Washington DC medics in trouble again

[speedygodzilla]

Let's not jump to any conclusions---------maybe it was the pt. who was adamant about not seeking treatment. How many times have you had the MI pt. adamantly refuse to go even though you say hey look at this EKG---you will die! Sometimes people have to be accountable for their own stupid mistakes.

All I am really saying is that I don't know whats going on in this scenario and I refuse to blame the medic or emt without knowing the truth.

I sure hope your right. The "diagnose" of Acid Reflux is what concerns me. Even if the pt stated that is all he thought it was you never let you CP pt think that is your primary thought. Sounds like the paramedic told him vital normal ekg normal, its probably just acid reflux. We can not rule an MI out only rule in. Being that it is always a possible MI till the hospital runs their test and say otherwise.

As for 911 abuse I don't see where that goes with this story, other than a paramedic ticketing him for his acid reflux. That is why I can see a great down fall to the idea of 911 abuse enforcement, but I also would like to see enforcement in many of the actually cases of abuse.

I wonder did he refuse care, or did they refuse transport?

Please keep us updated.

[VentMedic]

I have seen co-workers in my age group still in denial as we're taking them to the cath lab and wanting any glimpse of hope that it is all just a big mistake.

It wouldn't take much to convince someone who is already experiencing "denial" that it could just be reflux.

Just the same, it may not take much for the patient to sound "like it might be nothing (and hoping)" for FFs and Ambulance personel to jump on it as a chance to get a refusal.

Hopefully when looking at someone with these symptoms, other things or risk factors should be considered besides what he just ate. And considering what he just ate, what meds was he taking for BP or cholesterol? Has he even been seen by a physician in the past few years? Body type?

Other things to consider especially when considering all of the recent controversey with Washington D.C., how much training did they get for ECGs? Machine interpretation? Even in the hospital we may check a previous ECG to see if there are any sutle changes since not all MIs are textbook and some MIs may not have ECG changes at all.

This too will be interesting to follow. I doubt if it will in any way jeopardize their jobs and there will be a liability cap on the pay out to the family. So, it really doesn't matter if they were right or wrong.

[Arizonaffcep]

I have seen co-workers in my age group still in denial as we're taking them to the cath lab and wanting any glimpse of hope that it is all just a big mistake.

It wouldn't take much to convince someone who is already experiencing "denial" that it could just be reflux.

Just the same, it may not take much for the patient to sound "like it might be nothing (and hoping)" for FFs and Ambulance personel to jump on it as a chance to get a refusal.

Hopefully when looking at someone with these symptoms, other things or risk factors should be considered besides what he just ate. And considering what he just ate, what meds was he taking for BP or cholesterol? Has he even been seen by a physician in the past few years? Body type?

Other things to consider especially when considering all of the recent controversey with Washington D.C., how much training did they get for ECGs? Machine interpretation? Even in the hospital we may check a previous ECG to see if there are any sutle changes since not all MIs are textbook and some MIs may not have ECG changes at all.

This too will be interesting to follow. I doubt if it will in any way jeopardize their jobs and there will be a liability cap on the pay out to the family. So, it really doesn't matter if they were right or wrong.

Other than the racoon eye EMS got from it. I don't know how it's done in DC, but here is AZ, we are certified and cannot make a "diagnosis"-something about practicing medicine without a license. Not a reason to know what's going on with the patient and gaining as much info about medicine as possible...but it's outside our scope of practice to say "its acid reflux" or whatever. Quick way to loose your medical direction.

[itku2er]

I have been following this one so now I think I will add my thoughts. I think this is a prime example of them treating the monitor and not the patient. Any one that has chest so bad that they fall to the floor with them there is a problem some where. They used poor judgement on the fact that they took the word of the monitor and never really investigated. Every one in any health care setting knows that nothing is text book would be a perfect world if it were. The guy really should have been seen in the ER for a Cardiac work up and labs. But the medics should never have told them that it was just simpley acid reflux take pepto.

But then again on the other hand you have to ask why the family didn't transport him after the ambulance left and then sued their asses off when they got to the ER and he was found to be having a MI. If that was what killed him since the results of the autospy aren't in yet who really knows the answer to that. Or the family could have called 911 again and requested another ambulance service.

[p3medic]

It's the dead guys mother's story, so take it with a grain of salt. I think DC needs an overhaul for sure, however I find it hard to believe that the medics told the patient is was reflux, don't worry about it. I hope they charted well, and have a signature. A distraught mother will say lots of things. How come she didn't insist he go? If she was so concerned after all she could have pushed the issue.

[FormerEMSLT297]

I work in the DC area, and from everything I've read and heard about the incident including stuff from friends who work in DC Fire/EMS, the patient was convinced he wasfine, and told take pepto, you're having an acid reflux attack..... epigastric pain= AMI= Transport, it really does not get more simple than that....

This is DC's protocols on refusals...... and no where does it say suggest pepto...

http://fems.dc.gov/fems/frames.asp?doc=/fems/lib/fems/N7.pdf

Once agin this was a BLS unit with 2 FF/EMT's and a Paramedic Engine with 1 FF/Paramedic, while I was not there I can only assume that the other FF's wanted to get back to the house and get some rack time... and thought a 39 y/o male in good health could not have been having an MI....

DC will face another SERIOUS lawsuit, and the sadest thing is that a person is DEAD who may not otherwise have been....

Fire and EMS, kind of like Oil and Water, Gasoline and flames, does not mix, and when they do they create an explosive situation.

Once again my posts are my own and do not represent my agency, unit or dept.

My hearts go out to the family of the deceased.... RIP

As for denial the patient was reportedly rolling on the ground in pain asking to go and since the FF's are not talking all we hear fro mthe family is that "FD convinced him he was fine"

Sadest thing is ,,, they did not even do a 12 lead... only a 3-4 lead was done......

[Arizonaffcep]

Sadest thing is ' date=',, they did not even do a 12 lead... only a 3-4 lead was done......[/quote']

](*,)

[Dustdevil]

I hope they charted well, and have a signature.

Typically, the whole reason they do a no-ride in the first place is that they aren't in the mood for charting at all, much less well. After all, Turd Watch comes on in fifteen minutes.

[Arizonaffcep]

Typically, the whole reason they do a no-ride in the first place is that they aren't in the mood for charting at all, much less well. After all, Turd Watch comes on in fifteen minutes.

Hey! Don't knock it until you try it! You ever seen those corn kernels bounce in a red bikini?

[p3medic]

Well if they didn't chart it they are in a world of hurt. I couldn't imagine not writing something, but then again, I don't work for a fire department or in DC for that matter.