Emergency response back to Hospital

[epi-do]

From what you describe, there is no reason, in my opinion, for that patient to be transported L&S. It sounds as if the patient was stable, and as you stated, if all you are going to save is 30 seconds or so, is it still in the patient's best interest to drive L&S when you are that close to the hospital if the patient is unstable?

I think it is important to consider how close you are to the hospital along with how stable the patient is when deciding if L&S are needed. We have several ECF's that are across the street/next door to various hospitals around town. Have I ever driven L&S from the ECF to the hospital with some of these patients? Yes, because the transporting medic wanted it done. Do I agree with it? Not at all. When your total transport time without L&S is under 2 minutes, what does it gain? Absolutely nothing.

Doing what is best for the patient includes getting them to the hospital safely, not necessarily 30 seconds faster. Like Rid, the service I work for rarely runs L&S to the hospital. It also sounds as if we take the same types of patients in that way. I have only been at my new job for a couple months, but can easily count on one hand the number of patients that have been taken in L&S. That would be 2....an AMI and a ped with seizures that Valium wasn't touching and a 20-30 minute transport time non-L&S.

Hopefully, your partner is eventually able to see how flawed his thinking that "since we don't know we have to go L&S." If you continue to follow that logic through, then no patient would ever be BLS either since you "don't know" what might or could happen on the way to the hospital.

[NREMT-Basic]

I cant really imagine what caused this to degenerate into a screaming match. In my area we respond hot to all calls other than for standby and sometimes then. But from scene to hospital...we evaluate such things as distance to facility, stableness of patient and honestly, whether or not the presence of L and S and 65 mph is going to further destablize the patient. If your medic couldnt provide a reason why this should have been a hot transport, then he just likes the sound of lights and sirens and the adreline rush he gets from it. To me wekk and dizzy without extraordinary s and sx is not a hot call. Out here, usually the medic will make that decision but it sounds as though he might be a little challenged in that regard. Seems like maybe he should receive the aforementioned career counselling.

[FireGuard69]

There was no Medic. We are all BLS, with the hospital running ALS, and there was none dispatched.

[Just Plain Ruff]

NREMT did I read you right that you might run hot to a standby? I hope I read that wrong.

AS for running hot with this stable patient - tell your partner to STEP AWAY FROM THE KOOLAID!!!!!!!!!!!!!!!!!! He was wrong simple as that.

If he can come back and say why the patient warranted it with signs and symptoms to back it up then he can start to drink the Kool aid again.

If he can't then I'd get the heck away from him and let him kill someone other than you.

It's your licensure/livelihood on the line if you kill someone running hot when their condition didn't warrant it.

As for services that run hot to every call, that's bad news just waiting to happen.

[nsmedic393]

If he wants you to drive with the lights and sirens then go ahead and do it. Then you can laugh at him with everyone else at the hospital when the doctor sends the patient home before he can even get them off the stretcher.

[GhostMedic28]

As one of many EMS veterans in here I feel that I should comment on this as each area and service has it's own protocols and SOP's regarding transport. First off, I have worked for both BLS and ALS services, and in doing so I got quite a bit of experience. Ok, now on to the point.

If your partner was treating a patient whose c/c was nausea and dizziness with stable vitals and in no immediate distress, ask him what his medical reason was for wanting transporting emergency versus non-emergency. Granted, nausea and vomiting are some key signs for an MI, but nausea can also accompany a host of other illnesses. If he was so concerned for the patients condition, then he should have instructed you to transport in an emergency mode. After all, we aren't mind readers. To this day I still ask my partner how they want the transport (emergency or non-emergency).

Since we are from different states, and each state has it's own laws regarding the operation of emergency vehicles, remind your partner this....should you have transported the patient emergency, and in the course been involved in an accident, can YOU being the operator of the vehicle justify your decision to transport the way you did. After all, since you are the operator, it's your license/certification that may be suspended or revoked because you are in control of the vehicle.

I have worked with people like him in my career and I just tell them to do their job, and I will mine.

[strippel]

Our county dispatchers (usually) give us decent information, so probably about 1/3 of or dispatches are non-emergent responses. (We do use Medical Priority dispatching).

When we transport to the hospital, it is almost always non-emergent. I think I have used RLS twice in the last month, and one was yesterday with an unstable motorcycle accident patient. Another was an unstable IFT. We have a protocol (recently updated) that states in specific terms that the patient must be unstable.

We are a city/suburban service, with most of our trucks less than 10 minutes from the hospital. Even our country truck (30+ minute transport time) must drive normal speed, unless the patient is unstable.

In most instances, running RLS is more a liability than a benefit.

[becksdad]

From the information you provided, there is NO WAY I would run L&S on this call. And you guys are a BLS truck? Seems like you should only be running hot if you have a priority 1 patient such as Ridryder described. And even then, wouldn't you rendevous with an ALS truck if one was not close? We limit running hot to priority 1 patients or priority 2's that are potentially unstable (and in that case we take into account the nature of patients condition and transport times). If something changes in the back, and my partner wants to get there faster, he/she just asks me to light it up. There's no screaming match. You have yourself A REALLY BAD PARTNER!!!

Besides, running hot endangers everyone on the road - but most especially you!!. Then your partner. Then your patient. The decision to run down the road L&S should not be taken lightly, and reserved for times when it is really necessary. Tell your partner THAT'S A LEGAL ISSUE! If someone gets killed or injured because you were screaming through town with a priority 3 patient, who do you think the lawyers are gonna crucify?

[mediccjh]

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

Your partner is a f--king idiot.

[Asysin2leads]

Well, Becksdad and medic pretty much said what I was going to say. If the patient was really that critical, you should have rendevoused with an ALS unit, but from the sound of it, your partner is a moron. Tell him to knock it off before someone slaps the shit out of him. Just curious, is this an isolated asshole, or is your entire service like that? If its the latter, I'd say run Forrest, run away.