# Call 911?



## cfman (Mar 15, 2009)

Here's a situation I was faced with and would like to know what you'd do...keep in mind that I am simply a lay rescuer.

Came across an inebriated male.  He was vomiting, talking nonsense, etc.  He was lying on the ground, was too dizzy and drunk to get up, and at time began shivering and complaining that he was cold (I assume he was cold because his shirt was wet with vomit/water, although there could be a better medical reason related to the alcohol).  He was conscious, although he fell asleep for a little while (he was breathing - loud snoring), and when touching his palms he didn't feel cold or clammy.  He had several family members and friends who were caring for him and were going to take him home.  Do you call 911 and have pt transported to hospital or can the family simply monitor him to make sure the symptoms do not get worse?

Thoughts...


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## Ridryder911 (Mar 15, 2009)

What did he want to do? Was he injured or just drunk? Not all drunks need medical care, as there is very little they will do for the patient but monitoring. (yes, a banana pack and maybe some lab's). 

R/r 911


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## fortsmithman (Mar 16, 2009)

Here in the Northwest Territories we do not have 911 service.


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## cfman (Mar 16, 2009)

The pt was not injured, simply drunk.  I guess my question is at what point do you call EMS when you have a drunk pt?  I know that alcohol poisoning, for example, can be quite dangerous.


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## BossyCow (Mar 16, 2009)

Totally subjective. How much did they have to drink? What is their general health condition? What symptoms are they showing. We have a regular who likes to put away a gallon or so of wine, fall down and call us. She's generally nasty, uncooperative, and stinky. But, she has a history of cerebral bleeds and has had some significant trauma from SOME of her falls. So, we don't treat her for drunkeness, we treat her for the effects of the fall, or the accompanying health issues.

Someone who is so drunk that they are unresponsive needs to be seen. Not because they are drunk but because an unresponsive pt is 'bad juju'
They can vomit, aspirate,seize, and gawd knows what all else. According to my protocols, all unresponsive pts require an ALS evaluation. The unresponsive drunk can't tell you that oh.. by the way, I also took seven of my buddies percocet. Or, I'm a diabetic, or recently diagnosed with inoperable cancer, or or or or.....


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## redcrossemt (Mar 18, 2009)

He's talking nonsense and not able to get up... Possibly hypothermic... How do you know he's drunk? Are you sure there's no drugs on board? No diabetic type issues?

Call 911. Let ALS come and evaluate him. If they feel that it's safe for him to go home, they can have him sign the refusal and document who took him home.


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## zacdav89 (Mar 19, 2009)

Depending on the state here in Colorado if a person is intoxicated i.e. has one or more beer or alcoholic beverage under law is unable to make medical decisions for them self’s, I would have called it in to make sure, was he really drunk or a diabetic in need. The ambulance could have cleared him and then released him to his family but better to be safe


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## traumateam1 (Mar 19, 2009)

I would have called.. after all they can always be released after an eval. There's really no harm in calling when they don't need it, as opposed to not calling when they do need it... :wacko:


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## gicts (Mar 21, 2009)

zacdav89 said:


> Depending on the state here in Colorado if a person is intoxicated i.e. has one or more beer or alcoholic beverage under law is unable to make medical decisions for them self’s, I would have called it in to make sure, was he really drunk or a diabetic in need. The ambulance could have cleared him and then released him to his family but better to be safe



or cop.......


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## Veneficus (Mar 21, 2009)

redcrossemt said:


> He's talking nonsense and not able to get up... Possibly hypothermic... How do you know he's drunk? Are you sure there's no drugs on board? No diabetic type issues?
> 
> Call 911. Let ALS come and evaluate him. If they feel that it's safe for him to go home, they can have him sign the refusal and document who took him home.



You have authority to let an intoxicated person sign a refusal? 

In some countries there is a designation of "clinically drunk" but I have never seen it used in the US. 

(I also think many drunk people would't want documentation of who they went home with  )


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## redcrossemt (Mar 24, 2009)

In this situation, no, we would have not accepted a refusal.

In other situations, it begs the question - what is intoxicated?

We do often sign people off who have had a drink or two. They may have some odor on their breath, or may admit to drinking, or both - but they are A&Ox4, ambulating steadily, no neurological deficits, no slurring of speech, able to repeat back information (such as risks of refusal), etc. Careful documentation is key.


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## FF177EMS583 (Apr 11, 2009)

Honestly, I havent been in the EMS field for very long, i started in July 2008 but, in my opinion i would say that it would not need ALS/BLS support, but the family should take them to the hospital, because i mean not to sound insensitive, why should we kill ourselves running it "hot" to a drunk that is puking..

-FF. J.RICE
SUGARLOAF FIRE DEPT. 177
FREELAND FIRE DEPT.   136
SUGARLOAF EMS             577
WEST HAZLETON EMS     583


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## NEMed2 (Apr 13, 2009)

How did you come across this person?  Did someone contact you, knowing that you were medically trained (no matter how limited or experienced you are, someone will always assume the opposite.) Or did you come across this person in a personal setting, ie, a party?  If the family is willing to assume responsibility for the person, you can't make them do anything, but I would explain to them the potential consequences if they just take them home & put them to bed.  If this "drunk" person cannot manage to maintain their own airway they need to go to the hospital.  Were the snoring respirations due to them sleeping or something else? You never know about pre-existing conditions or whether there are other drugs on board.  What did your gut tell you to do?

My friend's brother died from drinking too much after falling asleep, vomiting & choking.  He has yet to forgive himself for it, and he wasn't even there.


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