Patient's Medications: To take or not to take?

[dmc2007]

I've heard varying opinions on whether or not it's best to take a patient's medications with him/her to the hospital. The main objection I've heard to doing so is that the medications will often get lost somewhere during the course of the patient's treatment, causing the patient to then incur the cost of replacing them. Anyone have any thoughts one way or the other?

 

[robbaN28]

If it's a ton of medications load them up in a box and take them. It's a couple, just write them down and head out.
You will put that you handled medications under valuables on your report.

 

[rhan101277]

Most times patients who are familiar with how riding in the ambulance works will have their medicines ready in a zip lock bag for your inspection. I inspect them handily

 

[TransportJockey]

If I'm getting them from home I just write them down and then leave the meds there. If they have them in a purse or backpack and they're away from home, they come with the pt.

 

[8jimi8]

take em, or leave em just make sure you get an ACCURATE list including dosages and compliance with each medication. It makes our jobs much easier in the hospital if we know what the patient does and does not take. We are required to document all items that come in with the patient.

 

[EMSLaw]

If the patient has only a few medications and they are clear on what they take, I just make note of the drug and dosage. If they show me a Wal-Mart bag filled with med bottles, I'll take them with, rather than spend 20 minutes sorting them out on scene.

 

[Aidey]

take em, or leave em just make sure you get an ACCURATE list including dosages and compliance with each medication. It makes our jobs much easier in the hospital if we know what the patient does and does not take. We are required to document all items that come in with the patient.

Sorry, but I had to LOL at that. The last time I had a patient that remembered that info it was a guy with Aspberger's that had crazy good recall ability. 1/2 of my patients can't even remember what medications they take, let alone any other information. I know it's helpful, it just isn't information EMS has much control over.



I personally don't like taking meds with me unless it's a specific situation, like an OD, cardiac arrest, or something else where having the actual bottles is relevant. For example I've taken medications before when I've noticed multiple bottles of the same pills all from different doctors

 

[firecoins]

leave the meds home. Make a complete accurate list provided your at the person's home where you can copy the relevant info off the bottles themselves.

 

[Smash]

Research has shown significant reduction in Medication errors when patient's own medications are taken in with them. I'll post the study when I get home.

 

[JPINFV]

Research has shown significant reduction in Medication errors when patient's own medications are taken in with them. I'll post the study when I get home.

As in significant in real terms, or simple statistically "significant."

 

[Melclin]

I can't be bothered backing up to see who said it, but you just do whatever you reasonably need too to get an accurate picture of the meds. If they're on 1 or 2, you can probably get away with just writing it down. If its more, or they're unusual, you'd better take them. Its not rocket science.

Many of the olds seem to have well prepared medication lists or plastic bags with all the meds, and taking them all is best.

I might add though that losing the meds is not really an issue because they're all cheap as chips here anyway.

 

[Aidey]

I might add though that losing the meds is not really an issue because they're all cheap as chips here anyway.

At my company we pay for lost medications, even if the patient can't prove we were the ones that lost them.

 

[the_negro_puppy]

We usually try and take them with us if they have them ready. If its only a couple of different or likely a short stay at hospital i justt write them down

 

[Smash]

As in significant in real terms, or simple statistically "significant."

I wasn't aware that there is a difference.

When one considers the staggering number of medication errors that occur every year, the tens of thousands of deaths that occur as a result of medication errors and the billions of dollars that they cost us, I would think that any efforts to reduce errors would be "significant"

 

[JPINFV]

I wasn't aware that there is a difference.

When one considers the staggering number of medication errors that occur every year, the tens of thousands of deaths that occur as a result of medication errors and the billions of dollars that they cost us, I would think that any efforts to reduce errors would be "significant"

All that "statistical significance" says is that there's a difference. It doesn't say anything to the size of that difference, so with a significantly sized study, you can make a 0.001% change "significant." A perfect example of this are the lights and sirens studies. Every single study regarding lights and sirens shows a [statistically] significant savings in time. Yes, lights and sirens does save time, this has been proven without a shadow of a doubt. The major question is, though, is the 30 seconds to 2 minutes a [clinically] significant difference?

Hence why the concept of "significant" needs to be described and why things like relative risk, 95% confidence interval, and odds ratios are vastly more important in medical research than a p value being at or below 0.05 (most widely used definition for statistical significance).

What would be interesting to see is what exactly changes when the medication is brought.

 

[8jimi8]

What exactly changes when medications are brought in, is a verifiable document is brought in, so that there is no guesswork as to: what BP med they are on, what the dosage is, if they take them as they are directed, if the patient understands what each medication is used for.

As for the LOL, come and do my job and then you can turn your upside-down into a frown. It is completely frustrating trying to extract such details from poor historians.

If you get a bottle of something and notice that it has been unfilled since march of 09, then you know they need a social work consult to get them some discounted medications, or you know to alert the MD to consider a less expensive alternative.

It may not matter to you after you get your cot cleaned, but consider that the extra moments and efforts you take at the home can greatly facilitate the continuity of care.

that's not so funny is it?

(btw, i might be cranky right now, i'm just finishing a 45 out of 36 hour work week with less than 8 hours of sleep between 3 shifts, no lunch breaks and left shift with one of my patients going onto a stemi alert. -- so please don't read any sarcasm or antagonism into my internet connotation)

 

[reaper]

Have been taking meds in for 20 years without a problem. Don't care if it is one bottle or 50. Unless the pt has a well prepared list to give me, all meds come with. I have never lost any meds. They are turned over to the Rn and they sign for them. If the pt is alert, they are left with them and the pt signs for them.

This is not rocket science. Responsibility and documentation go a long way!

 

[Aidey]

What exactly changes when medications are brought in, is a verifiable document is brought in, so that there is no guesswork as to: what BP med they are on, what the dosage is, if they take them as they are directed, if the patient understands what each medication is used for.

As for the LOL, come and do my job and then you can turn your upside-down into a frown. It is completely frustrating trying to extract such details from poor historians.

If you get a bottle of something and notice that it has been unfilled since march of 09, then you know they need a social work consult to get them some discounted medications, or you know to alert the MD to consider a less expensive alternative.

It may not matter to you after you get your cot cleaned, but consider that the extra moments and efforts you take at the home can greatly facilitate the continuity of care.

that's not so funny is it?

I'm sorry, but i'm sticking by my LOL because you made it sound like we (EMS) have some major control over that information, when in reality we have very little. I absolutely understand the information is helpful, its just that those poor historians aren't any better at their homes than they are at the hospital.

My favorites are the elderly or disabled people who have all of their meds in a weekly organizer....and none of the bottles. In those cases I usually bring the organizer with me. It's always fun when I get blamed for the pt not keeping the bottles.

 

[truetiger]

I've always been told to leave the meds at home and make an accurate list, because the ED staff frequently throws out the meds which could cost the pt hundreds of dollars with of medication.

 

[8jimi8]

we document and hold in the pharmacy all drugs that the patient comes in with.

If you don't care about continuity of care, you should re-evaluate your interest in medicine.

Are you bringing a little bitterness to the table? Are you just being sarcastic? Who is talking about it being EMS's fault if the information is simply unavailable. The whole point is to gather information that will help enhance the effectiveness of individual healthcare. I fail to see how you cannot grasp this.