# Calls In The Middle Of The Night



## svfd21emt (Apr 28, 2010)

We took a patient into the ER for Toe Pain at 300 in the morning...but get this...the patient walked down 2 flights of stairs and out to our ambulance with no problem at all...makes you wonder...the patient also told us that he took a pint of Jack Daniels to try and relieve the pain...it was dispatched as ALS but we downgraded to BLS...he couldnt wait 4 more hours when everyone is up at least...?????

Anybody else had calls like ths one or similar to it?????


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## spike91 (Apr 28, 2010)

We get those all the time. I do a great deal of overnights, and a few Tuesday's ago at the start of the shift at 0013 or something similar, we were dispatched to a parking lot by one of the dorm buildings for an unknown medical. We get there and it was two sorority girls that were a bit buzzed, nothing even resembling a medical emergency. Total waste of time.


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## MrBrown (Apr 28, 2010)

Hence why its nice that our Ambulance Officers can decline transport if its clearly not required


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## medic417 (Apr 28, 2010)

The reason this should have been ALS is quite possible that this was referred pain from an acute MI.  Perhaps non typical because he could be diabetic diagnosed or undiagnosed, or an alcoholic.  A number of possibilities are present that could lead to this non typical presentation and many a basic and more sadly Paramedic crew has been led astray and missed the boat and in the end the patient pays the ultimate price.  

Odds are though it really was just toe pain with nothing more but basics have no way of being even close to sure.


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## lightsandsirens5 (Apr 28, 2010)

All the time.............

We had one the other night at 0245 for a possible OD. Female pt who had just been put on a new med. and it was making her very drowsy and sluggish. When we showed up we found the now med. she was on was triazolam. She ended up refusing transport.
~~~~~~~~~~~~~~
And vent is 100% on target, as usual.B)


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## FLEMTP (Apr 28, 2010)

medic417 said:


> The reason this should have been ALS is quite possible that this was referred pain from an acute MI.  Perhaps non typical because he could be diabetic diagnosed or undiagnosed, or an alcoholic.  A number of possibilities are present that could lead to this non typical presentation and many a basic and more sadly Paramedic crew has been led astray and missed the boat and in the end the patient pays the ultimate price.
> 
> Odds are though it really was just toe pain with nothing more but basics have no way of being even close to sure.




its also quite possible they could be about to lay a golden egg out of their right ear....

 if it walks like a duck.. and quacks like a duck... its probably a duck...

Im sorry, but if there is no associated diaphoresis, nausea, pallor, shortness of breath, arm pain, abdominal pain, or ANY OTHER SYMPTOMS especially after walking down a flight of stairs... then what exactly would prompt you to do a FULL ALS workup on someone..... besides just a general lack of experience.... or being so scared of litigation that you ALS anyone that sneezes funny?

and they wonder why I call it "uncommon" sense  these days?


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## TransportJockey (Apr 28, 2010)

lightsandsirens5 said:


> All the time.............
> 
> We had one the other night at 0245 for a possible OD. Female pt who had just been put on a new med. and it was making her very drowsy and sluggish. When we showed up we found the now med. she was on was triazolam. She ended up refusing transport.
> ~~~~~~~~~~~~~~
> And vent is 100% on target, as usual.B)



Where is Vent posting in this thread?


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## medic417 (Apr 28, 2010)

FLEMTP said:


> its also quite possible they could be about to lay a golden egg out of their right ear....
> 
> if it walks like a duck.. and quacks like a duck... its probably a duck...
> 
> ...



Again as I've stated before you don't know what you don't know.  And as lacking as we Paramedics are, basics do not know enough to even try and use common sense and tell the person no ride for you.  Sorry there is many an MI that does not present with the classic symptoms you describe and anyone with any real experience would know that.  

Now I am not saying every painful toe gets full cardiac, stroke, etc, work up but a patient with booze on board needs more than a basic taking vitals to say it is only toe pain.


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## Epi-do (Apr 28, 2010)

In the last year, I have been dispatched for various reasons, only to show up onscene and find out the "patient" wanted the following:

walked to the bedroom and tucked into bed
assistance filling out the accident form recieved from PD earlier in the day, after a property damage MVC
a report on road conditions and the weather, even though they had just gotten home 15 minutes ago (per the person who called 911 to begin with)
directions to the ER to visit a family member

Now, what was that, that was already posted about common sense?


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## mycrofft (Apr 28, 2010)

*Had a football student in his bd with a fx femur.*

Out breaking curfew, drunk, hit by a car, ran three blocks and got into bed upstairs so he wouldn't be busted...and he had a fx femur.
Heavy carry downstairs too, but he was quiet.

Then there was the time with the boat on the levy...
http://www.emtlife.com/showthread.php?t=10015


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## CAOX3 (Apr 29, 2010)

You wouldnt believe half of them, I still cant believe most of them and I was there.


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## FLEMTP (Apr 29, 2010)

medic417 said:


> Again as I've stated before you don't know what you don't know.  And as lacking as we Paramedics are, *basics do not know enough to even try and use common sense and tell the person no ride for you.*



Im sorry, but aren't you a "head honcho educator"? So to say that basics do not know enough to even try and use common sense ... wouldn't you be one of the folks responsible for this? ( IF it were a true statement)



> Sorry there is many an MI that does not present with the classic symptoms you describe and anyone with any real experience would know that.
> 
> Now I am not saying every painful toe gets full cardiac, stroke, etc, work up but a patient with booze on board needs more than a basic taking vitals to say it is only toe pain.



Now it seems to be that being an educator, you would be aware that Basics are very much more capable of assessing more than " a basic taking of vitals" and who better to assess whether a paramedic is needed than someone that is NOT a paramedic, but knows the capabilities of a paramedic as well as their own limitations.

Paramedics by nature tend to over treat because that's what we are here to do... give medicines, start IV's, treat illness and injury... especially paramedics who did not get a good firm grasp of the basics of EMS as an EMT prior to entering Paramedic school..they skip right over BLS, and go for the ALS, just like they skipped right over being a field EMT and went straight to Paramedic.

Ive said it before, and I will say it again. I would rather have a competent, experienced EMT over a paramedic as a partner any day of the week.

And I've said this before and I will also say it again:

If you really feel that basics are this worthless, then its a shame they let you teach... because you're going to do nothing more than instill feelings of inadequacy in these brand new EMT students. 

If you really feel that way, please do me, and everyone else in EMS, as well as those trying to get into it a favor, and get out of teaching...and EMS while you're at it. You're doing us all a great dis-service!

In fact, I cant wait for the day that something happens and you need EMS. I hope a crew of two EMTs arrive, and treat you with top notch service, save your life, and do a damn good job of it.


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## medic417 (Apr 29, 2010)

FLEMTP said:


> Im sorry, but aren't you a "head honcho educator"? So to say that basics do not know enough to even try and use common sense ... wouldn't you be one of the folks responsible for this? ( IF it were a true statement)
> 
> 
> 
> ...



Wow that is just rude and uncalled for.  I would never wish harm on anyone because they hold a different opinion than I do.  Sadly I have had to use an ambulance before and thank goodness it had two Paramedics because I would have been dead had I been in an area that send basics who then try and figure out if they need to be HEROs or call ALS and let them have the glory.  

You are doing the disservice by lying to emt's by convincing them they know more than they do.  

It would also be nice if you read entire posts because you would also see I said Paramedics do not have enough education either.  

Is it my fault that both educational levels are so low?  Guess I am as guilty as all the other educators that still attempt to give a proper education despite the limited number of hours allowed.  Perhaps myself and all other quality education professionals should refuse to teach.  Wonder what would happen?  Oh I know they would pay someone else who does not care and would turn out test takers not medical professionals.  I assure you my students that are given course completions come out far ahead of most programs in actual patient care.  But I am honest with all levels of how little they are getting so they do not develop the EMT God or Paragod complexes so many on here seem to have.  I use those terms to mean think they know more than they do.  

As to you wanting a basic over a Paramedic partner really makes me wonder a few things but I will not pursue that.


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## lightsandsirens5 (Apr 29, 2010)

jtpaintball70 said:


> Where is Vent posting in this thread?


 
Ummmm...I don't know. I could have sworn.........Ermmm....IIIIII......heh heh heh.


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## EMSLaw (Apr 29, 2010)

medic417 said:


> Again as I've stated before you don't know what you don't know.  And as lacking as we Paramedics are, basics do not know enough to even try and use common sense and tell the person no ride for you.  Sorry there is many an MI that does not present with the classic symptoms you describe and anyone with any real experience would know that.
> 
> Now I am not saying every painful toe gets full cardiac, stroke, etc, work up but a patient with booze on board needs more than a basic taking vitals to say it is only toe pain.



You're kidding, right?  So, it's basically your opinion that every call needs a medic?  Okay, fine, but think horses, not zebras here.  If I called for medics on something like this, I'd get a tongue lashing from the medics when they showed up.


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## medic417 (Apr 29, 2010)

EMSLaw said:


> You're kidding, right?  So, it's basically your opinion that every call needs a medic?  Okay, fine, but think horses, not zebras here.  If I called for medics on something like this, I'd get a tongue lashing from the medics when they showed up.



Actually yes every call should at minimum have a Paramedic on scene.  I agree most items are horses but there are enough what would be zebras to a basic that would still be horses to a Paramedic to justify the costs.  I personally would not want a basic making the decision that my family member does not need a Paramedic as they again do not know what they do not know.


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## mycrofft (Apr 29, 2010)

*Send nothing but medics, and pay them like EMT-B's*

Anyone else going back on thread?


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## EMSLaw (Apr 29, 2010)

medic417 said:


> Actually yes every call should at minimum have a Paramedic on scene.  I agree most items are horses but there are enough what would be zebras to a basic that would still be horses to a Paramedic to justify the costs.  I personally would not want a basic making the decision that my family member does not need a Paramedic as they again do not know what they do not know.



We certainly have a difference of opinion, then.  I think you're painting with a broad brush - not all basics are incompetent know nothings (though some certainly are, as are some medics).  Perhaps because I work in a tiered system, I see things differently.

I tend to agree that EMT-Basics lack a strong foundation when they come out of class.  Some of them, and I hope I can include myself in this, realize that and try to learn more.  And unless you happen to work in a system where there are only dual-medic trucks, every EMT will eventually be in the situation where they are all the help that's coming.  In that case, if they have no confidence and have always had a medic to do everything, then the problems you predict will become a self-fulfilling prophecy.


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## Tincanfireman (Apr 30, 2010)

mycrofft said:


> Anyone else going back on thread?


 
We have been called for a toothache at 0415 after pt had left the ER at midnight with a script for Vicodan, but didn't feel like getting it filled at the Walgreens across the street from the ER right then.

We have a FF (frequent flyer, not a brother firefighter) who calls at 0550 c/o pain, then walks out the door to meet his ride to work before we complete our paperwork. Yeah, it's abuse, but if they call, we gotta respond... grrr.

"Feeling sick" @ 0215; arrive to find pt has had a head cold for several days, but "didn't have time to call before now". Wow...

Ah, the joys and adventures of urban EMS... =)


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## svfd21emt (May 7, 2010)

mycrofft said:


> Anyone else going back on thread?



I agree...I started this thread to find out what other people get when they respond to calls in the middle of the night. I didn't start this thread to have a battle started between people, which it what has seemed to be started. So hears my suggestion...


LET'S GET BACK ON THE THREAD!!!!!!!!!!!!!!!!!!!!!!!:excl:...haha

So has anyone else had any funny middle of the night calls or frequent flyers during the middle of the night?????????


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## wolfwyndd (May 11, 2010)

svfd21emt said:


> So has anyone else had any funny middle of the night calls or frequent flyers during the middle of the night?


We used to have a frequent flyer who was a diabetic.  She would call at all hours of the day / night and her chief complaint was always that when she checked her sugar her meter would just read 'HI' and not give her a number.  She she'd call 911 and want to go to the hospital.  Invariably we'd show up on scene and she'd be sitting in front of her TV smoking a cigarette (and sometimes on home oxygen at the same time) with an open bag of skittles, M&M's and empty Nestle's wrappers scattered about the table in front of her and on the floor.  Every single time we'd show up on her she'd admit that she'd been sitting there eating nothing by candy and junk food and every single time we'd explain to her that's why her sugar was so high.  She never did get it.  In any given year, just her alone probably accounted for 10 - 15 percent of our calls until she moved to another jurisdiction about two years ago.


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## johnrsemt (May 21, 2010)

call for sick person;   lady at the entrance of apartment complex waved us down,  and we followed her as she walked (with her purse over her shoulder) through the complex parking lot; to a row of buildings.  we unloaded the cot, and followed her to the back bldg, and to the back of the building.  she unlocked her door and told us, to follow her into the apartment
  when we left the cot outside the door and walked in with her, she told us that she was the patient, and that she threw up one time approx 20 min earlier.

   she got upset when I told her to follow us back to the truck as I pushed the empty cot back.  then had her sit on the airway chair,  seat belted in.  she wouldn't let us take vital signs,  due to us not having NEW, in the plastic bag; equipment.   told the hospital the same thing


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## JeffDHMC (Jun 7, 2010)

_Actually yes every call should at minimum have a Paramedic on scene._

To say that _most_ calls need a paramedic is ludicrous. To say they _all_ do is beyond the realms of understanding.

Any basic can manage a tight assessment. In my opinion the only difference between a good basic and a good medic is what the can do in regards to procedures and medications. Any basic worth his salt can do what is important; have a high index of suspicion obtain a solid hx for the receiving facility. The extra bells and whistles that come with being a medic are just that and rarely make a difference. Vive la EMT-B.

Jeff


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## reaper (Jun 7, 2010)

I hope all of Denver doesn't have this mind set. It is called education!


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## wolfwyndd (Jun 8, 2010)

> The extra bells and whistles that come with being a medic are just that and rarely make a difference. Vive la EMT-B.


I agree with MOST of what you said, but I'm not sure I agree with this.  I believe the majority of calls a Basic can handle on their own, but there's quite a bit of calls that require WAY more then a Basic can provide.  Any good Basic worth their salt can tell what calls are out of their realm of treatment and will call for backup immediately.


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## Seaglass (Jun 10, 2010)

wolfwyndd said:


> I agree with MOST of what you said, but I'm not sure I agree with this.  I believe the majority of calls a Basic can handle on their own, but there's quite a bit of calls that require WAY more then a Basic can provide.  Any good Basic worth their salt can tell what calls are out of their realm of treatment and will call for backup immediately.



I usually stay out of this old debate, but it's early in the morning and I can't sleep. 

I think that a good team of basics technically can handle most calls, but I'd still far rather have ALS as part of each crew. I hate wondering whether it's really worth calling the intercept. I really hate seeing patients in pain when they could get relief. And I really, really hate having them crash and wondering when the medic will get there.


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## TransportJockey (Jun 10, 2010)

reaper said:


> I hope all of Denver doesn't have this mind set. It is called education!



I live in Denver for the moment, and I've been clear on the fact that I don't ahve this mindset


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## Bullets (Jun 10, 2010)

Long time lurker here, I work the 1800-0600 shift, so i am the king of the late nigth calls. 

0200-0400 is prime time for drunk time, bars close at 2 and the drunks try to go home and get in all kinds of trouble. had a guy last week at the local Quik Check who walked 6 miles from a wedding in a tux, fell down in the deli, and called for a ride home. took him to the hospital, ER nurses were thrilled...

had a guy who seemed drunk, disoriented, definatley AMS, blew a .00, no problems upon admitance, just a strange guy...

frequent flier, hx of MS and on like 15 Rx, routinely calls between 5-6 for migraine, body pains, UME, only to be released within the hour. She would also routinely call 911, we'd respond, shed refuse our transport and request a private company. i had the officers document her refusals, and later had her locked up for inciting a public alarm after 15 refusals. now she just calls the private company direct


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## Stephanie. (Jun 12, 2010)

I once was called to a parking lot of a gas station right on the county line, for face trauma..?? Once we got there, the patient was a 6yom that was bleeding from his gums. (Him and his cousin were throwing a monster truck (toy) instead of pushing it around and he was hit in the mouth.) The mother stated that she had her grandmother drive her there because they didn't want to be transported by the other county. (Which is completely understandable :-X ) The medic stated that we could take him to the ED, but they wouldn't be able to assist with that, he would have to see a dentist. The mother acknowledged, and then came back and asked if we could transport them to the ED (which is over an hour transport) so they could walk across the street to the dentist office because 'she didn't have a ride'. :glare:

"yea lady, get in"


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## SauceyEMT (Jun 12, 2010)

spike91 said:


> We get those all the time. I do a great deal of overnights, and a few Tuesday's ago at the start of the shift at 0013 or something similar, we were dispatched to a parking lot by one of the dorm buildings for an unknown medical.* We get there and it was two sorority girls that were a bit buzzed, nothing even resembling a medical emergency. Total waste of time*.



WTF? Since when are two sloppy drunk sorority girls a waste of time? What f*ckin' planet are you on? h34r:


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