"I am not going to transport a stable pt with no significant mechanism of injury and no obvious signs of symptoms of disease unless they insist on it. For example, wife calls 911, says husband quit breathing, we show up, husband is awake, conscious and talking to us. Says he suffers from sleep apnea and fell asleep in a chair, he swears he's fine and wife over-reacted. Skin color is good, all vitals WNL, EKG shows NSR, O2 sat in high 90's am I going to make this guy go to the hospital and spend the next several hours being told that he's okay after every test in the book? "
I had to reply to this one, cuz it rang a bell with me. We had a call a while ago, wife called in, said her husband was unresponsive, about 0100. We get there, guy is awake, A&Ox3, NSR, 98% SpO2 on room air. States he feels fine, no cardiac history whatsoever, but bed is soaking wet where was laying and he was NOT incontinent. We hook him up, BP is 118/68, NSR. Guy says he feels fine, then tells us, "oh ya, and I passed out day before last for no reason, weird huh?". My partner and look at eachother and convince him to go in (in our bus) and get checked out. He jokes with us the whole way in, we are hospital based so we hang around. Run full chest panel/12 lead, the whole works. Everything comes back with normal ranges other than a slightly elevated WBC, but they are gonna keep him overnight for obs.
We go back to quarters, and 10 mins after get there we are paged to the floor for a code. It's OUR patient! He'd gotten to his room, nurse was attaching telemetry, and he without warning goes into full arrest. Of course, this was observed arrest, in house, and we worked on him for over an hour (our doc would NOT give up). End result...he died. Later find out he was 100% blocked on the right and 90% blocked on the left and the labs showed none of this. Something broke loose, and it killed him DRT. Just goes to show, you never know, ever. You do the best you can, you trust your training, and you have to try NOT to back and second guess everything you did. But that's near impossible, now, isn't it?