When rescuers first reached injured skier David Morse on Sugarloaf Mountain on Thursday afternoon, he was conscious and alert. Less than two hours later, he died in the back of an ambulance.
What happened between when Morse , 41, of Nova Scotia hit a tree on the side of the Lower Timberline Trail just after 3:30 p.m. and his death just after 5 p.m. is now the subject of an internal investigation by Franklin Community Health Network, a group that includes both the ambulance service and Farmington hospital to which he was being taken.
Morse’s widow, reportedly a nurse practitioner with 10 years of experience in an intensive care unit, described the events that transpired over that 90 minutes as “a comedy of horrors.”
In Dana Morse’s account of the incident — first published Sunday by the Halifax-based newspaper The Chronicle Herald — the grieving wife said emergency medical responders were slow to treat for internal bleeding and, when she asked to hold her dying husband’s hand in the back of the ambulance, she was kicked out of the ambulance instead.
“He is dying and I know he is dying and cannot live with myself if I am not holding his hand,” Dana Morse, who had been sitting in the passenger seat, said she told the ambulance driver, according to The Chronicle Herald. “I can’t explain to my boys — they are 11 and 14 — I cannot explain to them that I wasn’t with their father when he died. … He left me on the side of the road in a snowstorm, with me then chasing the ambulance screaming my head off to stop.”
Dana Morse told the Bangor Daily News on Tuesday she believes an investigation into the handling of her husband’s case will reveal it was even worse than depicted in The Chronicle Herald story, which she said was otherwise “completely accurate.”
“I will file a formal complaint to ensure the details are available for their investigation, as the printed details in The Chronicle Herald are not even touching the surface,” she wrote to the BDN in an email, adding, “I will not provide further comments [as] my focus is my boys.”
Carrabassett Valley Police Chief Scott Nichols said Tuesday that David Morse was able to tell members of Sugarloaf’s Ski Patrol how he lost control and crashed into a tree on a trail on the western side of the mountain. Nichols said police reviewed the incident, as is routine, to make sure it was an accident and not an assault — a determination he said investigators made easily.
“The best witness was Mr. Morse himself,” Nichols said. “He was alert and speaking to Ski Patrol, even though he was obviously injured. … Every situation is different. Ski Patrol does their best to secure the people and get them down the mountain as quickly as possible. From there it’s up to professionals to take care of the patient. Skiing is an inherently dangerous sport.”
Nichols said Ski Patrol removed Morse from the mountain within 12 minutes, and Dana Morse told her hometown newspaper the resort’s on-mountain team was “excellent.” But she claimed care for her husband unraveled from there. She said medical responders at the mountain clinic and the NorthStar ambulance crew were slow to treat him for internal bleeding, preferring to wrap an injured arm over taking blood pressure, listening to his chest or starting an IV despite acknowledging the likelihood of the unseen abdominal injuries, according to The Chronicle Herald report.
Dana Morse said she began to administer CPR herself when he went into cardiac arrest just before being put in the ambulance for the nearly hour-long drive to Franklin Memorial Hospital, a drive she said neither she nor her husband made it through.
Mark Belserene, administrator for Maine’s chief medical examiner’s office, said Tuesday the official cause of Morse’s death has yet to be determined, but he said he expected the evaluation to be completed this week.
In contrast to Morse’s case, the medical care and faster transportation provided by a LifeFlight helicopter crew is being credited as life-saving by the family of a New Hampshire man who suffered severe head and internal injuries in a snowboarding accident on the same mountain Saturday. Nicholas Jones, 24, of Bedford, N.H., was airlifted to Central Maine Medical Center in Lewiston after his crash, and despite breaking nearly every bone in his face, all of his right ribs, his pelvis and tearing his liver, is now reportedly expected to make a full recovery.
A call and email placed by the Bangor Daily News to Franklin Community Health Network Chief Information Officer Ralph Johnson, in part seeking information about the differences in the two treatments, were not immediately returned.
Franklin Community Health Network spokeswoman Jill Gray responded with a reiteration of a prepared statement.
“On Monday, we first learned about the press reports related to this situation that came out over the weekend,” Gray wrote to the BDN in an email. “We have launched our own internal review of what happened in this very tragic situation. Until we complete that review, it would be premature for us to respond to the allegations reported by the press.”
Dana Morse wrote Tuesday that she called the hospital and has been called back by a hospital representative.
“My sister spoke with someone from the ambulance company on Saturday, Jan. 14th,” she added. “She asked many questions and was provided minimal response except the supervisors name. I did call and leave a message for NorthStar ambulance and I have not heard back.”
and despite breaking nearly every bone in his face, all of his right
ribs, his pelvis and tearing his liver, is now reportedly expected to make a full recovery…. Wow… talk about being eaten by a bear and crapped of a cliff!
I think you are mixing up 2 stories. This guy died as a result of the accident.
Maybe you should go back and re-read the 4th paragraph from the end….it starts like this:
In contrast to Morse’s case, the medical care and faster transportation provided by a LifeFlight helicopter crew is being credited as life-saving
by the family of a New Hampshire man who suffered severe head and
internal injuries in a snowboarding accident on the same mountain
Saturday.
Sad. I feel it is going to be a while before we really know “all the facts.” And even then – I am not sure we want to.
Best wishes to both families…
Tragic. Two young kids and no father to finish raising them. Heart goes out to the family.
Unfortunately, the hospital/ambulance service cannot releash any information without the widow’s permission. Hard to defend oneself when you can’t ex;plain how the event unfolded. I have trouble understanding her explanation of the events. Northstar is a very competent service.
competant????????they left her on the side of the road while her husband was dying???????????need that explained again?unreal!
So it is impossible to misunderstand someone with sirens blaring while the thought of the driver is “I have to get this person to the hospital for immediate treatment” while the wife decided to take a front seat first then ask during the ride if she can go to the back? How was she supposed to get there? Magic? She added wasted time by having the driver pull over to get her to the back rather then going to the back of the ambulance first.
They are Canadian I get it, we can’t tick off the tourists so I am sure the Ambulance crew will get canned or something regardless of what took place.
Wouldn’t have to stop the ambulance. There’s a walk through.
Wouldn’t have to stop the ambulance. There’s a walk through.
Not all ambulances have a “walk through.
would you rather be left on the side of the road or know that because you thought you were better than the people treating your loved one, that you deserve to sit in the back and HOLD HIS HAND instead of letting them treat him.. she was causing problems and making it hard for them to treat a man who was dying.. . try taking a look at both sides
From what was described in the article, in my professional opinion, the wife is correct. I cannot comprehend why they would be so concerned with an injured extremity and overlook something so important as blood pressure (which decreases when one is bleeding). Even more outrageous, is that they kicked her out of the ambulance after she wanted to hold his hand.
Bet ya a buck the ambulance crew will say she was disrupting their treatment of the injured person. She was probably trying to get them to check his blood pressure, a bit hysterical perhaps as any spouse would be, maybe asking for a life flight, and they didn’t want to deal with her. Of course I wasn’t there so I do not know but this sounds like a plausible excuse from a crew that will be on the defensive.
Unionized ambulance crew? I had a terrible experience with Bangor a few years ago – 1 member was an absolute scum.
I was thinking the same thing and they might get away with it if it was just any regular “joe”…but this woman is an experienced NP and unlike most people, she knows what these EMT’s should have been doing.
One word explains why an arm is treated before a head: NEGLIGENCE
One word explains why an arm is treated before a head: NEGLIGENCE
*************************************************
Mr. Morse did not suffer a head injury (he was wearing a helmet) why would they treat a non-existant injury?
It was internal bleeding
if all this took place as told by she, then these idiots in the ambulance should be dealt with in the most severe way as possible.
but, does anyone remember what happened to the actor, liam neeson’s wife in canada? same type of accident, but insufficient treeatment, by hospital, the authorities here said if it happened here, she would be alive this day. either way, this sounds very bad. a ad occurrence. inexcuseable
If in fact she is giving the facts correctly, these people need to be held accountable and punished severely for there actions or lack of! I also believe there should be an independent investigation from an outside source not by the Franklin Community Health Network. I have become less trusting of internal investigations.
That is right. It is all who you know in that neck of the woods.
Honey,Its like that in all parts of the woods…
That is a shame. I operate with integrety and believe others should also.
Competent people don’t leave a woman, whose husband is dying in the ambulance, by the side of the road. THAT is INEXCUSABLE….
And she is a nurse practitioner to boot.
Unless they are emergency doctors, EMT’s are generally better equipped to deal with life threatening emergencies. As a medical professional, she should have known that the EMT’s primarily responsibility is the patient, not the spouse. If she was in any way hindering or trying to take charge of the situation, she needed to be dealt with quickly so the medics could do their jobs. Removing her from the ambulance may have been a necessity. Why are so many so quick to blame knowing only one side of the story??
She is a nurse practioner. Probably a hell of a lot more qualified than the EMTs
And a NP with critical care experience, at that!!
Critical care and emergency department are two different things. Just sayin’
Not
RNs and NPs who work in critical care are also VERY competent in emergency management.
RN I have read three accounts of this story; The BDN, The Portland Press Herald and the Nova Scotia paper (which is linked by the BDN) and while each story defers in some manner or form, the overriding consistency is her statement that she wanted to hold her dying husbands hand. So, did she want to provide care to her husband or did she want to hold his hand?
And as a RN you know the Stages of Grief with the second stage being “Anger”. You also know that a cardiac arrest from a traumatic injury has a survival rate approaching zero.
I feel for the wife, I really do. But I also feel for the crew. They cannot give their side of the story and the hospital cannot give their side of the story either.
Many things things for the street level provider changed when Maine EMS updated the statewide Protocols this past year. I have an idea what happened but I am going to keep those thoughts to myself as I have no way of confirming if I am correct of not.
I personally know this nurse in a professional setting and can tell everyone she is very competent and level headed to a point beyond that of some MD’s I have known, and much more skilled than any EMT’s I have met. And I do mean any, and have seen more than my share of their gross incompetence. Nurse Dana and her family are physically active and fit and I am sure she could confidently practice her calling in the field equally as well as in her clinic.
I have no doubt that she is professional, competent and skilled.
I’m sure your right but when a spouse is dying the best person to practice on them may not be their partner. Deny it if you chose but EMOTIONS run a little high if your watching your loved one die.
We weren’t there. We have no idea what happened.
In this case, I suspect that the best person to practice may well have been the spouse. EMTs who behaved as they did have NO business caring for humans (I know vet techs who would have dealt with this more intelligently).
Do you always pass judgement based on a one sided story HistoryGirl?
Isn’t Critical care where people with no insurance go when they have a cold? Not saying she has no experience in crisis but that is not the same thing.
Um, no…critical care = intensive care.
I have to disagree with the more qualified part as emergency medicine in the field is way different then medicine in a controlled environment like a hospital.
Mooselake,
It sounds like you are an EMT on a power trip. EMT-B’s are very low level medical personnel.. Even an paramedic has limited abilities. I’d rather have an NP working on me
I won’t speculate on the details, but it is very clear that she should never have been abandoned on the roadside.
Making a judgment based on one side of the story is, at best, foolish.
Based on what I have read of your posts, foolishness is something you know quite well
I think the BDN would prefer you attack the post rather than the poster HistoryGirl
if you are in a car accident or fall off a ladder, you would call an NP? ICU care is a controlled environment with many available hands. they do not deal with trauma until it has been packaged by the ER. call an NP and they will tell you to call 911. and do let us know how it works for you.
Or, if they’d rather not have EMTs work on them…next time there is an emergency, have the family throw them in the car and drive them to the ER instead. Saves diesel…which in turn saves the environment. And it frees up a truck that can go and save another life.
Leave her beside the road for God’s sake. How barbaric!!!
They were wrapping his arm…not monitoring his blood pressure or attending to his cardiac arrest
probably because the husband is dead .. a DUH comment on your part
if that is case, then why didn’t they let someone know rather than leave her there. Call the sheriff and tell him to go and pick her up, call SOMEONE, ANYONE to tell them where she is….
SHE is a NP with ICU background! She knows almost as much as an ED MD and certainly MUCH more than the EMTs. And the EMTs in this instance didn’t show responsible behavior to the PATIENT either. You better pray that you don’t have trauma and need the EMTs who were at this scene…..
She does not know as much an an MD or EMT. ICU is a completely different setting and as an NP she does not function near the level of an MD. So be careful what you wish for!
Maine Attorney General’s office should be investigating…,,,,,
The investigative authority rests with Maine EMS (which is part of the Department of Public Safety) and has a representative from the AGs office on the Investigations Committee. They meet on the 1st Wednesday in January, March, May, July, September & November at 9:30 a.m. at the Maine EMS offices, 45 Commerce Drive, Augusta, Maine.
You don’t leave someone with an advanced medical degree on the side of the road when you have a dying patient in the ambulance. The wife is a Nurse Practitioner. That means that she earned a graduate degree and passed a special exam that allows her to actually practice medicine and have her own patients. Nevermind the fact that she was his wife and the immorality of leaving her along the road in a storm.
Being that she is Canadian, does she have any authority or proof that she is able to treat patients in the US? Does she have any right to treat somebody already in the care of a liscensed EMT, whom are under the employment of Medical Hospital. Suppose the EMT’s followed her instructions and he still died, can you imagine the lawsuit that could be filed? Not saying one way or the other in regards to the outcome, but some food for thought.
“Being that she is Canadian, does she have any authority or proof that she is able to treat patients in the US?”
Short answer, No
~~~~~
“Does she have any right to treat somebody already in the care of a liscensed EMT, whom are under the employment of Medical Hospital. Suppose the EMT’s followed her instructions and he still died, can you imagine the lawsuit that could be filed?”
Maine EMS Protocols are very clear on this matter. If you are interested here is a link to Maine EMS protocols http://www.maine.gov/dps/ems/documents/2011MaineEMSProtocols.pdf and scroll all the way to the end, Page Black 1
~~~~~
“Not saying one way or the other in regards to the outcome, but some food for thought.”
I am a fatalist in this matter. When it is your time, it is your time.
Thanks, appreciate the info.
Likewise. Thanks. It spells it out pretty clearly the role of a passerby or family member.
What an attitude. Do you know when your time is? When his time should have been?
“What an attitude”?
Gopher I have seen people without a mark on their body after rapping their car around a telephone pole die during transport.
I have seen people so badly mangled that they should have died on impact or at the scene survive to the ER and beyond.
“Do you know when your time is?” No, but when it is it is.
” When his time should have been? ” It seems that it was last week.
You are wrong. Canadian nurses work in US hospitals on a regular basis. The only rub is the paperwork for legal employment, NOT the qualifications. She was not applying for a job
Chris how am I “wrong”?
Your comment that she had no qualifications to treat a patient in the US
My response was to UVSHTSTRM question: “Being that she is Canadian, does she have any authority or proof that she is able to treat patients in the US?”
My response to that question was: “Short answer, No”
I never said that she didn’t have the “qualifications to treat a patient”.
with regard to protocol ( from your link)
The patient’s own physician, physician assistant, or nurse practitioner may direct care
as long as they remain with the patient (in their absence, direction of care is subject
only to these protocols and OLMC). You may assist this person within the scope of your
practice and these protocols. Only a physician or independent nurse practitioner may
give orders outside of the MEMS protocols If you are the patient’s own physician, PA, or nurse practitioner, the EMTs will work with
you to the extent that their protocols and scope of practice allow.
If you are not the patient’s own physician, PA, or nurse practitioner, you must be a Maine
licensed physician who will assume patient management and accept responsibility. These
EMT’s will assist you to the extent that their protocols and scope of practice allow. They will
not assist you in specific deviations from their protocols without Medical Control approval.
This requires that you accompany the patient to the hospital and that their Medical Control
physician is contacted and concurs.licensed physician who will assume patient management and accept responsibility. These
EMT’s will assist you to the extent that their protocols and scope of practice allow. They will
not assist you in specific deviations from their protocols without Medical Control approval.
This requires that you accompany the patient to the hospital and that their Medical Control
physician is contacted and concurs.
They had no business ejecting her from the ambulance
I can think of several reason that one would “eject” someone from an ambulance.
And that changes anything I have written how?
Being that she is Canadian, does she have any authority or proof that she is able to treat patients in the US? Does she have any right to treat somebody already in the care of a liscensed EMT, whom are under the employment of Medical Hospital? Suppose the EMT’s followed her instructions and he still died, can you imagine the lawsuit that could be filed? Not saying one way or the other in regards to the outcome, but some food for thought.
First…it’s a life or death situation.
Second…it’s her husband.
If this happened to an American in Canada you’d be singing a much different tune, I’m sure.
What are you implying
In regards to leaving her on the side of the road (if true, which at this point I have no reason to believe otherwise) my tune would be the same, as in I think it was horrible. As to not being allowed to dispense medical advise, treatment, etc, I would not hold any ill will towards Canadian standards, laws, etc.
It has already happened in Quebec 3-4 years ago, only it was an actor in Canada. The Canadian hospital sent the lady home and she died from head from injury from the tree she hit. I never read anything like what is being portrayed in this story.
She has the right and the credentials
Read the protocol posted. Being Canadian does not change her skills
Being that she is Canadian, does she have any authority or proof that she is able to treat patients in the US? Does she have any right to treat somebody already in the care of a liscensed EMT, whom are under the employment of Medical Hospital? Suppose the EMT’s followed her instructions and he still died, can you imagine the lawsuit that could be filed? Not saying one way or the other in regards to the outcome, but some food for thought.
He died and then they turned around and did not go to the hospital as scheduled. I find that very odd.
Many nurses come and go accross the boarder – yes she could work in the US as the Canadian system of training is far more developed.
And they are licensed in both areas so they can do that.
I personally know Mrs. Morse – for your information she worked in US hospitals as a registered nurse for quite a while before she got married. Besides being a RN, she has several medicine-related degrees including a masters, and is a licenced Nurse Practitioner, NOT a practical nurse as suggested by some. Any reference to her being a practical nurse in the press is a total error. She is a fully qualified, highly respected medical professional with many years experience (including emergency and trauma) who has suffered a great loss, and deserves a lot more respect than many of you are giving her. If she was concerned about the quality of care her husband was receiving then it should be a wake-up call to a lot of people that there was a problem that should be addressed before someone else has to go through what she did.
Uvshtstrm. Your are so wrong and are fringing on incompentense and common sense.
Please explain smart guy! Considering 2/3rds of my post were questions and the other an observation in regards to a possible answer of said questions, how am I incompentent? What part was I wrong about? Are asking questions wrong? Please explain genius.
Well in Maine “unsolicited” medical intervention is covered in the Maine EMS Protocols. The crew must want it and the Medical Control Physician at the receiving hospital must approve it. The person offering to help must accompany the patient all the way to the hospital.
Now (setting aside that his wife was the one with the “advanced medical degree”) I wonder when the last time this person started an IV, intubated a patient, applied 12-lead EKG leads, performed a chest decompression, opened an airway with a surgical cricothyrotomy, etc…
I am not passing judgement on the care delivered (or not delivered) as I wasn’t there. But I do know that on the side of the road (or ski slope) I would rather have an EMT and Paramedic treating me than a “doctor” of any number of sub-specialties or a PA or a NP or a Nurse.
Maine’s EMS providers provide care and transport tens of thousands of patients a year without incident. I am not saying that something did not occur (and the fact the wife was left on the side of the road is VERY disturbing) during the transport. But I would prefer to wait and pass judgement after the investigation is completed.
Your third paragraph makes much sense. There is a big difference between working inside a nice warm hospital and being out in the field. I guess we will have to wait and see when all of the facts are in.
condolences to the family of Mr. Morse.
In this incident, airlifting him to a hospital would have made much better sense. Yes, he was coherent and alert, but obviously if the blood pressure was dropping, he was in big trouble. If the autopsy proves internal injuries leading to a loss of blood, this crew made the wrong call. Wrapping an arm while there is major internal trauma is not proper protocol. They should have listened to his wife.
gambler do you remember the what the weather was last Thursday? It was snowing and the way LifeFlight works is the pilot makes the decision to launch/don’t launch based solely on the weather. The pilot is not given any information on the patient.
Lifeflight does not fly those who are in cardiac arrest prior to their arrival.
I forgot about that absolute rule.
Your posts seem to be quite defensive regarding this man and his wife. From the article, too much time was wasted on the non-threatening injuries. Some of the time those in an ambulance have too little experience with the life threatening injuries or do not realize the importance of checking vitals in order to ascertain whether something more serious is going on. The drop in blood pressure is a clear signal to stop worrying about visible contusions and get cracking on saving a life that is ebbing. Sometimes those who have a little power want to take charge instead of listening due to their ability to be the BOSS—in this case, the EMT’s or whoever it was made a big mistake. If he were my family and I knew they were doing something wrong in terms of protocol for that kind of trauma, I would have regained control and taken over the care. Note that the next day, a young life was saved with proper procedure. Perhaps the weather was better, but near ski slopes, local ambulance crews need to have better access to radio frequency to get in touch with a trauma physician (ER doc).
“Your posts seem to be quite defensive regarding this man and his wife.”
Sorry you feel that way. I am stating facts based on 25+ years of field experience.
~~~~~
“From the article, too much time was wasted on the non-threatening
injuries. Some of the time those in an ambulance have too little
experience with the life threatening injuries or do not realize the
importance of checking vitals in order to ascertain whether something
more serious is going on.”
The article gives no time lines at all. In emergency situations seconds and minutes can and do seem like minutes and hours.
~~~~~
“The drop in blood pressure is a clear signal
to stop worrying about visible contusions and get cracking on saving a
life that is ebbing.”
A drop in BP is a very late sign of decompensated shock. It is one of the last things the body will do after shutting down circulation to the legs, arms, non-vital organs in an effort to keep the heart pumping blood and oxygen to the brain.
~~~~~
“Sometimes those who have a little power want to
take charge instead of listening due to their ability to be the
BOSS—in this case, the EMT’s or whoever it was made a big mistake.
If
he were my family and I knew they were doing something wrong in terms of
protocol for that kind of trauma, I would have regained control and
taken over the care.”
That is you opinion and you are entitled to it. I hope you never have to do that and the reason the medical community frowns on treating family members is if the outcome is poor or worse, who do you blame? Yourself.
~~~~~
“Note that the next day, a young life was saved with
proper procedure. Perhaps the weather was better, but near ski slopes,
local ambulance crews need to have better access to radio frequency to
get in touch with a trauma physician (ER doc).”
The difference between the two is the weather. Helicopters don’t fly to well in extreme weather.
After reading your post, I am hopeful that I never need you to take care of me….
Funny, that is not what my last patient told me.
One of the first things even a B-Emt does when a patient is packed and loaded into the rig is to apply oxygen then get a blood pressure and pulse reading. These 3 things are done from day one of employment with an ambulance service. If they dont do it, they shouldnt be in this line of work.
She was the one that gave him CPR before they got on the ambulance. She had began providing care for him. They did not properly prioritize treatment and did not treat for his internal injuries. She KNEW he was dying and wanted to be with him for his last bit of time. Not only were these EMTs NEGLIGENT in their care, they showed callousness and depraved indifference. Because this woman has a medical background and did begin treatment by performing CPR the spanky stick needs to come down HARD on these EMTs. Not only should they lose their jobs I personally think they should lose any licenses/certification and should do some jail time. That is just how wrong what they did is.
He had massive chest injuries, and she gave him CPR. Really?
This is going to be interesting, because of the wide differences in the various accounts.
More press accounts describe the wife as a Practical Nurse than a nurse practitioner.
If she was in the front seat and demanded that they allow her into the back of the ambulance as reported in most accounts, did she really think it was wise to have them stop the ambulance, let her out, let her back into the back, and then get back on their way? Insane.
While she was worried about being there while he died, the EMTs were no doubt worried about keeping him alive.
There is indeed a lot of crazy information being flung around, and I’m sure that watching her husband died had the woman upset. I think waiting for the investigation is probably a good idea.
His heart stopped beating before the ambulance arrived. What was she supposed to do other than resuscitate him?
And why didn’t the Sugarloaf National Ski Patrol begin CPR then? She has praised there care but they missed that?
It’s the first priority during any emergency medical assessment. The ABC’s. Airway-ensuring no obstructions. Breathing-is the patient breathing and if not why. Cardiac-check for pulse. If even one of the 3 above presented are not addressed, any other injuries involved are irrelevent.
You don’t know the current CPR- it is CAB NOT ABC. Nurse practitioners know this- AND when the heart stops, if there is internal bleeding and too low a circulation blood volume, no amount of CPR will work- he needed volume replacement
Regardless of how massive his chest injuries are, when his heart stops you HAVE to do CPR.
True. And, occasionally CPR breaks a rib or two depending on the pressure applied. The problem with some who perform CPR is not enough strength. I always green lighted resusi–Annie. History Girl is correct without blood—the CPR will not be work, yet, without a pulse—what choice would one have if they did not know for sure of the amount of internal bleeding.
So does that mean because she initiated the CPR she should be the one who rides in the back of the ambulance and provide the rest of the medical care just because she started the CPR? Medical degree aside…do you know how many by-standards start CPR? Should they go in the back of the ambulance and be the one who treats a patient just because they were the ones who started it. I think not. Yes, I understand that this was his wife but again in high stress situations involving a significant other judgments are clouded and reactions are not normal as if she was dealing with her everyday patients at her job. EMT’s go to school just like a Nurse Practitioner and they have to earn certifications just like a Nurse Practitioner and yes take a national standard test to get their license just like a Nurse Practitioner. There are also rules and regulations that EMT’s have to follow regarding passengers that are NOT the patient within the ambulance; granted and if the statements are true; leaving a person on the side of the road was not the correct answer.
I don’t want to split hairs, but please: EMTs do not go to school “just like a nurse practitioner.” EMTs, who are vitally important to our system, have basic education; one can become a paramedic in two years. A nurse practitioner goes to school for at least five to six years, and the profession is expected to mandate a four-year doctorate starting in 2015. Had it been a while since Mrs. Morse had started an IV? I have no idea. But I don’t think it takes recent job knowledge to know that you start one and that you always take a patient’s vital signs. Next question: Why doesn’t an enquiring reporter call the nurse at Sugarloaf and ask what he/she saw?
A jen if you are an RN you already know the answer to “Why doesn’t an enquiring reporter call the nurse at Sugarloaf and ask what he/she saw? “
Because there isn’t a nurse at Sugarloaf?
Try looking at HIPAA.
HIPAA applies to members of the health care team. If press accounts are correct, the patient was taken off the mountain by ski patrol and immediately turned over to the care of NorthStar. I don’t know who employs the nurse at the Sugarloaf clinic. Does anyone?
Well, as a preliminary matter, the patient is dead. HIPAA survives the death of a patient. A nurse at Sugarloaf would most likely be a covered entity.
I became an EMT basic in a semester. I became a registered nurse in 4 years. Thank you for pointing that difference out, jenrn47. Not to devalue the EMT basic, like you said, but there is a heck of a lot of difference between a certificate program and a Master’s degree. Holy cow–to compare the two is like comparing a paralegal to a judge. And jen, you know starting IVs is pretty much like riding a bike. You may be a little rusty, but it all comes back to you.
Actually a person can become a paramedic in just one year……
Not in most states concerned with quality
You can in Maine.
Like I said- not in most states concerned with quality-this event happened in Maine, right?
Thats pretty clear in the article, isn’t it?
Well why don’t you call Atlantic Partners EMS in Bangor and ask the admission process for Intermediate and Paramedic students.
But I will save you the call, Reading Comprehension, Essay, Medical Knowledge Exam, three recommendations. All are assigned a number grade. It goes to a Committee that is “blind” to the service and student name and they decide who gets in and who doesn’t based on the exams and recommendations. Of the last Intermediate class 13 applied and 11 got in. They will likely graduate 9-10 of the 11 and end test out first time 7-8 and the rest will re-test.
It’s important to note that a nurse has to be trained in a wide swath of situations, from the routine to emergencies that they may encounter in their hospital/nursing home/etc. setting. In contrast EMTs are trained to respond to extricate, stabilize, and transport. There job isn’t to heal you, it’s to try to keep you from dying while they get you to the healers. EMTs are specialists who perform these specific duties more times in a week than a doctor or nurse will in a year. If I have to go in for surgery or be cared for after yes I want a doctor or nurse, but if i’m pinned inside my car and bleeding I will pray that the first responder is an EMT every single time.
“She was the one that gave him CPR before they got on the ambulance.”
Doesn’t it seem odd to you that no one but her “gave him CPR”” Not the National Ski Patrol that she has praised for their care or Northstar Ambulance that she has condemned for their care. Why?
~~~~~
“She had began providing care for him.”
Again, why was that necessary if he was receiving such good care from the National Ski Patrol?
~~~~~
“They did not properly prioritize treatment and did not treat for his internal injuries.”
Well I wasn’t there and I know you weren’t there so I have no clue how you can make that affirmative statement.
~~~~~
“She KNEW he was dying and wanted to be with him for his last bit of time.”
And when was the last time an ER allowed a family member to hold the dying persons hand in an ER treatment room while they are working on trying to save their life?
~~~~~
“Not only were these EMTs NEGLIGENT in their care, they showed callousness and in difference.”
Well I will repeat, you and I went there so I have no idea if they were negligent in the care provided or not or if deviated from Maine EMS Protocols. Were they callous to leave her on the side of the road? On the surface yes and I can say I have never done that.
~~~~~
“Because this woman has a medical background and did begin treatment by performing CPR the spanky stick needs to come down HARD on these EMTs. Not only should they lose their jobs I personally think they should lose any licenses/certification and should do some jail time. That is just how wrong what they did is.”
Well once the investigation is complete and the facts are in why don’t we wait before we get our the “spanky stick”.
JD, based on my reading of OW’s comments, I think you are being conned and played. I for one don’t believe OW really believes the blather she is posting and is just being argumentative. BTW, thank you for your informative and factual posts.
The National Ski Patrol got him off the mountain. From there the medical responders at the clinic took over. So the National Ski Patrol did do a good job getting him down in 12 minutes.
Who staffs the clinic at Sugarloaf?
Im guessing you were there and see that first hand right?
Wait a minute. She knew he was dying. And he died. And the EMTs are responsible for not stopping what was inevitable. The EMTs are NOT accountable for NOT un-ringing the bell?
Maybe he didn’t die from injury of hitting the tree but from the injuries caused by a spouse in panic preforming CPR when a defibrillator was needed. I am not suggesting it.
I have seen many patient wheeled into the ICU, CSU and CCU but I have never seen one pulled in on a sled behind a snowmobile. Many of her patients are there because an EMT was the first to give that patient treatment while she was reading detailed charts with $100,000 in monitors watching every vital sign.
No one has enough information to draw any conclusions even to the issue of leaving her “on the side of the road.”
I see in the article it states that she started CPR. Why did she stop the CPR and get into the front of the ambulance? Why didnt she just get in the back of the ambulance if she was going to help or wanted to be with him?
I will agree that EMT’s are in a whole class of their own when it comes to treating people in the field and I would much rather have one of them with me in an ambulance than a doc or nurse any day. I have to wonder why they would leave this woman on the side of the road . This part makes no sense to me at all. I am very interested in hearing the rest of this investigation.
The article said she has 10 years experience in ICU…..
Yes it does. 10 years in a controlled, well lite, warm, non-moving environment. She is also used to working as part of a team where she knows each member of the team. She is also used to working on people after they have been treated in the field and in the ER. Finally and most importantly she is used to working on people other than her husband.
Controlled, as in you have available equipment and staff, doesn’t mean predictable. Patients in ICUs are sick, sick people. They can so south in no time. She had to have dealt with sudden emergencies quite often, so I would assume she was very capable.
I agree, but when was the last time she worked on her husband under those conditions? I know that I personally cannot work on family members because my emotions begin to cloud my judgement.
Skills generally used in a “controlled”environment do not dissappear just because the environment is less controlled. Even in a hospital CCU a situation can go “out of control” in a hurry and professionals CAN deal with that.
Chris never said they did “disappear”.
I have had an RN “assist” me on the side of a road with an MVC. She was unable to get (hear) a blood pressure. I was. I also was able to get one by palpation, which she either didn’t know, or had forgotten.
Needless to say, her admiration for what we have to deal with went way up.
Wow, a basic emt with an ego problem. Wake Up EMTs, you can’t even begin to compare to an emergency nurse, nurse pract. etc. My god emts, learn to accept help and appreciate it. I was a basic emt for over 20 years with hundreds of emergency responses. It is a rule as a basic emt to certainly accept a person with a higher level of training and education. No, an Id is not required at an emergency to PROVE your education. AnyEMT should be able to quickly recognize if someone is telling the truth by their performance and actions.
To me it is irresponsible to not accept assistance from a person of a higher level of education.
And yes, it is protocol to not allow family members to ride along in the ambulance. However, this case is a common sense exception. Wake Up.
An emt cannot do IV management. Therefore they can and should accept assistance from a higher level if available.
An EMT is again, a very basic level. For some reason a badge, and patch on them makes some of them swell up a bit and over step their limits.
Sorry to have to say all this but it is what it is.
” My god emts, learn to accept help and appreciate it.”
Unfortunately Maine EMS Protocols do not allow us to accept based on a wink and a nod. First the EMT must be willing to accept it, the Medical Control Physician must approve it and the person offering the assistance must be will to travel to the hospital. That is part is the jest of the Protocol.
And everybody starts some where happyguy123 EMTs, RNs, etc…
Slearly JD, you just don’t get it…..
HistoryGirl so what “don’t” I get?
Is it the fact that we have only one side of the story?
Or maybe it’s the fact that Maine EMS has specific protocols to follow?
Or maybe it’s because I have suggested that we not hang the ambulance crew before we know all the facts?
Or is is because I have strong opinions about the unsolicited assistance from other healthcare providers?
Let me tell you a story about one of my last field interactions with an RN in the field. We both arrived at the patients side at the same time for a reported altered level of consciousness. She made it very clear that she was the “nurse” and that she was “in charge”. I very politely explained to her my level of training and she again made it very clear that she was “in charge”. She then began to look around for equipment and discovered that we weren’t in her “world” but in my “world”. She very quickly decided that she didn’t want anything to do with the patient and backed off. Oh, and the patient that she demanded to care, what happened to her you might ask Well a blood glucose of 35 was the cause of her altered level of consciousness and after the administration of some D50 the patient “woke up” and looked at me and said “why are you here?” Several days later I happened to run into her and she apologized to me for her manner and that she “learned just what EMTs can do”
Do I expect you to change your mind about your comment “the LEAST educated people are EMT first responders on ambulances” and that it is “pretty frightening and backwards if you ask me”? No I don’t but maybe you will have a better understanding of why many of us have the feelings we do about unsolicited medical advice.
A finger stick and some OJ or candy would have accomplished the same and you are trying to tell me an RN could not figure that out without some fancy equipment. That is a joke. These fellows or gals lost the patient while jerking around with non-life threatening problems. Why can’t you see that they were not following proper protocol. What is it that most skiiers or boarders die from after going off the trail and hitting trees or rocks? You are trying to excuse mistakes.
In emergency situations, many medical professionals have worked on and saved their own family members. To tell me that she would have been of no use is nonsense. I do hope for your sake that you don’t work on a family member because you seem to think you would be useless.
gambler16 I do hope you don’t pass judgement without both sides of a story.
“A finger stick and some OJ or candy would have accomplished the same and
you are trying to tell me an RN could not figure that out without some
fancy equipment.”
Well when you don’t have the equipment at hand to do the job it’s pretty hard to determine what is going on. Altered level of consciousness can be a TIA, stroke, sepsis, low blood sugar, brain bleed, etc… My point was she was determined to take charge until she didn’t have have the equipment to do the job or someone to get the equipment.
~~~~
“That is a joke.”
Yes it is. When you accept responsibility to treat a person you should have the tools to do the job.
~~~~~
“These fellows or gals lost the patient
while jerking around with non-life threatening problems.”
You have no idea what happened. You or I weren’t there and to speculate based on a one sided story serves no purpose.
~~~~~
“Why can’t you
see that they were not following proper protocol.”
You and I don’t know if they varies from protocols or not.
~~~~~
“What is it that most
skiiers or boarders die from after going off the trail and hitting trees
or rocks? You are trying to excuse mistakes.”
I have offered no excuses for them. I have suggested that we wait for the facts to be determined. I have suggested that they followed Maine EMS Protocol regarding the use of MDs, etc…in the field.
~~~~~
“In emergency
situations, many medical professionals have worked on and saved their
own family members. To tell me that she would have been of no use is
nonsense. I do hope for your sake that you don’t work on a family member
because you seem to think you would be useless.”
I know two EMS professionals personally that worked on their spouses in traumatic injuries cases and in both cases the spouse did not survive. In both cases the surviving spouse had a large amount of guilt that they “didn’t do enough” and it was “their fault their” spouses died.
Thank you for providing us with your thoughtful and informed insight as it relates to this issue. My first inclination as I am sure is true for most of us is to have a “knee jerk” response as we are not familiar with all the intricacies that are involved. I do however, feel bad that his wife was not able to be at his side and he died alone without family around. I can understand her anger and hurt. All in all, a very tragic ending to this young man’s life.
As a nurse (with EMS background), I find your comments extremely insulting. For starters, starting an IV, applying chest leads, and doing CPR are elements of the utmost basic parts of any licensed healthcare provider’s job. Intubations and crics require specialized training and are NOT within the scope of practice of a basic EMT. Though I hope one was there, it did not make mention of whether or not a higher level responder was present. Also, a subspecialty of doctors are critical care medicine and EMS physicians. You wouldn’t want one of these folks taking care of you over a field EMT? And there are numerous studies that show that NPs give as good of, if not better, care as physicians. There are many competent and capable NPs and PAs in emergency settings. If an overzealous EMT wanted to steal the thunder and banished a seasoned critical care provider with a Master’s Degree (6+ years of schooling) in Nursing, then I hope they are punished to the fullest extent of the law. I highly doubt that the Medical Control doc would have denied a family member with those credentials access to their loved one in such a time. I hope they truly dig deep into this case and find out what really happened.
RN thank you for your input. I my self have over 25 years of field experience and have had “interactions” with RNs and other providers in the field. Some are willing to work WITH the crew and others want to TAKE OVER for the crew because they “know best”. But I would refer you to Maine EMS Protocol 2011 edition page Black 1 to see HOW Doctors, PAs, NPs, RNs may help in the field.
Now I will ask you this, how is a EMS provider in the field supposed to determine what sub-speciality the provider is? Last time I checked, they didn’t carry around ID cards to show what they can or cannot do.
I am not taking away anything from my brothers and sisters that provide health care. But I maintain that what we do in the street and what occurs in a hospital setting are different with different stressors and expectations. At EMMC when a critical care patient rolls through the door how many nurses, doctors and allied healthcare professionals take over for the one or two EMTs and/or Paramedics providing care in the back of the ambulance? I have seen as many as 8-10. So give us some credit for what we do. We often do more in the way of patient care with far fewer providers and normally deliver viable patients to the ER.
What happened in this case? Well I don’t know and that is why I wait for all the facts to come out. The one ever riding question I have was why was the wife left on the side of the road? That is something that I have never done and cannot fathom ever doing unless (and I am not saying they was the case) the passenger was making threats or becoming so disruptive that the passenger was interfering with the safe operation of the ambulance.
jd, you certainly are full of yourself. that’s a fact.
Not in the least MaineNana…I provide my experience to demonstrate that I have some “knowledge” to speak to the topic. Nothing more and nothing less.
jd- you are one of those who think that “25 years of field experience” makes you know what you are doing and that you know best- after reading your posts, it is apparent to me that you have a LOT to learn- and you are full of yourself. Maine Nana is right. You could use a dose of humble pie….and some further education.
My “posts” have been the truth. You may not like or cannot handle the truth but they are the truth never the less.
And as far as “humble pie”…I have some on a daily basis but thank you for offering an additional helping.
I find his info and first hand knowledge rather insightful.
I wonder how the story would read if she wanted to care for her husband, the EMT lets her he still died. Then the headline would read something like EMT abandons patient makes wife provide care until death. That would have everyone up in arms, not to mention lawsuit.
The difference between an EMT and a Nurse or Doctor is that the EMT is performing these procedures over and over and over. I can either have the Doctor with more schooling who hasn’t done a procedure in the last year or I can have an EMT with less schooling do a procedure they have done 3 times in the last month. Quantity of education alone doesn’t make for a good emergency responder, staying current and practicing your skills goes a lot further.
She is a critical care NP. Like all of acute care NPs, she must maintain ACTIVE competence starting an IV and central lines, intubating a patients, applying 12-lead EKG leads AND reading the 12 lead results, performing ALL aspects of CPR including
chest decompression, opening an airway with a surgical cricothyrotomy, maintaining fluid volumes to perfuse brain, heart, and kidneys (JOB ONE) , ordering emergency drugs, and much much more. She is undoubtedly certified in ACLS. And for any of you that think a hospital is more of a controlled environment than an ambulance, then think about the fact that the LEAST educated people are EMT first responders on ambulances….pretty frightening and backwards if you ask me.
HistoryGirl I do not dispute her training.
Maine EMS is clear about the use of MDs, DOs, PAs, NPs, RNs, etc…in the field; they have to be requested, the Medical Control Physician has to agree and the person offering the assistance has to agree to accompany the patient all the way to the hospital. That is the Protocol and if the EMTs (Basic, Intermediate or Medic) do not follow the Protocol then the have a problem with Maine EMS.
The other issue very few have brought up is the appropriateness of working on your spouse in a critical situation. I know at least to people who made that decision, both did and both times the spouses died. And in both case it messed up the head of the surviving spouses head for months to come.
And as far those “LEAST educated people” being the first responders…they have been saving and delivering viable patients to the ERs (and Paramedics) for the past 40+ years.
I do not discount the value of education, as I spent many years in the halls of academia, however I saw some uneducated guys many of which were most likely high school dropouts perform some really complicated medical procedures on the battlefield.
How very true.
In Canada
Actually she is reported as being a Practical Nurse. Not a Nurse Practitioner.
She is an active Nurse Practitioner in Nova Scotia.
how about she was more concerned about holding his hand because he was “dying” than letting them treat him. There are two sides to every story and my cousin leads NorthStar Ambulance. He has saved lives and even brought lives into this world in an ambulance. I fully trust that we aren’t getting the whole story, just a story from a woman who wants to blame someone else for her pain.
Good. They meet tomorrow. This had better be at the top of the docket.
Gopher first off they have to have a complaint to act on. So far all anyone has are allegations in a Canadian news paper and she is not taking calls according to her sister. (I don’t remember if that was in the Canadian news report of the Portland Press Herald article).
They can not be trusted either.
Holy…..talk about lack of compassion for this poor woman. Prayers to her.
If you want NP & Doctors in the Ambulance maybe you should ask for a tax increase. The only disrespect and lack of compassion I see is toward the EMT’s.
You might feel the same way if u were ushered out the door of the hospital as your loved one were dying or coding in the hospital and there was a blizzard u had to wait thru to see if they had survived. Seems kind of barbaric, doesn’t it?
Compassion without Insurance?
The medics may not have realized how fast the situation would deteriorate and then when it did probably didn’t want the pressure of having a significant other in the ambulance when they were having to do CPR and other life saving treatment. I can identify with them and it would be a hard decsion to make, especially if they realized how fast he was going downhill. It would have been good if they had given her a moment to say goodby, but as a medic, I wouldn’t have really wanted the pressure of a wife in the back with a high pressure case. A situation like this would not only involve CPR but finding veins for IV’s , and a high pressure patient usually rides alone. You need room in the back to work, and they were doing seveal different jobs. Hopefully they had two medics in the back or more.
Another note: lifeflights are weather dependant and not always available at the moment of the call. There are flying decsions to be made, or the unit may be involved in another call. We need the ambulance company to do a fair review before judgements are made and passed. Not only was the skier’s life at stake, but the medics livelihoods. The people to judge are the ambulance company and medical review boards.
Unbelievable! Whoever was in that ambulance needs to be fired. Not only were they out of line for leaving her on side of the road…but she would have more medical training and knowledge than the ambulance crew. This is disgusting…
First off, like many stories we don’t have all the information we need to make an informed educated decision on what happened.
Now, the patients wife does have more education and training then many folks in EMS. But, and this is a BIG HUGE BUT (setting aside the appropriateness of working on your spouse) her experience is in a nice, controlled setting. Not in the back of an Ambulance.
The other issue is “unsolicited” medical intervention. That means here in Maine a medically trained bystander that holds themselves out to be a doctor, nurse, Paramedic, etc…must be requested by the treating crew and with the agreement of the Medical Control doctor at the receiving hospital.
She’s got 10 years experience as an NP in an ICU. She would be one of the people the ambulance would have been rushing her husband to in hopes of saving his life…and they leave her on the side of the road.
Having worked in ERs for quite some time, I can tell you that there is a GIGANTIC difference between the ICU and working emergencies. ICUs are also relatively controlled.
And there is a HUGE difference between tending to a stranger and tending to a loved one who you just watched endure massive trauma.
She will win a lawsuit.
She would have to prove that the care delivered was not what another similarly experienced EMT/Paramedic with a similar patient in similar circumstances would have delivered AND that the treatment delivered substantially deviated from established Maine EMS Protocol AND that her actions did not contribute to any deviation (i.e. demanding that they stop the transport so she could hold his hand).
You act like the Medics had verifiable proof that she was an NP? While I agree that these EMT’s and hospital may be in a world of hurt, I don’t see how you can expect the EMT’s to take the word of any old person claiming to be a medical practioner.
sick comment
How so? Again please give some details.
Old Wench you and I normally are in agreement on most things on these comment boards. On this one I have to disagree with you. This incident needs to be investigated by professionals before blame is placed. In this case you are only getting one side of the story. Yes the wife was a NP but was she qualified in emergency medicine. More facts are needed before a judgement of any type can be made in this matter.
She has a decade of experience as an NP in an ICU. So yes, she was more qualified than the EMTs. If this happened where she works it would be her or someone like her that the ambulance was rushing this patient to.
And the EMT’s know this how? Because she said so?
Ten years in ICU and never worked in an ambulance (I presume) on one hand, or 10 years in the back of an ambulance in a remote setting taking care of the sick and injured in an already chaotic if not challenging environment? Give me the Medic any day.
An EMT is NOT a medic
No, but a medic is an EMT first…
An NP in an ICU is totally unlike working in an emergency department. And even in an emergency department, there would have been very few people who are able to treat someone outside of their nice, semi-controlled setting.
Have they ever started an IV in the back of a bouncing, moving box? Or on the side of a road with cars whizzing by? Or even been able to hear a blood pressure outside of the quiet room?
No.
I’m not saying either way what happened, but I can tell you, putting her out on the side of the road and driving away was UNCONSCIONABLE. There are far far better ways to deal with an upset spouse, and these EMTs apparently didn’t have the training (or compassion) necessary.
I’m also curious as to what level of responder we’re talking about. Were these basic EMTs or fully trained paramedics? News stories confuse the issue, referring to both as interchangeable. They are not. And Maine’s EMS system is very regressive as compared to other states, believe me. A Basic EMT cannot do many things that those in other states have been trained to do.
So I hold off on judging until all the facts are in, but believe me, the leaving her on the side of the road is totally wrong.
EMTs cannot start or manage and IV.
In Maine a Basic EMT may “manage” (adjust drip rate) a previously started IV when that non-medicated IV was established in a hospital setting and the patient is being transferred to another hospital.
A EMT-Intermediate and Paramedic may start IVs in the field based on standing written protocols.
Not in this state. In some other states, yes they can.
Ok, you apparently have all the answers that the rest of us and the investigators are yet to get. But I do know one thing, patients go through the ER and see and are seen by a lot of professionals prior to getting to the ICU.
Out of line on that one OW. How do you know that she has more experience and training than the EMS crew that was there? You don’t. None of us do since all of the facts haven’t been revealed yet. I have not worked in a field capacity since I was in Anbar province so I will leave the rest of the explaining to jd. Do you have any ideal just how much training and practical experience it takes for a person to have the “P” placed at the end of EMT? my guess is you don’t.
Do a little research…her practice is in an Intensive Care Unit.
Which is in a CONTROLLED SETTING!! What part of that don’t you understand? ICU nurses, ER nurses, Cardiac Nurses, Pediatric Nurses all work within a hospital which is a controlled, warm, dry environment. An EMT is out in the field, in snow, rain, extreme heated conditions. An EMT is trained to think fast for a fast paced setting. You don’t have your ICU nurse trudging through the woods in three feet of snow to get a patient, have to start treating them, and then carry them out of the woods, to the waiting ambulance. I have co-workers who are Paramedics with double the years or more than she has had as an ICU nurse. You are rushing to a conclusion without all of the facts.
IX bangor, you have an ego problem. People like you should find another hobby.
So what?
maybe she did have more knowledge maybe she didn’t, but her judgment is sseverely clouded by the fact that it was her husband, she asked them to STOP the ambulance, let her in the back so she could HOLD HIS HAND while he died.. Not treat him better than they could..
The medics may not have realized how fast the situation would deteriorate and then when it did probably didn’t want the pressure of having a significant other in the ambulance when they were having to do CPR and other life saving treatment. I can identify with them and it would be a hard decsion to make, especially if they realized how fast he was going downhill. It would have been good if they had given her a moment to say goodby, but as a medic, I wouldn’t have really wanted the pressure of a wife in the back with a high pressure case. A situation like this would not only involve CPR but finding veins for IV’s , and a high pressure patient usually rides alone. You need room in the back to work, and they were doing seveal different jobs. Hopefully they had two medics in the back or more.
Another note: lifeflights are weather dependant and not always available at the moment of the call. There are flying decsions to be made, or the unit may be involved in another call. We need the ambulance company to do a fair review before judgements are made and passed. Not only was the skier’s life at stake, but the medics livelihoods. The people to judge are the ambulance company and medical review boards.
Some good information in your post. I would like to add that recent studies have demonstrated that the presence of two paramedics does not improve patient care and has the opposite affect. The studies demonstrated that the preferred crew make up was a Paramedic and either an Intermediate or better yet, a Basic EMT. Why? Two Paramedics are looking at the patient from an advanced level of care and may miss the “basics”. The presence of a Basic EMT improves the care delivered. This information was published in the JEMS (Journal of Emergency Medical Services) several months ago.
And you are 100% correct on LifeFlight. The Flight Nurse and Flight Medic are given the patient information. The pilot is not provided with any patient information so they make their decision to “launch-don’t launch” based solely on the weather conditions.
When I was a firefighter back in the day late 80’s early 90’s we always said and the paramedics agreed with us they made horrible EMT’s because as you stated, they are not focusing on the basics.
As for what is going on in the back of the unit I agree, it can get hectic and I don’t ever recall us allowing any sort of family member in the back of the unit on any sort of call.
If the patient was the spouse of a doctor would you have allowed them in the back to help? I suspect you would have.
Why did that double post?
I would like to think we would have not ignored her.
What kind of a doctor?
She has a decade of experience as an ICU clinician. NPs act in much the same capacity that a doctor does. Had this happened near her hospital the ambulance crew would be bringing exactly this kind of patient to her.
I understand her credentials, I have been a career firefighter/paramedic for 25 years. You made a comment about a “doctor” being allowed in the ambulance. I doubt a podiatrist would have any emergency medical experience.
Maine EMS Protocol are very specific. You will find your answer on page Black 1 http://www.maine.gov/dps/ems/documents/2011MaineEMSProtocols.pdf
I actually think there may be something to the botched care for the man. I have held a patient who was bleeding out in my arms, and talked to him, all the while, someone else was taking his blood pressure. The blood pressure is the key, if it was extremely low, or even non-existent, this would have elevated the condition of the patient to critical.
Being an hour from a hospital certainly makes the case more problematic. Those of us in emergency medicine know that the “golden hour” makes all the difference between a recovery and the death of a patient.
As an armchair quarterback, I probably would have called for an air ambulance to fly him out, just as a precaution. I have never consulted the flight nurses on whether to launch an ATU or not. I call, put an ATU on standby, and if the patient seems flaky, I have them launch. They have never debated me on whether they were needed or not. I know that sometimes I have erred on the side of caution, but that is what is done in medicine.
I would not have wanted a family member present either if the patient was going sour on me. That is why surgeons do not operate on family members, nor do doctors treat themselves. They can be too close to the problem.
I am sorry for the loss of a father and husband.
Since I wasn’t there I have no idea what the care provided was. In years past PHTLS (Pre-Hospital Trauma Life Support) provided “short cuts” for determining blood pressure with out actually taking one. It has been several years since I took PHTLS so I don’t know if PHTLS skills came into play or not.
In the Canadian article I believe it was she is quoted as saying the crew did not bring in a “BP monitor” when they arrived at the clinic. That tells me she is looking for equipment that she is used to seeing in the ICU setting but isn’t carried by the majority of ambulances in the state.
In Maine the decision to launch/not launch rest with the pilot and the pilot alone and it is based on the weather conditions. As I recall Maine was in the middle of a snow storm and they may not have been flying. Don’t know for sure or if they were requested the two birds may have been tied up on other calls.
The wife in this case is a NURSE PRACTITIONER! That means that she was MORE qualified in the medical field than the ambulance staff. An NP actually practices medicine, and can usually prescribe medication and even assist in some surgeries. To become an NP you need at least a Masters Degree or a PhD and have to pass a national level board exam. What these fools did was the equivalent of kicking a doctor out of the ambulance. This man had a BETTER chance of survival if his wife were in the back of that ambulance with him.
And……..she is in the United States, not sure her NP status holds much in the US when the patient is already in the care of a EMT crew who is owned by a hospital. Imagine if the EMT crew listened to her and he died, can you say lawsuit. Or better yet, what if it turned out the EMT crew took her advise and the women turned out to have nearly zero medical training? Again, massive lawsuit. Fact is the EMT crew doesn’t have time to have her vetted.
And would that mean that if she is from NOVA SCOTIA too, that she is not certified to practice in this country? Nor could she identify herself as such and properly present her credentials. Most likely she was hysterical at the time and in order to save the mans life they had no other choice but to go when they did. And I would submit that they didn’t want to leave her any more than she wanted to be left. An ambulance is an emergency room on wheels and space is at a premium, You do the best you can with what you have and there is no room for tourists. A sad outcome and there is nothing that can change that. But when the staff are directly related to the patient they are most often removed from that patients care. It’s just not a good thing because close relatives cannot be objective. A bad day all the way around. Condolences to all.
Who cares, when you’re dying?? You’re just looking to stay alive.
It’s called an emergency for a reason.
In northern Maine there are many nurses that cross the border and work in american hospitals.
Who is to say that Mrs. Morse could not do the same. Things are a bit different in border towns. A lot of nurses from Canada, living near a Maine university received there certification in Maine.
Making it possible to practice both in Maine and Canada.
And those nurses that cross the border (just like doctors) need to hold valid licenses in both areas.
When they graduate a Maine nursing school they are required to take the certification testing, and they also will take a Canadian certification test as well. Making them eligible to practice in both countries.
I don’t think that changes what I said.
And i guess that doesnt change what i said either.
“And would that mean that if she is from NOVA SCOTIA too, that she is not certified to practice in this country? Nor could she identify herself as such and properly present her credentials.”
Sorry you are VERY mistaken.
Then I stand corrected. Something like this is a no win all the way around.
She is reported in the Canadian News as a PRACTICAL NURSE.. NOT A PRACTITIONER.
She is a ACTIVE-PRACTISING NURSE PRACTITIONER.
prescribing medicine and assisting in the OR have what in common with being in the back of the ambulance? We don’t know all of the facts yet. I do think that maybe you have been watching too much E.R. or House.
From the Maine EMS Protocols, regarding Non-EMS system medical interveners:
Please be advised that these Emergency Medical Technicians are operating under the authority of the State of Maine and under protocols approved by the State of Maine. These EMS providers are also operating under the authority of a Medical Control physician and standing medical orders.
If you are currently providing patient care, you will be relinquishing care to these EMS personnel and their Medical Control physician.
No individual should intervene in the care of this patient unless the individual is:
1. RequestedbytheattendingEMT,and 2. AuthorizedbytheMedicalControlphysician,and 3. Iscapableofassisting,ordeliveringmoreextensiveemergencymedicalcareatthescene.
If you are the patient’s own physician, PA, or nurse practitioner, the EMTs will work with you to the extent that their protocols and scope of practice allow.
If you are not the patient’s own physician, PA, or nurse practitioner, you must be a Maine licensed physician who will assume patient management and accept responsibility. These EMT’s will assist you to the extent that their protocols and scope of practice allow. They will not assist you in specific deviations from their protocols without Medical Control approval. This requires that you accompany the patient to the hospital and that their Medical Control physician is contacted and concurs.
Seeing as he was her husband I’m betting that she might have been his primary care giver.
“Seeing as he was her husband I’m betting that she might have been his primary care giver” I doubt it. It is unusual and has multiple pits falls and it is easy to blame yourself for missing and/or misdiagnosing injuries and illnesses.
She would likely have had a positive effect on him, if she had been allowed back there.
Loved ones do have that reputation, you know…..
The medics may not have realized how fast the situation would deteriorate and then when it did probably didn’t want the pressure of having a significant other in the ambulance when they were having to do CPR and other life saving treatment. I can identify with them and it would be a hard decsion to make, especially if they realized how fast he was going downhill. It would have been good if they had given her a moment to say goodby, but as a medic, I wouldn’t have really wanted the pressure of a wife in the back with a high pressure case. A situation like this would not only involve CPR but finding veins for IV’s , and a high pressure patient usually rides alone. You need room in the back to work, and they were doing seveal different jobs. Hopefully they had two medics in the back or more.
Another note: lifeflights are weather dependant and not always available at the moment of the call. There are flying decsions to be made, or the unit may be involved in another call. We need the ambulance company to do a fair review before judgements are made and passed. Not only was the skier’s life at stake, but the medics livelihoods. The people to judge are the ambulance company and medical review boards.
Nonsense.
She is an 10 year ER nurse and probably knew more than they did. They didn’t want her back there because she would know how badly they screwed up and to make matters worse, once he died in the ambulance they did not continue to the hospital they were to take him to – THEY turned around and took him back to SugarLoaf’s medical clinic – what the hell did they think the clinic could do but call the cornoner. They didn’t even phone ahead to the hospital to say they were bringing in a skiing accident victim so when Mrs. Morse got to that hospital they thought she was a crazy woman and didn’t know what she was talking about. Somebody’got some BIG splaining to do. I hope Mrs. Morse sues the pants off them when she gets through consoling her boys.
A resident of Kingston
Sonya Mohan
That is ridiculous! This poor woman. 8(
She needs to get a lawyer and have them do their own investigation!!
Do not trust Maine EMS and the hospital to do their investigation. There is a lot more that she needs to know about how Maine EMS system works!
Well Tim, it seems you have the inside track on how the “Maine EMS system works!”
Here is you opportunity to enlighten the less informed folks like myself.
I know you are connected JD, you know what I mean.
Timmy I am far from “connected”. Yes Maine EMS is a small group of people but Maine EMS takes appropriate action where it is called for. But you opinion is different, why?
@silverfox902:disqus First to suggest that a Nurse (A practical nurse as it is now being reported in Canada) has more experience or knowledge than a Paramedic is absolutely reckless and ridiculous, not to mention many Paramedics are nurses, PA’s, Nurse Practitioners themselves and work as Paramedics. Protocols determine what happens to people who die in care of an EMS crew. EMS Crews follow Direction Through Medical Control A Doctor in the E.R. they were transporting to. You are portraying allegations as fact. Shame on you.
AW a license status check of Nova Scotia show that she holds a “ACTIVE-PRACTISING NURSE PRACTITIONER” license. Odd terminology for sure but she is a Nurse Practitioner.
I personally know Mrs. Morse – she is a fully-qualified licenced Nurse Practitioner, NOT a practical nurse as erroniously reported in some newspapers–any reference to her being just a practical nurse is a total error. Also for your information she worked in US hospitals as a registered nurse for quite a while before she got married. Besides being a RN, she has several medicine-related degrees including a masters. She is a fully qualified, highly respected medical professional with many years experience (including emergency and trauma) who has suffered a great loss, and deserves a lot more respect than many of you are giving her. If she was concerned about the quality of care her husband was receiving then it should be a wake-up call to a lot of people that there was a problem that should be addressed before someone else has to go through what she did.
Opinions are great but I think that you might want to just stay in your lane on this one.
Oh dear Lord, this story makes me feel ill. That poor, poor woman.
It sounds as though the second patient treated at the mountain was referred to the LifeFlight instead of the local ambulance … makes perfect sense to me, after the death of the first man.
Except that Thursday of last week LifeFlight was likely not flying due to weather conditions. Don’t know for sure but passing judgement isn’t going to help anything.
Yup. Spending a few minutes in the back of a helicopter during bad weather would really help many to understand why those guys can’t be in the air when the weather is crappy
Do you live in Maine? If so then you know what was going on weatherwise last Thursday.
The weather last Thursday from Sugarloaf all the way past Kingfield was treacherous from at least 2pm until 5pm. No sane pilot would have approved a flight up there. I stopped skiing at 2:30 because the winds on the mountain (at your back) were so bad it felt like you weren’t moving, the light diminished in the storm, and you could not see the contours of powder versus the base of ice. It really wasn’t a day to ski. I’d even go so far as to suggest Sugarloaf shouldn’t have been open, and I’m an expert skier.
I hope a good lawyer was trailing behind that ambulance. If ever there was a time for an ambulance chaser, this is it.
oops
oops
I refuse to believe they put her out on the side of the road.
So sorry for your loss Mrs. Mores. Sorrier still for the treatment you received from the ambulance crew. They are not always like that. The crew in Brewer is great. Hose 5 in Bangor is very good too. I know many are very respectful of the feelings of the family even though their main concern is with the welfare of the patient. I do hope you find peace and comfort in the arms of friends and family.
RIP Mr. Morse.
While none of us have heard the otherside in regards to so many of the items at issue here. Can’t we put aside the fact she was a Nurse Practioner. If this is a fair point, please disregard and set me straight. Yes, she is a NP, but how do the EMT’s have anyway of knowing this, and even if they do, does she have any right to practice or implement medical advice while in the United States? What happens if her husband dies because of the advice she had given or even worse treatment she had administered? Sounds like the EMT’s would be up S%^t Creek w/o a paddle as would the hospital, can you imagine the lawsuit? Finally, as mentioned in previous posts, what if it turned out she was not who she claimed ie Nurse Practitioner, what then? I am guessing (again set me straight if I am wrong) there are laws or adminstrative policies that don’t allow people outside of employees (EMT’s) from performing or suggesting medical protocols in regards to patient care.
“The wife in this case is a NURSE PRACTITIONER!”
Yes she is…with a license to practice in a foreign country.
~~~~~
“That means that she was MORE qualified in the medical field than the ambulance staff. An NP
actually practices medicine, and can usually prescribe medication and even assist in some surgeries.”
I have already covered how Maine EMS approaches “unsolicited” medical intervention so I will not repeat it here.
~~~~~
“To become an NP you need at least a Masters Degree or a PhD and have to pass a national level board exam.”
And both EMTs, Intermediates (starting this year) and Paramedics have to pass a National written and practical exam before the are LICENSED by the State of Maine.
~~~~~
“What these fools did was the equivalent of kicking a doctor out of the ambulance.”
I have no idea why the wife was left on the side of the road but to say that the “man had a BETTER chance of survival if his wife were in the back of that ambulance” is ignoring the survival rates of traumatic cardiac arrest (remember the wife was quoted in the paper that she performed CPR on him prior to be placed in the ambulance) is almost ZERO.
“To become an NP you need at least a Masters Degree or a PhD and have to pass a national level board exam.”
You kinda need to translate this into Canadian. That may be the case here in the states but what requirements have they in Canada to obtain NP status.
Further, there’s a good chance she was hysterical and created more of a problem than an aide for the EMT’s involved. They may have set her out of the amulance with good cause.
Good comments. For clarification, my post was in response to another poster and as Disqus sometimes does, it posted my response as a standalone comment. Ah the mysteries of Disqus continue.
No I would think that you cannot just leave someone on the side of the road. She was able to diagnose him way better then an EMT for one and for two seriously?? The crew LET her go KNOWING I am sure how one would react in this situation assuming they have EVER had a call where ones spouse/family member was dying.
thank you for being so calm with your responses. I just can’t do it. These people don’t seem to understand what the differences are between those of us that work inside a building( in my case a telemetry unit) and those of you out in the field. I don’t really have a concept of what it’s like to be an EMT here in Maine. All of my EMS time was as a whiskey. EMS is definately a specialty just like any other medical or nursing specialty. Just like I wouldn’t want an EMT-P to diagnose me at my annual physical, there are many advanced practice nurses out there that have absolutely no business being in the back of a rig.
I repeat: who cares if it’s in a foreign country, when you’re dying??
Any port in a storm, and all
Interesting screen name.
One of the sad aspects of a helicopter service in Maine is that they are grounded as much as they fly due to the weather. I presume this was the situation here. My deepest condolences to the family.
I am so sorry for this woman. I must say though that I understand the ambulance staff needing to deal with the patient but not also the wife. God forbid I ever experience the same situation I pray that I would have the strength to stand back and let the medics/emts take my husband and go…in the process letting them do what they must to try to save him.
I refuse to believe they put her out on the side of the road.
they will cover it up…
Well if Maine EMS becomes involved through the investigative process they publish the minutes of all meetings and the outcomes of all cases on their web page.
Hope she hires a good lawyer!!!
Sugarloaf may be renamed after her late husband…
Why, Sugarloaf did nothing wrong!
It was their clinic,probably staff, knowing how civil case work, a very broad sweep is made of anyone involved and with deep pockets. They could be somewhat negligible when the dust/snow settles. It is going to be very interesting to follow.
The fact that the Sugarloaf crew got the injured man off the mountain in 12 minutes in commendable as it probably involved a ceritan degree of patient packaging. I don’t think anything wrong will be found there. The mistake was probably in the transfer of the patient or the length of time it took to get an ambulance get there. With his injuries, a lifeflight pobably would have been the best bet, but it may not have been available. This was the wife’s story that is born of grief. Let an impartial panal make the judgement with all info included.
Sounds like a lifeflight would have been too slow anyway. Tragic, but sometimes people can’t be saved.
How is Sugarloaf to blame?
You would have to know the the locals in CV to understand… just saying! I hope she gets a lawyer and it doesnt even have to be a good one. This has only been a matter of time.
I can absolutely believe this woman’s story after witnessing what happened with EMS when a family member was severely injured in a farming accident. Severe obvious external trauma and high likelihood of internal trauma, and the 2 ambulance personnel that showed up did not do much at all, just like this Mrs. Morse describes. No blood pressure check, no listening to chest, not even trying to cool him down in 90+ weather. Left son to hold arm of dislocated shoulder nor did they do much about compound fracture of the femur. Finally an uncle called a private service that is located nearby and THEY were the ones who did vitals as well as started an IV, etc and assessed for internal injury as a priority. Damned good thing there were no internal injuries, or I”m certain he would have died due to lack of treatment and incompetence of the first responders from the ambulance service. This article about Mr. Morse just brings that all back to the forefront. And I agree with the poster who says they do not trust internal investigations anymore.
My condolences to the family. I hope you keep up the fight to find answers and accountability. If nothing else, maybe this will safeguard others from having to go through the same thing. Small solace in a terrible event.
My heart goes to their family!
They knew the situation when they left the scene and if they didn’t want her to ride with them, they should have made the call then.
That said, even as a Nurse Practitioner, or whatever she was, she was not in the employ of the ambulance service, may or may not be licensed to practice in Maine, and may or may not have any experience in treating trauma in that sort of situation. Her presence in the ambulance should have been as his wife, and that’s it. It was not her job to administer care, or orchestrate the care. I’m left wondering whether she was so pushy in the ambulance as to interfere with the care and that is why they kicked her out.
As far as keeping her from her husband while he was dying…it would have been no different in an emergency room situation. When you have a loved one who is receiving care they don’t just let family members stand around and watch and hold their hands. The job of the medical team to provide care takes priority. I have only ridden in an ambulance once, my husband did not ride with me, and it was just myself and one EMT in the back, but it was pretty cozy to say the least. I cannot imagine having several people in there trying to provide emergency care while working around an upset family member. No matter what a further investigation reveals, the whole situation is completely horrible.
They knew the situation when they left the scene and if they didn’t want her to ride with them, they should have made the call then.
That said, even as a Nurse Practitioner, or whatever she was, she was not in the employ of the ambulance service, may or may not be licensed to practice in Maine, and may or may not have any experience in treating trauma in that sort of situation. Her presence in the ambulance should have been as his wife, and that’s it. It was not her job to administer care, or orchestrate the care. I’m left wondering whether she was so pushy in the ambulance as to interfere with the care and that is why they kicked her out.
As far as keeping her from her husband while he was dying…it would have been no different in an emergency room situation. When you have a loved one who is receiving care they don’t just let family members stand around and watch and hold their hands. The job of the medical team to provide care takes priority. I have only ridden in an ambulance once, my husband did not ride with me, and it was just myself and one EMT in the back, but it was pretty cozy to say the least. I cannot imagine having several people in there trying to provide emergency care while working around an upset family member. No matter what a further investigation reveals, the whole situation is completely horrible.
So far we have only her side of the story, a complaint made to a newspaper. I shall wait until a formal complaint is made and the other side is told. (If it can be released without violating patient confidentiality.)
I would think vital signs and a quick assesment were in order then treatment in pritory of injury. If these guys didn’t do that, their in BIG trouble, BIG BIG trouble.
Outrageous! This needs to be investigated by competent third parties.
Sugarloaf would be wise to also join in the investigation since they get good marks. After all, if this is the kind of treratement injured skiers get there, why ski there?
test
Sad , my heart goes out to the family.
I blame Bush.
Let the investigations take place and everybody and stop being would be lawyers and telling eachother that this should of been done or this should of not been done….The evidence will come out and than the chips will fall where they may….The man is dead, she is now a widower with boys who don’t have a father to grow up with…let’s show some sympathy for the family and stop all this second guessing….
My heartfelt prayers to the familes involved. Good Day!
The medics may not have realized how fast the situation would deteriorate and then when it did probably didn’t want the pressure of having a significant other in the ambulance when they were having to do CPR and other life saving treatment. I can identify with them and it would be a hard decsion to make, especially if they realized how fast he was going downhill. It would have been good if they had given her a moment to say goodby, but as a medic, I wouldn’t have really wanted the pressure of a wife in the back with a high pressure case. A situation like this would not only involve CPR but finding veins for IV’s , and a high pressure patient usually rides alone. You need room in the back to work, and they were doing seveal different jobs. Hopefully they had two medics in the back or more.
Another note: lifeflights are weather dependant and not always available at the moment of the call. There are flying decsions to be made, or the unit may be involved in another call. We need the ambulance company to do a fair review before judgements are made and passed. Not only was the skier’s life at stake, but the medics livelihoods. The people to judge are the ambulance company and medical review boards.
My apologies. Disquis was not working earlier and is still holding my comment. I am not ranting–just a frustrated poster.
I dont know I would think that if it were your wife/husband you’d feel different or maybe your mother but none the less was it right to let her go screaming for them to stop leaving her in the middle of a snow storm?? I was talking with a dispatcher the other day and asked if my town had video cameras in the ambulances so ensure things are handled properly and she told me no. I am unsure if we are the only ones who done or not but I think that we should cops have cameras in their cars why shouldnt ambulances??
The people to judge are the ambulance company and medical review boards.
I disagree with this. This is investigating from within the industry. I believe that healthcare consumers have the right to judge and to offer solutions to sometimes hidden or otherwise buried mistakes/errors/medical harm. Too often records disappear, harm is hidden, and nothing is done to remedy the problems in healthcare. Until transparency and accountability for healthcare consumers happens, not much will change.
this sounds incredibly mixed up. I hope they get answers. She is good wife and mum. May that family find a way to heal, loosing a dad is horrible.
If true these people should be fired.
My heart goes out to this poor woman and her two children. Such a terrible tragedy. The ambulance crew could have handled the situation a lot better than they did.
Granted no one is draggging anyone through the woods in a hospital, but that does not mean they do not deal with VERY difficult patients who can be combative, bleeding, and needing all kinds of IVs, these patients are very tenuous, etc….you have to be quick at assessing what’s going on and then act quicker….BOTH specialties are valuable….it’s just unfortunate that she was not able to ride with her husband.
If these facts are true, what a tragedy for the family, as well as an horrendous embarrassment for the state of Maine. Unless someone can explain to me why the actions of the ambulance personnel are considered within normal medical tolerances, I repudiate them as fellow Mainers.
How could this have turned out this way ?? There is no excuse for not calling lifeflight first thing , and who ever heard tell of them not taking your bloodpressure almost immediatley !!!! It sounds to me like a inexperienced crew . So Sad for his family and him –<3
Wasn’t it snowing last Thursday?
There are many different was to determine if a person is going into decompensated shock and BP is one of the last to fall.
The pilots make the determination in regards to flying (I believe) and condsidering it was windy as hell aloft and snowing like crazy, flying would have been out of the question.
Maine EMS I find to be poorly trained and unprofessional. They are not held to the same standards as REAL professionals like nurses or doctors. To throw a wife out of an ambulance is unconscionable. It sounds like the driver’s ego came into play. It should never have happened.
There must be a protocol giving the ambulance crews jurisdiction in an ambulance transport situation, however, if a trained medical professional like Mrs. Morse could see that improper medical procedures were being applied, what would be proper protocol then?
Are most full time ambulance services running two person crews? How many people were there in the back with the patient? Who was driving? Who was working on the young man?
Lots of questions that I hope can be answered publicly.
If the EMTs were negligent, then let them be punished. But, I’ve only seen one side of the story so far. It is easy to try and convict in the court of public perception. The BDN and the other news outlets (who broke the story two days ago–where were you BDN?) are only reporting on what they have for information. Can’t blame them for that, I guess. Look at the amount of interest this one story has generated: 181 comments and counting.
The truth will come out in time. I am hoping that the BDN follows up with this story and updates it regularly.
By and large, I feel that EMS in this state is good with some well qualified and competent EMTs giving good care. Like any profession, there are those who are not as good and all of us make mistakes. The stakes, obviously, are higher in medicine.
I feel bad for Ms. Morse, her children and her family. But I also feel bad for the EMTs that are going through this, wondering about their jobs, unable to publicly defend themselves. I also fear that many will paint NorthStar with a broad brush incorrectly concluding that this type of event is the norm rather than the exception.
In many cases, ambulances are staffed with one trained (EMT, Intermediate or Paramedic) and one CPR trained driver.
In other case, let’s say a Fire Department they are normally staffed with two trained staff members. The combination is only limited by the license level the service has from Maine EMS.
In the case of hospital based EMS the combination again are only limited by the license lever the service has from Maine EMS. If a RN is a member of the crew and is licensed by Maine EMS as a EMT, Intermediate or Paramedic they can ONLY practice up to their EMS level of licensure and not to their RN level of license.
…
Being a career firefighter/paramedic for 25 years I really find something amiss about this whole story. Leave it to the press to sensationalize the tragedy before all the facts are out. Unfortunately the ambulance crew has already been tried and convicted in the court of public opinion.
I assume she was trying to take over the case and she was booted because she became a hindrance to the treatment. Even though she is a nurse practitioner she is not employed by the ambulance and therefore would not be allowed to administer any care. Its a tragedy but a reality in rural Maine that ambulance rides take a long time. It is too bad that the helicopter wasn’t called in and I hope this will make lifeflight a more likely result to injury on the mountain. Maybe the mountain could even buy a helicopter if it allows skiing on trails that are dangerous due to conditions.
You can bet your bottom dollar if I witnessed a blundering EMT not doing what was necessary to save my husband’s life, I would intervene, and with great assertiveness. I know how hard EMTs and Paramedics work and under horrible conditions at times. Most are competent and hard working and many volunteer their services. But, as a former ER nurse I have seen incompetent EMTs and paramedics who should never be allowed near a patient. The same can be said for any level of healthcare providers. I will follow this story carefully. I know there is more to this story than meets the eye. Sadly, the most significant part of this story is that a life was lost. My sympathies are with the family.
kathydayrn what you have stated can be said about ANY medical professional…including RNs.
This story is unbelievable. This woman, an NP with 10 years of intensive care experience was just trying to save her husband and be with him . None of us know all the details, but the ambulance crew endangered this woman by leaving her on the side of the road. She probably tried, in desperation, to intervene to save her husbands life and that was perceived as a threat to these EMTs/paramedics. This is no excuse for them to desert her on the side of the road in a snowstorm. This story will evolve and I’m sure heads will roll…..as they should. The woman’s husband did not get the care he needed from the ambulance crew (no IV until he went into cardiac arrest??) and because she loved her husband, she likely tried to save his life. When she couldn’t do that, she wanted to be with him in his last minutes. Both of these things are reasonable and understandable. How do these situations evolve? I believe it is because of a superior attitude of medical providers that needs to be reined in. Arrogance has killed more patients that we know!
The woman’s husband did not get the care he needed from the ambulance crew (no IV until he went into cardiac arrest??) and because she loved her husband, she likely tried to save his life.
**************************************************************
…ad an IV would stop the internal bleeding from his obviously ruptured spleen? You said as a former nurse you would have intervened had you seen he was not getting “proper care.” Mr. Morse had massive internal injuries that could really only be treated by a surgeon. Would your “intervention” include slicing him open from sternum to belly button, fishing your hands around under a (probable) perforated colon and scooping up the mangled remains of a ruptured spleen, severing the blood vessel to the spleen and cauterizing it or reconnecting it to the other organ, sucking out the nearly 12 units of blood and giving a proper blood transfusion? This poor gentleman passed away an hour after his accident. Many people die “instantly” from trauma, many within minutes. Just because one is responsive for 30 minutes after the initial trauma doesn’t mean the injury isn’t severe enough to cause death shortly afterwards. Massive internal bleeding isn’t something that is successfully treated in an ambulance. I don’t think ambulances routinely stock 6+ units of each blood type in the rig. About a decade ago, Sonny Bono ad Michael Kennedy died shortly after crashing into a tree while skiing. Surely, Kennedy got excellent treatment just because of who he was—and he still passed away.
If the EMTs did not do a head to toe assessment, history/meds, and vitals signs to start and then monitor after that, then this man did not get the treatment he should have as soon as he should have. IVs should have been started right away if a low BP indicated a need, Oxygen applied, trendelenburg position used, etc. If they were just dealing with the broken arm….that was the least of his problems.
In a message dated 1/18/2012 4:53:44 P.M. Eastern Standard Time, writes:
(http://disqus.com/)
Frankforter wrote, in response to kathydayrn:
The woman’s husband did not get the care he needed from the ambulance crew (no IV until he went into cardiac arrest??) and because she loved her husband, she likely tried to save his life. **************************************************************
…ad an IV would stop the internal bleeding from his obviously ruptured spleen? You said as a former nurse you would have intervened had you seen he was not getting “proper care.” Mr. Morse had massive internal injuries that could really only be treated by a surgeon. Would your “intervention” include slicing him open from sternum to belly button, fishing your hands around under a (probable) perforated colon and scooping up the mangled
remains of a ruptured spleen, severing the blood vessel to the spleen and
cauterizing it or reconnecting it to the other organ, sucking out the nearly 12
units of blood and giving a proper blood transfusion? This poor gentleman
passed away an hour after his accident. Many people die “instantly” from
trauma, many within minutes. Just because one is responsive for 30 minutes
after the initial trauma doesn’t mean the injury isn’t severe enough to
cause death shortly afterwards. Massive internal bleeding isn’t something
that is successfully treated in an ambulance. I don’t think ambulances
routinely stock 6+ units of each blood type in the rig. About a decade ago,
Sonny Bono ad Michael Kennedy died shortly after crashing into a tree while
skiing. Surely, Kennedy got excellent treatment just because of who he
was—and he still passed away.
_Link to comment_ (http://disq.us/51kt3g)
If the EMTs did not do a head to toe assessment, history/meds, and vitals signs to start and then monitor after that, then this man did not get the treatment he should have as soon as he should have. IVs should have been started right away if a low BP indicated a need, Oxygen applied, trendelenburg position used, etc. If they were just dealing with the broken arm….that was the least of his problems.
******************************************************
there is nothing in the article that states the EMT’s DIDN’T do a proper assessment according to established protocols. Nothing in the article proves Mr. Morse’s BP bottomed out, and administering IV fluids don’t help one bit when you’ve lost 3/4 of your blood supply to the proper organs. The article stated that Mrs. Morse “said” the EMT’s were seemingly only concerned with splinting his broken arm. I think this investigation will show the EMT’s administered care according to all established medical guidelines. I also refer you to the rest of my post that said he suffered severe trauma and blood loss that caused his death. THAT is what he died from—not from “not being given proper treatment”. I also refer you to the post by “Dan” at 1:38pm today (it is just a few posts below this one) he also says Mr. Morse would not have survived being so far from a surgery center.
there is nothing in the article that states the EMT’s DIDN’T do a proper assessment according to established protocols …..there is nothing in this article that says they DID do a proper assessment either. If they had and his BP was low, then an IV would have been one of the first things they should have done.
Without the autopsy reports, and a completed investigation, you certainly seem certain about a lot of things. The article in the Canadian newspaper said that the EMTs did not check his BP, but went ahead to splint the arm. Like I said before not all the facts are in. You dont’ have them, I dont’ have them and neither does anyone else. I will watch this closely because I have a very strong suspicion that steps were skipped and a rapid patient decline was missed and misaddressed…..and the end result was the death of a young healthy but badly injured man. You will notice I am not making so called ‘facts’ out of my thoughts and ideas about this case, I am stating possibilities.
Too bad there isn’t a “rapid response team” for patients in the field! Perhaps this man could have benefited from one.
Unfortunately, these kinds of things can happen right in the Hospital or other healthcare settings, because caregivers fail to respond to patients or their representatives concerns and observations. Arrogancecan kill patients.
In a message dated 1/18/2012 5:45:32 P.M. Eastern Standard Time,
writes:
(http://disqus.com/)
Frankforter wrote, in response to kathydayrn:
If the EMTs did not do a head to toe assessment, history/meds, and vitals
signs to start and then monitor after that, then this man did not get the
treatment he should have as soon as he should have. IVs should have been
started right away if a low BP indicated a need, Oxygen applied, trendelenburg
position used, etc. If they were just dealing with the broken arm….that
was the least of his problems.
******************************************************
there is nothing in the article that states the EMT’s DIDN’T do a proper
assessment according to established protocols. Nothing in the article
proves Mr. Morse’s BP bottomed out, and administering IV fluids don’t help one
bit when you’ve lost 3/4 of your blood supply to the proper organs. The
article stated that Mrs. Morse “said” the EMT’s were seemingly only concerned
with splinting his broken arm. I think this investigation will show the
EMT’s administered care according to all established medical guidelines. I
also refer you to the rest of my post that said he suffered severe trauma
and blood loss that caused his death. THAT is what he died from—not from
“not being given proper treatment”. I also refer you to the post by “Dan”
at 1:38pm today (it is just a few posts below this one) he also says Mr.
Morse would not have survived being so far from a surgery center.
_Link to comment_ (http://disq.us/51lpy5)
There is one good thing to a discussion such as this, in addition to expressing sympathy to those unfortunate people involved. There appear to be some protocol issues here being analyzed and that hopefully will be improved, as needed. Who knows when any one of us might be the next victim?
What a bunch of backwoods EMT YAHOOS. She should have been allowed in the back of the ambulance and probably should have lead the treatment as she had more training then any of the other YAHOOS. I feel bad for her & hope she sues the heck out of all of them. There is no excuse for her being kicked out of the ambulance whatsoever!!!!!!
There are several reason why someone could find themselves on the side of the road instead of in the front of the ambulance. None have been stated in any of the articles I have read but there are legitimate reasons none the less.
Tragically the only thing that likely would have saved this guy was an immediate treatment at a trauma unit- and there was none. I believe he had a bleed on the brain & CPR wouldn’t have saved him. So very sad, who knows what really transpired.
I don’t know who, if anyone is to “blame” for Mr. Morse’s death, but my deepest sympathies to his family. If it is any consolation to Mrs. Morse at all: he knew you were there, loved him, and were doing your best to help him.
not to be the jerk but I am pretty sure the reckless skiing into a deadly fixed object killed him, not the personnel from the ambulance service. Just saying. You should know when you make the trip to Carrabasset Valley you are a good hour ride from any civilization. Okay so maybe I am a jerk but they are far from the responsible ones here in my book.
Contrary to the idiotic lay-person’s discussion that has been going on here regarding “who is better than who” ad infinium, this was categorically a traumatic arrest in an austere environment. This gentleman exsanguinated over a reasonably short period of time, and initially presented hemodynamically stable. No amount of crystalloid fluids, endotracheal tubes, pharmalogic intervention or CPR would have changed the outcome of, for example, a transected aorta. Traumatic arrests (that is, the injury is so significant that it causes you to DIE), have less than a .5% survival rate even in optimal conditions. This story is NOT about SAVING a LIFE. This, is what we colloquially call a dead man. If I can read between these cloudy lines, the distraught wife was difficult for the Paramedic (Northstar is a Paramedic service) to handle. This is rather commonplace in pre-hospital practice, and it is accentuated when the family is a medical practitioner of any kind. Any reasonably seasoned paramedic would know that survivability is nonextant in this scenario. One of Paramedic’s greatest challenges (and there is no absolute right answer) is to deal with panic stricken family in dire circumstances. This woman, ostensibly, didn’t want her husband to die! Unfortunately, there was NO changing this outcome given the extent of injury and distance from a trauma center.
….
That would be the legal term, yes. I prefer the term “dingbat” or any other term that describes a lack of common sense and critical thinking skills (Disquis would delete my post if I typed them) because those are exactly the kind of people that make mistakes like this.
Sugarloaf sounds like a real safe place to take a vacation…
As opposed to what, an Italian Cruise?
…
I am a nurse and a nurse practitioner in New England. The “competence” of rural first responders for life support is totally unacceptable and has been for years. All too often, the people who are first responders are adrenaline junkies who often have NO clue beyond basics of first aid yet think they are trauma surgeons. I suspect they decided to leave Ms. Morse beside the road because she knew more than they did and was demanding that they do the things that would have saved her husband’s life. Their SECOND error was to NOT call for life flight after ascertaining that he had a low blood pressure (which is the FIRST thing they should have done- blood pressure check supine then sitting- easy, fast cheap way of checking for life threatening low blood pressure). He hit a TREE- his mechanism of injury was TRAUMA. He should have been assessed for head and abdominal trauma immediately and airlifted.
It is time for the BUSINESSES in the area (Sugarloaf being one) to demand and oversee an improvement in the quality of care . And it is time for the STATE to demand better standards of care for first responders.
Life Flight was not available that day as it was snowing out. Life Flight was taken off line Thursday morning and was not put back online until Friday morning.
Well HistoryGirl you said in another post to me that you would not want me to treat you in an ambulance and based on this one statement “the FIRST thing they should have done- blood pressure check supine then sitting- easy, fast cheap way of checking for life threatening low blood pressure” shows me that you do not understand anything about field EMS.
This person hit a tree and was very likely collared and boarded before he came off the mountain to protect his C-spine. How would one sit up a collared and boarded patient pray tell without compromising the spine?
And Maine EMS uses the National Registry of EMTs curriculum for all levels of EMS (Basic, Intermediate and Paramedic) and end tests both written and practical national exams for the Basic and Paramedic and is adding the Intermediate this year. So I guess I am a bit baffled what better standards you would like them to be held to.
In defense of the responding ambulance, while not metropolitan by national standards, Northstar Ambulance is a mid sized, hospital based, full time EMS agency. While your cynicisim of proverbial backwoods volunteers is accurate in some sense, this agency is very arguably not in that catagory. Secondly, unless you plan on 1. Either volunteering your brilliant medical prowess to your local hometown vollies, or 2. Overseeing the funding of “competent” care in areas that literally might see a dozen calls in an entire year; I’m not sure your complaint is valid. Rural communities will CONTINUE to use barely functional ‘adrenaline junkies” who have no clue, because that is ALL that is avalible in communities of 60 – 1,200 people. I’ll be happy to sign you up for the next EMT course so you can get to volunteering as a competent responder.
This is a terrible tragedy and it’s pretty unfortunate that all of this poor spelling, poor grammar, and insane conjecture is being tossed around, both by the ridiculously uninformed public and the emotionally attached family. This man didn’t need an IV, he didn’t need his arm wrapped, he didn’t need a nurse practitioner in the back of an ambulance. He needed a surgeon, and he needed him or her quickly. Unfortunately, due to various circumstances, he didn’t get the actual definitive treatment he needed to survive, and a terrible tragedy resulted from a sport any participant should know is extremely dangerous. My most heartfelt condolences to the family.
Well said and very true.
They will work to cover it up and gloss over it.. in hope it will go away…………
Any reasonably seasoned paramedic would know that survivability is nonextant in this scenario.”” considedring this; would you not agree, It was paramount the wife should have been with her husband, in the back, rather than on the side of a road in a snow storm???
Gail, I do agree with that actually. In fact, the sad reality was in all likelyhood he shouldn’t have even been transported. That is a very difficult call for prehospital providers to make, and not all are really good at it. They are conditioned to try and exhaust all reasonable efforts…Without directly condoning a “slow code” scenerio, it would have been compassionate to allow the wife to just be near him. Perhaps she wasn’t having any of that? It’s really hard to say without more information.
Emt-I can start an IV…That would be EMT- Intermediate level. EMT-B (basic) Can not start an IV.
What a sad, sad situation. My condolences and prayers go out to his wife and children. My prayers go out to anyone who is caught up in this mess. Only a few people know exactly what happened, so passing judement without knowing all of the facts isn’t the best route to go, but to each their own. Just a sad situation, all the way around.
An NP and EMT are different levels regardless of where are. Remember, this is only one side of the story. She is telling her perspective and she is not qualified to run a trauma code in the field. She is the spouse who is in shock and cannot have an open perspective. The EMT’s and Hospital cannot tell their side due to HIPPA and there is always 2 complete sides to every story. So before everybody bashes the first people you will call in any emergency and many times for not-so emergent issues, remember that they will respond anytime, anywhere for you. You will expect immediate action and that is what they are there for. Call a NP next time and see how long it takes, since they are not on call for you for any reason. Be careful what you wish for and don’t bother to call the EMT’s if you need to. But you damn well will. If there were issues, then they need to be dealt with. It also sounds like Lifeflight could not have flown in that weather, so that reference is useless. So be careful to judge.