EMS Abuse

[StickEm]

Good responses here.

Here's a priority two from my last shift:

Called to a sick person.

We had a 61 y/o F CO leg pain; requesting (undisclosed hospital dowtown -40 miles away and out of county,).

The shift commander said to tell her medicaid would only cover the NEAREST APPROPRIATE facility. we get there, and this 400 lb. woman is sitting in her wheelchair, bags all packed and on her lap.

We ask what's wrong, etc, and she states she has PAD and a subsequent leg infection. Undisclosed medical facility downtown told her to come in TONIGHT for IV antibotic Tx, so she called us.

We kindly explained that if she wanted to go to (hospital downtown,), she would have to pay cash up front; Medicaid would not cover that. We could however, take her to the nearest appropriate facility, a mile away, and let them request a transport to the downtown facility so Medicaid would cover it.

She went along to the nearest facility. We explained that this is a 911 truck; we have to stay in the county unless medically necessary, and that she should not have called 911 for this. She said she would have called her normal transportation, but would have to wait three days.

It is on the tip of my toungue to say, "Oh freaking well, then, lose 290lbs and get your life back under your own control."

Again, not my problem, so I just help in a kindly fashion.

[Richard B the EMT]

Some of the medical facilities work against their own EMS, with advertisements in the newspapers saying, "When you have chest pain, call 9-1-1, and ask the 'Ambulance Drivers' to bring you to (Hospital name omitted, to protect the guilty)", as they have a cardiac specialty unit.

I should have mentioned that you cannot blame the call takers at the Public Safety Answering Point, either. Some of the callers are professional. They know the key words that assure a fast response, like "Having chest pain."

I heard a training tape, where the caller said his wife was having a baby NOW. The call taker, who happens to be known to me personally, put in the call to our Computer Assisted Dispatch system as an OBOut, per our policies, and gave really good instructions on delivering a baby, all the time reassuring the dad that everything that could be done was being done. There is the sound of a small baby crying in the background, as the dad thanked my call taker for their help, and broke the connection.

The ambulance showed up at the location, and...it's an empty lot? The crew requests dispatch call back, and when the phone was picked up, it was a pay phone several miles from the lot. This was before "Star-69' and before Caller ID. Somebody got the department good, with a phony call, complete to sound effects.

[spenac]

Our system is badly abused, but I was really enjoying this month as hadn't really had any complete BS until yesterday I was brought back to reality nothing but BS.

Thankfully as previously mentioned we do have in place the right to deny some patients, limited but better than nothing. Public needs to be educated, but I guess they have because as someone else mentioned they have learned what to say to get a lights and sirens response when in reality they need to take some aspirin and go to bed. We find a lot of patients call with one problem usually serious then we get there they say something else usually minor. But if they want the 90 mile trip to the hospital they will keep giving lots of symptoms that would only be true with MODS but we have to take them just to see a miracle as they leave the hospital before we do.

[JakeEMTP]

Had a call once where the C/C was a " cut on the hand ". We assessed their injury, nothing to serious, just a superficial 2 cm cut, minimal bleeding. We bandaged his lac and said he would require stitches to close it. He informed us that he didn't have any other way to get to the ED, so could we take him. Being concerned providers we informed him that it would be cheaper to take a taxi. In retrospect, he most likely got a free ride to the ED from us considering where we picked him up :roll:.

On the other hand, we had a respiratory distress call last week. U.O.A., we found the pt. on the front porch, standing up. She informed us that she had been choking on a piece of candy, but since expelled it. She thanked us for our quick response and said she was fine and didn't require our services.

I guess that's the way it goes. Some folks will always abuse the system, while others will not. It's a crap shoot.

[dahlio]

BS calls are common, such as a drunk I once had. Coming home from that call, we get flagged down for a Bike vs. Car, which was an intense call. It's all about that one exciting call that makes it all worth it. Yeah, you're gonna have to take BS calls, but when someone really needs help, it feels good, and really gets your adrenalin running.

[EMTYegerDude]

Interesting article. I know when I did the Explore Program for a local ambulance company a few years ago(that is how I got into the world of EMS),I remember going to some calls that were BS too. Including this woman who was pregnant and wanted to go to the hospital but her family didn't want to take her. Don't remember what the out come was. Bad for us is that I we have to take them unless they refuse to go to the hospital when we get there.

sara