Dealing with transients

[Glucatron]

Okay, had a walk up wanting a ride. Just didn't want to walk to shelter. Told them ambulance was for people going to er. Suddenly pt has been assaulted and needs to go to hospital. Total bull call. Any tips on tricking them into admitting they don't need medical attention?

 

[Ewok Jerky]

Okay, had a walk up wanting a ride. Just didn't want to walk to shelter. Told them ambulance was for people going to er. Suddenly pt has been assaulted and needs to go to hospital. Total bull call. Any tips on tricking them into admitting they don't need medical attention?

Not your job. You are in the delivery business. No deliveries = no job.

Maybe this guy just doesn't want to tell you about his rectal bleed because its embarrassing and he just wants you to deliver him to a doctor.

 

[Glucatron]

I have to disagree with that. I work in a very PC system (very much a "you call we haul") which is a change from my last system where you could do paramedic initiated refusals when you would get calls or walk ups just wanting a ride. So as soon as they hear they can only get a ride if it's to the hospital they suddenly have chest pain or shortness of breath or any number of complaints. I may have no options in the end because of the protocols I have to work with. I'm asking if any one has any verbal judo tactics. Or I could just call PD next time. My job is not to deliver transients to hospitals so they can bail (essentially a free ride). But I don't want to get too deep into the politics/philosophy of this. Another time. Regardless, while in this field we are used as a taxi that doesn't mean you can't fight the flawed system in an intelligent and effective way.

 

[PotatoMedic]

Call for PD. Report that your being harassed. State the person came up saying he wanted a lift to a shelter because he does not want to walk then changed his story to I was assaulted take me to the er after you refused.

Look! Problem solved!

 

[Tigger]

Post away from known areas of transient activity. Keep windows up and wear, large mirrored sunglasses.

That was the Boston solution.

 

[mycrofft]

Call for PD. Report that your being harassed. State the person came up saying he wanted a lift to a shelter because he does not want to walk then changed his story to I was assaulted take me to the er after you refused.

Look! Problem solved!

No cop will do that if he or she values their badge. They'll probably say "Hey, c'mon, just give him a ride, ok?". If they have to get into it, they will have to take a crime report, or if it goes sideways, arrest and book the person. You taking the person is a safe and easy alternative for them.
If the company can be shown you have problem riders, maybe they can talk to the PD. These guys (and women) are sometimes known to the local cops who have been rousting them for stuff for years and can take a warning from an officer.
Then, there is the issue of "Dang, I didn't think he was really sick" as you give a wrongful death deposition.

 

[Glucatron]

Call for PD. Report that your being harassed. State the person came up saying he wanted a lift to a shelter because he does not want to walk then changed his story to I was assaulted take me to the er after you refused.

Look! Problem solved!

I wish it was! Depends on the officer. Tigger, it was a walk up right at our OHQ right during crew change. If it does turn into an issue (they know where we live ahhh) PD will be my first resort. I just don't have a lot of faith in PD to not end up pushing them on us anyway. I will definitely try though.

 

[PotatoMedic]

Yeah when I was typing that I could picture the face of the cop. Really no good way that I know of.

 

[mycrofft]

I wish it was! Depends on the officer. Tigger, it was a walk up right at our OHQ right during crew change. If it does turn into an issue (they know where we live ahhh) PD will be my first resort. I just don't have a lot of faith in PD to not end up pushing them on us anyway. I will definitely try though.

Don't you just want to call a code on someone like that? h34r: h34r: h34r: (just kidding).
Had a local ED doc who would do unnecessary and "mildly" invasive stuff (rectal tube or urinnay catheterization) to such patients. He was told eventually to knock it off. (Translate "knock it off" from Doctorese to EMT-speak and it comes out "You're fired").

 

[Glucatron]

Don't you just want to call a code on someone like that? h34r: h34r: h34r: (just kidding).
Had a local ED doc who would do unnecessary and "mildly" invasive stuff (rectal tube or urinnay catheterization) to such patients. He was told eventually to knock it off. (Translate "knock it off" from Doctorese to EMT-speak and it comes out "You're fired").

Just imagine, it's easy if you try, how many system abusers and jail evaders would stop if we were allowed to do field foleys!

 

[ExpatMedic0]

Just a fine example of how the system we work in is broken. Not the poor homeless guys fault, he probably has mental health problems and just gets recycled through the system over and over. Its not your fault either, because you guys probably keep getting called to pick the same guy up.

Mentally ill guy+No long term mental health or assistance=Ambulance ride to ER+ER discharge= repeat the entire process. $$$$

 

[Carlos Danger]

I have to disagree with that. I work in a very PC system (very much a "you call we haul") which is a change from my last system where you could do paramedic initiated refusals when you would get calls or walk ups just wanting a ride. So as soon as they hear they can only get a ride if it's to the hospital they suddenly have chest pain or shortness of breath or any number of complaints. I may have no options in the end because of the protocols I have to work with. I'm asking if any one has any verbal judo tactics. Or I could just call PD next time. My job is not to deliver transients to hospitals so they can bail (essentially a free ride). But I don't want to get too deep into the politics/philosophy of this. Another time. Regardless, while in this field we are used as a taxi that doesn't mean you can't fight the flawed system in an intelligent and effective way.

I doubt there are any Jedi mind tricks that you can use that will be effective, because chances are these people already know that all they have to do is throw down the "but I'm having chest pain" card and per your protocols, you now have no choice but to transport.

If push came to shove, they could simply deny that they first asked for a ride to the shelter.

 

[DrParasite]

take them to the hospital. much easier to walk them to the truck, transport them to the ER, and leave them in triage, than to think of a creative way to deny them a transport.

 

[Glucatron]

I doubt there are any Jedi mind tricks that you can use that will be effective, because chances are these people already know that all they have to do is throw down the "but I'm having chest pain" card and per your protocols, you now have no choice but to transport.

If push came to shove, they could simply deny that they first asked for a ride to the shelter.

Not even, "these aren't the medics you're looking for..."? Well, thanks for the honesty

 

[AEMTstudent]

Okay, had a walk up wanting a ride. Just didn't want to walk to shelter. Told them ambulance was for people going to er. Suddenly pt has been assaulted and needs to go to hospital. Total bull call. Any tips on tricking them into admitting they don't need medical attention?

Just because he has nowhere to go and nothing to eat, doesn't mean he's a piece of garbage. How about you spend the night outside and see how long you last.

 

[Tigger]

Just because he has nowhere to go and nothing to eat, doesn't mean he's a piece of garbage. How about you spend the night outside and see how long you last.

What in the world are you talking about?

 

[NBFFD2433]

Not your job. You are in the delivery business. No deliveries = no job.

Maybe this guy just doesn't want to tell you about his rectal bleed because its embarrassing and he just wants you to deliver him to a doctor.

This

 

[TheLocalMedic]

We get this kind of BS from time to time. I just tell them exactly what is going to happen if I transport them: You're going straight to the waiting room, and I'm going to tell the ER that you are BS-ing us because you already said you just wanted to go to the shelter. You'll get no blankets, no food, a pissed off nurse and a quick discharge back outside, right back where you started.

I do play it safe though, unless it's exactly like that (a system abuser who openly admits that they want shelter and/or food) I'll generally err on the side of caution and give them a lift. I can rip out a PCR pretty darn quick, and it'll give me a little down time afterwards to hang out and not sit at post.

 

[ZombieEMT]

Transcients are people too. I got into this job to help people, obviously not for the money. Give them a ride if you can, does it hurt? Explain that if an emergency comes, you will have to let him out. If your company/municapality does not allow it, there are other options. Get police involved, not because they are being a pain but to offer help if needed. Some police officers do not mind giving a ride.


Just because they live on the street does not mean that he/she does not deserve compassion. Even druggies and drunks make mistakes, have a heart.

 

[unleashedfury]

I don't have that problem too often I can recall one that was stuck at the local walmart, didn't have a ride home so he pulled a "chest pain with syncope episode"

His GF had to come with they were both from the town we were transporting to, evidently it turned out his ride dumped him there and didn't have the money for a cab.

During transport he refused Aspirin IV access and all interventions. Got him to the ED got him out he went in and walked out 5 minutes later.