I want to inquire a little more on advising people to not go to the hospital. I mean I know you can obviously advise them not too in a situation such as a “stubbed toe”, but what about something like chest pain, head injury, abdominal pain etc., when you can’t see inside the body to rule out other things. Of course you can go by vital signs and presentation, but is that enough to discourage them? One situation specific question, when can a sports player be released to play after a possible head injury? In a head injury situation, what constitutes having signs of a possible concussion? Of course there’s the headache and nausea that a lot of people complain of after a head injury, but I’ve heard providers tell patient then didn’t have any signs of a concussion with those symptoms. What symptoms would you call signs of a concussion? I’m probably overthinking things.
Encouraging and discouraging transport
- Thread starter bdoss2006
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E tank
Caution: Paralyzing Agent
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No you can't.
What is the upside of having the bias to discourage transport? Aside from the frivolous complaints on their face (you know them when you see them) the ambulance is most ordinarily called with the expectation of transport. Short encouraging for immediate POV to the hospital, encouraging someone not to go to the hospital is dicey. On the field return to play calls without specialized training and experience for EMS personnel, ie, local BLS service doing a standby, is really dicey.
Called for a head injury, find a person who says he's had a head injury who wants to go to the hospital, drive them to the hospital.
Ok. For example what if someone is experiencing one of the things I named, and says “do you think I should go to the hospital?” Then what?
DesertMedic66
Forum Troll
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"Yes, I think you should go to the hospital" and then transport that patient to the hospital.
"I asked this in a series of questions a few days ago, but I want to get some more insight on this particular topic. When can you suggest a patient not go to the hospital? Of course you can for the stupid stubbed toe calls, but where do you draw the line? With the slightly more serious things I don’t feel comfortable saying don’t go to the hospital. We don’t have protocols for refusal, so I can’t refer to that."
Bdoss206, that's how you started an October 3rd thread -- a long, now-locked one that was not the best use of my senior years.
Seriously, why do this again?
Bdoss206, that's how you started an October 3rd thread -- a long, now-locked one that was not the best use of my senior years.
Seriously, why do this again?
CCCSD
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Can we lock this one also? If not, then it’s free range to provide answers to this multiple posted question.
NomadicMedic
I know a guy who knows a guy.
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This is the best answer you’re gonna get…
Transport them. They call, you haul. That’s all.
Transport them. They call, you haul. That’s all.
When they 100% want to go, yes of course. That’s all. But what about when they ask if you think they should go?
NomadicMedic
I know a guy who knows a guy.
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You don’t know enough to deter them take them.
Well the one from then was just people saying “follow your protocols”, me arguing that we don’t have protocols on refusals, then me proving we don’t have protocols on refusals.
Even with the stupid calls?
It's the same issue: transport decisions. You asked for advice and got plenty of it x2. Arguing with that advice is weird and adds no value to the discussion.
Try Googling "doing the same thing over and over and expecting different results."
DrParasite
The fire extinguisher is not just for show
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echoing what I said in the other thread:
As a general practice, when I was on the ambulance (per-covid), I never advised people to not go to the hospital.
I've seen more than my share of ambulances used as taxis, but at the end of the day, if they want to go, lets go. I get paid the same, my boss is happier, and it's less liability for me. Others might have different perspectives on that, but discouraging people from going to the hospital was never in my job description.
Taking your stubbed toe situation, why not? maybe they need x rays, and to be fitted for a boot. Maybe they don't have a car, and are unable to go to an urgent care. maybe it's 3am, they are writhing in pain, and nothing else is open. If they want to go, I'll take them; they might end up in triage for a few hours, which I will tell them, but I never would advise someone not to go. even if they don't want to go, I will always tell them to follow up with their PMD at their earliest convenience.
Can athletes be refuse transport after a head injury? of course... simply having a concussion doesn't mean you need to go to the ER; I know I didn't when I gave myself a concussion at work. Also doesn't mean you need to drag a person kicking and screaming against their will to the hospital. And if you want to drag a competent 300 lb linebacker against his will to the hospital for a possible head injury, that's probably not going to go well for you. I also don't clear athletes to play, that's an above my paygrade decision. Truth be told, if an athlete gets hurt, and doesn't want to go to the hospital, and I think they should, I'm going to speak to the head coach, and do my best to convince him or her to be evaluated, as the athlete will listen to the coach more than me. Works great with firefighters too.
We don't give medical advice here, so I don't want to provide you with the signs and symptoms and have someone misinterpret something I am saying... and Google's Gemini says "A concussion diagnosis is based on a combination of a physical exam, review of medical history, and tests that evaluate a patient's symptoms, cognitive function, and brain function"
however, these are are great resources for the signs and symptoms of a concussion, from people waaaay smarter than I:
Concussion
A concussion is an injury to the brain that results in temporary loss of normal brain function. Medically, it is defined as a clinical syndrome
www.aans.org
Ultimate Concussion 101 Guide: Symptoms, Signs, Treatment and Rehab
A concussion is the most common type of traumatic brain injury. Read our Concussion 101 Guide to know the signs and symptoms to report to a healthcare provider.
baselinetesting.com
CCCSD
Forum Deputy Chief
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If you can’t do your job, you shouldn’t be on a rig. You obviously don’t have enough experience or knowledge to know which is which.
DrParasite
The fire extinguisher is not just for show
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So the solution is to speak to your supervisor. Ask for your agency's protocols. if they don't have them, ask your supervisor what you should do. Nothing any of us say here might be applicable to your particular location, which is why many are saying you should ask your local supervisory staff for guidance on how to proceed. After all, I would hate for you to lose your job because you followed what someone said that ran afoul of your local agency's polocies.
CCCSD
Forum Deputy Chief
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We’ve told OP that and it keeps coming back asking the same things. I’m betting there is a serious disconnect with the ability to process and retain and function.
Every answer gets an argument.
Every answer gets an argument.
PotatoMedic
Has no idea what I'm doing.
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I will happily take a mandatory vacation for this reply.
Based on this and previous posts you have made, I have made the assessment that you do not have the capacity to do this job as you have not demonstrated any ability to use logical reasoning or solve problems.
Quit this profession, you are not capable of doing this job.
I will happily tell you that you are wrong. I do have the capacity, and anyone I work with would agree. Nope. I’m not quitting because I am capable of doing the job.
First of all, I am not an “it”. All the arguments are started by you generally.
FiremanMike
Just a dude
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You ask extremely basic questions on situations you should be encountering almost daily. You need to seek a mentor at your agency with experience and ask them these questions and stop asking random strangers on the internet on issues that have certainly been addressed in some manner at a local level. If you come back with “no one here knows the answer” then I’m going to tell you to quit that job immediately and find anything else to do.
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