Patient requesting "shutdown" prior to arrival.

[imadriver]

So, completely Non-Medical Scenario that happens frequently in my parts. I'd like to see some of your responses to this.

SCENARIO:

You are responding to a 32/yo Male, complaining of Back Pain that's been chronic x7 years, and is requesting an ambulance. Patient also is complaining that it's hard to take a deep breath because of the pain. So you are going down the street emergency and dispatch comes back and tells you "The Patient is requesting shutdown prior to arrival." You then ask back dispatch, "So you want us to respond non-emergency?" Then Dispatch answers "Well, I can't decide that. That would be your choice."


So What Would You Do?

-Generally, I usually shut down anyway. I work nights and it's hard to see the house numbers with lights flashing. However, the exception is us getting dispatched to any call I believe we'll either need Fire / Law / Supervisor as to mark where I am on the street level and remain visible for safety reasons. There are also certain sections of town that you Want to shut your lights off as to not get a large crowd (very quickly!) Now, I'm a firm believer that I am a "Servant of the Public", but these, always, makes me want to bust in their neighborhood with Lights, Sirens, and laying on the Air-horn at 3am when they decided to call. Just to do it.

 

[HotelCo]

Now, I'm a firm believer that I am a "Servant of the Public", but these, always, makes me want to bust in their neighborhood with Lights, Sirens, and laying on the Air-horn at 3am when they decided to call. Just to do it.

So waking everyone else up at 3am is being a public servant? Not everyone works nights....

They might not want attention drawn to themselves, maybe they don't want to wake everyone else up. Either way, who cares? If you feel like you're going to need PD, why wouldn't you request it beforehand?

I shutdown when asked, and at night, usually shut down when I turn into the residential area where the call is.


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[Handsome Robb]

There's no reason to go screaming through a neighborhood in the middle of the night with RLS. Usually we shut down the siren and coast in with our lights, houses tend to be market pretty well around here.

That is a little on the ridiculous side saying that since the pt requested you to shut down that you are tempted to do the opposite...

We are pt advocates. You and your partner's safety come first then the patient's needs/safety. Shutting down is not only safer for your partner and yourself it also complies with the pt needs. Why would you want to challenge that? Either they are try not to attract attention or they are trying to be polite to their neighbors...

 

[imadriver]

As said, I do shut down, and if they request it, I absolutely do. I've just always wanted to do it. There is one lady who does this about twice a month, and it's always because she stubbed her toe or something minor she makes up just to get up to the hospital across town so she can stay with her sister, who lives right next to the hospital, for the week. And she always waits until 2am cause she doesn't want her neighbors to know she is always calling for an ambulance. (And she tells you all this without hesitation.)

I've never done this. Just asking. And the shutting down in residential areas is just about what I always do. I shut off my flashers and turn on my flood/scene lights.

So waking everyone else up at 3am is being a public servant? Not everyone works nights....

They might not want attention drawn to themselves, maybe they don't want to wake everyone else up. Either way, who cares? If you feel like you're going to need PD, why wouldn't you request it beforehand?

I shutdown when asked, and at night, usually shut down when I turn into the residential area where the call is.

Completely agree with the last part. And You've never been in the situation that you needed Law and nothing about the call hinted toward that? I couldn't tell you how many times that happens to me. And That Only time I do leave my lights on at the road, is usually on Arrests or at least an actual emergency that fire or Law hasn't made it to yet. Just so they can spot me better.

That is a little on the ridiculous side saying that since the pt requested you to shut down that you are tempted to do the opposite...

We are pt advocates. You and your partner's safety come first then the patient's needs/safety. Shutting down is not only safer for your partner and yourself it also complies with the pt needs. Why would you want to challenge that? Either they are try not to attract attention or they are trying to be polite to their neighbors...

I'm not talking about being unsafe, Just because your lights are on don't mean you have to drive 70+ mph. And as said, I never have and never will unless I have to do this. Just a hypothetical question.

 

[JPINFV]

There's no reason to go screaming through a neighborhood in the middle of the night with RLS

I'll take this a step further. Generally inside neighborhoods there's no reason to use lights and sirens. In a lot of places there generally isn't enough room for cars to pull over properly anyways.

 

[Shishkabob]

Honestly, it annoys me too. If it's "emergent" enough to call 911 for an ambulance, at 3am, it's "emergent" enough to get the fastest response. If you yourself don't believe your condition warrants LS, then you should possibly use that thought process for something else, such as calling a taxi.





I'm not one that wants LS on every response... but that needs to be up to the condition at hand, and not necessarily the patients requests.

 

[usalsfyre]

You could take the lights and siren off the truck and it would make my day actually.

That said, I'll do it if requested, but the "I'm worried what the neighbors will think" crowd irritates the crap out of me. I've actually been told I needed to mover around to the back so the neighbors wouldn't see an ambulance.

 

[usafmedic45]

That said, I'll do it if requested, but the "I'm worried what the neighbors will think" crowd irritates the crap out of me. I've actually been told I needed to mover around to the back so the neighbors wouldn't see an ambulance.

If it's the middle of the day, I'll leave it on, especially for frequent flyers. If it's at night, I would hope someone would have the concern for waking their neighbors up. That's just the decent thing to do.

 

[Sasha]

Whats the point of using lights and sirens in a residential neighborhood anyway? Bring the little kids running to see the cool truck and get around the non exsistant traffic?

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[usalsfyre]

If it's the middle of the day, I'll leave it on, especially for frequent flyers. If it's at night, I would hope someone would have the concern for waking their neighbors up. That's just the decent thing to do.

The previous job I had I usually didn't turn them on after 7pm. Which irritated my last partner because she thought people moving to the shoulder was "fun".

The case I refer to above? Noonish in an "old money" neighborhood. Seems as though the wife was embarrassed of her husband's deteriorating condition from cancer (at least that was what the patient thought).

 

[Shishkabob]

Whats the point of using lights and sirens in a residential neighborhood anyway? Bring the little kids running to see the cool truck and get around the non exsistant traffic?

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Yes, but most kids, upon seeing and/or hearing an ambulance or other emergency vehicle, tend to have the forethought to NOT go out in the road... unlike your average civilian vehicle that doesn't scream "LOOK AT ME, HERE I COME!" and have an auto/ped on your hands.

 

[EMSrush]

Interesting discussion. I work for a commercial 911 service and we don't decide how we respond to the call; dispatch does. Dispatch can upgrade or downgrade us as they receive more information en route.

 

[usalsfyre]

Interesting discussion. I work for a commercial 911 service and we don't decide how we respond to the call; dispatch does. Dispatch can upgrade or downgrade us as they receive more information en route.

Same, but is anyone really watching? Due to the size of the town I was never "late" responding to an emergent call responding non-emergent

 

[imadriver]

If you yourself don't believe your condition warrants LS, then you should possibly use that thought process for something else, such as calling a taxi.

The lady I spoke of actually gave a decent reason: She would get arrested if she didn't pay a taxi. Doesn't matter for an Ambulance.

If it's the middle of the day, I'll leave it on, especially for frequent flyers. If it's at night, I would hope someone would have the concern for waking their neighbors up. That's just the decent thing to do.

On the bad side of this, I've actually had a complaint on me about me pulling up to a scene without my lights on. Family didn't understand why I "wasn't" responding emergency. I actually turned off my lights when I pulled on their road about two blocks away. But Perception is Truth.

Interesting discussion. I work for a commercial 911 service and we don't decide how we respond to the call; dispatch does. Dispatch can upgrade or downgrade us as they receive more information en route.

Generally, we don't either, EVERYTHING is Emergency Response unless it's a hold back, which we Can go emergency too a good staging area If there is a large distance to the call, but usually shut down a few miles out.

 

[Shishkabob]

The lady I spoke of actually gave a decent reason: She would get arrested if she didn't pay a taxi. Doesn't matter for an Ambulance.

Get PD out there and let them know about her views on calling an ambulance because she doesn't want to pay a bill. They'll have some words with her about 911 abuse.

 

[imadriver]

Tried it... PD slapped her wrist and now they don't want anything to do with her. She wont tell anyone else but the EMS crews that. Once anyone else is around she starts with the "I told him I'm having chest pain! And He's not doing anything about it!" Even though she was saying something about her fever or whatever it was that time.

- I think she knows the limit. It's not abuse until you do it more than X amount of times here per month. So it's not an "arrestable offense"

 

[Shishkabob]

Next time you're with her, key up the mic and have it admitted over the air.

Once recorded, start emailing people such as your supervisor / med control / etc etc about what to do in the future about blatant abuse from this person.



MedStar in Fort Worth has an option where if it's a known system abuser, and the APP deems it a non-emergent call, they give a call to Med control, update the doc, and then refuse to do a transport.

 

[imadriver]

oh my god Linuss you are a genius.

Of coarse, I couldn't do that on "purpose" though... hmm... I'll have to lean against my crew bench next time she's rambling, and think about it.

 

[JPINFV]

Is Florida a 1 party or 2 party consent state?

 

[imadriver]

Is Florida a 1 party or 2 party consent state?

If we are speaking of Voice Recordings, Everybody must consent before any recording can be made. (purposely)