Off duty at a restaurant, you witness a bari+geriatric fall

All kidding aside, with the bruising, I'm wondering if she's on anticoagulant therapy. Couple that with the slurred speech, and you've got a great chance for a CVA or some sort of head bleed. Keep her still, get as much history as you can, and wait for the on duty crew to show up. Unless, of course, you decided not to be Ricky Rescue and finished your meal instead.
 
J B said:
You're sitting at a restaurant, eating dinner. You hear something hit the floor. Look up to see a ~250 pound, ~80y/o F on the floor. She has a younger (~40y/o) woman with her, possibly a daughter.

The pt slurs her words slightly, has not had anything to eat in 12 hours. Possibly some dementia. Pt has what appear to be large bruises all over her face, but denies having any other falls today.

What do you do?
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Observe if she's still breathing, call for on-duty medical aid. I'm not going to "out" myself as a paramedic unless I have to. For all anyone knows, I'm a guy with a first aid card who cares enough to pull out his phone and call 911. I'm not too concerned about a spinal injury... however, I'm concerned about the possibility of a CVA causing, or a CHI as a result of the fall. Neither of those require spinal precautions.

After help arrives, I'm fading back into the woodwork and enjoying my own dinner.
 
If I was out of town I would just see if EMS was called and just sit back and eat my meal. If this happened in my town then there would e an expectation of me doing something (I'm in a small town where just about everyone knows I am EMS).
 
If 911 was called, my concern would be EMS units knowing me. I might involve myself but not out myself as a medic. Try and quietly gather info and pass it on to the EMS crew. I should be minimally involved.
 
I don't do anything off duty unless someone is in imminent danger/is dying right in front of me (eg an arrest, or bad car accident way out in the boonies). When I do help off duty I haven't really worried about getting sued for two reasons: 1) I'm an EMT, I don't have much to sue for and 2) If I do my job and provide good patient care there is not really a reason to be overly concerned.
 
Not to Necro an old thread but I agree with everyone here. She's not about to die so don't worry about it.

If you were the responding ambulance, sure. But there are three differential diagnoses for this:

1) Hypoglycemia.
2) Stroke.
3) Alcoholism.

1) Do a BGL.
2) Cincinnati stroke questions and grab 12-lead.
3) Seriously, alcoholics fall over all the time, have slurred speech and don't eat properly. Old people can be drunks too!
 
My only question is - are we really considering 250 lbs to be a bariatric patient these days? That's smack in the middle of the bell curve, at least here in good old 'MURICA.
 
Arovetli said:
Am I on a date with an incredibly beautiful woman? if so that totally changes my strategy.

Or, is the daughter hot? Im not really into the cougar thing, but hey, YOLO
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QFT, If I am looking to "impress" my date this could be my chance its Ricky Rescue Time!!! :ph34r:
-1 on the cool points for me being all but married.

dixie_flatline said:
My only question is - are we really considering 250 lbs to be a bariatric patient these days? That's smack in the middle of the bell curve, at least here in good old 'MURICA.
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I think if 250 is bariatric then most of my patients are fat bodies...

for the most part, I would offer limited assistance if need be. if the daughter appears to have things under control, or 911 has already been summoned I need to do nothing. If there is a need for minimal assistance I am sure I can offer a lending hand or a cell phone for 911. I don't need to run to my car grab a Ricky Rescue bag get vitals instruct daughter to hold C-spine get history meds, vitals etc. etc. I am off duty my personal life and professional life are 2 different things some people seem to forget that.
 
I would fall over too and see if other people play along... :rofl:


or loudly announce "stay away from the caeser salad here... it's a real killer... exhibit A and I rest my case"... then go back to enjoying my dinner
:P
 
Arovetli said:
Good Samaritan typically applies only to lay persons.

P.s., YOLO
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Good Samaritan can apply any time a duty to act does not exist. I.E., after duty hours.
 
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dixie_flatline said:
My only question is - are we really considering 250 lbs to be a bariatric patient these days? That's smack in the middle of the bell curve, at least here in good old 'MURICA.
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Bariatric is basically the same as morbidly obese. When the weight is causing illness, isolation, death, then it is bariatric.

If I'm six foot four and 250 and my shortness of breath, inability to wash and dry myself, fallen arches, knee and hip pain/degeneration, inability to shop for groceries or attend church, and hypertension are attributable to my weight, then I'm a bariatric patient.

If I'm four foot six and weigh two hundred and it is not affecting me clinically or socially, then I am not.
 
mycrofft said:
Bariatric is basically the same as morbidly obese. When the weight is causing illness, isolation, death, then it is bariatric.

If I'm six foot four and 250 and my shortness of breath, inability to wash and dry myself, fallen arches, knee and hip pain/degeneration, inability to shop for groceries or attend church, and hypertension are attributable to my weight, then I'm a bariatric patient.

If I'm four foot six and weigh two hundred and it is not affecting me clinically or socially, then I am not.
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I guess my definition of the term is colored by our use of it in the FD here; we call out the "bariatric unit" when our normal unit is incapable of safely accommodating a patient - our normal Ferno stretchers can only hold 400lbs, so anything above 400 I consider bari.
 
dixie_flatline said:
I guess my definition of the term is colored by our use of it in the FD here; we call out the "bariatric unit" when our normal unit is incapable of safely accommodating a patient - our normal Ferno stretchers can only hold 400lbs, so anything above 400 I consider bari.
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400lbs? Our gurneys hold 700lbs. Around 500+ lbs the patient becomes too wide to fit in our type II units.
 
Our normal gurneys can hold 700 lbs however for patient comfort anything over 350-400 generally gets our bariatric unit and bariatric gurney, which is twice as wide and can hold 1500 lbs. but it's the only manual gurney we own...
 
I just shake my head thinking about how well something loaded with over 300 pounds maneuvers through doorways and hallways in homes, not to mention steps and rotting porches.
And then I read that a mfg says their litter will take on 700 lbs.:unsure:
 
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