Rules against calling 911 when it isn't an emergency?

[WendyT]

I'm not complaining or bitching about a call, I'm the willing person here to attend every call as if it were my first. I'm the one with the bedside mannerism, even if it is a stubbed toe, I'm the one who is open to people, if you are hurting, then I understand the dilema you are going through. That is my job, I am here to care for you that is what I was trained to do.

[Jess]

I'm a EMT student right now and so far we have not been taught how to judge what is and is not an emergency, I wasn't even aware that we could do that *being sarcastic of course* :roll: SO I come to my next point, why don't we just continue doing our jobs and stop whining about the "BS CALL" we had last night. Yea I'm sure it sucks to get up at 2am because granny has toe pain...big deal! Find a new profession if its that emotionally harsh on you. Yes i agree wholeheartedly that there is abuse in the 911 system but laying around and complaining about it isn't going to get us anywhere. It will continue to happen no matter what measures are taken until someone finds a sure fire way to determine what is a true emergency and what isn't. what may not be an emergency to you, may be to them so good luck finding a solution on determining this. We are in this profession to care for people and be there in their time of need. time for a career change if your here for something other than what your trained to do. This post was not an attack on anyone here. Just my 2 cents worth. Take care and God Bless you all

[spenac]

I love comments from students and big city dwellers, these comments are big reason we are looked at as taxi's rather than part of healthcare. Most bumps, bruises, tummy aches, fevers, etc, etc are not emergencys and part of our job should be to educate people when they should call for an ambulance. Again I am all for them calling if they have a doubt, let us come check but then we should have the say whether they are transported. I know common sense is frowned on in EMS but I refuse to give up mine. I am educated enough to know that a stubbed toe will be fine either in just a few minutes or if broken will be fine riding in the family car. I still cannot believe how many people did not even have enough common sense to deny transport to the guy, in a scenario I posted, that just wanted go eat the hospital lunch special.

In my part of the world if I transport the stubbed toe, there will be no ambulance in a 3000 square mile area for close to 4 hours. As I stated I have no problem coming to check on a person, if they think they have an emergency. Thankfully I have protocols that allow us to say no to people. I am allowed to use my common sense. This does help there be a greater chance that the ambulance will available when someone has something more serious. Yes we still take lots of people that really could go private car, but they are more serious than the stubbed toe, and yes I have had more than one 911 call for a painful toe.

Be careful out there my fellow taxi drivers.

[Yummymedic05]

Spenac, not all of us are allowed to deny transport to patients. I do educate, and try to "talk them out of it" But if they want the ambulance, that's what they get. I'm a little closer to the hospital and have 14 gazillion vollies around if someone needs an ambulance while i'm busy. I tell them it's not an emergency, they will be fine, someone out there could be having a real emergency while i'm sitting there arguing with them, and i feel like if they want to go, i'd rather get it over with than waste more time arguing about the matter. Heck that's how I raise a child! No wonder she walks all over me!

[FredG]

What really needs to be done is implementation of Treat and Release protocols or alternative destinations. For a patient that we know doesn't need to be transported (stubbed toe type calls), let the EMS provider treat the patient and get a signature release. Another option for non-life threatening calls could be transport or referral to a doctor's office or a walk-in clinic. Many of the calls we see do not need a full blown ER and this would free up ER resources and has the potential of reducing transport and ER wait times, thereby improving EMS unit availability.

I know there was some talk a few years ago to allow transport of stable patients to 24-hour clinics, but I have not heard anything more in a long time. I don't think it went anywhere in this region.

Of course, with our litigous society, these options will be frowned upon. In fact, our Regional Medical Council director has flat out told us that he does not like RMAs and wants agencies in our region to reduce the number of RMAs we allow.

[spenac]

Fred, like your post. That is basically what my medical director has done. We do lots of treat and release. This statement will start a firestorm but we are allowed to administer several meds and advise patient to follow up with their own doctor. We also can take someone to the clinic here if it is open and they agree to treat them, but normally they say they are to busy, plus I feel bad taking somebody there because I wouldn't take a stray dog to be treated there.

Now at my second service no matter why the person called we are required to make at least 3 attempts to convince them to go by ambulance to the hospital. But most calls are within 5 miles of the hospital and maybe 5% are more than 15 minutes from it. I really feel like a taxi driver on most calls there.

[Richard B the EMT]

The policies I operate under call for me using judgement to know when to talk someone out of going to the hospital, to when I feel they really MUST go to the hospital. Also, for a patient under 5 years old, or older than 60, if they want to, or I feel they can, Refuse Medical Assistance, I can always call the nice Paramedics and On Line Medical Control Doctors at the OLMC for backup and/or advisement.

If the Doctor, after hearing our medical findings, S/S, and desires for the patient, and the doctor talking to the patient, if the Doctor feels "allow the RMA", it's the doctor's licence, or the doctor's feeling to transport against the patient's will (backed up by our local EMS supervisor, and if need be, the NYPD), the patient is going to be transported.

FYI, if the patient wants to go to a hospital other than where the local EMS crew usually goes, except for the trauma center, we have to clear it with the OLMC Doctor. Most times it is granted, but we are obligated to advise, if the patient condition goes "south", we might divert to a nearby hospital not previously discussed with the patient and their family.

Again, FDNY EMS has the luxury of most patients being located no more than 15 minutes travel time from the nearest appropriate ED, or a half hour, ground travel, to a trauma center. FDNY EMS crews do not have the power or authority to request a Medevac.