Called 911 Based on Bystander's Symptoms

[ZombieEMT]

I think the biggest mistake in all this was jumping to the conclusion that it is a CVA. Could certainly have been a CVA, could also be bells. We also see similar symptoms in a diabetic with hypoglycemia. As an untrained professional, you did what you thought was right, and did a good job. My suggestion is that you go to calling 911 and describing symptoms vs diagnosing. We can not diagnose CVA in the field. Get a history and get an assessment.

 

[NomadicMedic]

Or, say to the person, "you look like you're having a stroke. Sit down and let me call 911." In this case, I'm sure she would have told you to bugger off. Calling 911 on someone behind their back, who doesn't need or want your help, is not helpful to anyone.

 

[Wheel]

First of all, good catch on the symptoms. You correctly assumed that it could be a possible stroke, considering the patient's age and symptoms. I can tell you are excited about this new career path, and I encourage you to continue learning.

That said, you have no right to usurp this woman's autonomy. If she doesn't want an ambulance, she doesn't have to have one. It should be her decision though, if she is alert and oriented. Was she confused, altered, or in any other way obtunded? It doesn't sound like it, as she basically told you that she has seen a physician about the problem, and the physician decided that even in the presence of facial drooping that it would resolve in a couple of weeks.

Overall, I applaud that you were excited and willing to help this person. That's a good thing, and don't stop. You have to let people have their rights and make their own decisions though. I promise you that you will have patients that will want to do things that you don't think are right. You have to let them, within reason, if they are competent to make an informed decision.

 

[AlanShore]

Thank you

First of all, good catch on the symptoms. You correctly assumed that it could be a possible stroke, considering the patient's age and symptoms. I can tell you are excited about this new career path, and I encourage you to continue learning.

That said, you have no right to usurp this woman's autonomy. If she doesn't want an ambulance, she doesn't have to have one. It should be her decision though, if she is alert and oriented. Was she confused, altered, or in any other way obtunded? It doesn't sound like it, as she basically told you that she has seen a physician about the problem, and the physician decided that even in the presence of facial drooping that it would resolve in a couple of weeks.

Overall, I applaud that you were excited and willing to help this person. That's a good thing, and don't stop. You have to let people have their rights and make their own decisions though. I promise you that you will have patients that will want to do things that you don't think are right. You have to let them, within reason, if they are competent to make an informed decision.

She did seem extremely confused, i've been in her restaurant everyday for about a year. I've never seen her in this confused condition before, I was excited but quick to act without all the information. I did learn that through all of it.

She mumbled when she spoke and when I asked her name (After I called the ambulance) she was very slow to respond to me, (About 10 seconds)


Aside from the criticism that people seem to have a problem with a untrained citizen calling 911 and not knowing really what to do, Everything in this thread has been extremely helpful to me I am grateful for all of it.

I'll defend my reason for going outside to call however. We all have intuition that we use inside the scope of our practice. Mine kicked in, it told me that if I tell this women i'm calling 911 in front of her she will not be okay with it because she's alone in her business and more concerned about her business than her health.

Granted it's her right, and many can throw her blows at me for that. I felt it was the right thing to do.


Brings me even more mind boggling is that in 5 days of her business being open, no one had seemed to care enough to make sure the person is well, because of her face drooping and what seemed to be a confused mental state

Thank you to everyone who has contributed to "Alan's first time" I have learned mountains from just this situation and this post and I am archiving it for further reading

The hard part of this post:

I'd hope this forum is a place to learn instead of being a place where I can go to feel like crap for trying to help someone. If it's not then I have come to the wrong place to learn.

I get mad when I help people with computers too people, some people don't know how to copy and paste and I sit down and help them.

Please, just be mindful when you have a person filled with compassion for helping people, that you don't shove them in the sand as someone did to you when you were little.

 

[TheLocalMedic]

 

[mycrofft]

Here at EMTLIFE….(haha)

She did seem extremely confused, i've been in her restaurant everyday for about a year. I've never seen her in this confused condition before, I was excited but quick to act without all the information. I did learn that through all of it.

She mumbled when she spoke and when I asked her name (After I called the ambulance) she was very slow to respond to me, (About 10 seconds)


Aside from the criticism that people seem to have a problem with a untrained citizen calling 911 and not knowing really what to do, Everything in this thread has been extremely helpful to me I am grateful for all of it.

I'll defend my reason for going outside to call however. We all have intuition that we use inside the scope of our practice. Mine kicked in, it told me that if I tell this women i'm calling 911 in front of her she will not be okay with it because she's alone in her business and more concerned about her business than her health.

Granted it's her right, and many can throw her blows at me for that. I felt it was the right thing to do.


Brings me even more mind boggling is that in 5 days of her business being open, no one had seemed to care enough to make sure the person is well, because of her face drooping and what seemed to be a confused mental state

Thank you to everyone who has contributed to "Alan's first time" I have learned mountains from just this situation and this post and I am archiving it for further reading

The hard part of this post:

I'd hope this forum is a place to learn instead of being a place where I can go to feel like crap for trying to help someone. If it's not then I have come to the wrong place to learn.

I get mad when I help people with computers too people, some people don't know how to copy and paste and I sit down and help them.

Please, just be mindful when you have a person filled with compassion for helping people, that you don't shove them in the sand as someone did to you when you were little.

A hint? Read the first few responses to a new thread. Once the responses have gone over, say, eight, basically is often has spun away. If it is hurtful, stop reading, it is basically for entertainment and networking.
And don't forget you can message people too.

 

[mycrofft]

Love it

 

[JPINFV]

I'd hope this forum is a place to learn instead of being a place where I can go to feel like crap for trying to help someone. If it's not then I have come to the wrong place to learn.

We all feel like crap when we learn that, at a minimum, others feel like we screwed the pooch. However, as you said, you learned a lot, which is a good thing. Medicine, even at the EMT level, isn't necessarily easy, and it's easier to get bruised when discussing a critical thinking issue (are you coming to the right conclusion from the information at hand) then a psychomotor issue (did you do the proper steps).

TL/DR: It's not personal, don't take it as such.

 

[usalsfyre]

As for the neuro exam... I have been doing this job for about 20yrs, 911 and critical care transport. It may be nice to learn the cranial nerve exam and all that but honestly, speaking for myself, I would use it so infrequently that I would never remember it. I also question the necessity of it for stroke assessment in the field. I am all for the highest of standards in assessment but reality speaking if you don't use it, you lose it. The Cincinnati Pre-hospital Stroke Assessment is catches about 70% of strokes and is deemed to be a pretty good assessment tool for the field.

Funny I used a condensed version of it almost daily....

70% is crap as far as sensitivity goes. It means that you're missing 30% of stroke. I also have never seen the specificity for the Cincinnati but I can't imagine it's all that great.

 

[Wheel]

She did seem extremely confused, i've been in her restaurant everyday for about a year. I've never seen her in this confused condition before, I was excited but quick to act without all the information. I did learn that through all of it.

She mumbled when she spoke and when I asked her name (After I called the ambulance) she was very slow to respond to me, (About 10 seconds)


Aside from the criticism that people seem to have a problem with a untrained citizen calling 911 and not knowing really what to do, Everything in this thread has been extremely helpful to me I am grateful for all of it.

I'll defend my reason for going outside to call however. We all have intuition that we use inside the scope of our practice. Mine kicked in, it told me that if I tell this women i'm calling 911 in front of her she will not be okay with it because she's alone in her business and more concerned about her business than her health.

Granted it's her right, and many can throw her blows at me for that. I felt it was the right thing to do.


Brings me even more mind boggling is that in 5 days of her business being open, no one had seemed to care enough to make sure the person is well, because of her face drooping and what seemed to be a confused mental state

Thank you to everyone who has contributed to "Alan's first time" I have learned mountains from just this situation and this post and I am archiving it for further reading

The hard part of this post:

I'd hope this forum is a place to learn instead of being a place where I can go to feel like crap for trying to help someone. If it's not then I have come to the wrong place to learn.

I get mad when I help people with computers too people, some people don't know how to copy and paste and I sit down and help them.

Please, just be mindful when you have a person filled with compassion for helping people, that you don't shove them in the sand as someone did to you when you were little.

Don't feel bad. Like I said, I think it's great that you want to help. We need people who are eager. The only problem that I have is that ultimately it is her right to choose whether or not she wants help, whether she needed it or not. I just think that she should have been a part of the conversation about going to the hospital. You just have to remember that whether or not we know best, a patient still has the right to refuse anything and everything we can do for them, if they physically and mentally capable of doing so.

If you feel like I was shoving you in the sand, I apologize. Like I said, good job recognizing that something was wrong and that this person might need help. It may have come out heavy handed, but it was not meant to put you down. It just so happens that this is an ethics issue I have been researching, so I felt I needed to chime in.