"Stupid" pt/bystander/first responder tricks all rolled into one

mycrofft

mycrofft

Still crazy but elsewhere
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Simply put: what is it that you ALS types absolutely hate to see having been done to your patient before you show up? What can we lower life forms do better, less of, or prevent from being done? I'm posing the same question to BLS as well.
 
"Stupid" bystander/patient/first responder tricks rolled into one.

Simply put: what is it that you BLS types absolutely hate to see having been done to your patient before you show up? What can we lower life forms do better, less of, or prevent from being done? I'm posing the same question to ALS as well.
 
Not listening to your partner.
 
Or maybe...

..like the time the guy's boss slathered him with old Silvadine instead of irrigating/cooling a large area brun from a car radiator boilover?
 
Fire dept inflating the patient's stomach by "rescue" breathing,

then exchanging hi-fives and declaring victory while your suction machine just whines and whines and whines....
(Sorry FD, a real and repeated experience with one FD. I'm an ex-bro, don't shoot!);)
 
mycrofft said:
Simply put: what is it that you BLS types absolutely hate to see having been done to your patient before you show up? What can we lower life forms do better, less of, or prevent from being done? I'm posing the same question to ALS as well.
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1. Medical advice from unrelated bystanders with no medical training. No, the woman who just sorta of dropped while standing in line to get food at a water park probably isn't diabetic (especially since she's alert, orentied, and denies a history of DM), she's just a little dehydrated and over heated (yea for AC and free water in first aid). Furthermore, please don't tell me to give said patient anything sugary when she has had a gastric bypass operation.

2. Dear nursing homes:
If you are so concerned about your patient who fell down and went boom that you are sending the patient to the hospital for evaluation, please keep the following in mind:
A. Call sooner than later. Sending a patient out 4 hours after the event "just in case" really isn't all that helpful.
B. Do not move the patient if at all possible. In the unlikely chance that there might be an injury, moving the patient from the ground to bed, wheelchair, lunch, etc, might cause more damage. You're sending the patient out for just this reason after all.
 
Hint to bystanders- If you are preforming CPR and the pt is fighting you off, then they most likely don't need it!;):unsure::wacko:
 
reaper said:
Hint to bystanders- If you are preforming CPR and the pt is fighting you off, then they most likely don't need it!;):unsure::wacko:
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Whaaat!?! You mean you really are supposed to stop CPR after the second OW?
 
JPINFV said:
2. Dear nursing homes:
If you are so concerned about your patient who fell down and went boom that you are sending the patient to the hospital for evaluation, please keep the following in mind:
A. Call sooner than later. Sending a patient out 4 hours after the event "just in case" really isn't all that helpful.
B. Do not move the patient if at all possible. In the unlikely chance that there might be an injury, moving the patient from the ground to bed, wheelchair, lunch, etc, might cause more damage. You're sending the patient out for just this reason after all.
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Well said. In my opinion, you gave them some slack with the 4 hours.
 
1.Overzealous bleeding control
2.Don't question me infront of the patient in an attempt to 'outsmart' the ambulance crew

Had a patient wrap an entire forearm for a 5cm lac (I'm talking wrapped from wrist to elbow). It was a great looking job though, but pt began started c/o of 'tingling' in the fingers so I removed the dressing and re-bandaged just the area of the laceration....it really P/O'd the first responder and he made sure everyone onscene VERY aware that he had bleeding controlled until someone screwed with his bandage

EDIT: Have to add that situations like that are far and few between, usually only applies to ones that spanking-new. There is no way I can express how valuable seasoned responders are nor truly show the appreciation they deserve
 
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stephenrb81 said:
I removed the dressing and re-bandaged just the area of the laceration....it really P/O'd the first responder and he made sure everyone onscene VERY aware that he had bleeding controlled until someone screwed with his bandage
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Did you explain why you did it, its all about learning and if you look that blood was not flowing then flowing when you went at it, it could be seen as a disimprovment,
 
dermatologists. nuff said.
 
Scout said:
Did you explain why you did it, its all about learning and if you look that blood was not flowing then flowing when you went at it, it could be seen as a disimprovment,
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I explained that if there is a possibility that the circulation is being compromised the bandage should be reevaluated. One has to be receptive to learn though. Now if this was explained to me as a spurting arterial bleed then I would have left well enough alone. Pt fell off the handlebars of a bike onto some glass, wound was explained as "hardly oozing blood if bleeding at all"
 
you mean like nurses doing CPR on breathing, strong pulse teenage girls w/ gurgling respirations because she is choking on pizza... while the AED pads are on either side of her belly button?

Things like that ;)
 
Nurses in a nursing home placing a patient with diff. breathing on O2 via NRB at 4LPM because their machines don't go any higher and then reporting to us that they placed her on oxygen but she's quickly getting worse.

Also, JPINFV, you hit the nail on the head. Thankyou for posting that. I wish nursing home staff would actually see that though. :glare:
 
Don't get me wrong about SNFs, there are good ones out there and I, in general, don't mind the "just in case" calls. It's just when the "just in case" moment occured a few hours prior to even being called that makes me sigh in disappointment and feel that any care rendered is futile.
 
Family member who "is an RN" (translation: may be an RN. May also be someone who flunked out of medical asst. school 20 years ago and worked in a Dr's office for a week) trying to tell you what to do over the phone (and what she's telling you is against EMS standing orders).

Even worse: turns out to actually be a former ER RN (not a good reflection on that particular ER).
 
MAC4NH said:
Family member who "is an RN" (translation: may be an RN. May also be someone who flunked out of medical asst. school 20 years ago and worked in a Dr's office for a week) trying to tell you what to do over the phone (and what she's telling you is against EMS standing orders).

Even worse: turns out to actually be a former ER RN (not a good reflection on that particular ER).
Click to expand...

Doesn't have to be a former RN or any type of med. dropout.

Our first responder group has protocols to hold C-spine until boarded and blocked even if you have a collar on. The medical director for another service area in the state was a bystander on a call once and got forceful/argumentative with one of our FR's to let go of C-spine because we had a collar on.

The cool part about the call was the look on our medical directors face when we told him about the incident, it scared the heck out of me but goodness it was interesting. I would've loved to be a fly on the wall the next day when he made that phone call.
 
Done that!!

On a much earlier call, two car MVA, guy had the occupant of car #2 (a 70 Mustang) go lie down on the back seat because she had a nosebleed, said he was a doctor, we got his name, he drove off. Pt c/o neckache, we wound up spineboarding ths poor girl out of the back seat of that 'Stang because of a PODIATRIST!:ph34r:
 
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