Hospital calls 911 for patient.

Around here, some hospitals have policies that require them to call 911 for any non-patient having a medical emergency. I think it is silly.
I can understand if the hospital doesn’t have an internal response system for non-patient medical emergencies on the floors… but the average ER has patients come in POV that need to be helped from a car. How is this any different, if it is only a few feet from the ER?



The hospital I used to work for (and do my clinicals in) uses a concept called "Rapid Response" the idea is two-fold. One is for patients (inpatient or same-day surgery) that are declining (abnormal vital signs, change in responsiveness), but aren't a code yet - it essentially brings a code team to the patient to attempt to resolve the patient's condition. During day shift, there is a CRNP that leads this team, and at night, one of several docs in house is tasked with this responsibility.

This team's other responsibility is responding to on-site emergencies. If it is in hospital or just out front, they'll use a wheelchair or gurney... if it is outside, they'll call 911... But when we arrive, we'll find staff already caring for the patient.

This system works well for us.
 
Jon said:
Around here, some hospitals have policies that require them to call 911 for any non-patient having a medical emergency. I think it is silly.
I can understand if the hospital doesn’t have an internal response system for non-patient medical emergencies on the floors… but the average ER has patients come in POV that need to be helped from a car. How is this any different, if it is only a few feet from the ER?



The hospital I used to work for (and do my clinicals in) uses a concept called "Rapid Response" the idea is two-fold. One is for patients (inpatient or same-day surgery) that are declining (abnormal vital signs, change in responsiveness), but aren't a code yet - it essentially brings a code team to the patient to attempt to resolve the patient's condition. During day shift, there is a CRNP that leads this team, and at night, one of several docs in house is tasked with this responsibility.

This team's other responsibility is responding to on-site emergencies. If it is in hospital or just out front, they'll use a wheelchair or gurney... if it is outside, they'll call 911... But when we arrive, we'll find staff already caring for the patient.

This system works well for us.
Click to expand...

Almost every hospital in the country now has something similar to a Rapid Response Team thanks to this nationwide campaign:
http://www.ihi.org/IHI/Programs/Campaign/

Does anyone know how many emergencies outside of that ED you aren't called for? One call and some in EMS seem to get their panties in a twist. A hospital Rapid Response Team may respond to 1 - 2 call per shift or as many as 10 per shift. You know how many patients that team or the staff of the ED did drag in? I can guarantee you are not called for every patient that can't quite make it through the ED doors. And yes, even the Security Guards will rush a wheel chair through the parking lot to catch a patient before they hit the ground.

Some hospitals also have lift teams which are a true asset to move just about any patient who is any size including the very large bariatric. In most places, they definitely have the technology for the job. However, little hospitals may not have a lift team and the Rapid Response Team will be RNs/RRTs who also have many other patients as an assignment also. ED RNs may have up to and sometimes over 10 patients each. If two RNs leave their pods to go outside, that is 20 patients that will be without supervision.

EMTALA still says hospitals are to treat patients that are attempting to make it into their ED. However, the ED also knows its own limits and resources which is something EMS should consider for themselves. If they believe there is a patient that is better served by EMS than by their staff for whatever reason they call you. Sorry if it interrupts your paid to sleep or internet time but the ED may feel you are the best choice for the patient. You should take it as a compliment instead of whining about it or trying to say a hospital is wrong for making the decision to call you even if it is just policy.

EMS may then take the patient immediately to a Cath Lab or Trauma Center, bypassing the little hospital, for appropriate care. This is the loophole in EMTALA that I believe serves the patient well. That beats having the patient lie around in that ED for over 3 hours while an IFT to a trauma center or cath lab is arranged with the appropriate staff. Once blood and other drips are hung, it will probably be beyond the care of a regular ALS truck in most places. The hospital may have to free up an RN anyway to go with the Paramedics for a CCT.

Jon, only my first comment and link about the Rapid Response Team is directed at you.
 
Our station is literally right next to the hospital and I had a chest pain walk up the other day. We told him he could just walk to the ER (as its only 50 yards) but they insisted to be taken by ambulance so they would be seen faster.. :wacko:
 
carpentw said:
Our station is literally right next to the hospital and I had a chest pain walk up the other day. We told him he could just walk to the ER (as its only 50 yards) but they insisted to be taken by ambulance so they would be seen faster.. :wacko:
Click to expand...

Walking 50 yards with chest pain?

Were you not going with this patient?
 
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