Pt with urine problem

That's the biggest problem in most places. If you call 911, there are no other options. You'll get a cop, a fire engine or a medic unit.




Sent from my iPhone.
 
That's the biggest problem in most places. If you call 911, there are no other options. You'll get a cop, a fire engine or a medic unit.
.
Because that's precisely what 911 has been meant for since inception: Life threatening emergencies.
 
Because that's precisely what 911 has been meant for since inception: Life threatening emergencies.
What 911 was meant for and what "we" the public service people (Police, Fire, EMS) have turned it into is a "when in doubt, call" even if it's to complain about your neighbor's dog's barking or those darned kids that didn't get off your lawn last week...
 
A couple of quick points here...

1. Someone mentioned that this isn't the type of call a paramedic unit should be sent on. Almost all of the ambulances in this county (the ones operated by the fire department, what you get if you call 911) are paramedic units. There was no BLS-only ambulance available from my station at the time.

2. Someone mentioned that this isn't the kind of thing to call 911 for. I have two points to make on this issue. First, I don't know for a fact that he actually called 911. We have a non-emergency regular phone number to use for non-emergencies, but it actually goes to the same call center. I think the fact that the non-emergency number was used might let the call takers know these are the calls that can be put on hold longer, I don't know. He probably did use 911, but we can't say that as an absolute certainty. Second, my county does publicize that it will answer calls for non-emergency assistance. So this type of call does seem to fall in that category, so we can't really say that it's an inappropriate request.

And as has been already pointed out, this type of thing will get followed up by social services to see what can be done to get this person the long-term help that would be of the greatest benefit to him while freeing up emergency services for actual emergencies. Well in theory anyway.
 
We shouldn't be too quick to judge anyone who calls for assistance. It is quite possible that this person may have a diminished mental capacity and to them, this is a major medical emergency.

And if it is a frequent flyer who calls twice a day every day, that's job security.
 
In Los Angeles- We have BLS units and ALS units...- For Pt assists like "lift assists" they generally send the BLS unit none-lights and siren to the call to assist them- And if its determined that the patient is unable to care for self in any period of time- we take them to the hospital for definitive arragement later on- they hate that we waste a bed but thats where social services is at odd hours of the night... There needs to be a better system- but unforunately we are the stop gap measure.

I've transported a patient two blocks to a hospital because the Medic didn't want to deal with the patient who was "running out of medication". Yeah.. I wasn't happy about filling out a run report for a non-medical run and having to document the incident- but what was the guy to do? no-insurance, no primary care MD- and I rather he stay on his meds then degrade and turn into an actual call- Preventative care is always better.
 
What 911 was meant for and what "we" the public service people (Police, Fire, EMS) have turned it into is a "when in doubt, call" even if it's to complain about your neighbor's dog's barking or those darned kids that didn't get off your lawn last week...

Which clearly several people here are advocating, therefor not helping the crux of the issue.



but what was the guy to do? no-insurance, no primary care MD- and I rather he stay on his meds then degrade and turn into an actual call- Preventative care is always better.

Educate him on his abuse of the system, and advise him to call a non-emergent medical transport in the future if he so requires, or a taxi if he's able to.



And if it is a frequent flyer who calls twice a day every day, that's job security.

No it's not? The vast majority of them don't pay.

If anything, it's a drain on the system.
 
Which clearly several people here are advocating, therefor not helping the crux of the issue.





Educate him on his abuse of the system, and advise him to call a non-emergent medical transport in the future if he so requires, or a taxi if he's able to.





No it's not? The vast majority of them don't pay.

If anything, it's a drain on the system.

How is he to afford non emergent medical transport if he doesn't have insurance? The thing about non emergent transport, they CAN refuse to transport you because of inability to pay. An ambulance can't. Another thing, is they are super expensive. Our base for BLS txp is over 300 plus mileage.

There is NO universal alternative ESPECIALLY for those who don't have insurance. It's part of the job.

And yeah, it is job security, even if they don't pay. It ups the call volume. Less calls, less personnel needed.
 
If only there was a reimbursement plan for preventive care, treat/assist without transport, etc.

This is one of the reasons why the CP/AAP role hasn't gone mainstream. It isn't education, as there are alot of RNs and Paramedics who would love the job and either have or will get the education necessary.

There is no reimbursement plan under our service category for this service (there is a plan under Home Health rules - but you'd have to meet all of those regs as well). If a plan is ever developed and implemented, then hopefully we can have a national standard for a CP/AAP Provider (vs. waiting decades before getting close to a national standard and ending up with a schism similiar to the current one re; provider levels/education).

Ideally, care on the street should never be about the money. Realistically, it's always about the money. Services that are unable to refuse transport are going to have to adapt to the growing uninsured population (or non-reimbursed). I would love to see that adaptation be in the direction of treat/release, CP/AAP providers.
 
In my town, thats a PD call all the way. Anything like that lift, assist, ect gets a Radio Car not an ambulance
 
Back
Top