Pts Who Are On A Truck More Than You

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maconEMS219

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In The County I Work In, Which Is Very Very Small. We Have Three Bases. One Truck At Two Of The Bases And Two At The Larger Of The Three Bases. So At Times When It Gets Busy We Are Quit Understaffed. We Have About Five Regulars That Call At Least Once A Day. I Vividly Remember One Day I Was Workin Medic 10 We Were Called Code 2 (non-emergent) To One Of These. Usually We Sit And Talk With Her For A Few Minutes Then Go Back To The Base. This Day We Were The Only Truck In Town The Other Was Transporting Out Of The County. When We Were Paged To A Tree Fallen On A Man. First Responders Got On Scene And Started Trauma Code. She Had Refused Treatment And Transport But As Soon As She Heard This And Knew We Would Be Leaving She Grabed Her Chest And Starting Screaming......

What Would You Have Done In This Situation
 
I would stay with your patient. The second she has an actual complaint or a change in condition, you are commited to her until she a) signs another refusal covering her new "issues" or b) she is dropped off at the ER. Fail to do either constitutes patient abandonment. You no longer need to worry about what other "cool" stuff is going on. If she is problematic about calling, its time for a supervisor, director, and / or law enforcement to get involved.

Besides, it sounds like the tree call wasn't really an emergency anymore. The the patient is dead! Blunt chest trauma + no pulse = dead person, no intervention required....................return to service, have a nice day........
 
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Med Control !!!!!!!!!!!!!
 
Ditto... Real or not, she is a patient. As Flight-LP described traumatic arrest are dead.

Contacting my medical control would had been useless, it is a operational problem not medical direction.

p.s. .. Macon welcome to the site, but your post was Hard To Read, With The Capitalization Of Each Word ... ;)
 
what would i have done?

well, if the powers that be required me to sit around with a known repeat offender hypocondriac while something serious went shorthanded i'd definitely ask that the protocals reflect it

~S~
 
on that particular call she did sign another refusal for the second complaint. and of course the other call was DOA. Her family has recently moved her in with them.
 
maconEMS219 said:
In The County I Work In, Which Is Very Very Small. We Have Three Bases. One Truck At Two Of The Bases And Two At The Larger Of The Three Bases. So At Times When It Gets Busy We Are Quit Understaffed. We Have About Five Regulars That Call At Least Once A Day. I Vividly Remember One Day I Was Workin Medic 10 We Were Called Code 2 (non-emergent) To One Of These. Usually We Sit And Talk With Her For A Few Minutes Then Go Back To The Base. This Day We Were The Only Truck In Town The Other Was Transporting Out Of The County. When We Were Paged To A Tree Fallen On A Man. First Responders Got On Scene And Started Trauma Code. She Had Refused Treatment And Transport But As Soon As She Heard This And Knew We Would Be Leaving She Grabed Her Chest And Starting Screaming......

What Would You Have Done In This Situation
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well, to me it is an ethical question when you are faced with basically it is whether or not you think she is serious. just because she suddeny has chest pain, doesnt necissarily mean she is faking, it is possible maybe not likely but possible. Basically if you had left her, you better be darn sure she is faking, otherwise if she died it would have been 100% your fault, you didn't hurt the other person, but you could have hurt her if you left without her consent. plus I think that would be abandonment.
 
on that particular call she did sign another refusal for the second complaint. and of course the other call was DOA. Her family has recently moved her in with them.
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well maconEMS219 is there a right $$$ for wasting a precious resource? 911 is for emergency services, and people like this who cry wolf because they wish to gain their families sympathy unfairly tie up that resource for the rest of us.

I don't know how your dept bills out, but i'd ask that they hit any of these Fred Sanfords in the wallet as hard as possible....

sanford.gif
 
I don't know how your dept bills out, but i'd ask that they hit any of these Fred Sanfords in the wallet as hard as possible....
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and how would you tell the difference between a "fred sanford" and someone who genuinely thinks they are having a heart attack and it turns out to be reflux ?
 
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We have someone currently who calls sometimes two or three times a day. Once there, she refuses treatment, says she's fine, but two hours later... calls again. She's lonely, not very healthy and oh yeah.. drinks like a fish. So, she gets a bit unsteady with her walker, falls down and calls us. She has called us to help her into bed, help her out of bed, pick her up, sit her down. We griped about it often at run review, but kept reminding our volunteers that even the annoying can have real, serious medical issues and even though we were all tired of being her in home caregivers, we still needed to do our jobs and give her a thorough pt assessment when we were called there.

Finally, we got toned out to "Patient Assist - Patient states unhurt but needs help getting back into chair." One of our EMT's noticed swelling and bruising on her face. The patient denied having fallen but couldn't give a good accounting of how she got the fat lip. We talked her into going in and turns out she had a major subdural hematoma going on.
 
Problem patients can be referred to your county social service agency for evaluation and followup. They can allign this patient with appropriate community/county services that would greatly reduce the number of times she calls 911.
 
ckrump said:
Problem patients can be referred to your county social service agency for evaluation and followup. They can allign this patient with appropriate community/county services that would greatly reduce the number of times she calls 911.
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We have done that with varied results. The patient has to be severely compromised or unable to provide basic care for themselves. If they are just lonely and anxiety ridden over every little pain that they are afraid might be 'the big one', social services can't do a thing for them.

The key is to remember those pain-in-the-tukus patients can have real problems. It might not be this call, but it will be the moment we get complacent. Evaluate the patient, document everything you find.

My hubby recalls having to fish the EKG strip out of the garbage can in the medic office on a public assist on a frequent flyer. Pt just wanted help to the toilet at 3am. Pt. signed a release, told the medics to go home and let him :censored: in peace. Hubby ran a strip on the 12 lead just to cover his butt. Caregivers found the guy stone cold dead, still on the toilet the next morning. Hubby was able to document, guy was alive and fine when he saw him earlier. Document, Document, Document!
 
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