Strange situation

rwik123

rwik123

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Hey guys, I need your opinion. Last night my uncle was hospitalized because of heart related problem. An un-named company responded. Apparently they spent 15+ minutes in the drive way trying to get a line in, ultimately giving up...after causing blood to splurt everywhere. After talking to my uncle he claimed they were just emts, not paramedics according to there insignias. BLS rigs don't carry ALS equipment so he must of been wrong on that case, but I'm seriously considering contacting the company in lieu of the care provided. In my thoughts I would not delay transport that long to wait for a line, and the lack of skill troubles me.

Opinions?
 
rwik123 said:
Hey guys, I need your opinion. Last night my uncle was hospitalized because of heart related problem. An un-named company responded. Apparently they spent 15+ minutes in the drive way trying to get a line in, ultimately giving up...after causing blood to splurt everywhere. After talking to my uncle he claimed they were just emts, not paramedics according to there insignias. BLS rigs don't carry ALS equipment so he must of been wrong on that case, but I'm seriously considering contacting the company in lieu of the care provided. In my thoughts I would not delay transport that long to wait for a line, and the lack of skill troubles me.

Opinions?
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I've seen lines go wrong, and I can understand on a non-critical patient waiting 1-3 minutes to try to get a line in, but 15+ minutes? Holy crap.
 
It's really not right for us to armchair quaterback the call, without understanding the patient, their condition, and the thinking of the medics, especially when we know so little about the call. If you know anything else about what was going on we can analyze that, but otherwise it's anyone's guess...
 
the reason for the call was because he was extremely tachy around 145.. he has an internal defib that has gone off a couple times in the last month and has to undergo ablations for the bad rhythms, other than that from what I know he was fairly stable
 
Are you sure it was 15 minutes? It might have felt like it, but was more like 5-10.

If they were BLS then they wouldn't have IV catheters and tubing. Unless this is an area that allows for BLS IV therapy. However, the blood would not spurt. That aterial blood, not veinous.
 
Thats still not a lot of info. There are lots of reasons for a hr of 145. Such as: anxiety, heart defect, sob, copd, chf, embolism, kidney failure, infection and the list goes on.
Lines are started as it is expected the pt will likely get fluids or medications for their cond. How imminent that is tends to determine the speed of aquiring the line. Lines blow for a variety of reasons, some people you can't see or palp a vein as they are deep. Others the veins are delicate and blow easily. Sometimes it is operator skill or they are just having a bad day. It happens.

If your uncle has concerns about his care he can certainly contact the company. I doubt they would give you any info as you were not the pt.
Do you know what your uncles dx was?
 
I would look at the call times and also leave it to the lawyers.
 
Heart problems. Did he have any AMS?
Getting stuck can feel like it takes forever. I know he's a loved one. But if he's getting transported for a heart related issue, I don't know how much I would trust that.
Especially, when you're stating that BLS don't carry ALS equipment. Ask him to describe the ambulance for you.
 
Anyone who calls a lawyer for this is a nitwit. Sorry, but seriously? A lawyer for a short delay and failed IV line?

To the OP, unless your uncle is 80, 145 is not extremely tachy. It is fast, but not "Holy crap, something is super wrong!" tachy. I would also want to confirm the time spent on scene with the company before going anywhere with this, as 5 minutes can feel like 15. It would also be prudent to find out if anything else was done in that time, like a 12 lead, or another set of vitals etc.

Lastly, it would be a good idea to clarify "blood spurting everywhere". IVs leak, but spurt?
 
rwik123 said:
Hey guys, I need your opinion. Last night my uncle was hospitalized because of heart related problem. An un-named company responded. Apparently they spent 15+ minutes in the drive way trying to get a line in, ultimately giving up...after causing blood to splurt everywhere. After talking to my uncle he claimed they were just emts, not paramedics according to there insignias. BLS rigs don't carry ALS equipment so he must of been wrong on that case, but I'm seriously considering contacting the company in lieu of the care provided. In my thoughts I would not delay transport that long to wait for a line, and the lack of skill troubles me.

Opinions?
Click to expand...

Out of everyone here, I absolutely love playing Monday morning quarterback. However, "heart related problems," tachycardia at 145 (which I agree it's fast, but not "OMGWTFBBQ fast!"), and an ICD that discharged a few times in the past month which was treated with catheter ablation is absolutely not enough information to make any sort of argument for or against.
 
An on scene time of fifteen minutes that includes packaging a patient and moving him to the ambulance, getting vitals and assessing him seems like pretty good time to me.
 
Have an immediate family member contact the companies Information Officer and get the PCR because they can't refuse that to you. Then go from there.
 
I can package that call in 14 minutes.

/Obscure?
//Also, don't ask me how I remember a show that according to Wikipedia stopped being made the year I was born.
 
rwik123 said:
Hey guys, I need your opinion. Last night my uncle was hospitalized because of heart related problem. An un-named company responded. Apparently they spent 15+ minutes in the drive way trying to get a line in, ultimately giving up...after causing blood to splurt everywhere. After talking to my uncle he claimed they were just emts, not paramedics according to there insignias. BLS rigs don't carry ALS equipment so he must of been wrong on that case, but I'm seriously considering contacting the company in lieu of the care provided. In my thoughts I would not delay transport that long to wait for a line, and the lack of skill troubles me.

Opinions?
Click to expand...

Funny part is; we spend 5-15 minutes on scene. Especially, if it's the patient's house.
We have to write down all the medications, get the history of the patient, some ask us to shut certain appliances off, etc.
Also, if your uncle was having heart problems I'm sure they hooked up a 12-lead right away. Maybe they put your uncle in the ambulance with a medic right away as his partner would gather more information. During that time, they got an IV started. Oh and people do bleed from IV's, by the way.
That would very reasonably explain the time they spent on scene.

What kind of education do you have when it comes to EMS?
 
clibb said:
Funny part is; we spend 5-15 minutes on scene. Especially, if it's the patient's house.
We have to write down all the medications, get the history of the patient, some ask us to shut certain appliances off, etc.
Also, if your uncle was having heart problems I'm sure they hooked up a 12-lead right away. Maybe they put your uncle in the ambulance with a medic right away as his partner would gather more information. During that time, they got an IV started. Oh and people do bleed from IV's, by the way.
That would very reasonably explain the time they spent on scene.

What kind of education do you have when it comes to EMS?
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I do understand that 15 minutes on scene is normal between taking a sample history and the rest of the assessment, but I believe the 15 minutes was actually trying to start the IV itself. It got to the point where he said forget it, and they stopped attempting and began transport.

What kind of education? I'm an emt-b student, just past my state practical. I have no field experience, but IMHO a double medic crew should be able to start an IV. They both tried, and failed after several missed attempts. Once again, I'll try to get more info today about the specifics and clear up the discrepancies.

Also I'm not curious about legal action, I'm just looking at it with the thought of maybe lack of experience of the medic crew itself.
 
It is not reasonable to expect that just because it may have been a double medic crew they could get an IV started on anyone. There are a reason that hospitals have specially trained IV therapy nurses whose job is to start IVs and draw blood on people.
 
Aidey said:
It is not reasonable to expect that just because it may have been a double medic crew they could get an IV started on anyone. There are a reason that hospitals have specially trained IV therapy nurses whose job is to start IVs and draw blood on people.
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And even then there are times when the most expert staff is unable to start a peripheral IV.
 
Okay, sorry then if it was a stupid thing to think, you all have much more experience with them than me. I didn't realize all this

Rwik123
 
rwik123 said:
Okay, sorry then if it was a stupid thing to think, you all have much more experience with them than me. I didn't realize all this

Rwik123
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Not stupid, really. I've been there, and when it's my family member or someone I love in the ambulance, I'm exceptionally picky about what good care looks like. I have to intentionally talk myself down to accepting "standard" instead of maybe "outstanding."

I intentionally work to mellow myself every day, because I can be a very critical person.
 
rwik123 said:
Okay, sorry then if it was a stupid thing to think, you all have much more experience with them than me. I didn't realize all this

Rwik123
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Nothing stupid here. Asking questions is how you learn. Ask lots.
It is impossible to second guess anthing on this call with the information given. Find out your uncles diagnosis and treatment and learn from it.
 
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