abckidsmom
Dances with Patients
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Scenario: At 0130, you are called for an 18 yo female with an altered mental status. The additional on dispatch is just "caller states that the patient is not acting right, and she's 5 months pregnant." You have a 15 minute response time.
During the response, the dispatcher adds that the patient herself called in and asked to cancel the ambulance, but that her speech was slurred, and given the history on the address in the CAD there is a potential for drugs or alcohol to be involved, and they have you continue in.
When you arrive on scene, you are met at the door by a young man who identifies himself as the patient's fiance. He leads you through a cluttered but not terribly unkept double wide trailer to a bedroom, where the patient is lying on a bare mattress, covered completely by a dirty comforter except for her head. She says, in a slurred voice, "I told them not to send you, you aren't going to touch me, and you can go ahead and leave."
She looks very pale and it looks like a lot of effort for her when she moves around in bed. She has dark circles under her eyes. Getting the demographic info, you determine she's A&Ox4, and adamently refuses to be evaluated, does not give a reason other than, "I'm OK, just leave me alone!"
She has had issues with hypoglycemia, and was treated and released by EMS for the same 10 days prior to this event. She has a history of Crohn's disease, but has had that well under control with a medical regimen. She's G2A1P0, 21 weeks gestation with a baby boy. She reports that she has had regular prenatal care, but can't name her doctor or the name of the practice.
She refuses any physical exam, include all vital signs and blood glucose monitoring.
A deputy arrives and is willing to do whatever you think is right.
What do you do? How comfortable are you with your decision? Will you lose sleep over this girl?
During the response, the dispatcher adds that the patient herself called in and asked to cancel the ambulance, but that her speech was slurred, and given the history on the address in the CAD there is a potential for drugs or alcohol to be involved, and they have you continue in.
When you arrive on scene, you are met at the door by a young man who identifies himself as the patient's fiance. He leads you through a cluttered but not terribly unkept double wide trailer to a bedroom, where the patient is lying on a bare mattress, covered completely by a dirty comforter except for her head. She says, in a slurred voice, "I told them not to send you, you aren't going to touch me, and you can go ahead and leave."
She looks very pale and it looks like a lot of effort for her when she moves around in bed. She has dark circles under her eyes. Getting the demographic info, you determine she's A&Ox4, and adamently refuses to be evaluated, does not give a reason other than, "I'm OK, just leave me alone!"
She has had issues with hypoglycemia, and was treated and released by EMS for the same 10 days prior to this event. She has a history of Crohn's disease, but has had that well under control with a medical regimen. She's G2A1P0, 21 weeks gestation with a baby boy. She reports that she has had regular prenatal care, but can't name her doctor or the name of the practice.
She refuses any physical exam, include all vital signs and blood glucose monitoring.
A deputy arrives and is willing to do whatever you think is right.
What do you do? How comfortable are you with your decision? Will you lose sleep over this girl?
