Caller Emergency vs "Real" Emergency

[MMiz]

Since I've started working in EMS, I always get a chill down my spine when I think that people are calling me and my partners for medical emergencies, we are 911. It's an amazing feeling to respond to an emergency and comfort and treat patients, providing a service that they sometimes desperately need.

But how do you really define an emergency, as my definition and my patients often differ. It's not like we have long talks, or any talks, about this matter, but sometimes when you're treating someone for a minor condition, one that really doesn't require immediately medical attention, how do you cope with the idea that you coded, lights and sirens, through traffic, risking your life and the lives of others, all for this minor medical emergency?

Whether it be having two units, BLS and ALS being dispatched for a jammed finger, when both you and the patient know it's just a jammed finger, or any of the other endless non-emegency calls we respond to, what's your personal reaction?

So what's your personal reaction?
Who is to fault? The pt? Dispatch?

 

[BloodNGlory02]

Honestly I blame tv. Commercials, TV shows, and doctors paid to advocate for a product. They throw around generalized symptoms and tell people these are symptoms of such and such, then you get grandpa with ONE symptom and grandma freaks out and calls 911 believing grandpa's dying because the guy on tv said so. Or the bayer asa commercials with "8/10 MD's suggest taking this if you feel symptoms of a heart attack".

Or Rescue 911, Third Watch, ER etc. Everythings an emergency on these shows.

 

[TTLWHKR]

I figure that when someone calls 9-1-1, THEY are having some sort of emergency. Maybe not seem like much to seasoned folks like us, but it is to them. Treat it as professionally as possible, maybe suggest on some of the more minor ones that they seek care by their private physcian by POV. Afterall, you can't refuse to tx someone, unless you want to end up a headline on here.

 

[Jon]

Also, this is "their" emergency, not yours, so don't get too hyped-up over nothing. If your CAD is getting you a BLS / ALS 2-tier response on a stubbed toe, it may be time to change the response order in CAD to get the APPROPRIATE resourses.


Jon

 

[MMiz]

By the way, the jammed finger happened as a result of PD radioing in for a student who jammed his finger while playing sports.

I was working a nearby standy, so I grabbed the equipment and walked the 50 yards to the patient. I then get a page that ALS is on the way RLS.

We had no radio, so I use my cell phone and downgrade ALS, not even thinking to cancel them. I hand't worked in months, and I've never cancelled ALS, it didn't ever occur to me. :unsure:

You should have seen the looks on their faces when they had to do all the paperwork, refusals, and company forms for this kid with a jammed finger that we treated with an ice pack. Oops.

Another life saved. Another life saved.

 

[coloradoemt]

Originally posted by BloodNGlory02@Apr 15 2005, 10:13 PM
Honestly I blame tv. Commercials, TV shows, and doctors paid to advocate for a product. They throw around generalized symptoms and tell people these are symptoms of such and such, then you get grandpa with ONE symptom and grandma freaks out and calls 911 believing grandpa's dying because the guy on tv said so. Or the bayer asa commercials with "8/10 MD's suggest taking this if you feel symptoms of a heart attack".

Or Rescue 911, Third Watch, ER etc. Everythings an emergency on these shows.

I cannot believe people actually still try to blame things on the TV... :lol: As far as the shows you listed and everything being an emergency on them... well yes they are!! They are shows with that theme. Just like Law and Order, Boston Legal, etc. are about Laws and lawyers.

I do not give emergency or non-emergency any thought. Just because I see what I do all day most every day does not give me the right to judge a pts feelings or opinion. If a broken arm is the worst thing that has ever happened to an individual then that could very well be an extreme emergency to them. Just because I have been on a core, multi-system trauma, etc. does not give me the right to downgrade someone elses "emergency". When you get in the habit of second guessing the importance of a call you are also setting yourself up for failure to perform your duties.

 

[KEVD18]

call comes out over the air: abulance 1, respond to 123 Fourth st for the unknown medical
thisis a call we get no less than once a week. its a man, w/c bound, alcoholic/drug user. he's a med seeker, cut and dried. so one day, the call comes out to go pick him up. doors go up,ambulance rolls out, priority three(hey we know this guy and its no emergency). the bus takes its time and finally gets there to find this guy on the floor howling in pain w/obvious deformity to his l. foot. seems he had bashed in on the door frame. he was transported p2 to the hospital

classic case of a call being down triaged w/o due cause. we treat every unknown like its the end of the world. i can cancel als if there not needed. i can cancel fire if there are no access issues. i can cancel police if unnecessary. but what i cant do is make thos other resources appear out of nowhere because i know the guy that called having "chest pain" just wants someone to talk too, so i canceled everybody else

 

[Jon]

Originally posted by MMiz@Apr 16 2005, 05:52 AM
I've never cancelled ALS, it didn't ever occur to me. :unsure:

You should have seen the looks on their faces when they had to do all the paperwork, refusals, and company forms for this kid with a jammed finger that we treated with an ice pack. Oops.

Umm... Can you recall onscene - Here is is common to have ALS roll up, you explain the situation, say "I don't think we need you" medics get back in truck and go away, cancelled onscene by BLS.... They don't make patient contact.

This is common around here... Probably a little gray-area, but not HORRIBLE.


Jon

 

[rescuecpt]

Originally posted by MedicStudentJon+Apr 17 2005, 12:09 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (MedicStudentJon @ Apr 17 2005, 12:09 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-MMiz@Apr 16 2005, 05:52 AM
I've never cancelled ALS, it didn't ever occur to me. :unsure:

You should have seen the looks on their faces when they had to do all the paperwork, refusals, and company forms for this kid with a jammed finger that we treated with an ice pack. Oops.

Umm... Can you recall onscene - Here is is common to have ALS roll up, you explain the situation, say "I don't think we need you" medics get back in truck and go away, cancelled onscene by BLS.... They don't make patient contact.

This is common around here... Probably a little gray-area, but not HORRIBLE.


Jon [/b][/quote]
In NY ALS can make patient contact and then say "this is a BLS call" and leave. When we have enough people on my crew to run an ALS rig and a BLS rig I will go in the fly car with a driver, check it out - if it's bad I'll transport, if it's BLS I'll go back to HQ w/the extra driver and fly car.

 

[Firechic]

ColoradoEMT, I really liked your response.
My department only runs ALS MICUs, so we never have a strictly BLS response.
I treat all calls as emergencies until otherwise indicated. I base this on a call I had when I first became a paramedic. My partner and I were dispatched to a "knee pain" call. An elderly gentleman fell onto his knee. Upon arrival, I asked why he fell - he said there was uneven pavement and lost his footing. We gave the knee some attention and asked if he wanted his BP checked since we were there and assured him it was a free screening. My partner couldn't hear a BP, so he places the patient on the LP12 to see if we could get a reading...extremely low. I explained what I found and asked him if we could take a look at his heart. Well, to make a long story short.....he was in 3rd degree heartblock, took him to the hospital, and he had a pacemaker implanted later that day.
What seems to be a minor call may be an entirely different story!

 

[CodeSurfer]

Firechic -

Runnning every call the way it should be is the only way to prevent mistakes. Your call is the perfect example of what they teach us to do in class. If you run calls that way you will never miss anything. Awesome job.

 

[MedicPrincess]

Its easy to get complacent about calls. In the time that I ran on the fire side, we had many calls that we all basically said, Not again lets go. But as far as the crew I ran with, we would run every call as it was dispatched keeping in mind it could be our mother/kid/wife/husband/loved one that needed the help.

Even the 80 year old lady with toe pain, and nobody at home to talk to, that is scared during the thunderstorm because her lights went out gets treated because as one of you said to HER it is an emergency.

Just try to keep in mind that it could be your loved one that is having the same kind of emotionally panicy response, and treat everyone that way.

 

[rescuecpt]

We had the head lac last night that I mentioned in another thread. We had a hard time finding a crew (I showed up about 10 minutes after the alarm went off - i got home from work and dad told me the siren had gone off so I went up to see what was going on). I ended up riding with a probie (still in EMT class). In the end I'm glad it was me who went because everyone else was just saying "he cut his head, no big deal"... well, his BP went from 140/78 to 90/60 in the span of 5 minutes while enroute to the hospital. I'm glad I took his injury seriously and monitored his vitals every five minutes, or I would have had a not-so-conscious patient by the time I got to the hospital 25 minutes away. Simple solution, head down, feet up, high flow diesel = much better! He stabilized and the probie learned a good lesson about not underestimating injuries that look simple. Basic little calls like that give me such happiness sometimes. I know, I know... I'm a whacker. :lol: