# Here I am Shaking My head Again!!



## MedicPrincess (Oct 6, 2005)

You know, I guess I will never stop being surprised at how rotten some people are.  Our patient load has been like this tonight:

1 guy with 7 bullets in him - mostly in the head

2 CVA's

2 Positive MI's

1 Trauma Alert - Motorcycle Vs F350

and the usual coughs, colds, back pains, psychs ect.

The mom of one of our sore throats came to my window and started pitching a fit that her daughter had been here 2 hours and they took "that guy" before her.

It went like this from there...

"Yes Ma'am, we did.  He has a critical life threatening injury."
"But he walked in."
"Yes Ma'am he did.  But seeings as though he was shot, he would naturally go first."
"Well we have been here for 2 hours and we were here before him."
"Yes ma'am, but I am sure you understand someone shot in the head should be seen right away before a sore throat."
"No, we were here first, we should get to go first.  I guess we will just have to leave."
"Ok, I will tell the Nurses you have left, as soon as they get out of the room with the guy who was shot IN THE HEAD."

And away she went.  People SUCK!!!


----------



## Wingnut (Oct 6, 2005)

:blink:

you should have added that if she took her daughter to HER DOCTOR maybe she wouldn't have been waiting so long.


----------



## Jon (Oct 6, 2005)

:blink: 

Oooooohh Kaaayy then.

Stupidity has no bounds.


It would have been better if they asked "how can I get seen that fast?" answer being, of course, "go get yourself shot."

Jon


----------



## rescuecpt (Oct 6, 2005)

Hehehe, I know this is bad, but if a friend tells me they're going to the ER, first I ask "why the heck would you want to do that - I know a very nice doc-in-the-box you could go to".  If they insist, I tell them they need to vomit, pass out, or have respiratory difficulty otherwise they'll be sitting there for hours.  They come back and say "yep, I was there for 6 hours, but the girl who passed out got taken in right away."


----------



## Wingnut (Oct 6, 2005)

It gets pretty ridiculous what people go to the ER for. I know the main reason is because they can't afford a visit with a regular doc or a walk in clinic, but c'mon, they can definitly pick better times to call. 
It's kind of like that resp distress call you get at 4am. Walk into the person's house and get, he's had trouble breathing for 3 days!  (I would just LOVE to ask, why didn't you take him to the doc then, during the day, when it started, instead of waking us up??)
My husband went in once for kidney stones. It was a Sunday and he was in bad shape... he had to wait 8 hours, but he hurt too much to complain.


----------



## TTLWHKR (Oct 6, 2005)

I always 'hated' when people called an ambulance for stupid ****, as if they were going to get seen in the ER more quickly. Of course that's what people do, you walk in and you wait, you get wheeled in and you're the center of attention. Luckily we have the golden key, known as Triage..

If you can walk, aren't bleeding severely, aren't vomitting, are conscious, aren't having serious chest pain with one of the following being SOB, abd pn or diaphoresis.. You get to sit in Triage and wait.

Only bad part is that some ER's won't sign off, until someone is seen... So it ties units up, always important to know where the ER's transport stretchers and wheel chairs are! That way you can have some idiot sign the sheet, and put the patient on someone elses stretcher (unless theirs is better, in which case you leave yours and take theirs).

UofPMC had a sign about the check in window that said "Triage: Worse Cases Take Priority, No Matter How Long You've Been Waiting. I.E. Lack of Planning On Your Part, Does Not Constitute an Emergency On Ours."


----------



## Jon (Oct 6, 2005)

> _Originally posted by TTLWHKR_@Oct 6 2005, 11:00 AM
> * UofPMC had a sign about the check in window that said "Triage: Worse Cases Take Priority, No Matter How Long You've Been Waiting. I.E. Lack of Planning On Your Part, Does Not Constitute an Emergency On Ours." *


 I LOVE the sign..... does it say ALL of that???


As for triage and waiting.... I've heard stories of how MCP Hospital in Philly used to be. They closed last year, and the year before that, they dropped their status as a Level 1 Trauma Center.... I spen 2 months posting there in a ALS truck for stat transfers from the ER and ICU before they closed.... they still had walk-in GSW's, because everyone but EMS thought they were still a trauma center  

Anyway... it used to be that 8 hour waits were common, even for "real" things like kidney stones and gallbladder attacks. I've heard stories of the ER attending going into the waiting area at 1730 or 1800, and explaining that it was a busy day, and it would still be awhile before most folks got back, and he understood it was dinnertime, and that most folks had been there since before lunch. "If you want to go home to get dinner... we can't stop you. Please check out with the clerk before leaving. You will lose your place in line, but if you feel like you can go home to eat, you probably don't need to be here anyway, and can folow up with your family Doctor tomorrow. If you stay, we will get to you, but it wil be awhile... we are working as fast as we can."  Apparently a bunch of folks would leave......


Jon


----------



## Wingnut (Oct 6, 2005)

> _Originally posted by MedicStudentJon_@Oct 6 2005, 10:58 AM
> * You will lose your place in line, but if you feel like you can go home to eat, you probably don't need to be here anyway, and can folow up with your family Doctor tomorrow. *


 That day I took jay for the kidney stones, there were people in there with thier wristbands on, talking, laughing, etc. If you can eat, laugh, chat up on your cell phone...Do you REALLY need to be in the ER???

There should be a little ER gnome, with a clip board and a special hat  that sends these people home.


----------



## rescuecpt (Oct 6, 2005)

> _Originally posted by Wingnut_@Oct 6 2005, 12:44 PM
> * There should be a little ER gnome, with a clip board and a special hat  that sends these people home.   *


 I like magical elves, personally.

Someone to enforce the "EMERGENCY" part of emergency room.  Not free doctor visit.  

At one of our hospitals, they have set up a 2 room fast-track area for all non-emergent visits.  You see a PA and a CNA.  That's it.  They order x-rays, wrap you, do minor surgical procedures (stitching, non-critical impailments, whatever), and write scrips.  Works pretty well, but they're ALWAYS crowded.


----------



## Wingnut (Oct 6, 2005)

> _Originally posted by rescuecpt+Oct 6 2005, 01:56 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (rescuecpt @ Oct 6 2005, 01:56 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-Wingnut_@Oct 6 2005, 12:44 PM
> * There should be a little ER gnome, with a clip board and a special hat that sends these people home.  *


I like magical elves, personally.

Someone to enforce the "EMERGENCY" part of emergency room.  Not free doctor visit.  

At one of our hospitals, they have set up a 2 room fast-track area for all non-emergent visits.  You see a PA and a CNA.  That's it.  They order x-rays, wrap you, do minor surgical procedures (stitching, non-critical impailments, whatever), and write scrips.  Works pretty well, but they're ALWAYS crowded. [/b][/quote]
 We have the exact same system, except you see a PA. But it doesn't reduce the crowd or the waiting time. 

Magical Elves are cooler, yes, but Gnomes are grumpier. They'd get less flack.


----------



## TTLWHKR (Oct 7, 2005)

> _Originally posted by MedicStudentJon+Oct 6 2005, 10:58 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (MedicStudentJon @ Oct 6 2005, 10:58 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-TTLWHKR_@Oct 6 2005, 11:00 AM
> * UofPMC had a sign about the check in window that said "Triage: Worse Cases Take Priority, No Matter How Long You've Been Waiting. I.E. Lack of Planning On Your Part, Does Not Constitute an Emergency On Ours." *


I LOVE the sign..... does it say ALL of that???


As for triage and waiting.... I've heard stories of how MCP Hospital in Philly used to be. They closed last year, and the year before that, they dropped their status as a Level 1 Trauma Center.... I spen 2 months posting there in a ALS truck for stat transfers from the ER and ICU before they closed.... they still had walk-in GSW's, because everyone but EMS thought they were still a trauma center  

Anyway... it used to be that 8 hour waits were common, even for "real" things like kidney stones and gallbladder attacks. I've heard stories of the ER attending going into the waiting area at 1730 or 1800, and explaining that it was a busy day, and it would still be awhile before most folks got back, and he understood it was dinnertime, and that most folks had been there since before lunch. "If you want to go home to get dinner... we can't stop you. Please check out with the clerk before leaving. You will lose your place in line, but if you feel like you can go home to eat, you probably don't need to be here anyway, and can folow up with your family Doctor tomorrow. If you stay, we will get to you, but it wil be awhile... we are working as fast as we can."  Apparently a bunch of folks would leave......


Jon [/b][/quote]
 Yeah, it really says that. It's true.. Just b/c you waited till a friday nite a 9pm to figure out that you can stand your sore throat, doesn't mean it's an Emergency that you can't wait till Monday morning.


----------



## MedicPrincess (Oct 7, 2005)

> _Originally posted by TTLWHKR_@Oct 6 2005, 10:00 AM
> * Of course that's what people do, you walk in and you wait, you get wheeled in and you're the center of attention. Luckily we have the golden key, known as Triage..
> 
> *


 One patients family came to my desk last night, they asked how much longer they would have to wait.  I gave my canned "Its been a busy night" speech.  They responded with, 

"I don't know about all that.  I know I had my mama come here by amblance and she still aint seen no Dr.  Alll theys done is put that thing on her arm and its been 3 hours."

I responded with my also canned "Well think of it this way, When you come into the ER and the nurses and Dr is standing there with gloves on waiting for you, its not looking to good for you.  But if they put your chart in the rack you can rest assured they are reasonably certain you will live to see another day.  If it were me, I'd rather they not be standing there with gloves on waiting.  What do you thing?"

After staring at me for a few seconds with that deer caught in the headlights look, he turned and said "Well I's guess I's will go sit and wait with mama.  But could I's get one of them hot blankets, cause I's freezin my toes off."

OH...mama came by EMS for finger pains.


----------



## Wingnut (Oct 7, 2005)

> _Originally posted by EMTPrincess+Oct 6 2005, 11:25 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (EMTPrincess @ Oct 6 2005, 11:25 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-TTLWHKR_@Oct 6 2005, 10:00 AM
> * Of course that's what people do, you walk in and you wait, you get wheeled in and you're the center of attention. Luckily we have the golden key, known as Triage..
> 
> *


One patients family came to my desk last night, they asked how much longer they would have to wait.  I gave my canned "Its been a busy night" speech.  They responded with, 

"I don't know about all that.  I know I had my mama come here by amblance and she still aint seen no Dr.  Alll theys done is put that thing on her arm and its been 3 hours."

I responded with my also canned "Well think of it this way, When you come into the ER and the nurses and Dr is standing there with gloves on waiting for you, its not looking to good for you.  But if they put your chart in the rack you can rest assured they are reasonably certain you will live to see another day.  If it were me, I'd rather they not be standing there with gloves on waiting.  What do you thing?"

After staring at me for a few seconds with that deer caught in the headlights look, he turned and said "Well I's guess I's will go sit and wait with mama.  But could I's get one of them hot blankets, cause I's freezin my toes off."

OH...mama came by EMS for finger pains. [/b][/quote]
 Princess, I love your stories from work...


Good second speech, I would imagine that shuts a few people up   

Finger pain??


----------



## CaptainPanic (Oct 7, 2005)

OWWW! I JAMMED MY FINGER! SOMEBODY CALL 911!!! ROTFL :lol:  :lol:


----------



## Wingnut (Oct 7, 2005)

> _Originally posted by CaptainPanic_@Oct 7 2005, 09:21 AM
> * OWWW! I JAMMED MY FINGER! SOMEBODY CALL 911!!! ROTFL :lol:  :lol: *


 LMFAO  :lol:  :lol:  :lol:


----------



## TTLWHKR (Oct 7, 2005)

> _Originally posted by CaptainPanic_@Oct 7 2005, 09:21 AM
> * OWWW! I JAMMED MY FINGER! SOMEBODY CALL 911!!! ROTFL :lol:  :lol: *


 I had a fireman jam his finger while loading cribbing, he turned white as a ghost and collapsed.. Couldn't move, couldn't talk, just layed there.

VasoVagal Reaction.


----------



## Jon (Oct 7, 2005)

> _Originally posted by TTLWHKR+Oct 7 2005, 01:16 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (TTLWHKR @ Oct 7 2005, 01:16 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-CaptainPanic_@Oct 7 2005, 09:21 AM
> * OWWW! I JAMMED MY FINGER! SOMEBODY CALL 911!!! ROTFL :lol: :lol: *


I had a fireman jam his finger while loading cribbing, he turned white as a ghost and collapsed.. Couldn't move, couldn't talk, just layed there.

VasoVagal Reaction. [/b][/quote]
 Layed????

Laid!

Jon


----------



## CaptainPanic (Oct 7, 2005)

He got laid.....     :lol:


----------



## MedicPrincess (Oct 7, 2005)

> _Originally posted by MedicStudentJon+Oct 7 2005, 12:46 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (MedicStudentJon @ Oct 7 2005, 12:46 PM)</td></tr><tr><td id='QUOTE'>
> 
> 
> 
> ...


Layed????

Laid!

Jon [/b][/quote]
  :lol:    :lol:    HA!  Jon correcting anybodies spelling....NOW i have seen it ALL!!!


----------



## Jon (Oct 7, 2005)

> _Originally posted by EMTPrincess+Oct 7 2005, 06:04 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (EMTPrincess @ Oct 7 2005, 06:04 PM)</td></tr><tr><td id='QUOTE'>
> 
> 
> 
> ...


:lol:    :lol:    HA!  Jon correcting anybodies spelling....NOW i have seen it ALL!!! [/b][/quote]
 Good point...

but it wasn't so much spelling as grammer....


----------



## TTLWHKR (Oct 8, 2005)

> _Originally posted by MedicStudentJon+Oct 7 2005, 12:46 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (MedicStudentJon @ Oct 7 2005, 12:46 PM)</td></tr><tr><td id='QUOTE'>
> 
> 
> 
> ...


Layed????

Laid!

Jon [/b][/quote]


----------



## TTLWHKR (Oct 8, 2005)

> _Originally posted by CaptainPanic_@Oct 7 2005, 02:53 PM
> * He got laid.....     :lol: *


 Actually...   B) 

That's one of the quirks about being married.






> *Layed????
> 
> Laid!
> 
> Jon *




Inflatable women don't count.


----------



## CaptainPanic (Oct 8, 2005)

> _Originally posted by TTLWHKR+Oct 7 2005, 11:08 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (TTLWHKR @ Oct 7 2005, 11:08 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-CaptainPanic_@Oct 7 2005, 02:53 PM
> * He got laid.....    :lol: *


Actually...   B) 

That's one of the quirks about being married.






> *Layed????
> 
> Laid!
> 
> Jon *




Inflatable women don't count. [/b][/quote]
 actually for some marriage negates the need to be undressed.

as for the inflatable for some it better than nothing, sadly.

-CP


----------



## ffemt8978 (Oct 9, 2005)

T.M.I.


----------



## Wingnut (Oct 9, 2005)

> _Originally posted by ffemt8978_@Oct 9 2005, 02:30 AM
> * T.M.I. *


 ROFL  :lol:  :lol:


----------



## TTLWHKR (Oct 9, 2005)

> _Originally posted by CaptainPanic_@Oct 8 2005, 07:34 PM
> *
> 
> as for the inflatable for some it better than nothing, sadly.
> ...


 That's just wrong...


----------



## emtff99 (Oct 22, 2005)

I can remember getting calls in the Projects @ the wee hours of the morning, because "my baby gotsta cold, she gotsta go ta childirns" (This was back when the Pa Welfare System had the Green Med Cards & Blue Visa Med Cards) We would explain that which hospital was closer (McKeesport was only 2 miles away, Braddock was 4 miles & Children's was 9 miles away) and also the child with a cold is not a serious emergency to run to CHP,  Wow, that tick them off!! (A few of them were Crack heads or herion Addicts, and Oakland was the place to get their goodies).  


I am happy now running Country Ems, less mess to deal with & still a "few" idiots but not as many.


----------



## ma2va92 (Oct 22, 2005)

I really enjoy the pt's that call for the little stuff... ie: foot hurts times 2 weeks... so i had to calll 911 cause the car is dead....  pt. walks to the ambulance......4yo with a running nose x4days.... well I call medical control to let them know we are coming in and with what.... reply is 10-4 please place pt. in waiting rm.... YESSSSSSSSSSSSS.. love it

then pt. will start why are you putting my in a wheel chair and sitting me in the waiting room......They are working on sick ppl in the  ER and will call you as soon as they can........ smile and walk away.. if i say to much I'll get into troble.. caue there is a lot to tell them....

just wish they would OK us to charge .... it's still all free..... all volunteer service

or dispatch would have IQ listed with the caller ID.... and let us know..we have a plant life IQ call


----------



## Stevo (Oct 22, 2005)

well we all know jacho rules won't allow for an er to turn away so much as a finger don't we, and we ems'ers can't refuse to transport one either right?

somewhere there's 45 million uninsured Americans that have figured this out eh?

maybe we should call it Whine-11 ?

~S~


----------



## emtff99 (Oct 22, 2005)

Many Frequent Flyers!!! "My baby gotsta cold", "I have been sneezing for 5 days now & cant walk" (But yet walks to the Unit!!!) the list goes on & on. What really would crack me up though is when the Pt has something (IE: the sneezing x5days) and you would ask them "Why havent you called your Reg. Dr for this?" the Response was "I dont have any Health Insurance or cant get Welfare"  I have always bit my tounge & but wanted to ask "You think We wont send you the bill directly?" Part of Human Nature or stupidity,,who knows.


----------



## MedicPrincess (Oct 22, 2005)

> _Originally posted by Stevo_@Oct 22 2005, 08:57 AM
> * well we all know jacho rules won't allow for an er to turn away so much as a finger don't we, and we ems'ers can't refuse to transport one either right?
> 
> *


 This isn't so much as JACHO not allowing an ER to turn anybody away, but a bigger and more evil monster known as EMTALA.  

A private hospital that does not accept Medicare or Medicaid has the ability triage a patients wallet before triaging the patient.  However, the second they start to accept state and federal money, they fall under EMTALA and nobody can be turned away until the receive their medical screening and any stablizing treatment by a physician.


----------



## Stevo (Oct 22, 2005)

> *bigger and more evil monster known as EMTALA. *



i stand corrected princess, yet of the few industrialized nations subscribing to such a tedious system where so many are left to thier own means that they should seek such avenues, can we really say we blame them?

in fact, the greater % of personal bankrupcies are from health related maladies here. That the bankruocy laws have now changed is more salt in the wound, the only saving grace, iirc ,is medical bills can't gain interest like credit cards can.

maybe some here have followed the big 3 auto makers?, as i hear the chief negotiable betwix union and corp is health related bennies, they really are going to be an upper echelon garnish as we continue to outsource and walmartize America

any 'have not' whom has had to shell out $300 after the paperwork brewhaha , i.d. check, and interogational tactics employed to scare them off,  simply to get into a doc-in-the box for 15 minutes so that they can get some antibiotics for something simple like a sore throat is going to like the looks of whine-11 a whole lot better

interesting to be a fly on this mountain of manure eh?

~S~


----------



## Jon (Oct 22, 2005)

> _Originally posted by EMTPrincess+Oct 22 2005, 12:31 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (EMTPrincess @ Oct 22 2005, 12:31 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-Stevo_@Oct 22 2005, 08:57 AM
> * well we all know jacho rules won't allow for an er to turn away so much as a finger don't we, and we ems'ers can't refuse to transport one either right?
> 
> *


This isn't so much as JACHO not allowing an ER to turn anybody away, but a bigger and more evil monster known as EMTALA.  

A private hospital that does not accept Medicare or Medicaid has the ability triage a patients wallet before triaging the patient.  However, the second they start to accept state and federal money, they fall under EMTALA and nobody can be turned away until the receive their medical screening and any stablizing treatment by a physician. [/b][/quote]
 On the other hand, though.... I've heard of systems where EMS is able to "refuse" a patient for a B.S. Complaint. The most common system I've heard of involves Taxi vouchers given out by the medics. That way, the Pt. still goes to the ED if they want to, but they don't tie up a rig.

Jon


----------



## Stevo (Oct 22, 2005)

an apt refusal Jon, i say give all the taxi drivers a hear channel, those that speak pigeon english ought to be a real rip in the ER....

~S~


----------



## MedicPrincess (Oct 25, 2005)

> _Originally posted by emtff99_@Oct 22 2005, 09:04 AM
> * I have always bit my tounge & but wanted to ask "You think We wont send you the bill directly?" *


 and I would ask, why bite your tounge.

I can't tell you the number of times a day here in the ER I will look as someone who is walking out, or who is being admitted to an ipatient bed (depending on the type of bed), and ask that patient for their portion of the bill.  If they give me that line about not having money I will tell them every time, "we are an emergency room not a free clinic.  We will send them the bill directly."

I see no problem with telling them they are going to get the bill.


----------



## Wingnut (Oct 25, 2005)

> _Originally posted by emtff99_@Oct 22 2005, 10:04 AM
> * Many Frequent Flyers!!! "My baby gotsta cold", "I have been sneezing for 5 days now & cant walk" (But yet walks to the Unit!!!) the list goes on & on. What really would crack me up though is when the Pt has something (IE: the sneezing x5days) and you would ask them "Why havent you called your Reg. Dr for this?" the Response was "I dont have any Health Insurance or cant get Welfare"  I have always bit my tounge & but wanted to ask "You think We wont send you the bill directly?" Part of Human Nature or stupidity,,who knows. *


 While they are a pain, I have to admit I've used the ER twice in my time because I could not pay the bill THAT DAY, but had to go to the doctor that day.  But I guess the ER gets more people using it as free healthcare.


----------



## Jon (Oct 25, 2005)

I know how you feel.

I'm off insurance right now..... I'm not "fulltime" enough at my "fulltime" job, partially because I took 2 weeks off *unpaid* to go to LA....

I've had an ingrown toenail for a few months.... the big chunk of it just came out Sunday night after I'd showered..... My foot hurts less know, and doesn't look infected (but I'm watching it closely).

With any luck, if it does get infected, I'll drop a strecher on it first, and then get it covered by the squad (Joking!!!!).

My concern now is getting a flu shot... looks like I'll be going to the GROCERY store on All Hallow's Eve to get one for $25.

Jon


----------



## rescuecpt (Oct 26, 2005)

> _Originally posted by MedicStudentJon_@Oct 25 2005, 05:49 PM
> * I know how you feel.
> 
> I'm off insurance right now..... I'm not "fulltime" enough at my "fulltime" job, partially because I took 2 weeks off *unpaid* to go to LA....
> ...


 The squad doesn't give them to you for free?


----------



## emtff99 (Oct 27, 2005)

> _Originally posted by rescuecpt_@Oct 26 2005, 01:44 PM
> *
> The squad doesn't give them to you for free? *


 I know our FD/Ems does not give them to us for free, kind of wish they would though. But yet, I have *NEVER* had a flu shot either as an adult.


----------



## Jon (Oct 28, 2005)

my one squad will give them, for free, bt they only reserved 10 shots this year, and they aren't giving the shots until mid-novemeber. I usually get my shot in early october (helped last year, I got it the day before the vaccine shortage was announced).

I'll drop $25 at the local Clemens for one. (If they would only do them at WaWa, I'd be happy :lol: )

Jon


----------

