# "OH S#@T!!!"



## SCEMT-B (Oct 26, 2005)

Well about a week ago I had a call go strait to hell. My partner and I where spending our day training a new EMT. Our last call of the night gave our greeny a great introduction, if you want to call it that. Bout 1930 we are dispatched to a residence for a "Possable bowel obstruction". Don't ask me how they thought it could be that. We race to the scene code 3 (In my company they may tell you its a code 1 call to an ER but they never are) We get on sence and I start talkin to this guys in house nurse. the guys diapheretic (SP) lythargic, and breathing 30 a minute. They claim hes a DNR but they haev no orders to prove it. We start baggin the guy. While my partner and the newbie do that I examine the guy and find this bruse covering his entire lower abdomen. in the LLQ a nice big bulge. Well needless to say we load the guy and race for the ER. I waited about 10 minutes fora nurse to get to me and while I'm in the middle of my report the guy goes V-tac!    The nnurse andI waited for what felt like 30 seconds to see if his dfib would fire and it enver did nor was his pace maker helpin. It was insaine, the guy was V-tac for 3 minutes before he came out of it. No one still knows how he came out of it. 

 The whole experiance just blows my mind  :blink:


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## Jon (Oct 28, 2005)

> *We race to the scene code 3 (In my company they may tell you its a code 1 call to an ER but they never are)*



I hate the whole code vs. Class thing... I get confused.

Other comment.... I understand running hot for an ER run, but what would happen if you "got caught?" Could you lose your job???


As for "what it could be".... no idea, except the abdominal pain, and perhaps not taking a dump in 2 weeks, could have had a bowel obsturuction, maybe apendicitis, maybe just old and looking to die....

As for DNR's with no orders, always a tough call, and *COMMAND's *call . In PA, we have a state out of hosptial DNR law, so, if the SNF cannot produce the act 59 forms, we must work the patient, unless command tells us otherwise.

Does sound like an intresting call for a rookie!

Jon


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## MedicPrincess (Oct 28, 2005)

As far as what could be wrong, maybe you could get some follow up on it.

Even if the nurse did produce a valid DNR order, from the sounds of it this guy wouldn't meet the grounds for needing it.  He had a pulse, he was breathing.  He need assistance - yes.  But he was not apneic.  

DNR means Do Not Resuscitate.  It doesnt mean withhold treatment and interventions in hopes the guys becomes a code then you can say "Oh hes a DNR so we don't have to work him."


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## Strike3 (Oct 28, 2005)

You must work for Medcare...


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## SCEMT-B (Oct 29, 2005)

Yes I work for medcare    Its better then working for Personal Scare...and as far as DNRs go in SC, EMS are to have the DHEC approved EMS DNR to treat as a DNR. Don't ask me I don't make the rules. 

As far as Follow up goes the guy had a living will not a DNR. As far as running code my supervisor agred with me running code to the scene. Now the pattient according to his nurse and the Doctor that treated him, whom I did meet that day, said the bruse came from when he fell over his walker three weeks ago. He had jsut been released from the hospital a week prior to the call that day. The patient did not have a bowl obstruction as his Hospice nurse thought he had though the pt had not had a bowl movement all day. He infact did have a hemmorage from his previous injury.

btw MSJ been doing this for 2 years now


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## Jon (Oct 30, 2005)

SCEMT-B - I wasn't calling you a rookie, but was talking about your trainee.

As for the Bowel obstruction.... gotta love that.... ya put someone on stool softner for a while, and then they DON't poop, once, for a day..... OHMYGOSH, the world will end.

As for running hot, just commenting. My squad (911) has some specific policies on when/when not to run hot.

Anyway,

Jon


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## Strike3 (Oct 30, 2005)

I'll call you a rookie.  j/k

Do you work for any of the counties?


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## Stevo (Oct 31, 2005)

DNR ?

i thought it stood for 'Don't need A  Rig' ?

~S~


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## SCEMT-B (Nov 1, 2005)

Strike3, not yet, working on a few other things before I go apply at charleston. I jsut moved here a little overa year ago from California.


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## pfmedic (Dec 4, 2005)

I love it when they code and nobody can find the directives.


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## bravofoxtrot (Dec 4, 2005)

LLQ? Probably not appendicitis.


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## TTLWHKR (Dec 5, 2005)

DNR doesn't mean do not treat. If they don't need resuscitation, they need to be treated. Too bad Med Command is too f*cking stupid to think this way.

As for the patient... enema.


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## CodeSurfer (Dec 10, 2005)

DNR...? Oh yeah, means the patient had dinner, or they're a dinosaur.  Only the SNF translations.


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## TTLWHKR (Dec 10, 2005)

Code 3 = Priority 1 = Class 1 Medical or Trauma.

PA:

Class 1 = CTD
Class 2 = Naaaa.. go, but itta be aight
Class 3 = You called an ambulance for _THIS?_
Class 4 = Coo Coo
Class 5 = DRT... Possibly DRTT&T.

Old PA Ambulance Service Codes: (I learned these from my father's war stories.) 

Code 37 = Class 3
Code 38 = Class 2
Code 39 = Class 1


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## Strike3 (Dec 10, 2005)

SCEMT-B,

That's funny you say that, I just moved here from San Jose, CA about a year ago...Been working for Charleston county since Feb of last year..


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## CaptainPanic (Dec 11, 2005)

After 9-11 alot of dispatchers quit using 10-codes altogether in an attempt to get funding from Homeland Security because they followed the federal guidelines of operation..... only problem is Homeland security is flat broke....


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## emtd29 (Dec 11, 2005)

Gotta love that

hmmm  quote didn't work, let's try that agan...


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## emtd29 (Dec 11, 2005)

pfmedic said:
			
		

> I love it when they code and nobody can find the directives.


 


  Ya just gotta love that!!


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## daemonicusxx (Dec 11, 2005)

i dont really agree with the no code 3 if you're a private service. last time i checked i have the same equipment on my ambulance that the FD does, and we all treat the same illnesses, and we all are responsible for patient care. should i really question using my lights and sirens when i think i need to? should i really be afraid that i might get "fired" for driving code? i think its stupid, and i will tell anyone that. i dont think that my patient should suffer becuase a city is hindering my capabilities to deliver the highest patient care possible. say someone dies because i cant drive fast, not very likely, but in the event that it did happen, who's shoulders is it gonna fall on?


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## Jon (Dec 12, 2005)

daemonicusxx said:
			
		

> i dont really agree with the no code 3 if you're a private service. last time i checked i have the same equipment on my ambulance that the FD does, and we all treat the same illnesses, and we all are responsible for patient care. should i really question using my lights and sirens when i think i need to? should i really be afraid that i might get "fired" for driving code? i think its stupid, and i will tell anyone that. i dont think that my patient should suffer becuase a city is hindering my capabilities to deliver the highest patient care possible. say someone dies because i cant drive fast, not very likely, but in the event that it did happen, who's shoulders is it gonna fall on?


I have no problem running hot in ANY ambulance for a serious patient condition.

I do have a problem with the dispatcher teling me to run hot to the dialysis clinic because we are late for a pickup that she forgot to log.


Jon


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## ksEMTbabe (Jan 20, 2006)

pfmedic said:
			
		

> I love it when they code and nobody can find the directives.



LOL! That's the quickest way I know of to get every department administrator in town out from behind their desks and to the scene like their pants were on fire.


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## EMT_Chick (Jan 22, 2006)

The dispatchers @ Medcare had you run code to a residence? They amaze me more and more everyday LOL.


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