I’m pretty militant about it. My ex-husband, who is a firefighter, never wore his, not ever. He claimed to have seen ‘too many’ (in his words) accidents in which the occupants were trapped by their belts with the car on fire and burned to death. It drove me nuts, but I’ve instilled the seat belt logic in my kids.
The first question I ask at the scene of a car accident is, “Did you have your seat belt on?”
Just go through their clothes and look for loose change…
How do you feel about treating patients who have self inflicted injuries or problems…such as ODs, self harm etc?
And how often do patients throw up over your ambulance?
I don’t have any problems treating them. What concerns me, is that these patients are more likely to try to hurt us, so we have to approach cautiously, and we usually have police cover as well.
Way more often than I’d like! We carry emesis basins like they have in the hospital, so usually people throw up in there. It maybe only happens every couple months that somebody actually throws up on the ambulance itself.
What do you do if the patient requests transport to a specific hospital? If I ever need emergency transport to a hospital, there is one I prefer.
We do our best to take patients to the hospitals they want to go to. However, there are some cases where we can’t. There’s a few hospitals in our metro area that are too far out of the city for us to transport to. If the hospital you want to go to doesn’t have the services you need, we have to take you to a different hospital. For example, there’s a couple hospitals in town that don’t have cardiac cath labs, so if you’re having an MI you need to go to a different hospital. We’re obligated by state law to take major trauma patients to a trauma center. Also, sometimes we get people so sick that we can’t go past the closest hospital. People are generally pretty understanding when we explain it to them.
Despite all that, I’d estimate we take people to their hospital of choice at least 90% of the time.
There was a report a few months ago about the jaw-dropping practice of using ambulances as taxis. In other words, a person (typically a little old lady) calls an ambulance complaining of a vague but worrisome symptom (chest pains, for example) and asks to be taken to a specific hospital. Having been transported there, she calmly walks out and goes off to do whatever she was planning to do (e.g. shopping at a mall conveniently located near the hospital she asked for). Naturally this costs everyone concerned a bundle (except the “patient,” who cannot be found) and there’s nothing you can do about it, since you have to treat every case as serious.
Does this happen in your system?
I’ve never heard of this happening here. I’ve had a very few patients that have called 911 and requested transport to a far away hospital because they had a doctor’s appointment there. They usually get a speech about how the 911-system works and that we can’t take them anywhere other than the ER (true, with a couple exceptions explained below). I also had a patient who called 911 because they couldn’t get to their doctors appointment because they now weighed 900 pounds and no longer fit in their car. In addition to everything else, they didn’t fit in our ambulance either. After some discussion, we scheduled the patient to be picked up by a bariatric ambulance. As an added bonus, since it was a scheduled transport and not 911, they could go right to the doctor’s office.
Generally speaking, if you call 911 the ER is the only place I can take you. There are 2 exceptions to this. Where I work, we can send someone who’s intoxicated with no injuries or complaints directly to detox. In some cases, we can also take a patient directly to the OB unit, bypassing the ER. Other than that, it’s the ER or nothing.
There’s been some discussion about allowing transports to non-ERs, such as urgent care centers. In my opinion, however, this is probably not the best use of 911-ambulances. If you don’t need the ER, you probably don’t need the ambulance, either.
Yeah, that’d make you a taxi driver with a stethoscope.
D&R
We also transport straight to OB.
Where is my stethoscope, anyway?
A local EMT once told me that they would get 2-3 calls a week about a Really Fat Person that Fell and Needed Assistance.
I scoffed at the time, but continue to ponder. Do you have to respond to many of those calls?
I’m just wondering if “the local EMT” was full of shite or not. In the interest of science and all…
What I meant is that the person requests transport to the ER, then, once arrived at the ER, at some convenient moment gets up, walks out, and goes off to do whatever it was they wanted transport to.
Incredibly self-centred behaviour, but apparently it happens.
It’s not always a really fat person. Sometimes it’s an elderly person or someone with significant medical problems. Standard terminology is “lift assist.” In the system I work in, ambulances don’t respond on lift assists- it’s handled by the fire department. If the call comes in as a fall with no injuries, we don’t go.
At my part time job, ambulances ARE sent on lift assist calls and I know it varies all over the country. In my experience, the vast majority of lift assists are for elderly patients. Although, my partner and I have the record at my part-time job for doing a lift assist for a 650 lb patient.
matt- I’ve not heard of that happening here. I wanted to mention some of the other ambulance as taxi calls we get.
I’ve described myself as an Emergency Taxi Driver.
Nothing else? C’mon, this is the slowest time of the year!
Not a question, just a “thank you” to you and your fellow EMTs and Paramedics…
Back in May I broke my ankle. Badly. The guys who responded were very kind, considerate, and did a great job of keeping me, my husband and our guests (why yes, of course it was at a party :smack:) calm and getting the situation handled as efficiently as possible.
They took the time to explain all my options to me for hospitals, explained why the closest hospital probably wouldn’t be a good choice, and then gave clear directions to the person driving my husband down to the hospital we WERE going to. They kept me talking and answered all my questions, and they were SO nice. They even told the ER nurse that I was “easy to take care of” - which I disagreed with, but hey.
On behalf of all of us who are scared, in pain, and generally being seen on what could be the worst day of our lives - THANK YOU. Thank you for being there, for being patient, and for putting up with us when we’re not at our best. Thank you for doing it day after day after day, when it has to wear on you.
I, for one, appreciate it very much.
Ok,. I’ll bite again. I’ve been struggling with how to ask this question, so bear with me a little here.
A fairly common meme in the paramedic blogs I read is about how everyone who goes into the profession has starry-eyed visions of “saving lives” , intubating, IVing, defibrillating and medicating like an EMS Tasmanian Devil, most of the time in an upside-down car in the ditch while waist-deep in water in the pelting rain (did I leave out any cliches?) and, that for the most part, the most valuable thing paramedics actually do is to provide transport to an ER/OR while making sure things don’t get any worse. A corollary to this is that paramedics rarely save lives, they mostly stabilize the patient to get them to where the lifesaving can actually happen.
I guess the question I’m struggling to formulate is: on what percentage of your calls do you feel you actually *save *a life? And the biggest problem I have is how to define " save" from a paramedics’ perspective. Sure, if you show up, patient is in asystoly, you shock them, and they convert to a normal rhythm, I think anyone would call that a save. But the collision victim with internal bleeding to whom you just apply IV, O2, and a big bolus of diesel to get them to the OR, is that a save? What about the possible MI with the inconclusive EKG whom you give O2 & aspirin and a ride?
What’s your take on the whole " lifesaving" thing, and how often do you think you’re actually doing it? If not very often, then where do you find your reward in your profession?
I’ll jump in on the ‘saving a life’ question. I’m in a volunteer squad, and I took 83 calls last year. Of those, 3 were ones where my personal actions resulted in the patient not dying on the spot. One was a lacerated arm with an arterial bleed, an old lady who was not breathing strongly (not distress, just not breathing), and a COPD patient who was near respiratory arrest.
The rest fell into one or more of several categories: large group effort of which I contributed, situations that could have wound up as fatalities but the intervention happened before the hair on our collective necks stood up, general calls that were serious but not a life threat, or bullshit calls.
To apply the SWAGs:
95% or so of my calls are medical matters, as opposed to trauma;
10-15% of all calls are bullshit.
about 10% result in a large rescue response, defined as requiring more people that are in the ambulance that shift. It’s rare that the ambulance crew will work the physical extrication; they will direct the extrication and provide medical support. Come the next day, the people from the previous crew will extricate but not do the patient care unless absolutely necessary.
3 saves in 83 works out to 5%, if you’re really generous when rounding. I’m sure that I did more than that, but I’m deliberately diluting the figure because I was most often part of a larger team effort.
ETA: My fulfilment comes not the cape and tights with a S logo mentality, but an addiction to redlights and siren, and the ability to handle an unknown situation when I get to it.