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medical assisting

Can anyone give me some info on this situation? It's for class. As a medical assistant, if a patient faints in the reception area what would be the proper response?

Are You Still In School? yes

Are You Working? yes

Re: Syncope/Fainting in the Medical Office's Reception Area.

What a great question. Let me give it a shot... Let's see if I remember correctly...


Syncope

Syncope results from anxiety and nervousness and may be the result of lack of food, fever, infection or lack of sleep. Impulses through the vagus nerve cause a dilation of the blood vessels in the splanchnic area and slow down the heart. This results in less blood flow to the brain, a temporary cerebral anoxia, and the patient faints.

Recognition

1. The patient may become anxious, sweaty, pale, nauseated and may ask for water.

2. The patient may become unresponsive. This can range from drowsiness to actual seizure-like activity.

3. Normally, when a person faints, he/she falls down.

4. The pulse will be weak and slow. Both systolic and diastolic blood pressure will be decreased.



In an emergency, after a quick initial assessment of the emergency condition, send a co-worker/fellow medical assistant, or fellow student (on externship) for the portable O2 unit and smelling salts. Remember the most important rule that under no circumstances should the person that just fainted be left alone.

***Remember: That's why it is so important that EVERYBODY that works in the medical office -- whether it is the front office staff, students on externship, or back office staff knows where the emergency kit, oxigen tank, crash cart is located!!!! Make sure this get's done as part of your standard office procedure and is strictly enforced.

Immediately send your co-worker to go get or call for the nearest RN and physician to help in assessing the problem. Give a short description of the emergency (such as syncope, or acute anxiety with hyperventilation) and the exact location. The key is to be short, specific, and calm to avoid confusion and tragedy. But DO stress the urgency.

In the meantime only one person should attend to the person that's fainted. Chaces are this will be the administrative medical assistant from the front desk recepition area.

Look, listen and feel for breathing and establish level of responsiveness/awarness by gently shaking the unconscious person's shoulder and asking “ARE YOU O.K.?”.

*** Remember: ALL medical assistsants that have received the right training know first aid/CPR (and again, that's why I have spoken out so strongly against hidden pitfalls of taking online courses that promise "become a certified medical assistant in 6 weeks online". See: http://medicalassistantnet.blogspot.com/2005/09/key-to-medical-assistants-success.html).


Lay and keep the unconscious person flat (do not attempt to get him/her up to walk) -- laying the person flat, even if it is on the floor, will keep him/her safe and return blood flow (and thus oxygen) to the brain. Establish the airway.

A fainted person's tongue may fall back and obstruct breathing. Continue to monitor blood pressure, breathing rate, awarness and other functions.

***Remember: Let the nurse and doctor take over as soon as they arrive. In a medical office with well trained staff in an emergency situation help should arrive within only a few seconds!!!


Only people immediately involved in the emergency should be in the area. Unnecessary crowds add to confusion and hinder resuscitation efforts. Medical office staff should be assigned to shelter the person attended to, disperse crowds and keep corridors free.


The doctor, nurse, and medical assistant will see to the fainted person's welfare as a team. Usually such incidences turn out okay. Make sure everything gets documented properly in the patient's medical chart.

Danni R.
Website Owner/Admin

Your Professional Title/Credentials: Website Owner/Admin

Are You Still In School? No

Are You Working? Yes

Re: medical assisting

Administering oxygen is administering a medication, and should not be done without a physicians order. if they have CHF, you could do more harm than good.

From what I have understood, you have not started treatment on a patient until they are brought back into the room, so we are not liable if something happened in the waiting room. That being said, I would initially do an " all page" or get a physician out there ASAP by whatever means possible. There are many phisiological factors that could cause fainting, and we do not have the assessment skills to determine which. I would do vitals while waiting for the physician, and then assisting him/her with whatever they need- 02 sat, ammonia inhalant, calling 911, operating the AED. administering 02 etc...

Your Professional Title/Credentials: CMA/ RMA/CNA /SN

Are You Still In School? Yes

Are You Working? Yes

Re: medical assisting

Great point Tracy!

I appreciate your posting this addenum to my post to make it clear: the Medical Assistant will NOT -- under no circumstances ever -- be the one to administer oxygen, or any other medications from the emergency crash cart, or medicine chest unless trained to do so, and unless it's ordered by the physician or other supervising health care provider.

However, for a medical assistant to run and fetch the oxygen tank, first aid kit, or crash cart in an office emergency as long as he/she is following the Standard Office Procedure (SOP). If it states otherwise then don't. That's what I meant in my above post. I did not mean "administer it".

I am glad you caught that. Thanks!!!

Danni R.

Your Professional Title/Credentials: Website Owner/Admin

Are You Still In School? No

Are You Working? Yes

Re: medical assisting

Thanks Danni. I wasn't certain if that was what you were implying or not, just wanted to clarify :)
BTW- love the new look of the board!

Your Professional Title/Credentials: CMA/ RMA/CNA /SN

Are You Still In School? Yes

Are You Working? Yes

Re: medical assisting

Tracy, I cannot thank you enough. There are a handful very loyal visitors (without mentioning names you know who you are) who have returned and posted to this and the Yahoo Medical Assistant forum. Each one knows how much I appreciate their support and that I could not have done it without them. I am running over 10 web sites for medical assistants, medical coders and billers, and phlebotomists on my own. I own them, design them, maintain them, finance them, promote them, correct them, expand them, and answer questions that come in through their contact forms. What a taks!!! All from a small corner desk in my living room.

Many a times I asked myself whether I might be crazy, but I LOVE what I do and I would NEVER hang it on a nail. Sometimes it gets frustrating and there never is enought time. Had it not been for the kind of support of people like you, it would have been even more daunting. But with so much help and so many rewards it is a very very worthy labor of love.

Yes, you noticed it there were changes here. The former message board was free through Bravenet. Now it is a "paid for" setup (still through Bravenet) because we have grown so much and mostly, quite honestly, I got tired of their pop-up ads. This is much better.

Thanks for noticing it. And please do continue to come back to post. It's a worthy cause and I am counting on you (and my other unnamed helpers!).

Your Professional Title/Credentials: Website Owner/Admin

Are You Still In School? No

Are You Working? Yes

Re: medical assisting

I applaud you for keeping up with all of that! It would have been so nice to have this forum when I was in MA school. I may not visit as much as I used to, but I'm not going anywhere. I live this site. Thanks for keeping it around for all of us!

Your Professional Title/Credentials: CMA/ RMA/CNA /SN

Are You Still In School? Yes

Are You Working? Yes

Re: medical assisting

I agree: Danni's dedication to the field of MA is so valuable... I found the site before I ever entered school, and Danni motivated and educated me about becoming an MA. Now, that I'm actually practicing, I still find this site great: it's a place where MAs can chat about the issues that impact our field, and offer/obtain advice and feedback.
Don't know what we would do without ya, Danni...

Are You Still In School? RMA, BMO

Re: medical assisting

hello all!! I just started school about a month ago so very new to MA so any advise would be welcomed! But I have a question when I signed up for MA my school is telling me that MA's are higher up then LPN/LVN's is this true? thank you to all.....bye bye

Are You Still In School? yes

Are You Working? no

Re: medical assisting

I would say higher up- responsibilities are different. MA's are trained in the 3 areas- clinical, administrative and lab. LPN's geared more towards hospital patients.

Your Professional Title/Credentials: CMA/ RMA/CNA /SN

Are You Still In School? Yes

Are You Working? Yes

Re: medical assisting

Don't consider yourself "higher up" than an LPN/LVN. MAs is a different profession, sort of. If you are trained in the Associates Degree level, you will have training in lab and x-ray. This is something that LPNs don't have. BUT nurses are trained to assess, provide a nursing diagnosis, and plan and evaluate care; MAs don't do this (unless you obtain additional education).
In short, you can't compare apples and oranges...

Are You Still In School? RMA, BMO

Re: medical assisting

From what I have come to know the LPN has been phased out. There is litle clinical difference. Where the difference comes in is that Medical Assistants are more universal than that of the LPN's. We are cross trained to do not only clinical but also administrative. I hope this helps with all the other information that you were given previously.

Your Professional Title/Credentials: Medical Assistant w/ Associates degree

Are You Still In School? no

Are You Working? yes

Re: medical assisting

There will always be a need for LPN's especially in the hospital IMO. In trying to save the almighty buck, I cannot see an all RN staff being implemented. LPN's are necessary to keep cost down for the hospitals. They have had the " phasing out" discussion for over 15 years and it has yet to happen.

Your Professional Title/Credentials: RMA/ CNA/ SN

Are You Still In School? yes

Are You Working? yes

Re: medical assisting

Hi I just wanted to add my 2 cents. I work in an Urgent Care facility, with MAs and LPNs, that unfortunately gets some patients who should have called 911 instead of coming to us.The MAs and LPNs that I work with see the patient sometimes up to 40 minutes before the doc does. We triage the patients and usually work independantly. At my office, we clean wounds, do EKGs, get the patient history, fill out the Xray slips, pull up the labs and any previous Xrays, administer O2 if their pulse ox is below 90%,and set up for sutures before the doc is even in the room. I know not all places work like this, but our docs train us very well for our facility and have complete faith in our technical skills.

Your Professional Title/Credentials: CMA

Are You Still In School? no

Are You Working? yes

Re: medical assisting

Hi,

This is a great question. Every clinic/hospital and private pratice I have worked for has an emergency plan set-up. Everyone from the receptionis to the doctors have scheduled duties. I can list them for you just for informational purposes.

(Everyone that is assisgned duties are fulltime employees that work the day shift 8-5: night shift 5-closing other staff took over)

Patient is down
1)Code Blue is Called.(Overhead Page)
2)On Call Doctor and Nurse,RN are first to arrive.
3)1-Medical Assistant Grabbed wheel chair&1-LPN Grab Emergency Kit. Meet on Site.
4)Medical Assistant job when arrived at site: Documentation of Pt Name, Vitals,.
LPN job: Assist the RN with patient needs (Vitals,IV etc)
5)1-Medical Assistant would bring the crash cart to code blue site(my job) (this had oxygen/difibulator/ sterile dressings/ tubing and more.) I set-up equipment requested and hand to Dr/RN/LPN to admin.

You were assigned this duty every other month and there were schedules handed out to every employees (there were also alternates picked incase of employee was not in. The employees were hand picked by exp and skills. Chances are if your doctor was the On Call Doctor on duty your whole team had duty. This worked well because you work together everyday and knowing what your team needs to perform each medical procedure is a bonus also in an emergency.

Now if you come accross a pt that is down, we were instructed to:
1)request a code blue pt - call the team.
2)Check for pulse. Respiration. If none:
3)CPR ASAP! If pt breathing on own we waited with the patient.
4)Patient is alert, Pt name, pulse, respiration and stay with pt til team arrives.
That is it.

The code blue team needed to take over.

As a Medical Assistant wit many years exp, this question is asked right away in an interview. You know the employor will ask you at sometime of you interview "Do you have any questions?" Make this a priority questions. You will be given this information, and believe me, if you work any clinic/hospital, knowing the on call schedule for the day will is a life saver.

Sorry so wordy
Hope this helps.

Your Professional Title/Credentials: Medical Assistant

Are You Still In School? no

Are You Working? yes

Re: medical assisting

Just remember the ABCs of resuscitation. Everyone in a medical facility should be CPR certified but not every patient who faints needs resuscitation.

On the matter of ammonia inhalants - no longer recommened by several organization - the AHA is one of them and so is the Center for Phlebotomy education.

And yes you are certainly liable for anything that happens to the patient in a waiting room. Why you think you are not liable is a mystery to me. If a patient hits their head on a chair in falling,or trips on a carpet and falls, you better believe the office will be held liable.

Now, let's think about the Good Samaritan laws in your state. In most states, a medical professional is not held "liable" if they acted in good faith, followed accepted procedures and accepted NO PAY for the first aid rendered. But still, that patient is on your property so you ARE liable from the moment they set foot on your sidewalk until they have driven away from you facility. Maybe medical treatment doesn't begin until the patient is in the exam room, but don't think for one minute that you are not liable for that patient in the reception area!

Your Professional Title/Credentials: BSE; RMA(AMT)

Are You Still In School? no

Re: medical assisting

Until the patient is brought out of the waiting room, the treatment that they consented for has not begun. I'm not saying the hospital isn't liable for accidents and such, but this is an important issue as patients do get turned away and referred to the hospital. Even though it had been recommended that they go somewhere else, treatment hadn't technically started since they were never brought back. It's been a sticky discussion at my job as we have gone out to peoples vehicles to assess in the past.

Your Professional Title/Credentials: RMA/ CNA/ SN

Are You Still In School? yes

Are You Working? yes

Re: medical assisting

I seem to be getting confused about which question we are trying to addres. I thought it was "What do you do if a patient faints in the office?"

How is this related to "the treatment they came in for does not begin until they are taken back to the patient exam area"

As for going out to the parking lot for patients in their car: Again - I refer you to your state's Good Samaritan Laws. These laws were enacted to prevent health care providers from being held "liable". Some of the tenets of GSLs are:

1. The person receiving the treatment would want it.
2. The health care provider is acting in good faith and following recommended standards.
3. The health care provider accepts no money or renumeration for the act (first aid, cpr, whatever).

So certainly if a person becomes ill in your office's parking lot, you are covered from "liability" for rendering aid.

How did we get from a person fainting in the waiting room to "tell them to go to the hospital?"

Certainly, EVERY physician office or health clinic should have in place emergency procedures. Please make sure you know them well, If your clinic does not, help the doc put some in place!! Show them how valuable you are!!

Your Professional Title/Credentials: BSE; RMA(AMT)

Are You Still In School? no

Re: medical assisting

I was only responding to the comment
"And yes you are certainly liable for anything that happens to the patient in a waiting room. Why you think you are not liable is a mystery to me. If a patient hits their head on a chair in falling,or trips on a carpet and falls, you better believe the office will be held liable"

and responding to what our clinic policy is.

Your Professional Title/Credentials: RMA/CNA/SN

Are You Still In School? yes

Are You Working? yes