# Pt's idea of an EMERGENCY vs EMS Provider's sense of URGENCY!



## SerumK (Dec 22, 2010)

I created this Emergency-Urgency-Matrix:







I hope that clears things up!


----------



## bahnrokt (Dec 23, 2010)

Nice, you also need one with the PT standing at the end of the driveway waiting for you, call the crew by name and then proclaim: "the staff at (near by Hospital) were ****s this morning, lets go to (far away hospital)..


----------



## jjesusfreak01 (Dec 23, 2010)

bahnrokt said:


> Nice, you also need one with the PT standing at the end of the driveway waiting for you, call the crew by name and then proclaim: "the staff at (near by Hospital) were ****s this morning, lets go to (far away hospital)..



Only time in my limited experience that I have seen a medic refuse the patients hospital choice was when they decided the wait in the waiting room was too long, went across the street to the Walgreens, and called 911. They asked to be taken to a hospital further away, we refused, took them back to the waiting room, where the triage nurse sent them to the back of the line when the found out what had happened (they were actually about to be called for triage). Oh, and they were feigning horrible back pain and asking for meds on the one minute drive to the hospital, after walking into the ambulance unassisted without expressing any pain.


----------



## JJR512 (Dec 24, 2010)

SerumK said:


> I created this Emergency-Urgency-Matrix:
> 
> I hope that clears things up!



It is now December 24, 2010, and I hereby proclaim this to be the highlight of my year.


----------



## EMTDON970 (Dec 24, 2010)

Or you show up to there house lights and siren and they have there suitcase with them..........gotta love that


----------



## jjesusfreak01 (Dec 24, 2010)

EMTDON970 said:


> Or you show up to there house lights and siren and they have there suitcase with them..........gotta love that



This happened to me last week, but i'll give him a break because we did pull him off a Southwest flight.


----------



## C.T.E.M.R. (Dec 24, 2010)

jjesusfreak01 said:


> This happened to me last week, but i'll give him a break because we did pull him off a Southwest flight.:lol:
> 
> We have one who calls at least once a week. usually for pills etc. Last time i picked this pt up for SOB Difficulty breathing. basically had a little cough. husband shoulda been in the back, but she needed her meds filled so we get to take her to get her prescriptions filled. yay for me! we were dispatched P1 l&s i was so mad as well as my partner. no 02 her sp02 high 90s. UGH i cant stand some people.
> 
> ...


----------



## EMSLaw (Dec 24, 2010)

jjesusfreak01 said:


> Only time in my limited experience that I have seen a medic refuse the patients hospital choice was when they decided the wait in the waiting room was too long, went across the street to the Walgreens, and called 911. They asked to be taken to a hospital further away, we refused, took them back to the waiting room, where the triage nurse sent them to the back of the line when the found out what had happened (they were actually about to be called for triage). Oh, and they were feigning horrible back pain and asking for meds on the one minute drive to the hospital, after walking into the ambulance unassisted without expressing any pain.



Our protocols is "closest appropriate facility" - which I think is pretty standard.  If one hospital is five minutes further away, I don't have a problem going to the one the patient prefers, especially if they have strong feelings about it.  

Here's a scenario that annoyed me - though it falls into an urgent, 'you need to go' box on the emergency chart. 

2300 hours, BLS is dispatched to a "diabetic emergency".  Upon arrival, patient ambulates out the door in no obvious distress and says, "Are you the guys taking me to <far away hospital>?"  When asked what the nature of his emergency was, patient said that he had seen his doctor, who had drawn labs.  At approximately 1600, the doctor's office had called and told patient his BGL was 800, and he should proceed to the ED.  Patient has just now called 9-1-1 for an ambulance.  Suffice it to say, patient's vital signs (other than BGL, apparently, though we are unable to take it in the field) were within normal limits, patient reliably denied any symptoms, and the physical examination was unremarkable.  

So, we told the patient that he certainly had a medical problem that needed immediate treatment, and he should go to the hospital.  But, being a 9-1-1 service (and volunteer non-billing, though that hardly matters here), we really only transported to local facilities.  We offered two hospitals in reasonable distance, one of which was the same hospital system as the place he wanted to go.  He insisted on transport to the hospital far away.  We offered to call a private ambulance for transport and wait with him, but he didn't want to do that because he'd have to pay for it.  Despite our best efforts ("Sir, you really need to be treated.  Any hospital can handle this, and if you don't get it taken care of, it could kill you." etc., etc.), he wanted to refuse.  

Then he suddenly got dizzy, and decided that the local hospital would be just fine.  

Harrumph.


----------



## johnrsemt (Dec 25, 2010)

I have had patients call 911 from the waiting room at the Hospital.  dispatch would call my private service for us to take them.   we would take them from waiting room to ED ambulance entrance and back to waiting room.   and bill them for it.   company would take them to small claims court for the bill.   usually the only one that they would take to court.


----------



## Icenine (Jan 3, 2011)

I got called to the parking lot of the ED Entrance last spring.  Pt w/ breathing difficulty.

Wife stated "It's to wet outside to go in for help".  This was on a rainy Spring Day.  One car length away was a receiving canopy, that she could have pulled under.

My partner asked her to pull around while I walked in an got a wheel chair.  Triage nurse was flustered as to why we were bringing patients through her entrance.

Charge nurse had to go to lounge and laugh it out.


----------



## tactics (Jan 10, 2011)

*Awesome*

Nice, this should be posted in every ed department waiting room!







SerumK said:


> I created this Emergency-Urgency-Matrix:
> 
> 
> 
> ...


----------

