Ok. IMHO, there aren't any "minimum guidelines" for when to call an ambulance. Yes, there is abuse of the 9-1-1 system. Yes, I've heard "I've got Medicaid.. that means I get to ride in the ambulance for free instead of taking a cab."
Are there patients who go by ambulance who don't "really" need it? Yes, there are - plenty of them. On the flip-side, though, there are many examples of people driving themselves to the hospital when they should call 9-1-1.
For example... when you are having a heart attack, if the "hosptial comes to you" by way of a good EMS program, you will get faster care, and faster care upon arrivial at the hospital. Paramedics often have protocols that often let them do much of their patient care without consulting a doctor first. They can give you asprin, oxygen, nitroglycerin, use a EKG machine to do a cardiogram of your heart and determine, to an extent, whether or not you are having a heart attack. Often, they can give you morphine to reduce the chest pain and reduce the stress on the weakening heart. If you drive yourself to the ER, you might get there before you would on the ambulance... but you won't have an IV started, a first cadiogram done, asprin, and your first dose or two of nitro and perhaps morphine. You will have to register, be seen by the triage nurse, then get taken back to a bed. When you come in by ambulance, if you are REALLY sick, you get to go right back into the treatment area... in fact, in some systems, if the pre-hospital cardiogram reveals that you are having an active MI (Miocardial infarction - Heart attack) ambulance crews are bringing patients straight to the cardiac cath lab. If you drove yourself in, it will take time to get the initial evaluation done... Part of this is load on ER staff vs. EMS staff... In the field, I usually only have 1 patient I am responsible for. I can't get my patients mixed up and cause a medication error. A paramedic in the field can give patients medication on "standing orders" and do it immediatly after they determine the need for the medication. In a hospital, a nurse is often responsible for 3-5 or more patients, and only physcians can order medications.
What I am trying to say is:
If you have a valid medical complaint, ANYTHING... a fracture, nausea, whatever... and you feel that you need to get to an ER, than feel FREE to call 911. As long as you don't say "I called 9-1-1 and you HAVE to take me to the hosptial for my clinic appointment," you shouldn't have any problems with the EMS crew... they should be caring and do their best to make you comfortable. Also, when you call 911, make sure that you answer the call-takers questions fully and honestly. Don't say you are having chestpain unless you are actually having chest pain... all systems prioritize calls to some extent. In some cases, you will only get a "basic life support" ambulance, staffed by EMT's... not an "advanced life support" ambulance staffed by Paramedics... Paramedics start as EMTs and have more training on managing serious medical emergencies... for the most part, if all you need is advanced first aid (fractures, etc), than an EMT is all you need.
To get back to the point about when to call 9-1-1 - When I am treating a patient and they say they don't want to go to the hospital by ambulance, they will get there on their own - I ask this question:
-Is there someone who can drive you? (If you are saying you feel weak, or perhaps you are bleeding profusely... what happens if you pass out while driving yourself to the ER? You could further injure or kill yourself or others)
In some cases, driving yourself, or being driven to a hospital is a reasonable alternative to ambualnce transport. I work as a Security Officer/EMT at an office complex that backs up against a hospital. My boss has told me that I should "discourage" the employees from going to the hospital "on their own." In our case, in reality, it DOES take longer for an ambualnce to arrive than for me to drive myself to the hosptial. Further, we are so close to the hospital that an ambualnce crew often doesn't have time to provide lots of care going to the hospital.
Ok... I've run the gamut back and forth... basically, it is your call... if you are close to a hospital, feel that you can safely get there, and you are only minorly/moderatly sick or injured, than you can probably do OK without going by ambulance... on the same token, if you call 9-1-1, EMS will come and take you to the hospital (as long as you have an actual medical complaint). - For example... if you need stiches, or something else that is urgent, but not emergent, you could probably drive yourself to the ER.
Oh.. and a caveat - this IS NOT medical advice, just what I've wittenseed as both a patient and provider.
