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Re: [E-Chir] Scenario 5

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  • Kathleen Gormanshaw
    Since I chose to call an ambulance I deliberately did not look for a splint. I m not highly experienced with splints and slings, just basic training, and I
    Message 1 of 13 , Jan 23, 2010
      Since I chose to call an ambulance I deliberately did not look for a splint.  I'm not highly experienced with splints and slings, just basic training, and I don't need this person to move more than a couple of feet before the experts come.  Therefore, the experts can decide if he needs a splint for the ride to the hospital, and deal with it if they do.
       
      If opting for personal transport, I'd probably look at a simple sling and splint.
       
      Eyrny
    • Bethoc (Lesley)
      That s the best part about improvisational first aid - you don t need to be good with commercial splints!   For long limbs, pick something that won t bend, is
      Message 2 of 13 , Jan 23, 2010
        That's the best part about improvisational first aid - you don't need to be good with commercial splints!
         
        For long limbs, pick something that won't bend, is wider than the limb and is long enough to stabilize the joint above and below the injury.
         
        In this case, for a forearm, you could use a piece of wood (the lid of a feast gear box for example), thick carboard (cut up a cardboard box used to carry in food items for the kitchen and make a dual layer so it won't bend), or a hardbacked book (of the larger coffee table variety). Alternatively, just splint the arm to the body by wrapping the person's arm, elevated, against their torso with fabric. Triangular material is great for both creatings slings and longer rectangular shaped wraps to tie stuff up.
         
        For toes and fingers, "buddy tape" the injured finger to the adjacent non-injured one in the absence of a splint.

        An ambulance is not necessarily warrented for this kind of injury, although they do carry the commercial splints on board, it is unlikely that they will encourage EMS transportation to the hospital.
         
        Also consider that although we do pay OHIP, there is a "top up" charge for the use of EMS. I think that applies whether or not you transport but I'm not sure. I'll find out. I think it's about $90. A taxi would be cheaper. It's likely a full charge for out of province participants (we used an ambulance for my son in Nova Scotia and got dinged for $600).
         
        with regards
        Bethóc
         
        who is all for improvisational first aid as long as it works (you should see some of the stuff I've seen..Oi!)
         
        Per saltire purpure and gules, a sea-unicorn argent within a bordure per saltire Or and argent
         
        Golden Otter Pursuivant, Kingdom of Ealdormere
        Pursuivant, Canton of Vest Yorvik, the High Seat of Septentria
         
        Ut sit magna, tamen certe lenta ira deorum est
        The wrath of the gods may be great, but it certainly is slow
        what does {o'} mean? See Da'ud notation: http://www.sca.org.au/herald/commentary/Da'ud%20Notation.htm 
         
        solis sacerdotibus. Ave atque vale.


        --- On Sat, 1/23/10, Kathleen Gormanshaw <kgormanshaw@...> wrote:

        From: Kathleen Gormanshaw <kgormanshaw@...>
        Subject: Re: [E-Chir] Scenario 5
        To: E-Chir@yahoogroups.com
        Received: Saturday, January 23, 2010, 8:57 AM

         
        Since I chose to call an ambulance I deliberately did not look for a splint.  I'm not highly experienced with splints and slings, just basic training, and I don't need this person to move more than a couple of feet before the experts come.  Therefore, the experts can decide if he needs a splint for the ride to the hospital, and deal with it if they do.
         
        If opting for personal transport, I'd probably look at a simple sling and splint.
         
        Eyrny


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      • Ninka
        ________________________________ From: Bethoc (Lesley) To: E-Chir@yahoogroups.com Sent: Sat, January 23, 2010 9:09:45 AM Subject:
        Message 3 of 13 , Jan 23, 2010



          From: Bethoc (Lesley) <bethoc12thc@...>
          To: E-Chir@yahoogroups.com
          Sent: Sat, January 23, 2010 9:09:45 AM
          Subject: splints Re: [E-Chir] Scenario 5

           >Also consider that although we do pay OHIP, there is a "top up" charge for the use of EMS. I think >that applies whether or not you transport but I'm not sure. I'll find out. I think it's about $90.
           
          Actually, if you are covered under OHIP the uncovered cost of EMS is $45 and that is only if we transport a patient. If we arrive on scene, treat and do not transport then there is no charge. If you are from another province or another country and you are not insured then you will be dinged with the full bill.
           
          Xristina


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        • Kathleen Gormanshaw
          Do you know if group insurance, such as a company provides, typically covers the EMS transport cost? Eyrny
          Message 4 of 13 , Jan 23, 2010
            Do you know if group insurance, such as a company provides, typically covers the EMS transport cost?
             
            Eyrny

            On Sat, Jan 23, 2010 at 9:48 AM, Ninka <dyscordant_rose@...> wrote:





            From: Bethoc (Lesley) <bethoc12thc@...>
            To: E-Chir@yahoogroups.com
            Sent: Sat, January 23, 2010 9:09:45 AM
            Subject: splints Re: [E-Chir] Scenario 5

             >Also consider that although we do pay OHIP, there is a "top up" charge for the use of EMS. I think >that applies whether or not you transport but I'm not sure. I'll find out. I think it's about $90.
             
            Actually, if you are covered under OHIP the uncovered cost of EMS is $45 and that is only if we transport a patient. If we arrive on scene, treat and do not transport then there is no charge. If you are from another province or another country and you are not insured then you will be dinged with the full bill.
             
            Xristina


            Be smarter than spam. See how smart SpamGuard is at giving junk email the boot with the All-new Yahoo! Mail


          • MaryCatharine
            Yes smile If you have extended coverage, by all means, It does cover the fee. We are very fortunate here in Ontario. The cost of having an ambulance just show
            Message 5 of 13 , Jan 23, 2010
              Yes>smile
              If you have extended coverage, by all means,
              It does cover the fee.
               
              We are very fortunate here in Ontario.
              The cost of having an ambulance just show up to a call is
              Approximately $950.00 and up.
              I am thankful for the $45.00 fee and any extended coverage>smile.
               
              MariaKatharina
               
              -------Original Message-------
               
              Date: 01/23/10 10:45:06
              Subject: Re: splints Re: [E-Chir] Scenario 5
               
               

              Do you know if group insurance, such as a company provides, typically covers the EMS transport cost?
               
              Eyrny

              On Sat, Jan 23, 2010 at 9:48 AM, Ninka <dyscordant_rose@ yahoo.ca> wrote:





              From: Bethoc (Lesley) <bethoc12thc@ yahoo.ca>
              To: E-Chir@yahoogroups. com
              Sent: Sat, January 23, 2010 9:09:45 AM
              Subject: splints Re: [E-Chir] Scenario 5

               >Also consider that although we do pay OHIP, there is a "top up" charge for the use of EMS. I think >that applies whether or not you transport but I'm not sure. I'll find out. I think it's about $90.
               
              Actually, if you are covered under OHIP the uncovered cost of EMS is $45 and that is only if we transport a patient. If we arrive on scene, treat and do not transport then there is no charge. If you are from another province or another country and you are not insured then you will be dinged with the full bill.
               
              Xristina


              Be smarter than spam. See how smart SpamGuard is at giving junk email the boot with the All-new Yahoo! Mail


               
            • b1laxson
              Okay, a little complexity here... Case 1) OHIP covered chirurgeon calls for a non-covered patient. Patient refuses ambulance. Is there a fee and who pays? Case
              Message 6 of 13 , Jan 23, 2010
                Okay, a little complexity here...

                Case 1)
                OHIP covered chirurgeon calls for a non-covered patient. Patient refuses ambulance. Is there a fee and who pays?

                Case 2)
                If I act as a Chirugeon at an event in the states. (Lets say not Pennsic which has EMT on site anyway). Visiting chirurgeon calls for EMT but patient refuses. Does the chirugeon get a bill?


                Brian the Green
              • b1laxson
                I liked these reminders. ... PS: for limb splints the SCA has a habit of being heavily stocked in 3ft long, 1 1/4 rattan.... Brian the Green
                Message 7 of 13 , Jan 23, 2010
                  I liked these reminders.
                  > -keep fingertips visible for distal circulation check
                  > -NO use of traction.. just spint as you find it. Traction cannot be properly maintained without the use of specialized and expensive equipment
                  > -consider if this person is on blood thinners or has a bleeding disorder (internal bleeding may be more severe and/or serious sequelae)
                  > -remove rings/watches if any on affected limb

                  PS:
                  for limb splints the SCA has a habit of being heavily stocked in 3ft long, 1 1/4" rattan....

                  Brian the Green
                • Bethoc (Lesley)
                  The only thing I don t like about rattan being an arm splint is the narrow width. Ideally even an improvised one should be wider than the limb.. and
                  Message 8 of 13 , Jan 23, 2010
                    The only thing I don't like about rattan being an arm splint is the narrow width. Ideally even an improvised one should be wider than the limb.. and considering some of the sizes of our fighters (muscled up and molson muscle both) a rattan sword may not be sufficient. Now, for lower limbs, with one secured to either side of the length of the leg (groin to beyond the foot) that's another matter altogether.
                     
                    regards
                    Bethóc
                     
                    ps and thanks for the prompt clearing up of OHIP/EMS surcharges! I don't work until later in the week and wouldn't have an answer for the group until then.

                    Per saltire purpure and gules, a sea-unicorn argent within a bordure per saltire Or and argent
                     
                    Golden Otter Pursuivant, Kingdom of Ealdormere
                    Pursuivant, Canton of Vest Yorvik, the High Seat of Septentria
                     
                    Ut sit magna, tamen certe lenta ira deorum est
                    The wrath of the gods may be great, but it certainly is slow
                    what does {o'} mean? See Da'ud notation: http://www.sca.org.au/herald/commentary/Da'ud%20Notation.htm 
                     
                    solis sacerdotibus. Ave atque vale.


                    --- On Sat, 1/23/10, b1laxson <b1laxson@...> wrote:

                    From: b1laxson <b1laxson@...>
                    Subject: [E-Chir] Re: Scenario 5
                    To: E-Chir@yahoogroups.com
                    Received: Saturday, January 23, 2010, 11:46 AM

                     

                    I liked these reminders.
                    > -keep fingertips visible for distal circulation check
                    > -NO use of traction.. just spint as you find it. Traction cannot be properly maintained without the use of specialized and expensive equipment
                    > -consider if this person is on blood thinners or has a bleeding disorder (internal bleeding may be more severe and/or serious sequelae)
                    > -remove rings/watches if any on affected limb

                    PS:
                    for limb splints the SCA has a habit of being heavily stocked in 3ft long, 1 1/4" rattan....

                    Brian the Green



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                  • dyscordant_rose
                    ... It does not matter if the person who calls 911 is OHIP covered, covered by other insurance or completely uninsured, you will not get charged a bill for
                    Message 9 of 13 , Jan 27, 2010
                      --- In E-Chir@yahoogroups.com, "b1laxson" <b1laxson@...> wrote:
                      >
                      > Case 1) OHIP covered chirurgeon calls for a non-covered patient.
                      > Patient refuses ambulance. Is there a fee and who pays?

                      It does not matter if the person who calls 911 is OHIP covered, covered by other insurance or completely uninsured, you will not get charged a bill for calling 911. The ambulance fees only go to the patient and only if there is a transport.

                      > Case 2) If I act as a Chirugeon at an event in the states. (Lets say > not Pennsic which has EMT on site anyway). Visiting chirurgeon calls > for EMT but patient refuses. Does the chirugeon get a bill?

                      AFAIK, the person calling 911 will not get charged a bill for making the phone call. How the rest of the ambulance billing works however, I don't know and I suspect would be state specific, just as ambulance billing in Canada is different between provinces.

                      Xristina
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