Your Repeat Customers?

[Simusid]

Let's talk "Frequent Fliers" !

I know every service must have their own share of regular repeat "customers". Being new, I haven't met all of ours yet. I know we have two diabetics that we visit at least once per month for hypo seizures. One generally does not take care of himself physically, and mismanages his diet. The other appears to be in quite good shape, we see him biking often, has an insulin pump and checks his sugar 15 times per day (it's what he told me anyway, yes everyone lies!).

I'd be interested to hear

1. Your most common conditions that generate FF's (diabetic and resp?)
2. If there is an obvious split between "this person is doing the best they can" and "this person is a bonehead making bad choices"
3. If your service tries to provide any proactive services to reduce the FF calls

 

[vquintessence]

1. Alcohol, drug addicts, epilepsy, DM, asthmatics, cardiomyopathy.

2. i) Generally the drunks and addicts don't take care of themselves (shocking!).
ii) Some asthmatics exascerbate the issue by repeatedly (and I'm talking like 10+ simultaneous doses) administering their MDI's in hopes of not having to be evaluated or pay a bill. I'll usually offer those poor souls a neb treatment with a stern reminder not to do what they WILL do again... as well as having the understanding they desire a treat-and-release (only when feasible). We've attempted to be proactive with correcting this by at least directing social services their way... but to no avail.
iii) Wide range of DM pts that either don't take any care of themselves to being an innocent mistake once every couple years. Alcohol seems to complicate the former group all too often.
iv) Some epileptics are non-compliant. Others are cursed to experience numerous seizures with tonic-clonic activity numerous times a day. Usually the ones calling the ambulances are bystanders who don't know the pt.
v) Cardiomyopathy... well genetic and lifestyle play huge roles. Who knows with many cases; was it the chicken or the egg.

 

[eveningsky339]

I live in a university town, where the joys of arriving to the scene of drunk college students never cease to make me smile. Easy calls, though, not much you can do for a drunk kid, except put him on O2 and pretend that it helps somehow.

 

[ZVNEMT]

i get a couple frequent fliers... i get Ms. My-sickle-cell-is-acting-up, who is in so much pain she that she is able to walk out to the ambulance, but by the time we get to the hospital is non-ambulatory. and then Ms. Cuz-I-gots-Medicare, who explains to us that taking a cab to the Dr is too expensive.

 

[EMSLaw]

What about the old people who call once a week for an assisted lift? We seem to have a goodly number of those

 

[johnrsemt]

my old area had quite a few:
the guy with back pain who would run out of meds, and call 911 with a crazy story. my first time with him was: "I was hit by a car, while I was sitting on my couch in my living room".
the guy who had bad pancreatitis, would drink and get pain that he felt was chest pain. he got so bad that the police would come with us, he would step off his porch and be arrested for public intox.

older lady who would call for assist for things like her home O2 wouldn't work. we stopped that one, by taking turns stopping at her house on the way into station, talking to her for 10-15 min and head to station. she was lonely.

 

[Sasha]

At my old job it was
1) Renal Failure
2) Nope.
3) Nope, it was welcomed! It meant money!

My current job it's not much of a problem. Love IFT.

 

[Seaglass]

Let's talk "Frequent Fliers" !

[*]Your most common conditions that generate FF's (diabetic and resp?)
[*]If there is an obvious split between "this person is doing the best they can" and "this person is a bonehead making bad choices"
[*]If your service tries to provide any proactive services to reduce the FF calls
[/LIST]

1. Diabetes, renal, asthma, drunk, psych. We also have a handful of bizarre chronic illness patients who we see pretty often.

2. We try not to judge, because you never know. For instance, we just learned that a new frequent flier drunk who we've all been hating has been drinking because he just had most of his immediate family die. But yeah, sometimes there are pretty obvious distinctions. We do our best to treat all patients equally no matter what.

3. Community education in the form of pamphlets and co-sponsoring occasional educational events.

 

[emtfarva]

Psych.....

I would say the most repeat customers I see are Section 12's (MA speak for psych Pt's). Other than our normal IFT Pt's. Most common is CRF. As for our 911 calls, could be anything... Mostly again Psych, DM, Falls, SOB, Psych, oh yeah, Psych....

BTW, You are like the closest person on this site that lives near me. Welcome.

 

[thegreypilgrim]

Usually it's ETOH related or drugs - but the drug users usually tend to die or court-ordered to detox before having too many OD episodes.

The standard frequent flier is the disheveled homeless guy, ETOH, calls 911 because he wants a ride to the hospital to get something to eat...or because he's passed out on the sidewalk and a cell phone hero calls it in.

Aside from that it's the people with chronic conditions who are non-compliant and/or useless and/or unable to properly care for themselves. Such as epileptics, DM pts, renal failure, COPD, or CHF patients - we have a guy in our area who gets chest pain & shortness of breath several times a week.