One time showed up to the hospital to transport an elderly female home. So I walk in, start getting report from the RN and realize something's not right. Pt is an elderly female (~70s), completely A&Ox4, can walk and talk, doesn't require a gurney or BLS monitoring. So, I hand her a physician certification statement (PCS) form and tell her the patient has to meet medical necessity for ambulance transport. Her response?Got sent to a local ED for a BLS discharge back to nursing home. Walk in and PT is sitting up at the edge of bed - "Want me to walk out to the truck and make it easier?
Partner tells RN to wait a sec...walks out to call dispatch who tells us not to take it since PT doesn't need a cot.
Same day they sent the two EMTs on a 10 day old w/ trauma
I know it isn't the intent of this thread, but there is so much wrong with this. I'm not sure why this is an SNF horror story and not an unprepared/inexpereinced crew horror story. It sounds like the LPN gave all of the appropriate info to the crew, whether the dispatcher got the proper info, we will never know. I'm not sure why, once it was known that this was more likely a stroke, it turned into a hot mess. It's a stroke pt, they are pretty routine and no cause for panic, even if their symptoms are increasing. Why is your dispatcher telling you where to take the pt? Isn't that your job and your decision? The LPN might not understand the different capabilities of different hospitals, that is normal since it is not their job to know that sort of thing. As the person making the destination decision, it is your job to educate, not berate. Why are you hauling *** at 85mph, endangering yourself and everyone on the road, for a stroke in someone who is more than likely not a tPA candidate?Partner and I are driving back to our station after a simple ALS transfer. About half way back dispatch calls us for "seizure activity" at a nursing home we service and the SNF doc wants transferred to an outlying hospital. I jokingly tell the medic that, knowing the rep some nursing homes have, it'll be something completely different.
We get on scene, find the room. "LPN" starts giving report..."left side weakness..."
Medic: is the hemiplegia new for her?
"LPN": yea..in the last hour. O and slurred speech and a bit of facial droop.
Medic and I look at each other.
He heads in the room and starts a stroke assessment. I start calling dispatch/supervisor and let them know call just became hot mess and asking where they want us to divert to for a possible stroke alert. As I'm on hold with dispatch I hear the patient tell the medic that it feels "like the time PT had an aneurysm".
Patient and "LPN" try to insist on original destination. They get a quick lesson on "closest appropriate" as the original hospital doesn't have the same capabilities. Medic tells the "LPN" our supervisor will call shortly to discuss further.
Load PT. I start placing patches for 4 lead and getting vitals, medic attempts IV. I crawl up front and start hauling *** to the stroke center. 5-8 minutes out from the hospital I see medic start making the "go faster" motion as he asks if we can pick it up. Apparently the facial droop is worsening. "Well I'm going 85..." ... "O...OK..."
So yeah. I've read the SNF horror stories. Finally got to experience one.