grumpy old man with heart problems reuses help

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ellominero18

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You arrive on scene to find an elderly gentleman sitting in his recliner. He is obviously disturbed that you are here. He says that his wife called you after he told her not to. When you talk with the gentleman, you find that he is having a significant amount of chest pain that radiates down his left arm and into his jaw. He says that he is tired of hospitals and does not want you to do anything for him. He tells you that he has a long history of heart problems and was recently told he needed a heart transplant. You try to convince the man to let you transport him to the hospital for treatment, but he continues to refuse care. You ask him and his wife if he has some form of advanced directive there at home, and they tell you that "the doctor is working on it but has not sent it home yet." What do you do?

• What options do you have?
• Is there anything you can say or do to convince the patient to go to the hospital?
• What if he becomes unconscious before you leave; will your approach change then?
• Would your approach be any different if the patient had a valid advance directive present?
 
And more homework?
 
the answer to all these are covered in the text and or class. They aren't to difficult if you read the chapter or paid attention in class.
 
Strap em down :P
 
Put a hoodie on the guy and Zimmerman him.
 
Is he a little guy, or a big guy? That would determine if I threw him over my shoulder against his will or not.
 
If he is mentally competent, he can refuse care. I think we definitely want to get signed refusal here because it's not unlikely that something serious is happening.

Would it be good to put it bluntly? "Sir, there's a good chance you're having a heart attack and may die if you don't come with us. You don't have to come, but I will need you to sign this form that says we explained the risks to you and you still wanted to refuse care."


If he goes unconscious after telling us he doesn't want to go to the hospital... I dunno... He didn't want to go to the hospital even after we explained the risks, so we shouldn't really have implied consent that we would usually have in an unresponsive patient. However, I guess if he doesn't have a DNR we pretty much have to begin resuscitation whether he would have wanted it or not?
 
J B said:
If he is mentally competent, he can refuse care. I think we definitely want to get signed refusal here because it's not unlikely that something serious is happening.

Would it be good to put it bluntly? "Sir, there's a good chance you're having a heart attack and may die if you don't come with us. You don't have to come, but I will need you to sign this form that says we explained the risks to you and you still wanted to refuse care."


If he goes unconscious after telling us he doesn't want to go to the hospital... I dunno... He didn't want to go to the hospital even after we explained the risks, so we shouldn't really have implied consent that we would usually have in an unresponsive patient. However, I guess if he doesn't have a DNR we pretty much have to begin resuscitation whether he would have wanted it or not?
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it is implied consent the second he goes unresponsive.
 
Let him stay home and die in peace. It is a much better way to go than how I would be torturing him at the hospital.


Medic Tim said:
it is implied consent the second he goes unresponsive.
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Eh that is a gray area. If he made it very clear what his wishes are before going unresponsive then I would honor that.
 
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Grab some popcorn and a soda and wait for him to become unresponsive.
Once he does then go for it.
 
Chase said:
Let him stay home and die in peace. It is a much better way to go than how I would be torturing him at the hospital.




Eh that is a gray area. If he made it very clear what his wishes are before going unresponsive then I would honor that.
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If those wishes aren't in writing, it is here say and his family will own your butt later on in court
 
Chase said:
Let him stay home and die in peace. It is a much better way to go than how I would be torturing him at the hospital.




Eh that is a gray area. If he made it very clear what his wishes are before going unresponsive then I would honor that.
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text book question got a text book answer
 
In all seriousness, your girlfriend either needs to take the class another time when it won't be so taxing on her, give up all together if she's simply not getting it, or wake her butt up and do her own work. This isn't nail school where her biggest mistake would be a painting someone's nails wrong, these are people's lives. She either needs to take this seriously, or quit. Having her boyfriend do her work isn't going to help pass that test at the end either. And they love legal questions on the certification exam.
 
EMTnurse said:
In all seriousness, your girlfriend either needs to take the class another time when it won't be so taxing on her, give up all together if she's simply not getting it, or wake her butt up and do her own work. This isn't nail school where her biggest mistake would be a painting someone's nails wrong, these are people's lives. She either needs to take this seriously, or quit. Having her boyfriend do her work isn't going to help pass that test at the end either. And they love legal questions on the certification exam.
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Harsh, but true. I understand wanting to get your girlfriend some help, but trying to get strangers on a forum to do it completely for her and then getting upset when they refuse to do someone's homework is a little riduculous.
 
EMTnurse said:
In all seriousness, your girlfriend either needs to take the class another time when it won't be so taxing on her, give up all together if she's simply not getting it, or wake her butt up and do her own work. This isn't nail school where her biggest mistake would be a painting someone's nails wrong, these are people's lives. She either needs to take this seriously, or quit. Having her boyfriend do her work isn't going to help pass that test at the end either. And they love legal questions on the certification exam.
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Of note: nail techs average over 400 hours of training for their certificate programs. EMTs on the other hand...

Things that make you go hmmm...
 
Tigger said:
Of note: nail techs average over 400 hours of training for their certificate programs. EMTs on the other hand...

Things that make you go hmmm...
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Lol, actually that includes nails, hair, make up and waxing
 
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