# 101 Ways to Tell a Patient You Don't Need an Ambulance, Without Actually Saying so..



## IRIDEZX6R (Aug 16, 2011)

What key phrases do you guys use? Let the hilarity begin!


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## ArcticKat (Aug 16, 2011)

Dude, if you come with me you're getting this (14ga) in your arm, if you go in that car over there, you don't.


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## Epi-do (Aug 16, 2011)

I am more than happy to take you to the hospital in the ambulance, however, I am unable to do anything for your stubbed toe, and will just end up being a very expensive taxi ride.


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## JJR512 (Aug 16, 2011)

We don't mention expense because we don't charge.

I have heard things said like, "We'll be happy to take you if you'd like us to. In our assessment you look fine and your vitals are good. If we take you to the hospital you're in for a bumpy, uncomfortable ride and you're not going to get seen any quicker than if you have your [relative/friend/neighbor/local taxi company/etc.] take you, and we'll probably be directed to drop you off in the waiting room. You also have the option of contacting your own doctor to see what they think. And if you don't go with us now but things get worse later, feel free to call us again and we'll be happy to take you."

More or less.


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## firetender (Aug 16, 2011)

We can bring you but you'll be travelling with a corpse we just pulled out of the river that we were delivering to the Morgue when we got diverted to check you out.

or...

Your next door neighbor is scheduled to have a seizure at 4:30 today. We'll be back then.


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## MrBrown (Aug 16, 2011)

Brown would say something to them like "if you go to the hospital they are going to sit you in chairs, you won't get seen any faster and you are still going to be in for a very long wait and they probably won't do much, you are better off .... "

Then again Brown has never really said anything like that as Brown knows Brown is spoilt because Brown has no obligation to undertake non clinically necessary transport even if the patient insists


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## bigbaldguy (Aug 16, 2011)

Untuck half your shirt and pick up an empty beer bottle from the side of the road then come staggering around the side of the ambulance and in your best deliverance voice state the following.

"Git in dah back uh duh truck and take dem clodes off, we'se gonna havt'a take a looksee at yah"


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## jjesusfreak01 (Aug 16, 2011)

We are happy to take you to the ER if that is where you would like to go, however, during our evaluation we were unable to find any signs that you suffer from an emergent condition that would benefit from a trip to the ER. We recommend that you see you primary care/urgent care doctor as soon as possible. Feel free to call us back if anything changes or you change your mind about going to the hospital. Please sign this form that absolves us from liability in case you actually are fixing to die. Have a nice day.


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## DesertMedic66 (Aug 16, 2011)

We can't say that a patient doesn't need to be transported by an ambulance. If they want to go for the smallest reason then well they are going. If they don't want to go even for the smallest thing we have a whole 12 step process for signing AMA :wacko:


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## STXmedic (Aug 16, 2011)

What this time?
No, it still hasn't changed
No, you aren't dying
Did you call your doctor yet?
No, the ED isn't going to treat your high BP of 140/92
Does your car have gas?
No, i'm not saying I _wont_ take you
Yes, you _are_ wasting my time
THEN TAKE A TAXI!!!
Alright, see you in a little bit



One side of the dialogue that I heard not too long ago


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## Flightorbust (Aug 17, 2011)

when I was doin my clinicals) Shure we can take ya, But were gonna let the student handle the call. looks at me, they taught you IV's right.


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## fast65 (Aug 17, 2011)

We'll basically tell them "we'll gladly take you to the hospital if you want, however, I can't guarantee that your insurance will pay." Then we can go on and explain further if need be.

Sent from my mobile command center


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## IRIDEZX6R (Aug 17, 2011)

You want to go because you're hungry? Well, I'm sure they'll get you something eventually. But, you know. Its a friday night, the ER is packed with all those ETOH and DFO's. But you know, it'll only be a couple hours in triage, and then a couple hours in a hall bed, and a few more hours after that. But I'm sure SOMEONE will get you something, eventually. No insurance you say? It'll be one exspensive meal sir. You changed your mind you say? Here, sign this form. Good day, sir.


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## traumaluv2011 (Aug 19, 2011)

I haven't gotten anything that didn't really need a transport, yet. Anything that was pretty minor, like a few scrapes and stuff the patient was smart enough to know they didn't really need to go to the hospital. Even a guy on a bike stuck by a vehicle going 30-35 mph. Medics checked him out after we did and we couldn't find anything serious. He only had minor abrasions on his hands.


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## Lady_EMT (Aug 19, 2011)

traumaluv2011 said:


> I haven't gotten anything that didn't really need a transport, yet. Anything that was pretty minor, like a few scrapes and stuff the patient was smart enough to know they didn't really need to go to the hospital. Even a guy on a bike stuck by a vehicle going 30-35 mph. Medics checked him out after we did and we couldn't find anything serious. He only had minor abrasions on his hands.



That seems like a decent enough mechanism to push him to go to the hospital... 

I've always loved the people who think the ambulance will get them seen quicker. I tell them, "do you want an expensive ride to the waiting room, or do you want to drive yourself?" Lol. 


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## Hunter (Aug 19, 2011)

Flightorbust said:


> when I was doin my clinicals) Shure we can take ya, But were gonna let the student handle the call. looks at me, they taught you IV's right.


 
Lol! I think I'll use this one some time...


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## mikie (Aug 19, 2011)

*I haven't personally done this...*

The plethora tactic around here seems to be telling patients which hospitals are "busy" thus we'll have to take you to XXX hospital (which has a poor reputation)...REFUSAL signed!


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## HotelCo (Aug 19, 2011)

Lady_EMT said:


> That seems like a decent enough mechanism to push him to go to the hospital...
> 
> I've always loved the people who think the ambulance will get them seen quicker. I tell them, "do you want an expensive ride to the waiting room, or do you want to drive yourself?" Lol.
> 
> ...



Mechanism of injury isn't an indication of needing to goto the hospital. 


Sent from my iPhone using Tapatalk


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## STXmedic (Aug 19, 2011)

HotelCo said:


> Mechanism of injury isn't an indication of needing to goto the hospital.
> 
> 
> Sent from my iPhone using Tapatalk



http://www.youtube.com/watch?v=YzYxz_uvtSI&feature=youtube_gdata_player


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## MrBrown (Aug 20, 2011)

PoeticInjustice said:


> http://www.youtube.com/watch?v=YzYxz_uvtSI&feature=youtube_gdata_player



Looks like EMS in California all right 

While one should not discount a mechanism of injury, it cannot be used in isolation from sound clinical judgement to determine treatment 

Should we give some bloke a CT just because he was in a road traffic accident? No.  Should we strap everybody to a long spine board just because they hit their head? No.


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## Lady_EMT (Aug 20, 2011)

MrBrown said:


> Looks like EMS in California all right
> 
> While one should not discount a mechanism of injury, it cannot be used in isolation from sound clinical judgement to determine treatment
> 
> Should we give some bloke a CT just because he was in a road traffic accident? No.  Should we strap everybody to a long spine board just because they hit their head? No.



Didn't watch that link, but I'm assuming it's that animated video about everyone freaking out about moi? Haha awesome video. 

And yes, Brown, I agree. I just think it should be the difference between being "yea, it's not a big deal, just sign this refusal," vs "I can't make you go, but I'd highly suggest you get checked out, even if you drive yourself to the hospital."


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## MedicBender (Aug 20, 2011)

mikie said:


> The plethora tactic around here seems to be telling patients which hospitals are "busy" thus we'll have to take you to XXX hospital (which has a poor reputation)...REFUSAL signed!



Yup... Most of them want to go out of county to some hospital in N. Baltimore or DC. 

My partner uses this one a lot

"I'm sorry ma'am but county protocols state that we take you to the closest appropriate facility, and we unfortunately can't take you 45 minutes north just because you don't like the doctors here"


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## mikie (Aug 20, 2011)

*Bon Secours, anyone?  ;-)*



MedicBender said:


> Yup... Most of them want to go out of county to some hospital in N. Baltimore or DC.
> 
> My partner uses this one a lot
> 
> "I'm sorry ma'am but county protocols state that we take you to the closest appropriate facility, and we unfortunately can't take you 45 minutes north just because you don't like the doctors here"



Yes!  I hate this!  "Our protocols says..."  -but there is some truth to the 'closest medical facility crap' when patients really want to go to their covered hospital, which typically isn't more than a few more miles down the road (cause we ain't short hospitals around here...).  I hate hate hate it.

edit: i'm not talking about bypassing a level 2 to go to a level 1 or other Specialty Referral Center,  this is more for the casual medical, if you will


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## MedicBender (Aug 20, 2011)

mikie said:


> Yes!  I hate this!  "Our protocols says..."  -but there is some truth to the 'closest medical facility crap' when patients really want to go to their covered hospital, which typically isn't more than a few more miles down the road (cause we ain't short hospitals around here...).  I hate hate hate it.
> 
> edit: i'm not talking about bypassing a level 2 to go to a level 1 or other Specialty Referral Center,  this is more for the casual medical, if you will



We usually pull the closest facility thing when they request a hospital that requires us to pass 5 other hospitals on the way there. 

The only time I've gone to a level 2 vs. a level 1 is when we are close to PG Trauma then to STC. Even though I HATE going to PG...


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## jjesusfreak01 (Aug 20, 2011)

mikie said:


> Yes!  I hate this!  "Our protocols says..."  -but there is some truth to the 'closest medical facility crap' when patients really want to go to their covered hospital, which typically isn't more than a few more miles down the road (cause we ain't short hospitals around here...).  I hate hate hate it.



We will happily take people to any hospital they wish within county, and although there is one hospital that has a somewhat worsened reputation, it is requested more than the others (for who knows what reason). We can also go to neighboring counties if requested or for closest appropriate facility, but "I want to go to UNC" isn't accepted by all medics as a legitimate reason, and I have heard the phrase "choose again" uttered when the patient requested such a transport.


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## JJR512 (Aug 20, 2011)

MedicBender said:


> Yup... Most of them want to go out of county to some hospital in N. Baltimore or DC.
> 
> My partner uses this one a lot
> 
> "I'm sorry ma'am but county protocols state that we take you to the closest appropriate facility, and we unfortunately can't take you 45 minutes north just because you don't like the doctors here"


 
Where are you? Judging by this comment and the later one about PG vs. STC, it seems pretty obvious you're somewhere between Baltimore and DC, probably in PG or AA. Howard is always closer to STC than PG Trauma.

(I'm in Howard County, by the way. )


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## irish_handgrenade (Oct 12, 2011)

I arrived on scene at the greyhound station,  and a transient male got into my truck. I asked him what the problem was he says " my knee hurts real bad".  I asked him how long ago it started and he replied, " oh about 30 maybe 35 years ago". In a stunned voice/look I asked him if anything had changed or if the pain was worse in some way? He replied " nope, figured I'm not really sure where I am in town, or what's close to me, and I don't have anything else to do so I figured now was as good a time as any to go get it checked". With the most shocked look on my face I told the MSN," this is the most blatantly abuse of an ambulances I have ever seen, I will take you to the ER, but if someone dies on this side of town while I'm transporting you I want you to know it is your fault. " I then told him to buckle hus seat belt and not to talk to me during my map to the ER.


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## canadianparamedic (Nov 19, 2011)

Say "yeah you can come with us to the hospital but first  you have to help us  dump these bodies in the back into that ditch."


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## Shishkabob (Nov 19, 2011)

"She's an adult, it's her decision if she wants to go or not, not yours.  If she doesn't want to go, that's fine by us"


"So, do you want us to take you?"


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## BrushBunny91 (Nov 20, 2011)

You can walk can't you?


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## STXmedic (Nov 20, 2011)

Is that your car? Does it run?


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## crazycajun (Nov 20, 2011)

Sure we will take you!! Is this your first time in an ambulance? No, well it is my first time with a PT and I have been playing around with these paddle thingies making grilled cheese and I have been dying to try them on a PT and today is my.... I mean your lucky day!!!!


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## rhan101277 (Nov 21, 2011)

I had a call where someone got hit by a lightbulb in the hand.  It was one of those small energy saving ones that go in lamps.  He had a very MINOR abrasion, if that, that didn't even break the skin.  He was worried about possibly getting mercury poison and wanted to get checked out.  I said hop in.  Wish I could have said call a taxi.


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## rhan101277 (Nov 21, 2011)

firefite said:


> We can't say that a patient doesn't need to be transported by an ambulance. If they want to go for the smallest reason then well they are going. If they don't want to go even for the smallest thing we have a whole 12 step process for signing AMA :wacko:



This, but no 12 step process needed.  It is tough to explain what could happen if you don't go get this paper cut looked at that didn't break the skin.


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## medicnick83 (Nov 21, 2011)

I personally use the honest route;

We had a call for a girl who had blisters and such all over her body, we got there and when we go there the blisters/spots had gone from "all over" to "only a here and there" so I told her honestly, I can take you to hospital, but you'll probably only get seen tomorrow morning - and by the time they (the doctors) see you, your spots would've gone away and then you're going to be so angry at "ME" because I bought you here. LOL.

See how it is in the morning, if it hasn't gone away completely, go to the doctor/hospital - or, call a ambulance again.


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## shannonlovesth (Dec 24, 2011)

We get a lot of "Do you think I/He/She should go to the hospital" basically we just say if they don't have to go "We are an ambulance company legally we have to recommend you go but we can't force you to. It's up to you."


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## themooingdawg (Jan 30, 2012)

firefite said:


> We can't say that a patient doesn't need to be transported by an ambulance. If they want to go for the smallest reason then well they are going. If they don't want to go even for the smallest thing we have a whole 12 step process for signing AMA :wacko:



in la county?


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## themooingdawg (Jan 30, 2012)

So here's the deal, everything that we can do from our side checks out: your heart looks great, your blood pressure is fine, and you're getting good oxygen to your body. Based on your complaint, its not necessarily an emergency that requires something to be done at this exact time, we can take you to the hospital if you want, but rest assured that you will not get seen any faster as you may have heard from people. Usually for your situation, you'll be waiting for at least 6 or so hours before you get checked out, and even then its only to take your blood pressure and ask you what your name is. Also, the ambulance ride that you could've avoided by having you brother right there drive you will also cost you about 1300 dollars.


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## SkaMedic (Jan 30, 2012)

This one is the worst...true story.

I was on the ambulance and responded to a woman who had a seizure while she was waiting in line for her check at the social security office.
The fire department was on scene checking her out and bystanders were saying they watched her have a "full body seizure".
While she was still lying on the floor, the captain asked her if she drove herself. She said yes.  Then he asked her if there was anyone who could take her to the hospital.  She said no.  Then he asked if she had any family. She said she had a son but before he could say anything else she said that she hadn't seen him in over 20 years.  I couldn't believe it when he said, "that's ok m'am, if you have his number I can call him for you, he can take you to the hospital, you can see your son"  I couldn't believe how lazy these guys were.  I felt so sorry for her and told her not to worry, we were going to take her.  Once fire department saw that we were an ALS unit they were gone so fast and left us with the patient.


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## DesertMedic66 (Jan 30, 2012)

themooingdawg said:


> in la county?



RivCo


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