Glucagon without an IV

[p3medic]

No, being drunk is not necessarily an emergency, but once someone suffers an injury or illness while drunk, and an ambulance is summoned, I believe that the EMS crew should transport. As stated previously, someone who is under the influence can not understand the consequences, and their signature on a refusal form is therefore worthless.

The fact that someone has consumed alcohol does not render them incapable of understanding the risk's of not being tranported. Having a couple of drinks does not forfit you civil rights, I'd suggest speaking to an attorney as to what is required to legally transport someone against their will.

[crotchitymedic1986]

You raise a good point --- how do you determine who is too drunk to sign your refusal:

Blood alcohol level ?

Breathalyzer ?

Ability to recite the ABCs backwards ?

By number of drinks they state they have ingested (of course the answer is alwsys two beers).

P.S. I am not suggesting you transport anyone who has had a drink, I am suggesting you transport those who are intoxicated.

[crotchitymedic1986]

Check ! your move.

[akroeze]

Do you believe the police should bring every person they arrest for public intoxication to the hospital or call an Ambulance?

[crotchitymedic1986]

I would say most already do, as they have learned from their lawsuits over drunks who died while in a holding cell. But to answer your question, if they do not have a jail nurse or medic to monitor the patient, then it is in theirs and the patients best interest to have the patient evaluated. Did you not read the post on here about the surgeon who had a stroke, but was determined to be just drunk, and not transported ?

But lets carry it out to its logical conclusion:

Lawyer to you: How intoxicated was this patient when he signed the refusal ?

you: what do you mean ? he was drunk, i dont know how drunk.

lawyer: so you have no idea what is BAC level was ?

you: no.

lawyer: so you didnt know if his BAC was .08 or .50 did you ?

you: no

lawyer: his BAC level was .35 when he arrived at the ER by the second ambulance an hour later. Do you think someone who has a BAC at 3 times the drunk driving limit in most states, and at the recognized toxic/ lethal limit, can make rational intelligent decisions ?

you: of course not

checkmate.

[reaper]

You have to remember something. A lot of the time, you are dealing with life long Diabetics. They have dealt with this disease for ever. They know what has happened to them, they know why it has happened and they know what was done for them.

A lot of them probably know more about their disease then the Er Dr does. They also know that they will lay in a hospital bed for hours, eat a crappy meal, have their BGL checked a couple times and be sent home with a $1000 bill. Most know they can do the same thing at home.

I have no problem leaving them at home, if they know what is going on. They must have someone with them to watch over them and make sure they eat. I also check their Glucometer to make sure it is accurate. If this is the tenth time their BGL has dropped in a month, then I will convince them to go to the ER or at least make a Dr's appointment.

There is a difference when dealing with an injured pt or an intoxicated pt and dealing with someone that has a treatable disease, who has a thorough understanding of that disease!

I also will transport any pt that we are called to more then once in the same day. If their BGL drops a second time, then they do need evaluated or they did not take care of the problem themselves.

[crotchitymedic1986]

So if i have someone with chronic angina, who had chest pain that was relieved by 3 ntgs, and he knows his pain, and knows when he is having angina versus MI, I shouldnt try to get him to go to the ER for evaluation ?

[reaper]

I never stated that you shouldn't try to get every pt to go be evaluated. I suggest that any pt having a problem, be evaluated.

If the Angina pt wants to refuse, then that is also his choice. The nice thing in America, is you have the choice to run yourself into the ground, if want!

[Arizonaffcep]

I am tossing this out there just as FYI (general)...in (I believe) Singapore, if you call for an ambulance...you can't refuse. You must be transported. Just from a different point of view (saw it on Discovery a while ago...may not be Singapore...but in that area of the world).

[Arizonaffcep]

Also, this seems like a similar thread from earlier...

http://www.emtcity.com/phpBB2/viewtopic.ph...asc&start=0