Calls In The Middle Of The Night

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svfd21emt

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We took a patient into the ER for Toe Pain at 300 in the morning...but get this...the patient walked down 2 flights of stairs and out to our ambulance with no problem at all...makes you wonder...the patient also told us that he took a pint of Jack Daniels to try and relieve the pain...it was dispatched as ALS but we downgraded to BLS...he couldnt wait 4 more hours when everyone is up at least...?????:rolleyes:

Anybody else had calls like ths one or similar to it?????
 
We get those all the time. I do a great deal of overnights, and a few Tuesday's ago at the start of the shift at 0013 or something similar, we were dispatched to a parking lot by one of the dorm buildings for an unknown medical. We get there and it was two sorority girls that were a bit buzzed, nothing even resembling a medical emergency. Total waste of time.
 
Hence why its nice that our Ambulance Officers can decline transport if its clearly not required :P
 
The reason this should have been ALS is quite possible that this was referred pain from an acute MI. Perhaps non typical because he could be diabetic diagnosed or undiagnosed, or an alcoholic. A number of possibilities are present that could lead to this non typical presentation and many a basic and more sadly Paramedic crew has been led astray and missed the boat and in the end the patient pays the ultimate price.

Odds are though it really was just toe pain with nothing more but basics have no way of being even close to sure.
 
All the time.............

We had one the other night at 0245 for a possible OD. Female pt who had just been put on a new med. and it was making her very drowsy and sluggish. When we showed up we found the now med. she was on was triazolam. She ended up refusing transport.
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And vent is 100% on target, as usual.B)
 
medic417 said:
The reason this should have been ALS is quite possible that this was referred pain from an acute MI. Perhaps non typical because he could be diabetic diagnosed or undiagnosed, or an alcoholic. A number of possibilities are present that could lead to this non typical presentation and many a basic and more sadly Paramedic crew has been led astray and missed the boat and in the end the patient pays the ultimate price.

Odds are though it really was just toe pain with nothing more but basics have no way of being even close to sure.
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its also quite possible they could be about to lay a golden egg out of their right ear....

if it walks like a duck.. and quacks like a duck... its probably a duck...

Im sorry, but if there is no associated diaphoresis, nausea, pallor, shortness of breath, arm pain, abdominal pain, or ANY OTHER SYMPTOMS especially after walking down a flight of stairs... then what exactly would prompt you to do a FULL ALS workup on someone..... besides just a general lack of experience.... or being so scared of litigation that you ALS anyone that sneezes funny?

and they wonder why I call it "uncommon" sense these days?:rolleyes:
 
lightsandsirens5 said:
All the time.............

We had one the other night at 0245 for a possible OD. Female pt who had just been put on a new med. and it was making her very drowsy and sluggish. When we showed up we found the now med. she was on was triazolam. She ended up refusing transport.
~~~~~~~~~~~~~~
And vent is 100% on target, as usual.B)
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Where is Vent posting in this thread? :P
 
FLEMTP said:
its also quite possible they could be about to lay a golden egg out of their right ear....

if it walks like a duck.. and quacks like a duck... its probably a duck...

Im sorry, but if there is no associated diaphoresis, nausea, pallor, shortness of breath, arm pain, abdominal pain, or ANY OTHER SYMPTOMS especially after walking down a flight of stairs... then what exactly would prompt you to do a FULL ALS workup on someone..... besides just a general lack of experience.... or being so scared of litigation that you ALS anyone that sneezes funny?

and they wonder why I call it "uncommon" sense these days?:rolleyes:
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Again as I've stated before you don't know what you don't know. And as lacking as we Paramedics are, basics do not know enough to even try and use common sense and tell the person no ride for you. Sorry there is many an MI that does not present with the classic symptoms you describe and anyone with any real experience would know that.

Now I am not saying every painful toe gets full cardiac, stroke, etc, work up but a patient with booze on board needs more than a basic taking vitals to say it is only toe pain.
 
In the last year, I have been dispatched for various reasons, only to show up onscene and find out the "patient" wanted the following:
  1. walked to the bedroom and tucked into bed
  2. assistance filling out the accident form recieved from PD earlier in the day, after a property damage MVC
  3. a report on road conditions and the weather, even though they had just gotten home 15 minutes ago (per the person who called 911 to begin with)
  4. directions to the ER to visit a family member

Now, what was that, that was already posted about common sense?
 
Had a football student in his bd with a fx femur.

Out breaking curfew, drunk, hit by a car, ran three blocks and got into bed upstairs so he wouldn't be busted...and he had a fx femur.
Heavy carry downstairs too, but he was quiet.

Then there was the time with the boat on the levy...
http://www.emtlife.com/showthread.php?t=10015
 
You wouldnt believe half of them, I still cant believe most of them and I was there.
 
medic417 said:
Again as I've stated before you don't know what you don't know. And as lacking as we Paramedics are, basics do not know enough to even try and use common sense and tell the person no ride for you.
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Im sorry, but aren't you a "head honcho educator"? So to say that basics do not know enough to even try and use common sense ... wouldn't you be one of the folks responsible for this? ( IF it were a true statement)

Sorry there is many an MI that does not present with the classic symptoms you describe and anyone with any real experience would know that.

Now I am not saying every painful toe gets full cardiac, stroke, etc, work up but a patient with booze on board needs more than a basic taking vitals to say it is only toe pain.
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Now it seems to be that being an educator, you would be aware that Basics are very much more capable of assessing more than " a basic taking of vitals" and who better to assess whether a paramedic is needed than someone that is NOT a paramedic, but knows the capabilities of a paramedic as well as their own limitations.

Paramedics by nature tend to over treat because that's what we are here to do... give medicines, start IV's, treat illness and injury... especially paramedics who did not get a good firm grasp of the basics of EMS as an EMT prior to entering Paramedic school..they skip right over BLS, and go for the ALS, just like they skipped right over being a field EMT and went straight to Paramedic.

Ive said it before, and I will say it again. I would rather have a competent, experienced EMT over a paramedic as a partner any day of the week.

And I've said this before and I will also say it again:

If you really feel that basics are this worthless, then its a shame they let you teach... because you're going to do nothing more than instill feelings of inadequacy in these brand new EMT students.

If you really feel that way, please do me, and everyone else in EMS, as well as those trying to get into it a favor, and get out of teaching...and EMS while you're at it. You're doing us all a great dis-service!

In fact, I cant wait for the day that something happens and you need EMS. I hope a crew of two EMTs arrive, and treat you with top notch service, save your life, and do a damn good job of it.
 
FLEMTP said:
Im sorry, but aren't you a "head honcho educator"? So to say that basics do not know enough to even try and use common sense ... wouldn't you be one of the folks responsible for this? ( IF it were a true statement)



Now it seems to be that being an educator, you would be aware that Basics are very much more capable of assessing more than " a basic taking of vitals" and who better to assess whether a paramedic is needed than someone that is NOT a paramedic, but knows the capabilities of a paramedic as well as their own limitations.

Paramedics by nature tend to over treat because that's what we are here to do... give medicines, start IV's, treat illness and injury... especially paramedics who did not get a good firm grasp of the basics of EMS as an EMT prior to entering Paramedic school..they skip right over BLS, and go for the ALS, just like they skipped right over being a field EMT and went straight to Paramedic.

Ive said it before, and I will say it again. I would rather have a competent, experienced EMT over a paramedic as a partner any day of the week.

And I've said this before and I will also say it again:

If you really feel that basics are this worthless, then its a shame they let you teach... because you're going to do nothing more than instill feelings of inadequacy in these brand new EMT students.

If you really feel that way, please do me, and everyone else in EMS, as well as those trying to get into it a favor, and get out of teaching...and EMS while you're at it. You're doing us all a great dis-service!

In fact, I cant wait for the day that something happens and you need EMS. I hope a crew of two EMTs arrive, and treat you with top notch service, save your life, and do a damn good job of it.
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Wow that is just rude and uncalled for. I would never wish harm on anyone because they hold a different opinion than I do. Sadly I have had to use an ambulance before and thank goodness it had two Paramedics because I would have been dead had I been in an area that send basics who then try and figure out if they need to be HEROs or call ALS and let them have the glory.

You are doing the disservice by lying to emt's by convincing them they know more than they do.

It would also be nice if you read entire posts because you would also see I said Paramedics do not have enough education either.

Is it my fault that both educational levels are so low? Guess I am as guilty as all the other educators that still attempt to give a proper education despite the limited number of hours allowed. Perhaps myself and all other quality education professionals should refuse to teach. Wonder what would happen? Oh I know they would pay someone else who does not care and would turn out test takers not medical professionals. I assure you my students that are given course completions come out far ahead of most programs in actual patient care. But I am honest with all levels of how little they are getting so they do not develop the EMT God or Paragod complexes so many on here seem to have. I use those terms to mean think they know more than they do.

As to you wanting a basic over a Paramedic partner really makes me wonder a few things but I will not pursue that.
 
medic417 said:
Again as I've stated before you don't know what you don't know. And as lacking as we Paramedics are, basics do not know enough to even try and use common sense and tell the person no ride for you. Sorry there is many an MI that does not present with the classic symptoms you describe and anyone with any real experience would know that.

Now I am not saying every painful toe gets full cardiac, stroke, etc, work up but a patient with booze on board needs more than a basic taking vitals to say it is only toe pain.
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You're kidding, right? So, it's basically your opinion that every call needs a medic? Okay, fine, but think horses, not zebras here. If I called for medics on something like this, I'd get a tongue lashing from the medics when they showed up.
 
EMSLaw said:
You're kidding, right? So, it's basically your opinion that every call needs a medic? Okay, fine, but think horses, not zebras here. If I called for medics on something like this, I'd get a tongue lashing from the medics when they showed up.
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Actually yes every call should at minimum have a Paramedic on scene. I agree most items are horses but there are enough what would be zebras to a basic that would still be horses to a Paramedic to justify the costs. I personally would not want a basic making the decision that my family member does not need a Paramedic as they again do not know what they do not know.
 
Send nothing but medics, and pay them like EMT-B's

Anyone else going back on thread?
 
medic417 said:
Actually yes every call should at minimum have a Paramedic on scene. I agree most items are horses but there are enough what would be zebras to a basic that would still be horses to a Paramedic to justify the costs. I personally would not want a basic making the decision that my family member does not need a Paramedic as they again do not know what they do not know.
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We certainly have a difference of opinion, then. I think you're painting with a broad brush - not all basics are incompetent know nothings (though some certainly are, as are some medics). Perhaps because I work in a tiered system, I see things differently.

I tend to agree that EMT-Basics lack a strong foundation when they come out of class. Some of them, and I hope I can include myself in this, realize that and try to learn more. And unless you happen to work in a system where there are only dual-medic trucks, every EMT will eventually be in the situation where they are all the help that's coming. In that case, if they have no confidence and have always had a medic to do everything, then the problems you predict will become a self-fulfilling prophecy.
 
mycrofft said:
Anyone else going back on thread?
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We have been called for a toothache at 0415 after pt had left the ER at midnight with a script for Vicodan, but didn't feel like getting it filled at the Walgreens across the street from the ER right then.

We have a FF (frequent flyer, not a brother firefighter) who calls at 0550 c/o pain, then walks out the door to meet his ride to work before we complete our paperwork. Yeah, it's abuse, but if they call, we gotta respond... grrr.

"Feeling sick" @ 0215; arrive to find pt has had a head cold for several days, but "didn't have time to call before now". Wow...

Ah, the joys and adventures of urban EMS... =)
 
mycrofft said:
Anyone else going back on thread?
Click to expand...

I agree...I started this thread to find out what other people get when they respond to calls in the middle of the night. I didn't start this thread to have a battle started between people, which it what has seemed to be started. So hears my suggestion...


LET'S GET BACK ON THE THREAD!!!!!!!!!!!!!!!!!!!!!!!:excl::)...haha

So has anyone else had any funny middle of the night calls or frequent flyers during the middle of the night?????????
 
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