Emergency response back to Hospital

[FireGuard69]

This was a major point of arguement between the guy I am working with today. He was treating a pt whos c/c was dizzieness and nausea. Vitals stable, pt walked to bus. I was driving, and since the pt was, in my opinion, stable, I elected to not go to the hospital Lights and Siren. The hospital is MABY, 3-4 minutes away normal driving speed. When we cleared the call, he went apesh!t on me.

Im talking screaming in quarters between the both of us, completly unprofessional on both our parts, but our debate is still going.....is it appropiate for BLS to go "cold" to hospital with a pt whos c/c is minor, and vitals stable. I am NOT going to go code to drop off a stable pt. It is endangering everyone on the road, no matter how safe I drive, its the other jagoff who we have to worry about.

Opinions?

[fiznat]

Absolutely! In my service we hardly ever transport BLS priority 1. It would have to be something pretty major, with no medic available, for that to happen. I wasnt there to see the patient or hear the whole story, but sounds like your partner is waaay in the wrong here. Not only should a pri 1 transport to the hospital be pretty rare, but the s+s you provided do not indicate it (altough it is possible the patient was more unstable than you thought), and being that close to the hospital it seems there really was no need for it. Do you guys routinely transport patients on priority regardless of complaint and presentation?? Thats dangerous!

Not only that, but dont you do pri 2 responses in your service area? ...I mean, responding to a 911 call without lights + sirens? We do, I'm pretty sure its very common. If the dispatcher on the other end of the 911 call is able to make a determination hot vs cold response based soley on what the patient tells him over the phone, why cant a trained, experienced EMT make that same determination based on a patient that he has evaluated in person?

And even further, in my service usually the provider tech'ing the call makes the transport priority decision. He is the one taking care of the patient, and therefore he is the one most able to make a determination unstable vs. stable. If he didnt tell you to go pri 1, that also is his own fault. No reason you should be yelled at for this at all, by any stretch of the imagination.

[FireGuard69]

He never said anythign until after the call. IF we did go code, it would have saved MABY 15-30 seconds.....Not a good choice IMO

[fiznat]

Ask him WHY he thought the patient was unstable. What in his assessment did he find that led him to believe that risking lives by going pri 1 would have made a difference in this patient's outcome. Dont forget that going priority 1 is DANGEROUS. There should always be a good reason.

If he answers you by saying that you "cant be sure" if the patient was unstable or stable, then tell him he needs to learn how to do a better patient assessment, as well as a better evaluation of risks + benefits of risking people's lives on the road.

[FireGuard69]

Per him, since we dont know, we HAVE to go code. Its a legal issue he says

[Oilersfan1]

From what you have said going hot simply doesn't make sence at all. Your partner is wrong. Saving 30 seconds simply isn't worth the added risk for a stable patient.

Cheers

[fiznat]

Per him, since we dont know, we HAVE to go code. Its a legal issue he says

lol thats retarded. I cant believe he actually thinks that.

...Then again, in NJ you folks arent even allowed to pump your own gas-- haha so maybe its not too far off to believe that the state wont let you make clinical decisions based on your assessments, either. haha

[nsmedic393]

Sounds pretty silly to me. Round here we transport 99% of our patients code 2 (non L+S) to the hospital. The decision lies with the attending medic.

The way I look at it, if they aren't going to die in the extra 30 seconds it takes to get to hospital then I'm not using the lights.

[Ridryder 911]

Invite him to enter this forum. Now, with this said.. "he's an idiot".! First, if he does not know what it is or know what to do, then he needs to seek a career counselor for a different profession.

There are only a few conditions I will run back "hot".. an AMI, that only chance is a CABG and this is dependent on how anxious the patient is, CVA in occurrence for thrombolytics, and AAA that appears to be tearing.. maybe a few other cases.

Like you described, you saved maybe a whopping 30 seconds and for what ?

I would invite him to consider this, if the patient was killed in the EMS unit while responding back to the hospital and yes, he apparently was stable as you described, what would his legal coverage be?

Good luck, hopefully you can get a partner that knows "what to do"

R/r 911

[rat115]

Here we rarely transport pts to the hospital L&S. If our dispatchers tone a call as an "emergency medical" or as an accident, we get to the ambulance shed and to the scene hot. Once we're there, we make the call how emergent the call is. I think I've been on a call where we transported L&S 6 times in 14 months and those were either auto accidents or heart attacks. One was a GSW.