# Finally! EMS abuse in the spotlight!



## All Ryle Dup (May 22, 2013)

This is a story with video out of California, but it certainly applies EVERYwhere! It should be a National PSA. Share this on your twitters or facebooks or whatever! I get that it is the nature of our job to deal with some BS, but we can all agree that it's getting outrageous. It is a contributing factor to increasing call volume, diminished down time, personnel injury, increased response times, flat out burn out, etc. I hope this local story gains traction. I'm in Vegas, so I can tell you we have more than our fair share of BS!
Enjoy & Disperse. 

http://www.news10.net/news/article/245933/2/911-system-strained-with-abusive-calls


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## 46Young (Jun 6, 2013)

All Ryle Dup said:


> This is a story with video out of California, but it certainly applies EVERYwhere! It should be a National PSA. Share this on your twitters or facebooks or whatever! I get that it is the nature of our job to deal with some BS, but we can all agree that it's getting outrageous. It is a contributing factor to increasing call volume, diminished down time, personnel injury, increased response times, flat out burn out, etc. I hope this local story gains traction. I'm in Vegas, so I can tell you we have more than our fair share of BS!
> Enjoy & Disperse.
> 
> http://www.news10.net/news/article/245933/2/911-system-strained-with-abusive-calls



No matter where I go, from ghetto areas of queens and Brooklyn, to the suburban Southeast, to one of the most affluent counties in the nation, the BS calls are always there. 

We have our share of frequent fliers that call several times a week, or even several times a day, as the case may be. There have been several instances of patients being permanently placed into nursing homes since they shouldn't have been living alone due to lack of function, and kept wearing out 911 to help out with activity of daily living issues. 

Many of our non-acute calls here are due to ignorance and laziness. People just call 911 instead of trying to solve their own (minor) problems before calling an emergency number. If I had a dollar for every patient that was stable and functional, called 911 for a minor sick-related complaint, owner a working car, and had family follow behind us in that car, I could pay my mortgage for this month.

At one time, we had a patient that worked near a hospital, which was farther away than two other facilities. The call was always for asthma, in the morning, close to the time we were supposed to get off shift. This guy would get his free treatment, and a free ride to work. He didn't stay in the ED; he just left for work. We got our regularly scheduled late job.

We need a law that it's the provider's discretion what hospital that the pt goes to. We should be able to txp to the closest appropriate facility all of the time, unless we feel like accommodating the pt. We should be able to bypass a hospital that's on diversion, even though the pt still insists on going there.


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## mycrofft (Jun 6, 2013)

This is about abuse of the 911 system. The thread title suggests to me people spitting on EMTs.


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## All Ryle Dup (Jun 7, 2013)

mycrofft said:


> This is about abuse of the 911 system. The thread title suggests to me people spitting on EMTs.



Is it not metaphorically? Take me to work in your cabulance? I'd rather they spit on me.


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## Jim37F (Jun 7, 2013)

I heard on the news that Santa Monica, CA is wanting to start a pilot program where the medics can determine where you need to go, such as transporting to an Urgent Care instead of an ED


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## CentralCalEMT (Jun 7, 2013)

In Fresno County, CCEMSA, the EMS agency has ruled that several individuals who have abused 911 literally hundreds of times each can be refused transportation if their vital signs are stable. Their pictures and information is carried on the units and there are protocols in place to refuse transport to them. Additionally, some other patients who are known as system abusers that have abused the system less than the most severe ones are listed as patients who no longer have hospital choice and must be taken to the closest hospital regardless of their request. EMS is such a limited resource that its nice to see a proactive approach to this issue.


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## the_negro_puppy (Jun 7, 2013)

Jim37F said:


> I heard on the news that Santa Monica, CA is wanting to start a pilot program where the medics can determine where you need to go, such as transporting to an Urgent Care instead of an ED



We sorta have the ability to do this-

Attended a  41 y.o M pt c/o headaches last few hours. Pt had been unwell with cold / flu like symptoms for 2 days, with sore throat before developing a pertinsilar abcess. Was placed on ABs by Family doctor that morning. Had fever throughout the day but was afebrile on our assessment. Also stated he hadn't been drinking much fluid / water. ALl neuro assessments were normal, BP, HR, BSL everything. No rsik factors for a bleed. Had taken paracetamol / weak codeine combo but wasn't helping too much. Nil emesis so he could tolerate oral fluids.

I told the pt of my assessment- that his headaches were due to insufficient hydration and having an active infection. I informed him that my assessments were normal and that a CVA / stroke / serious infection was unlikely. I offered him transport to hospital outlining what they would do there (20 minute drive away) or gave him the alternative of attending an after hours clinic that was open and bulk-billed (no out of pocket) cost, to be assessed by a physician and possibly given alternative analgesia. He opted to go to the nearby clinic with his mother driving him. 

This was beneficial in that it avoided using an ambulance when it wasn't really required, and avoided using up an ED bead, nurse , Dr etc for a condition that probably wasn't an emergency. As the patient was seeing the Doctor immediately, there is less liability on myself as he is going to a higher level of care, and if the Physician thinks he needs to attend an ED it will be arranged.

I was more comfortable NOT transporting as I have had the same condition this year with identical symptoms.


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