# Please *DO NOT* jump in my truck barking orders



## stephenrb81 (Sep 1, 2008)

Was dispatched to a "possible overdose/unresponsive".  Arrived on scene and found patient unconscious in bed.  Patent Airway, Resp 16, Pulse 70s, Responds to Pain, Initial BP 118/72, Glucocheck 94.  Family Believes pt od'd on Ativan (Pt had 30 day supply, was in day 28 of Rx) and ETOH.

Once in the back of the ambulance, I was switching pt from portable O2 to the amb's O2 when a family member jumps in the back and said she just wanted to tell the pt goodbye and will see her at the ER.  She then questioned why we haven't started a line on the patient yet.  I attempted to explain that we are a BLS unit and will have an ALS unit meet us en route to the hospital.  She then started into this fit about Activated Charcoal.

I am great at remaining calm, I understand family and bystander's fear and apprehension and I can understand how they can become frantic.  I explain to her calmly that I am unable to give her charcoal at this time.  I was just fixing to explain why when she informed me, in an unfriendly manner, that I better give her some charcoal and the pt will respond positively in 20 minutes. She then got out of the back of the ambulance and proceeded to slam the back door. How can expect me to administer the activated charcoal to an unconscious patient?  

I can get over being yelled "DO SOMETHING" by family on scene. As I mentioned, I understand their reactions and I don't let it get under my skin.  I don't mind being asked "why aren't you doing <insert intervention here>", more often than not, the explanation is received positively. But it crosses the line when they jump in the back of my truck and start yelling at me *TELLING* what I better be doing.

Is this considered an "ego-slap" because I am being told what to do while "on my turf" or is it acceptable to get just a little pissed in a case like this


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## firecoins (Sep 1, 2008)

This is a family memeber. Just be calm.  They will yell no matter what. Don't agitate them more.


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## MMiz (Sep 1, 2008)

If my family member was in a life threatening situation I'd be frantic too.  There's no telling what I'd say or do.

You're the professional, and it's your job to keep being the professional.  There will always be people who don't understand what we do, but it's critical that we don't lose it.


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## karaya (Sep 1, 2008)

Got news for ya... this won't be your last "family encounter". More will follow.  Just let it roll off your shoulders and all will be fine.


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## mikie (Sep 1, 2008)

stephenrb81 said:


> She then questioned why we haven't started a line on the patient yet.  I attempted to explain that we are a BLS unit and will have an ALS unit meet us en route to the hospital.  She then started into this fit about Activated Charcoal.



Does (you know of) she have some sort of medical info behind her choice to admin activated charcoal and instantly want a line started?


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## stephenrb81 (Sep 1, 2008)

mikie333 said:


> Does (you know of) she have some sort of medical info behind her choice to admin activated charcoal and instantly want a line started?



Yes, after the run I found out she was an RN (possibly retired, unsure if retired or not).  I wanted to wait a bit before disclosing that because I didnt want it to appear I was starting some Nursing vs EMS argument.

Also, I know not to let family and "scene-drama" get too me, been on a truck for nearly 5 years



Edit: Just re-read your post....I initially read it as asking if she had medical background instead of "info"


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## mycrofft (Sep 2, 2008)

*Never ever ever never-never ever...ever..let them into the rig!*

Not ever. They're bound to see them empties rolling around in the cab.


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## stephenrb81 (Sep 2, 2008)

mycrofft said:


> Not ever. They're bound to see them empties rolling around in the cab.



I tend to cut them open and panel the bench seat with them....gives it a kick-*** chrome-effect


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## mycrofft (Sep 2, 2008)

*Morphine Bristojects?*

.........


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## Flight-LP (Sep 2, 2008)

stephenrb81 said:


> Was dispatched to a "possible overdose/unresponsive".  Arrived on scene and found patient unconscious in bed.  Patent Airway, Resp 16, Pulse 70s, Responds to Pain, Initial BP 118/72, Glucocheck 94.  Family Believes pt od'd on Ativan (Pt had 30 day supply, was in day 28 of Rx) and ETOH.
> 
> Once in the back of the ambulance, I was switching pt from portable O2 to the amb's O2 when a family member jumps in the back and said she just wanted to tell the pt goodbye and will see her at the ER.  She then questioned why we haven't started a line on the patient yet.  I attempted to explain that we are a BLS unit and will have an ALS unit meet us en route to the hospital.  She then started into this fit about Activated Charcoal.
> 
> ...



Precisely why I do not allow family in the back of the unit! (with the excpetion of calm mothers accompanying their children).

Be polite, expedite your departure from the house to the truck, do it all in there or on the road. God put locks on ambulances for a reason...................


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## BossyCow (Sep 2, 2008)

The worst case of this I'd ever seen was on a call for an unconscious male, seen in the ER for a head injury 2 days prior. Show up and the guy is quite simply tanked to the gills. He reeks of alcohol and has no visible trauma. Apparently he passed out two days earlier and supposedly hit his head. Family was livid that ER treated him as though he had merely passed out (blood alcohol was very high) because he had quit drinking and they knew that if he had passed out it had to be from something other than alcohol. the ER can't share the blood alcohol level with the family without the pt's permission so is unable to satisfy the family.  

I show up.. guy is alert only to verbal. Sister is on scene. She's screaming that he is obviously suffering from undiagnosed issues related to the head/c-spine injury that the hospital negligently ignored from 2 days prior. She's telling me the name of the atty she's going to get to sue the hospital and how much she's going to get for it on his behalf. She KNOWS that he's sober as a judge and has been for weeks now. Rehab is really working this time and the hospital, us and society in general is merely refusing to give a decent guy another chance. Blah, Blah Blah.... 

Anyway, as I'm trying to get a set of vitals and do my initial assessment, she steps in front of me and says.. "I know what I'm doing, I work at the prison and have FA training.. she hauls off and slaps the guy across the face two or three times.. I'm talking full roundhouse whacks that cause the guys head to spin on his neck. I turn to the other EMT on scene, the one with the clipboard and said.. "Please note in your report that his sister just compromised his C-spine by repeatedly striking him in the face." Then I had to get in to her face and inform her that if her brother did have a c-spine injury she may have just caused it to be much, much worse and told her that if she didn't leave the room and let us do our job, I was going to pull all my crew out of her house until law enforcement secured the scene. 

She left, sobbing and screaming that she knew what she was doing and we were all various types of mean spiteful bodily orifices. 

Turns out the guy was again just drunk out of his mind. Never heard that a lawsuit was filed.. went on two more calls to this guy later. Last one, he was barely breathing due to a drug overdose. First time I ever saw Narcan do its job.


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## liftwithlegs (Sep 6, 2008)

BossyCow, wouldn't that be illegal? She got in your way, and prevented you from providing care, which in my state is illegal.


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## firetender (Sep 7, 2008)

I apologize, Bossy, but that's one of the funniest scenes I've had pictured to me in a long time! I'd love to help you out, but I'm too busy laughing.


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## firecoins (Sep 7, 2008)

liftwithlegs said:


> BossyCow, wouldn't that be illegal? She got in your way, and prevented you from providing care, which in my state is illegal.



It is illegal but not everything brings an arrest with it.


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## MRE (Sep 7, 2008)

I'm still wondering if the family member in the first case was expecting the EMTs to start a line and administer the charcoal through it!!


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## karaya (Sep 7, 2008)

KB1OEV said:


> I'm still wondering if the family member in the first case was expecting the EMTs to start a line and administer the charcoal through it!!


 
Hmm, maybe something she saw on TV??


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## stephenrb81 (Sep 8, 2008)

KB1OEV said:


> I'm still wondering if the family member in the first case was expecting the EMTs to start a line and administer the charcoal through it!!



I wonder myself.  I told my partner after the run "How did she expect me to give Activated Charcoal to an unconscious woman, pour it on her abdomen and hope it absorbs"


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## MRE (Sep 8, 2008)

stephenrb81 said:


> I wonder myself.  I told my partner after the run "How did she expect me to give Activated Charcoal to an unconscious woman, pour it on her abdomen and hope it absorbs"



Nah, you just use a very large bore needle.  You know, to get the chunks through.


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## rhan101277 (Sep 14, 2008)

I think standard folks to understand scope of practice.  When people see the ambulance come they believe these people are the best trained people available.  They don't understand BLS, ALS etc.  Also giving activated charcoal to a unconcious pt would be silly, even a regular un-trained person should understand this.


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## rhan101277 (Sep 20, 2008)

Go ahead and administer the charcoal, that will shut the family member up.  But leave you pt with no airway.  Ask the family member if the pt is superhuman and can swallow while unresponsive, then maybe a light will come on. I didn't realize I commented on this thread six days ago.


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