of is the most important. Spell the word "folk" out loud. Now,…"
Dec 31, 2009
Joe Paczkowski replied to Joshua D. Hartman's discussion First things First: Is the Patient "Sick" or "Not Sick"?
"For me, real sick/not sick (not the idiotic AAOS system) involves doing an assessment including HPI and a focused physical on scene. As a basic, if at any time I categorize the patient as critical (which can occur as soon as I look at the patient)…"
Dec 31, 2009
aaron left a comment for Joshua D. Hartman
"just came bye to say hi & how are you doing today & i'm an emt-b from va & be safe out there"
Dec 31, 2009
Neil White replied to Joshua D. Hartman's discussion First things First: Is the Patient "Sick" or "Not Sick"?
"Okay, Having looked at some stuff, is this principle the same as the one advocated by AAOS comically at www.sicknotsick.com????? Because it seems, through the pages that are available at google books, that this is all about the "general…"
Dec 31, 2009
Duncan Hitchcock replied to Joshua D. Hartman's discussion First things First: Is the Patient "Sick" or "Not Sick"?
"I had a Medical Director many years ago that imparted the same philosophy of "Is the patient sick or not sick". This mind set became part of my philosophy of prehospital care. And I continue to teach this to every new EMT and Paramedic I…"
Dec 31, 2009
Bob Sullivan replied to Joshua D. Hartman's discussion First things First: Is the Patient "Sick" or "Not Sick"?
"I think there's a book out about this with pictures of pstients in various stages of sickness. When a patient looks sick from the door everything moves faster. The initial assessment questions get yes-or-no answers and you take a blood…"
Dec 30, 2009

Profile Information

Employer/Affiliation
Paramedic/EMT-I/EMT-D
Primary Agency/Department Type
Volunteer Fire/EMS Department, Volunteer Rescue Squad, Paid Fire/EMS Department, Municipal Agency, Hospital
Primary Department/Agency Name
New York Presbyterian Hospital
Years in EMS/Public Safety
15
Other Past or Current Departments
Englewood Hospital & Medical Center EMS
Hatzalah Volunteer Ambulance Corps
Holy Name Hospital EMS
Mobile Trauma Unit - USSS/DSS
Global Medical Guardians
Hilton Head Island Fire & Rescue
Day Job
Managing Editor, TCTMD - Cardiovascular Research Foundation
Personal Site/Profile
http://www.tctmd.com

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At 6:56am on December 31, 2009, aaron said…
just came bye to say hi & how are you doing today & i'm an emt-b from va & be safe out there
 
 
 
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