RedAirplane
Forum Asst. Chief
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(Based on a scenario or two I have seen, scrubbed to prevent identification; I would like your thoughts).
It's a hot dry day without a cloud in the sky.
A family comes up to you asking for a bottle of water. You send your partner to grab some water and notice a male about 12 y/o who just doesn't look good. He is sweaty, flush red, in a slouching / tired posture, and has one hand on his abdomen. You offer him a seat and he takes it.
The parents advise you that their son was not feeling well so they wanted to get him some water. With their permission, you start asking a few questions. The pt is having a headache (3/10) and sharp abd pain (5/10) with nausea and dizziness. The headache is new and the abd pain, nausea, and dizziness have been worsening since morning. He had a hot dog to eat and hasn't drank much all day. The pt takes no medications and nothing like this has ever happened before.
Examination of the abdomen reveals a diffuse pain, unable to be located by the patient. Palpation does not affect the severity of the pain.
You suggest that the patient be evaluated by paramedics for possible transport, but they end up refusing care. You suggest that the pt be seen by his MD, but he does not have an MD. The parents say that they will take him to urgent care but don't want EMS/hospital because they don't have insurance.
How okay are you with this refusal? Your gut instinct wanted an ALS evaluation / transport unit to be called to the scene, but your partner and supervisor both seemed perfectly okay with this as an ordinary refusal.
It's a hot dry day without a cloud in the sky.
A family comes up to you asking for a bottle of water. You send your partner to grab some water and notice a male about 12 y/o who just doesn't look good. He is sweaty, flush red, in a slouching / tired posture, and has one hand on his abdomen. You offer him a seat and he takes it.
The parents advise you that their son was not feeling well so they wanted to get him some water. With their permission, you start asking a few questions. The pt is having a headache (3/10) and sharp abd pain (5/10) with nausea and dizziness. The headache is new and the abd pain, nausea, and dizziness have been worsening since morning. He had a hot dog to eat and hasn't drank much all day. The pt takes no medications and nothing like this has ever happened before.
Examination of the abdomen reveals a diffuse pain, unable to be located by the patient. Palpation does not affect the severity of the pain.
You suggest that the patient be evaluated by paramedics for possible transport, but they end up refusing care. You suggest that the pt be seen by his MD, but he does not have an MD. The parents say that they will take him to urgent care but don't want EMS/hospital because they don't have insurance.
How okay are you with this refusal? Your gut instinct wanted an ALS evaluation / transport unit to be called to the scene, but your partner and supervisor both seemed perfectly okay with this as an ordinary refusal.