A story heard on the radio

[Foxbat]

So I was driving to work this morning and turned my radio on in the middle of some program (so I might have missed something). What I did hear I did not like.
They were telling a story about a woman who had an onset of stroke-like symptoms. She did not want to call 911 because she wanted to go to a stroke center where her father went earlier rather than going to a nearest ER. Also, in the nearest hospital "nobody knew her so she was afraid they won't know what's wrong with her" since her speach was very slurred.
So she called her friend and somehow managed to explain her she wants her to pick her up and go to the stroke center.
And then they went on describing how great that stroke center was and that she "couldn't have made a better choice". Doctors ended up administering her thrombolytics, like, 2 minutes before it was 3 hours since the onset of symptoms, then she got transported by ground to a higher level stroke center, made full recovery, happy end.
Am I the only one who thinks the public may get a wrong impression of what to do? I tend to think EMTs would be able to recognize stroke symptoms and to bring her to the closest appropriate facility (or perhaps physicians could administer tPA even at the nearest ER). In an emergency like that I'd rather have patient to call 911. Or am I wrong?

 

[reaper]

What would an EMT do for a stroke pt? Drive them to a stroke center.

I think her friend did that for her!

 

[Sasha]

I tend to think EMTs would be able to recognize stroke symptoms and to bring her to the closest appropriate facility

You would think so, but some people seem to be adamently against an EMT bypassing the closest facility... (And JP and I were just debating something similiar the other day via AIM! )

Sometimes it's easier for the patient to just go by POV instead of risking being taken to the closest facility and await transport to a CP center or stroke center or what have you. Sometimes transfer can take hours, and with some time sensitive emergencies that can do a lot to impact patient outcome!

 

[Aidey]

We take patients to the hospital they request to go to. In fact, if we make the decision for a patient who is competent we will get into massive trouble. We are only allowed to make the decision in 3 cases.

1. The pt says "I don"t know" and we ask "Is the closest ok" and they say "yes".
2. The pt is unable to tell us, and there are no friends or family on scene to relay what hospital they have been too before.
3. It is a trauma activation or code stroke (those have to go certain places).

 

[johnrsemt]

In Indy where I used to work: we took the patients to the closest APPROPRIATE facilities: strokes=stroke centers, MI=cardiac cath, trauma etc.
Beyond that we would take patients to were their insurance wanted them taken; taking a patient to a hospital that their insurance didn't like can cost a patient over $10,000 more for an ED visit.

Here in Utah, where I moved to last year: EMS takes you to the closest hospital (except in Major Trauma); neighbor was having chest pain, her 3rd MI; felt the same but more severe: they took her to the closest hospital; (by 4 blocks); even though that hospital did nothing with Cardiac, and the hospital of her choice, that had done all of her cardiac work was 4 blocks farther away. the first hospital took 6 hours to transfer her, even though the 1st 12 lead at the ED (and the ones in the Ambulance) showed her having an acute MI.

Scary