[josefresco]

"I advised Will on why ambulances should be reserved for life or limb threatening injuries and that every ambulance that is thoughtlessly called for a non-life-threatening injury is one less ambulance that is available to actually save a life rather than be used as a convenience."

What a load of absolute garbage. Shame. There are plenty, PLENTY of ambulances to go around. This isn't some wartime situation where medical care should only go to those about to die.

A few years back my wife had a back injury that prevented her from walking. We called an ambulance, and it was the best decision both according to her (who couldn't move) the ambulance paramedics, and the doctors at the hospital. Her injuries WERE NOT LIFE THREATENING, but she still required an ambulance to transport her without further injuring her back and potentially causing paralysis. Again, not life threatening, just paralysis - no big deal right?

Basil Besh should step down from whatever position they hold.

[Spooky23]

You're talking about a situation that justifies calling an ambulance. You're probably not qualified to assess the injury, your wife could not move and had an acute injury. The article is describing medical professionals in a clinical environment making medical judgement calls.

Most workplace injuries are not emergencies. Even the example given of a broken hand is not an injury that is helped by an ambulance ride, if anything you are delaying treatment by calling 911 and waiting for an ambulance to be dispatched for a very low priority injury. Most companies have a policy of calling 911 only to avoid liability -- they care more able getting sued for the result of a car accident on the way to the hospital than the employee. In this case Tesla has medical personnel on site who can make subjective judgements and do so with their license at risk.

The other thing being missed is once you're admitted to the hospital for a workplace injury, you're stuck in the Worker's Compensation system and end up in a kafka circle of bureaucracy where as an employee you end up wasting alot of time and potentially alot of money as the insurance companies, independent doctors, etc all fight over pennies.

As far as "there are PLENTY of ambulances to go around" that often is not true, especially when you're talking about a big workplace like a factory where getting in and out will take a long time. My brother is a fireman paramedic who gets bullshit ALS calls all of the time. It's really frustrating when September comes and people in car accidents or serious injuries are left waiting because some panicked coed calls 911 for a passed out drunk friend who is "dying, I don't think she's breathing" every Friday.

I'm no Tesla fanboy, if you look at my comments I'm often harshly critical of them. But IMO this is an article on a boring topic that nobody understands that is ginned up and novel because we're talking about Tesla.

[_ea1k]

I definitely agree with this, especially the last paragraph. I feel like a lot of people responding to this have never really talked to factory workers. There is a lot more ambiguity here than they seem to realize. Unfortunately there is a lot of moral hazard here as well.

[blub]

"Even the example given of a broken hand is not an injury that is helped by an ambulance ride, if anything you are delaying treatment by calling 911 and waiting for an ambulance to be dispatched for a very low priority injury"

The thought processes of some of you genuinely scares me. What happens if the person goes into shock from the pain and loses consciousness in the taxi? How the f do they even put the seatbelt on, if their hand is broken? What kind of small talk will the Lyft driver make with them? "Is that a piece of bone I see peeking there you naughty naughty boy!"

[24gttghh]

I don't want get too involved in this discussion, but in the medical sense, one does not simply "go into shock from the pain". For shock, there needs to be some mechanism that is interrupting the circulatory system and preventing proper blood flow to the tissues of the body[0]. Sure, that mechanism could be something that also causes one to go unconscious. It may be also be an "Acute Stress reaction" [1], and it does not seem to involve a grave threat to the circulatory system. It's psychological. Note: I am not a doctor, and anything I've said here should not be misconstrued as medical advice/diagnosis. I've simply taken a first-aid course.

[0]https://en.wikipedia.org/wiki/Shock_(circulatory)

[1]https://en.wikipedia.org/wiki/Acute_stress_reaction

[toast0]

Most people have two hands, and in a pinch can buckle themselves with either. Anyway, the driver or a coworker/onsite medical staff can buckle them in as well.

If the person loses conciousness on the way to the hospital, the driver can either call 911 on the way and arrange a transfer to the ambulance or just pull up to the emergency room and yell / honk / go in to get help getting the person out. Hopefully the onsite clinic would call ahead so that the ER / urgent care knows what to expect.

If the patient is in fairly stable condition, and it's quicker to get them to the hospital with a taxi than an ambulance (because of ambulance priorities), it seems prudent to take a taxi.

I see further in the thread that an ambulance was denied for a back injury, which seems less prudent.

[wiseleo]

Driver is likely not to notice the passenger is unconscious. I completed well over a thousand rides and many of them were with passengers who did not interact with me. Once they are in the rear seats, I do not observe them. Looking at traffic keeps me busy enough.

Driver has no duty to alert ER staff or arrange supplemental transport.

Lyft and Uber could offer medical transport service at an appropriate rate where the driver would get trained and tasked with additional duties.

Navigating into Tesla factory from the freeway takes time. Most drivers will get pinged from the freeway. Unless the driver has been to that facility many times, finding the right pickup point on any large corporate campus is a challenge.

I have transported several people to ER. Those were demanding rides due to elevated risk of passenger causing damage to my car.

Ambulance priority - patient stability Rideshare priority - no damage to the vehicle

As you can see, they are not aligned.

[ameister14]

Are they alone all this time? Why would they be alone in the car?

[Spooky23]

The same thing that happens to a person who is sitting in an office chair waiting 90 minutes for an ambulance to be dispatched for a low-priority injury.

[AndrewBissell]

For a serious injury, the right thing to do is call 911, describe the situation, and let them make the call whether to use an ambulance or private transport. Tesla doesn't want the 911 call because it creates a paper trail for injuries they don't want to report, and because they're desperately low on cash. Part and parcel with the culture of deception at that company.

[Aeolun]

I think you can probably replace the name of the company in this article with anything and people would still be outraged.

[Spooky23]

Really?

~30 people, including several employees have been killed by private garbage haulers unsafely operating in NYC since 2014. That's a pretty serious workplace safety problem that affects the public, but lacks the Tesla clickbait factor and associated hand-waving.

[PhasmaFelis]

> The article is describing medical professionals in a clinical environment making medical judgement calls.

The article describes medical professionals making medical judgment calls, and getting censured or fired for it.

[jonathankoren]

>The other thing being missed is once you're admitted to the hospital for a workplace injury, you're stuck in the Worker's Compensation system and end up in a kafka circle of bureaucracy where as an employee you end up wasting alot of time and potentially alot of money as the insurance companies, independent doctors, etc all fight over pennies.

This is very strange advice. It sounds like you’re arguing that when you’re seriously injured at work, you shouldn’t seek appropriate medical care.

That’s the kind of right out of The Jungle isn’t it?

[Jtsummers]

Neck and back injuries are a good reason to call an ambulance. The original quote refers not just to life but "life or limb". I suspect any reasonable person would extend that to "paralysis". Back and neck injuries often render a person immobile (as you say, for risk of further injury).

Your anger seems grossly misplaced and based on a deliberate misreading or uncharitable reading.

[josefresco]

See my other replies, Tesla denied ambulance service to man with a severe back injury, unable to walk.

[eduah]

Are you really willing to believe that if the medical doctor thought and ambulance was required for the supposed injury, they will choose to have someone die on their watch, with full legal liability for the death. What do you think the doctor has to gain by arranging other no ambulance medical transport here.

[AndrewBissell]

The doctor was taking a calculated risk that whatever care the worker didn't get, as a result of taking a ride share instead of an ambulance, wouldn't kill him. Keeps Tesla's ambulance costs and trip numbers down.

[coldtea]

>What a load of absolute garbage. Shame. There are plenty, PLENTY of ambulances to go around. This isn't some wartime situation where medical care should only go to those about to die.

And your response is some anecdotal story about calling an ambulance when it wasn't really needed?

Do you think ambulances (and trained medical professionals to staff them) come in plentiful supply?

Do you know that many people die every year waiting for an ambulance and due to ambulance non-availability all around the world?

  “It’s shocking how close or how often the ambulance level 
  gets to ‘Level Zero’ or close to ‘Level Zero.’ What this 
  means is there are no ambulances left in the city,” 
  Joseph Ross told the committee.

https://www.nbcsandiego.com/news/local/Medics-and-EMTs-Lack-...

https://globalnews.ca/news/3995973/hamilton-code-zero-ambula...

https://www.boston25news.com/news/someone-is-going-to-die-25...

https://www.npr.org/sections/health-shots/2017/04/11/5230259...

https://www.cbc.ca/news/canada/new-brunswick/david-harvey-de...

https://www.pressreader.com/south-africa/daily-dispatch/2018...

https://www.bmj.com/content/321/7270/1176.2

https://www.theguardian.com/society/2018/jan/18/ambulance-cr...

https://www.theguardian.com/society/2018/mar/31/ambulance-cr...

https://www.theguardian.com/society/2017/dec/17/alarm-sharp-...

>Basil Besh should step down from whatever position they hold.

Perhaps, but not because of an ignorant rant.

Note also that Basil mentions "life OR LIMB threatening" -- not just life threatening. And that can easily include risk of paralysis...

[josefresco]

> And your response is some anecdotal story about calling an ambulance when it wasn't really needed?

I think you missed the point. My anecdote was meant to outline how the ambulance WAS really needed despite my wife not in a life threatening situation.

Back injuries are very, very, very serious. I spent a few days considering the possibility that my wife wouldn't ever walk again. If someone even suggested we took an ambulance needlessly I (and the doctors treating my wife) would have gone ballistic. I'm checking out from this thread as it's clearly effecting me emotionally.

>Do you know that many people die every year waiting for an ambulance and due to ambulance non-availability all around the world?

We're talking about Nevada, not the world.

[coldtea]

>We're talking about Nevada, not the world.

Well, I gave examples from Boston, California, and elsewhere. And it's not like parts of Nevada fair better:

  Despite such efforts, the shortage of medical 
  professionals is so serious in the Esmeralda County town 
  of Goldfield that 32-year-old Danie Johnson and her 55- 
   year-old mom, DeEtta Sligar, run a volunteer ambulance 
  service for the town’s roughly 300 residents.

  With no medical clinic in town and the nearest hospital 
  more than 110 miles away in Bishop, California, Johnson, 
  Sligar, two other EMTs and four drivers spend hours at a 
  time ferrying ill residents across the border. They 
  receive $132,058 a year from the county to keep their 
  ambulance and an old backup running.

That's par for the course for rural places everywhere. But ambulance shortages are there even in the biggest of cities (it's matter of state recourses and proportion of ambulances and medical pros to the population, not an absolute matter of population size).

[user5994461]

It's not a shortage of ambulances but more an issue of not having any hospital in a 100 miles radius.

[brianwawok]

The article says life or limb. You keep taking out limb and talking about your wife’s back. That seems dishonest to me at best.

[Spooky23]

It's not dishonest, it's just irrelevant.

If your friend fell off a ladder and hurt his/her back in a way that prevented them from moving, what would you do? The chances are that you don't know how to assess that injury. It's prudent for you to call 911 and have an EMT and/or Paramedic assess and make the call on the next action.

It's different if you are a doctor, working at a factory, and have an injured employee brought to your infirmary.

[josefresco]

Read the article again, focus on the part about Stephon Nelson.

[Ntrails]

And his point is that "Limb threatening" covers back injuries as well. You're being disingenuous implying that your situation was the sort of thing which the Doctor was advocating not using an ambulance for when he's said nothing of the sort

[JacKTrocinskI]

The problem is a shortage of EMTs, not that people are abusing the system and calling ambulances for no reason.

[coldtea]

Given bounded resources, there might always be a "shortage of EMTs". Some rural places for example don't have the funds to even support one (and an a couple of emergency situations can peak demand even in bigger cities).

The shortage might be at the root of the problem, but it also might be unavoidable. It's not always a given that a shortage can be fixed (or when it will be fixed). And given a shortage, people who call ambulances for no reason (which very much exist) make things worse.

[JacKTrocinskI]

Totally agree with you. The thought of someone advising another person on whether or not to use an ambulance when they ask for one is unimaginable. Maybe there are some people that abuse the system, but I think the overwhelming majority of people know when to call an ambulance without having to be advised on it. Either there are some hardcore Tesla fanboys on this forum or seems to me there might be some Tesla PR going on here, don't know what to make of some of the comments and of course can't prove where they originate from.

[loceng]

Even in this context of a it being doctor advising another person?

[travisoneill1]

I knew an EMT who called himself a "Medicaid chauffeur". Said people would call for headaches. The thought of NOT advising another person on whether or not to use an ambulance when they ask for one is unimaginable.

[jhayward]

> The thought of someone advising another person on whether or not to use an ambulance when they ask for one is unimaginable

You literally can't imagine a medical doctor, responsible for the patient in question, advising on whether an ambulance is indicated or not? Because that's what you appear to be saying.

[phil21]

I feel you're being kind of disingenuous here ignoring the "and limb" part of his "life and limb" statement.

It's quite clear Basil would be calling an ambulance in your wife's situation - as there was significant risk in additional injury (the "limb" part of his statement) if not otherwise done.

Knowing medical professionals who actually work in the ED overuse of all emergency services - including ambulances - is embarrassingly common.

[josefresco]

“I couldn’t walk, I couldn’t sit down. I couldn’t even stand up straight,” said Nelson, who’s 30 and used to play semiprofessional football. He asked for an ambulance, but the on-call Tesla doctor said no – he could take a Lyft to the hospital instead."

Sure about that?

[blub]

Actually, according to the article they didn't want to call an ambulance for someone that couldn't walk, sit or stand straight (Stephon Nelson).

It's sad that we're debating whether an ambulance is needed for people with back injuries or mangled/broken fingers.