Abdominal Pain scenario

[EpiEMS]

Solution: EMS could not solve the problem. My particular issue needed definitive care. This was an Infected Ulcer in the Descending colon(left side). Definitive care has shown, Ulcerative Colitis. This was compounded by a broken rib that was still in the process of healing. (left side as well), compounded further by moderate- severe electrolyte imbalance, which was producing severe cramps.

Oof, no fun. If you don't mind my asking, did you have surgery (bowel resection?) for the ulcerative colitis?

My 2 ambulance trips produced severely different treatment routes. One group of medics gave pain control, until i was tolerable, but didn't snow me with analgesics. the other group did not give pain control, did just about nothing, and refused to transport my girlfriend with me for some reason.

Did the first medics medicate you prior to moving you?

On the latter point, I agree with DesertMedic66, transporting family is contraindicated in my mind, especially if they have their own car and the patient is a competent adult or teen.

 

[NysEms2117]

Oof, no fun. If you don't mind my asking, did you have surgery (bowel resection?) for the ulcerative colitis?

No sir, currently successfully medicated with a Mesalamine based medicine called Apriso. after a round of steroids antibiotics and the whole kit and kaboodle.
https://www.aprisorx.com/

Did the first medics medicate you prior to moving you?

no, i was just kind of shuffled (with whatever assistance i could muster) onto the stretcher, started an IV within seconds of entering the ambulambs, pain control after that.

On the latter point, I agree with DesertMedic66, transporting family is contraindicated in my mind, especially if they have their own car and the patient is a competent adult or teen.

i suppose, i feel certain times its okay, especially if you put them up front.

 

[DesertMedic66]

i suppose, i feel certain times its okay, especially if you put them up front.

Increased liability if we get into an accident, people steal things, people freak out, I don't want an unknown persons butt on my seat where I spend 12 hours a day.

 

[NysEms2117]

Increased liability if we get into an accident, people steal things, people freak out, I don't want an unknown persons butt on my seat where I spend 12 hours a day.

Fair points . I understand why.

 

[EpiEMS]

No sir, currently successfully medicated with a Mesalamine based medicine called Apriso. after a round of steroids antibiotics and the whole kit and kaboodle.
https://www.aprisorx.com/

no, i was just kind of shuffled (with whatever assistance i could muster) onto the stretcher, started an IV within seconds of entering the ambulambs, pain control after that.

i suppose, i feel certain times its okay, especially if you put them up front.

Whew. Glad it's going ok!

I don't know if I would have wanted to move! At least they started narc'ing you up as soon as they could.

I have no problems with a family member in the front, if they're capable of acting like an adult. All too often...they can't seem to.

 

[NysEms2117]

if they're capable of acting like an adult. All too often...they can't seem to.

I would've yelled at her . I get it but I also feel there's a patient benefit factor especially if they have never been in an ambulance or gone to a hospital before

 

[VentMonkey]

I very rarely transport anyone other than the patient. If your girlfriend is able to drive herself to the ED that is overall going to be the better option

Increased liability if we get into an accident, people steal things, people freak out, I don't want an unknown persons butt on my seat where I spend 12 hours a day.

Fair points . I understand why.

I have no issues with taking family members to the ED with me, within reason. Here, we're strongly encouraged to take them if they wish to come. Now, understandably there are family, and/ or friends that I would not want coming with me for several types of reasons; theses people are often "verbally judo-d" into taking their own vehicle, and/ or meeting up with said patient later at the ED.

As a parent, if I wished to ride with my child regardless of their age, you're damn right I would not be happy with someone telling me I can't, as would my wife. I think over the years I have begun to understand this firsthand. So, for me the average well-meaning family member who means no harm, and may be able to provide further history on the way to the ED (gotta love the "cubby holes") I take with me. If it's a small, scared child I let mom in back, and if anything I am leery of the patient's parent who doesn't want to ride along, especially if they don't have other children to tend to at the time of the call. I do miss the days when we would slap baby of mom's lap, then on the gurney at times (talk about liability) as it made some things easier; clearly this was extremely unsafe though.

This is just my take, and reasoning as to why I would let a presumably reliable family/ friend ride in with us without hesitation. Obviously, they're belted in, but I guess I feel like who am I to tell them no? They're concerned, and again as long as they're fairly level headed they're welcomed to join in.

To add to this, with critical calls, on scene or even en route I was taught by one of my paramedic proctors to invite them in if they so wish, which I do. If they're genuinely calm, and concerned and want to know what, and why we are doing what we are doing, why not allow them to see, and/ or know what it is their family member is being put through? I clump this into the "explaining the procedure" category; sometimes family wants to know, which is fine. This is no dig at @DesertMedic66's style, it's just what I have been taught, coupled what I have learned over the years from a "concerned family member's" point of view when my child/ wife is ill, and taken to the ED, or U/C for treatment. I have yet to take an ambulance, though.

 

[DesertMedic66]

I have no issues with taking family members to the ED with me, within reason. Here, we're strongly encouraged to take them if they wish to come. Now, understandably there are family, and/ or friends that I would not want coming with me for several types of reasons; theses people are often "verbally judo-d" into taking their own vehicle, and/ or meeting up with said patient later at the ED.

As a parent, if I wished to ride with my child regardless of their age, you're damn right I would not be happy with someone telling me I can't, as would my wife. I think over the years I have begun to understand this firsthand. So, for me the average well-meaning family member who means no harm, and may be able to provide further history on the way to the ED (gotta love the "cubby holes") I take with me. If it's a small, scared child I let mom in back, and if anything I am leery of the patient's parent who doesn't want to ride along, especially if they don't have other children to tend to at the time of the call. I do miss the days when we would slap baby of mom's lap, then on the gurney at times (talk about liability) as it made some things easier; clearly this was extremely unsafe though.

This is just my take, and reasoning as to why I would let a presumably reliable family/ friend ride in with us without hesitation. Obviously, they're belted in, but I guess I feel like who am I to tell them no? They're concerned, and again as long as they're fairly level headed they're welcomed to join in.

To add to this, with critical calls, on scene or even en route I was taught by one of my paramedic proctors to invite them in if they so wish, which I do. If they're genuinely calm, and concerned and want to know what, and why we are doing what we are doing, why not allow them to see, and/ or know what it is their family member is being put through? I clump this into the "explaining the procedure" category; sometimes family wants to know, which is fine. This is no dig at @DesertMedic66's style, it's just what I have been taught, coupled what I have learned over the years from a "concerned family member's" point of view when my child/ wife is ill, and taken to the ED, or U/C for treatment. I have yet to take an ambulance, though.

If I have a pedi patient (we don't get a lot of them) I will let mom or dad ride in, unless possible abuse by the parents is suspected. If the patient is an adult who is AOx4 and is able to provide me with accurate information then there is no need for family to come along. Unless the family does not have a working car then I will take one person and only one. Overall its better if the family takes their own car so that they have a move of transportation once at the hospital for when the patient gets discharged.

 

[VentMonkey]

If I have a pedi patient (we don't get a lot of them)Overall its better if the family takes their own car so that they have a move of transportation once at the hospital for when the patient gets discharged.

Yeah, it's all circumstantial, you'd be surprised at the amount of patients that "look fine" to us then end up with admission orders.

I agree with asking if they have their own mode if they're an able bodied person so they don't get stranded. Also, if they're so distraught of the patients particular complaint, I may ask my partner, or fire to see they can get famiy or friends to drive them to the hospital.

 

[BobBarker]

All depends on your department's policy. I remember a couple years ago I was over at a friend's house. His 85yo neighbor walks into his house with a 9 inch gash in her leg, dripping blood. We put pressure on it and when LAFD arrived, the ambulance allowed 3 of us to ride in the back with her. I think it was primarily because she had no family, the firemen liked our jokes and we didn't mind staying at the ER with her and drive her back home. As long as the patient wants the other person to come with them, they don't make the situation any worse and your department allows it, I don't see any reason why not.

 

[Handsome Robb]

We'll take one rider and only one and they are belted in the front seat. Peds or special needs patients are the only times I'll let people in the back.

9 times out of 10 we get people to driver themselves while we transport though.


Sent from my iPhone using Tapatalk

 

[bakertaylor28]

Mind you, having only read the initial scenario, My differential guess would be either A) a perforated Colon, B) Chron's Disease or C) An atypical presentation of appendicitis (mind you without radiology to go on.) My gut instinct leans toward A , however.