Emergency Provider RMT
There are 2 types of RMT: emergency/urgent and routine.
Emergency/Urgent are cases where the CHA sends in an RMT document to the message center proxy called NW emergency/urgent RMT. The CHA then calls the on-call inpatient doc for that village and they talk about the patient and what to do for the patient. These calls can sometimes end up in a medevac, sometimes the patient is sent to the ED via commercial flight and sometimes the patient is treated and sent home.
Routine RMT is handled by ambulatory providers and the CHA sends in a document and the provider responds electronically.
Sometimes the CHA will call the ED and ask to talk to the ED doc, usually because they are doing CPR on a patient and haven’t had time to start any documentation. (In general, do not activate medevac if CPR in progress.) You will be expected to talk the CHA through the case. These are highly stressful situations for the CHA – remember this is certainly someone they know and often a relative. There is often chaos in the background and it can be hard to hear the CHA or determine what is going on. Please be very patient at these times. The CHA will want you to make the determination when to stop resuscitative efforts. Generally speaking, we don’t have them do CPR for more than an hour. So at about the 45 minute mark, ask them to start thinking about stopping CPR. Sometimes they don’t want to and we let them keep doing CPR longer. This is especially true if it is a baby or a child. If it is a child, get the pediatrician on the phone if you think that will help. Link to code resuscitation section of Emergency RMT.
If you get other calls from CHAs regarding other emergencies (strokes, seizures, village deliveries, etc) re-direct CHAs to the NW doc on call for that village. Peds on call can also be contacted for any pediatric patient.