Do you make a good patient?

[Chris07]

There's an old saying which states "Doctors make the worst patients." This got me to thinking, can EMS providers be worse patients than doctors? Honestly ask yourself this question: "If I was to suddenly become extremely ill or injured at this very moment, would I make a good patient?"

I reckon that most would say yes, as you are most likely in a place where you are familiar with the EMS system and even those working in it.

What if you were to become injured (heaven forbid) while driving around on vacation in a place you are not familiar with?

A scenario:
You are driving in a different state and are involved in a moderate motor vehicle collision (Airbag deployment no passenger compartment intrusion, vehicle totaled). You have no pain in you neck/back, good motor and sensation in all four extremities but the crew wants to put you in full c-spine. Would you refuse or go along with it?


The key questions:
Would you be a difficult patient? Meaning, would you take your own assessment of your injuries to have more weight than the EMT/Medic tending to you? Would you refuse treatment if it doesn't coincide with how you would treat yourself? Do EMS providers make the worst patients?

 

[EpiEMS]

Ooh, that's a fair question to ask.

I'd be a terrible patient if the system had bad protocols.
If I'm in a modest MVC, I won't be boarded, no way, certainly not without pain. They can try the "poke the spine test" all they like. Unless there's pain or deformity, don't board me, please.

 

[Epi-do]

I would have to agree to even be a patient first. (Once, I had an anaphylactic reaction to a medication and made my husband drive me to the ED, rather than allow the EMS service in the area we live in come anywhere near me.) After that was established, I am sure I wouldn't be the best patient out there, but hopefully not the worst one, either.

In the situation you presented, I would absolutely refuse a backboard. They don't do anything positive, except make it easier to move someone, and can be detrimental in some situations. And then there is the whole "I can refuse any treatment" argument.

Outside of a backboard, I would like to think I wouldn't be too difficult. I may ask why they are doing this or that, but can't think of anything else I would refuse, if it were appropriate treatment at the time.

 

[EpiEMS]

Outside of a backboard, I would like to think I wouldn't be too difficult. I may ask why they are doing this or that, but can't think of anything else I would refuse, if it were appropriate treatment at the time.

Presumes that the treatment is appropriate and effective

Backboards, eh...

 

[Epi-do]

Presumes that the treatment is appropriate and effective

Backboards, eh...

Of course! Don't you know that paramedics save lives?!?!?!?

 

[Anjel]

Of course! Don't you know that paramedics save lives?!?!?!?

And EMTs save paramedics!!!!

 

[NomadicMedic]

I joke with my wife all the time, "if I'm ever hurt, put me in the car and drive me to the hospital. Don't you ever, even think about calling the medics."

I know my coworkers would find some excuse to RSI me.

There is also no way I would allow myself to be placed in any type of C-spine precautions.

 

[Epi-do]

And EMTs save paramedics!!!!

See now nicely I set that up for you? :rofl:

 

[EpiEMS]

I joke with my wife all the time, "if I'm ever hurt, put me in the car and drive me to the hospital. Don't you ever, even think about calling the medics."

Last thing I'd want to do is take a unit out of service when I've got people around with a perfectly drivable vehicle. Don't wanna be *that* guy who's got three cars in the driveway, three available drivers, but *had* to call 911.

And EMTs save paramedics!!!!

 

[CFal]

Ooh, that's a fair question to ask.

I'd be a terrible patient if the system had bad protocols.
If I'm in a modest MVC, I won't be boarded, no way, certainly not without pain. They can try the "poke the spine test" all they like. Unless there's pain or deformity, don't board me, please.

heh heh "poke the spine test"

[YOUTUBE]http://www.youtube.com/watch?v=YzYxz_uvtSI[/YOUTUBE]

 

[CritterNurse]

I think I'm a fairly good patient. I tend to go to the local urgent care center a few times a year (don't feel bad enough for the ER, but too sick to wait a few days to get into my regular doctor) and they seemed to appreciate it when I told them to go ahead and use the medical terms instead of trying to dumb it down into laymen terms. Of course now most of them know me and use the medical terms from the start.

I am careful not to say "I have this, I want that" when they ask why I've come in. I'm usually there for the same chronic problem, but I phrase it as "I feel like such-and-such is happening again", list the symptoms, and what I've been doing about them. A couple of times I've gotten "Why did you wait so long to come in" and one time after they did the assessment "Are you sure your pain is only a 3?"

 

[EpiEMS]

To be fair, those protocols would be an improvement -- there's no board

 

[PaddyWagon]

I got a spiderman sticker from my wound care nurses after dealing with a bad MRSA for over 5 months, so I must be a model patient.

 

[Wheel]

I will almost definitely be refusing a nrb or lsb, and I would hope they could justify their treatments without saying the word protocol. Other than that I'd probably be ok.

 

[Tigger]

I don't think I'm a bad patient, I just make my wishes known.

I hit a tree skiing a year ago with my lumbar area, going fast. I was not in the ski area boundary, so I would have had to pay for rescue, and I don't exactly have 1500 bucks lying around.

So despite being in what is certainly the worst pain I've ever been in, I had my buddy put my skis on and hoist me to standing. I then shuffled about a half mile back to the area while having the worst spasms I could imagine. I couldn't help screaming every time they came on.

I finally got to the area and couldn't go any further so we got the ski patrol to come down. As the patroller checked me out I mentioned I was an EMT and didn't think I had a spinal cord injury (you know since I had been walking and everything) that I just wanted to be sledded down. They insisted on ambulance, which I eventually relented to. To get to the ambulance they insisted on using a board. I asked nicely if they could use the scoop to put me on the stretcher mattress but I said no. They wanted my jacket off (understandable), so I helped them take it off rather than get it cut off. The I-85 wanted to start an IV, but I refused that since I didn't think I needed one of room temp fluid, considering my vitals were fine and I was freezing. The hospital gave me warmed fluid.

I tried to be as polite as possible and talk to the crew about where they worked and how awesome their equipment was, but at that point all I needed was a ride and muscle relaxers.

 

[Aidey]

There is also no way I would allow myself to be placed in any type of C-spine precautions.

I've said more than once if I'm ever in a wreck and can't get out of the car before EMS gets there, the first words out of my mouth when they get there will be "Touch me with that c-collar and you'll be charged with battery".

 

[CFal]

I don't think I'm a bad patient, I just make my wishes known.

I hit a tree skiing a year ago with my lumbar area, going fast. I was not in the ski area boundary, so I would have had to pay for rescue, and I don't exactly have 1500 bucks lying around.

So despite being in what is certainly the worst pain I've ever been in, I had my buddy put my skis on and hoist me to standing. I then shuffled about a half mile back to the area while having the worst spasms I could imagine. I couldn't help screaming every time they came on.

I finally got to the area and couldn't go any further so we got the ski patrol to come down. As the patroller checked me out I mentioned I was an EMT and didn't think I had a spinal cord injury (you know since I had been walking and everything) that I just wanted to be sledded down. They insisted on ambulance, which I eventually relented to. To get to the ambulance they insisted on using a board. I asked nicely if they could use the scoop to put me on the stretcher mattress but I said no. They wanted my jacket off (understandable), so I helped them take it off rather than get it cut off. The I-85 wanted to start an IV, but I refused that since I didn't think I needed one of room temp fluid, considering my vitals were fine and I was freezing. The hospital gave me warmed fluid.

I tried to be as polite as possible and talk to the crew about where they worked and how awesome their equipment was, but at that point all I needed was a ride and muscle relaxers.

In Vermont they don't charge for rescues because they think it would discourage people from requesting help when it is really needed.

 

[Trashtruck]

There's an old saying which states "Doctors make the worst patients." This got me to thinking, can EMS providers be worse patients than doctors? Honestly ask yourself this question: "If I was to suddenly become extremely ill or injured at this very moment, would I make a good patient?"

I reckon that most would say yes, as you are most likely in a place where you are familiar with the EMS system and even those working in it.

What if you were to become injured (heaven forbid) while driving around on vacation in a place you are not familiar with?

A scenario:
You are driving in a different state and are involved in a moderate motor vehicle collision (Airbag deployment no passenger compartment intrusion, vehicle totaled). You have no pain in you neck/back, good motor and sensation in all four extremities but the crew wants to put you in full c-spine. Would you refuse or go along with it?


The key questions:
Would you be a difficult patient? Meaning, would you take your own assessment of your injuries to have more weight than the EMT/Medic tending to you? Would you refuse treatment if it doesn't coincide with how you would treat yourself? Do EMS providers make the worst patients?

No, because I wouldn't be a patient at all. I know if I need to go to the hospital. I also know if I need to go to the hospital via ambulance(a cold, sh*&^y day in hell). Otherwise, I'll get there in time if need be via pov/cab, whatever.
I won't hassle the crew when they arrive, though. I'd say something along the lines of, 'Hey guys, I'm fine. I'm a medic so...' I'd ask them how they have to write things up 'in these parts' and go from there.
If they drive up, roll the window down, ask me if I'm ok, and I say, 'Yep' and they go on their merry way, that's fine. If I say I'm fine it means...I'm fine. If they don't believe me and start feeding me a line about the MOI and the kinematics of trauma and the need for assessment and calling the doctor and blah blah blah, I'd say, 'Look guys, I get it. Write it up however you want so you don't get in trouble. I'm fine'

 

[Engineered]

I tend to think that sometimes being in EMS actually tends to hurt me as a patient.

I had an experience a few years ago in a Hospital in NYC where I went in, told them exactly what was wrong with, and instantly they seemed to discount it (it was RATHER serious) and sent me on my way with meds that would have made my condition rather worse.

Went to a specialist the next day (who was a senior as he discribed it "fellow") with that hospital, confirmed what I had assumed I had had, and gave me the proper medication, which ended up pretty much saving my life. Needless to say, my bills were excused from the hospital (I don't believe in lawsuits of that kind, so I didn't), but sometimes knowing things doesn't help. (Nor does having interns only seeing you).

Other then that, I tend to laugh at pretty much everything when injured, bad stress response when its myself.

 

[Tigger]

In Vermont they don't charge for rescues because they think it would discourage people from requesting help when it is really needed.

Incidentally this happened at Stowe. I left the area through a "gate" where clear warning is given that you are responsible for the cost of your rescue should you need one while out of the ski area boundary.

Now that I have done some reading, I see that VT doesn't generally fine people, but at the time I was not aware of that. It was also freezing and it would have likely taken quite a while for a team to reach me.