vs-eh? Posted June 12, 2006 Posted June 12, 2006 With the information provided, this would be a BLS call here. No question about it. You can query all the differentials you want, sure it COULD be this, that, whatever... But you could use that argument for 1000's of BS complaints, then you are either the most thorough EMS professional in the world or perhaps you should step back and call it what it may in fact be...a complaint that you or I would not be calling the ambulance for... The thing that stood out most for me was the fact this person called after 5 MINUTES of being dizzy! :roll: The same argument could be said for your 30 year old, otherwise healthy patient who has had N/V/D x 5 hours. Pt. had the same lunch with several friends, all of whom have the same symptoms. The pt. is normotensive, and otherwise unremarkable. You don't have any anti-emetic available to you, so other than holding that emesis bag, you are driving this light weight to the hospital. Do you have ALS ride in the back? Why? Sure they may need/get fluids in the hospital. But are they ACUTELY in need of immediate treatment by an ALS provider? The answer is no...
PRPGfirerescuetech Posted June 12, 2006 Author Posted June 12, 2006 "Prpg," Is this a 2 Paramedic unit, a P-I unit or P-B? At this call is there 2 ambulances, or just 1 (meaning yours)? Out here, Ace844 As quoted before. Limited MIC P-B. This area is primarily P-B til you hit Philadelphia proper. Even then EMT's are creeping in.
PRPGfirerescuetech Posted June 12, 2006 Author Posted June 12, 2006 For the Medis who responded that they would ALS the patient. -why would you ALS the patient?
Ace844 Posted June 12, 2006 Posted June 12, 2006 As quoted before. Limited MIC P-B. This area is primarily P-B til you hit Philadelphia proper. Even then EMT's are creeping in. "prpg," Since your at the call and the medic should have doen a full assessment and having found what you mentioned than it is BLS all the way. Now, things may have been different in another situation. But the fact of the matter is..IF...THE WHAT IF... Everyone os so afraid of happens. The medic is right there. This is of course assuming the BLS partner is completely competent and has common sense intact... Out here, ACE844
pmedic623 Posted June 13, 2006 Posted June 13, 2006 Where's the part where she elects to get seek treatment on her own and then we leave singing Kumbaya......623
Arachne Posted June 13, 2006 Posted June 13, 2006 If I may chime in as the BLS such a patient may be triaged to... I would be perfectly content teching this patient, especially if ALS was driving. If something changes, ALS is there and probably was standing there through most my assessment prior to loading, so s/he already knows the story. S/he could start a NaCl lock if so motivated. If the ALS really wanted to tech, that's fine too - it saves me writing the report. If I came across this patient while working on a double basic truck, and she had absolutely no other symptoms and nothing was setting off my "ALS-radar", I would probably transport her BLS. She has no signs of instability (not physiological instability anyways). Depending on her demeanor, I'd consider that she might be a psychiatric patient whose medications have run out*, that there's something else that she doesn't want to tell us, or that she has some other motivation for wanting a ride to the hospital. Dizziness may just be -something- to tell the "ambulance drivers", especially if she felt the need to call 911 after 5 minutes of dizziness. This wouldn't change my treatment, but it's something I'd consider. *It's previously stated that she denied any PMH and medications, but there's no guarantee she's being honest. I don't like to presume dishonesty, but when things are just weird or don't add up, it's something to consider.
ncmedic309 Posted June 13, 2006 Posted June 13, 2006 I'm not to concerned with having a BGL at this point (it would be nice), but I would like to see an EKG. Otherwise, it's a BLS run...with this presentation, she wouldn't get any ALS intervention from me...
hammerpcp Posted June 13, 2006 Posted June 13, 2006 I would inform this person that I do not have any drugs to give her and send her home. Maybe call her a cab if I am feeling nice. This is an NLS pt. As in No life Support needed. Why is she in the park anyway if she had onset of symptoms at home right before 911 call?
etfink Posted June 13, 2006 Posted June 13, 2006 I hope it will not be offensive to have a BLS give his opinion this :wink: I would feel very comfortable with this patient and have had many patients presenting like this be turned over to me. There is a caveat however; lets run a strip and get a BGL prior to downgrading. Just like a refusal I cant imagine downgrading without a full set of vitals. Dizzy...we need a d-stick. In AZ this is a BLS skill and after a BP and pulse this would be one of the first things I do. I understand the idea of well as long as ALS is here...and it never hurts to be more cautious, however i can't think of many medics that I have worked with that would ride in on this if their local protocols allow it.
RaceMedic Posted June 13, 2006 Posted June 13, 2006 ok based on the fact that in the original post you said she was in the park, right? ( i didn't repost it so go back and re read it lol ) so when she said she was at home, does she have an altered mental status ? if so there is your ALS ticket. Or did you forget and just put her back in the house as an oversite? just wondering. Be Safe Race
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