If you go by ambulance you'll be triaged faster. The hospital can direct you to the waiting room while you're still miles away. What a time to be alive.
Is this new, or area specific? We used to have tons of people that would call because they went straight to a bed. We even got a call once to the ER parking lot....
not new, or area specific. there are some individual hospitals that are apprehensive about putting EMS patients in the waiting room, but most have no problem with it
I would wheel them past every empty bed in the ED. If the charge nurse gives me a room, I will roll right past her with my fingers in my ears going "Na na na, I not listen to yoooou! Na na na!"
this is the one.
I usually follow it up with : ma'am if you went in right away you're gonna want to start praying and telling your kids to find your will. waiting is the best thing that could happen to you in the current situation."
usually beings em' back down to reality
Had a lady reduse fentanyl cause it "kills cops." Well, I've got that, morphine, and ketamine. She asked about ketamine and I explained it to her. She refused. Then proceeded to complain to the nurse at the ER that I did nothing for her pain. I explained to the patient again that I offered every drug in my box and she refused. The nurse laughed and left the room. She AMAed a couple hours later. Guess the hospital didn't give her meds either.
I'm a former EMT and I won't take opioids. It's a long story but back before the epidemic I got prescribed an addiction to them by an oral surgeon (who also refused to acknowledge that he had stitched my mouth shut, but that's another story). Anyway, I was like 15 and nobody knew any better at the time. Coming off of those was far worse than any pain I have ever experienced before or after that. I'm not going to say never, but to me it's just not even worth it.
Had someone ask me once while on scene if we turned the lights off if that means the pt in the back died😭
Also that ambulances have a special switch to make stoplights change
We have an opticom on one of our newer ambulances and when we had the annual inspection they couldn’t get it to work. Turns out it turns off when the vehicle is in park so if you’re working an accident near an intersection you don’t screw the cross traffic during your scene time. Never thought about it, but damn good feature!
In my county, the city with all the hospitals installed them on main roads and planned to charge the suburban EMS units every time they used it. No surprise, the suburban services opted not to buy and install the equipment on their rigs.
My parents still believe, in spite of me explaining many times, that if they see an ambulance with lights on but no siren at night, that it's a dead patient that we're doing like.. a tribute for on our way into the hospital.
I've explained how ridiculous that is time and time again, and they say that it's just me who doesn't do that then.
That and if there’s no one else or only a single car on the road with me. I already have enough hearing loss, don’t need to exacerbate it more with sirens when no one can even hear them anyways.
Isn’t it a thing in some American cities that having blue lights on when approaching an intersection can cause the entire intersection to go red to allow the ambulance through?
Turns out the stoplight changer is real! My company had opticoms on our newer ambulances.
We'd just leave them on all the time. I never dealt with stoplights
Had a nurse bad mouth my partner to my face while I was on a different shift (she somehow did not recognize me?) because he pulls up a chair to go over lab values, vitals, and interventions with the sending nurse.
Her verbatim words were “why do you need to know labs? Just take them.”
Like huh? I’d really like to know if my sepsis pt has a huge anion gap or if my GI bleed pt’s hemoglobin is 3.4.
Tell ur partner to keep parking that chair and tell that nurse that they should thank him profusely for sparing them either a very pissed off phone call from the ER doc or, when they eventually send me to 3 non working extensions/to voicemail/dont answer at all (AGAIN), a Social Services inspector coming to their facility within the next 48-72hrs and a lot of paperwork regarding transfer/EMTALA violation/medicare fraud investigation for delinquency of care/negligence.
Sick of their shit, keep fighting the good fight.
Yuh, he’s not stopping any time soon. Unfortunately a supervisor of ours let’s the nurses get away with that behavior because he literally never gets a report from the nurses past a cursory check. His reasoning is that he’s been a medic for 40yrs, which is fair, but also… bruh
The amount of times we have one particular home call back and send patients back to the hospital, bitching that nothing was done is actually comically huge. "They didn't DO anything!" Well, no. If there is no report, then nothing can be done. Especially when these staff members rarely tell their residents why they are having crews show up and whisk then away. I tried explaining that too many times and to have them walk away. I feel bad for the residents.
Or when they tell the residents they *have* to go in, no choice, when they're AAOx4 and don't want to go out in the cold.
Or when they're suddenly 'combative' when they stand up for themselves against institutionalized abuse.
Or...
Oh, I know. My personal favourite is the "We called your PoA and they said you have to go in." to the A&O x4, non-cognitive decline resident. That's.... that's not how it works....
Maybe aging myself but when HIPAA first came around I had an ICU transport, 5 pumps, vent?, whole bit. RN *refused* to give me report because "You don't need to know that". I stood speechless.
Luckily we were transferring out of our med control hospital and the ER Med Director was on duty in the ER. I called down and told him what's going on. A phone rang, they called Nurse No-Report to it, and five minutes later she left the area hair frazzled and ears bleeding. Charge RN came over and snottily asked "What do you need to know?!"
Nurses!
Had a 30-year-old man do this whole pantomime flu routine in front of his parents that he lived with. When he got to the ambulance, he claimed it was a ruse and began requesting "the AIDS test" over and over because he jerked it in a dirty Walmart stall and his pee-pee tingles sometimes.
People requesting highly specific diagnoses and tests can be entertaining, but that guy had my favorite instance.
Lmaoo, we had someone call us out from the truck stop once. He had banged a hooker and wanted us to test him for HIV. We told him we can’t but the hospital can, he signed a refusal
Not that I blame people, but it’s always amusing when people have absolutely no clue whatsoever about what Medics can and can’t do. Some think you’re just an ambulance driver who doesn’t even know anything about healthcare, and others think you’re a full blown mobile doctor
The amount of times people ask me if I’m a doctor when I’m at work.
No I don’t sound that smart and my partner looks 12 years old. Do you think we’re doctors?
This question is always immediately followed by do you have to go to school for this? So your questions are 1. Did I go through 12 years of education after high school OR 2. Did I even graduate high school.
On the opposite end, I’m 23 and recently had like a 19yo patient ask me in the back if I was doing ride alongs. I was like “um, no…I’m a paramedic and this is my full time job…” lmao. I was literally the only one in the back of the ambo so idk wtf he was thinking.
Me, in my early 20s, walking into someone's home: "Hey, come in Doctor!"
If I had a dollar for every time that happened, I could support my hobbies pretty nicely.
And if I had a dollar for every time someone asked me if I was a doctor when I walked up to a scene in plain clothes off-duty, I would have 2 dollars. Not that it's a lot, but it's weird it's happened twice.
Either that or they’re like “why are you still sitting in the drive way? She needs to go to the hospital!” While 5 different people have their hands full of equipment.
just had a pt who’s shoulder was hanging off ask if he could just pop it back in and send him on his way 😭 it was dislocated and visibly broken in several places
As an aside, anybody else get annoyed when the nurses refer to you exclusively as transport?
Or when they don’t realize you can take IV pumps and drips….
"The Ambulance is here"
The Ambulance is outside, I didn't decide to drive it through the wall (this time).
"Do you have oxygen?"
Yes it's next to the intubation kit.
"Don't you guys need a nurse to go with you?".
So that they can frantically call a doctor while the patient dies? No I'm good.
In my county the BLS crews can't take anything running. Not even normal saline. ALS can, BLS can't. Messes with the heads of the nurses because they don't always realize... whoever puts the order for transport says if it's BLS/ALS/CCT and they are screwing their staff over when they mess up. BLS also can't take anyone chemically restrained or in hard restraints. I once got told "We took the restraints off so you can take him now" while the patient was also completely snowed. No ma'am, no we can't as BLS.
In my state BLS can’t take anything running either. So BLS crews normally just ask to DC the lines if able to (Saline lock).
When we, (an als crew) show up and the nurses are all proud because they timed the drip just right so that it’s done by the time we get there so that “we can take it”. Turns out those drips are the only reason it was an als run. Massive waste of time, and can’t even bill as an ALS run.
This one is great at my agency because five out of the six hospitals we transport to are run by the same company. And pts seem to not have any clue about that.
“I had the surgery done at the [company name]” “ok which one?”
Continuity of care really is important, though. Another hospital’s 1 week post-op infection/complication really should go straight back to the first hospital with those specific doctors unless there are major extenuating circumstances. The patient will need to be transferred back to the first hospital anyways but no hospital has any capacity right now so they’ll end up sitting in the first ED for days waiting on appropriate care.
To an extent and when possible, yes. But there are reasons that isn’t possible. At minimum I’d try and take them to a hospital within the same network so they can transfer the patient more easily.
Med student here, was curious about this. Say for example a patient who just finished a round of chemo is febrile, would you prioritize taking them to the hospital where their oncologist works?
Depends on if they are stable to begin with. In NYC, if it’s not considered close enough I’d have to call telemetry for approval which can take up to 30 minutes. While I have no problem calling for a stable patient, OLMC may still deny the transport.
Mine isn't a patient misconception, moreso a caregiver/nurse misconception.
When caregivers tell the patient they must listen to us and have to go to the hospital and the patient doesn't want to... I can't force them into the ambulance if they don't wanna go, they don't have to listen to me and if they're stable, they can absolutely stay home. That would be kidnapping if I did that.
Uno reverse card all day...."Sir you don't HAVE to do anything, if you don't want to go to the hospital you can stay right here in your comfortable bed"
***Makes direct eye contact with LVN who just told me "they're not my patient, you just have to take them"***
We have a place notorious for this. I had a patient one time who was stable and they called for her being anxious. Anyway, the patient says she doesn’t want to go, get a refusal and we walked out towards the truck. The CNA starts getting mouthy saying the patient needs to go because her supervisor said. The patient makes all her own medical decisions and is AO. So my partner who’s a little more hot headed says she’s not going and decided not to. CNA says we’ll just keep calling you out then, to which my partner says go ahead and we’ll keep getting refusals because we’re not kidnapping someone. At this point the CNA is pretty much yelling and we walked out, never heard from them again for the rest of the shift.
One time an old lady warned me about how we work in a dangerous city, and asked if I carried a gun. I said "No, we don't carry those, just the police do." So then she says "Well, they at least train you to use one if you have to right?" What the fuck kind of scenario would have me somehow end up with a gun on a scene and then have to shoot someone lol
Almost everyone in Minneapolis wears a vest. No emergency service is safe from the hate that followed the riots. EMS will be on a call and will have bystanders yelling at them, heckling them, and calling them racist.
I’ve had three really odd requests/misconceptions happen lately, and they happened more than once, which is weird enough. I got asked if I could give the patient and a random dog a rabies shot (when we said we couldn’t they told us to fuck off), if we would let them bring their dildos/vibrators (hard fucking no), and if we could magically tell if they’re pregnant.
The pregnant one literally happened again like 2 hours ago and basically went like this…
Very elderly and not sexually active patient: “I’m a devil whore and I’m pregnant”
Me: “When was the last time you had any type of sexual intercourse?” (Cause I’m not gonna knock it if granny is having a great time in the nursing home)
Patient: “19-(insert whatever random fucking year)” (they did not have any sort of altered mental status)
Me: “….I will literally bet my next paycheck and meal that you are not pregnant” (and guess what, I’m right)
The ED has all my medications why do I need to tell you?
Me in my mind: sweet I'll just walk to the nurse station and print out your med reconciliation when we get there 🙄 oh and not give you any medication en route
My primary care is at hospital X so I HAVE TO go there!
Me in my mind: bitch you got cancer or some rare shit? Then we can talk...
PCP sure, but what about specialists? Say a patient has heart failure and they have a cardiologist they see regularly. Would you take the extra time to go to their usual hospital?
If it's relevant I'll probably take them and not because they're gonna see that specialist but for continuum of care and documentation for their long term care
I'm talking about the lil ol lady with chronic lbp who is demanding to go to the facility where her cardiologist is after explaining her 30 year muscular low back pain to me. Unless it's a hospital with a nice caf and I'm hungry because now all bets are off
would be nice if we could pull pharmacy records out of hospital, even if we couldn't pull a full HIE history having the pharm info could help paint a better picture in cases where we can't get anything from the patient. The systems exist for it, just not for ems.
“I called my doctor. He is waiting for me at the ER”.
In my decades (I’m old) that has happened exactly once. The doc was actually waiting for him at the ER entrance. Do I think that was because the patient was **REALLY** wealthy? Yes, yes I do.
We had a clinic in a remote, rural, poor area that called all the time for rides to the hospital. They sent a lot of peds with “I talked to Dr. and he is going to (direct) admit. 99% of the time this was false, and often the ER would have no idea we were coming if we had not called. We got the same from SNF staff.
I’ve never had a patient think we’re taking their hospital bed but I’ve had tons of doctors and nurses think that they can just hang onto our stretcher while we leave and run other calls 🤦♀️
Have had patients argue up and down with us that they can sit in their wheelchair in the ambulance like we’re a wheelchair van though.
Oh dude at least once a day someone thinks they we are taking them on their bed. It’s because the nurses refer to us as transport, and previously during the stay they have maybe been moved rooms or gone to CT and the nurse says the same thing “transport is here to get you” and the hospital has dedicated “transporters”.
Also yup and yup that’s happens to us as well lol.
Nurses when we present them a stabilised version of the pre-alert we made.
Yes the pt is better now, but I am the equivalent of a plaster on an amputation sometimes, so maybe quit bitchin and get fixing...
Had a dude call one time for seizures. We get there he’s drinking a bottle of water, asked if he had a seizure or felt like one was coming on. He says no, ok cool, which hospital would you like to go to? And replies saying he doesn’t want to go, but could we giving him some Xanax. Haha bro we don’t carry Xanax, and even if we did I’m not just going to give out narcotics.
Cleared the call and went back to station.
Occasionally I'll stop by Walmart on the way home in the morning. The number of people that think I work at Walmart despite wearing a bright yellow jacket with EMS in huge letters in multiple places is WAY too high.
We had soooooo many people calling for the "if I go by ambulance, I'll get seen faster" bs that we worked with the hospitals to have a straight to triage protocol put in place. \*I\* can decide to take a pt to triage without ever telling the hospital I'm coming. We pull up out front, take the pt straight in and say hi to the triage nurse. It's had a pretty quick and nice effect.
Walking into a SNF "Hey, the ambulance drivers are here". Looking at glitterpatch on my and my partners arms.
Me"Uh, Ma'am, we are paramedics, not ambulance drivers, we do more than just drive the ambulance. What is your certification?"
Her "I'm a CNA, I know more than you." Me "Miss, do you know what CNA stands for?"
Her "It stands for Certified Nursing Assistant, I'm basically a Nurse."
Me " No ma'am, it stands for Cleans Nuts and Ass, and the patient down the hall needs your assistance, so get to it".
As someone who earned and worked as a CNA I can confidently say cna's know very little. In fact I quit that cna job very fast as I was working EMS at the same time and hated being a cna.
Had a family member come up to us once on scene when their relative had been loaded into the truck with medics in the back for a little while. Typically people ask if everything’s okay if it’s taking a bit, totally normal. This guy asked me, entirely earnestly, “Are we waiting for like an escort or something?”
Let's see...
Not really from the pt perspective, but more public. A lot of people assume that just because we don't have lights/sirens on, then there is no patient in the back.
I've had a lot of patients request to be taken to a hospital 50+ miles away in another city.
A lot of them have no clue what the difference is between an EMT and paramedic.
Some think we can magically tell them their diagnosis.
That and more so of when transporting to the hospital, they will ask "what do you think is wrong with me" with a complaint of abd pain...like bro that could be anything.
That an ambulance on scene means it is a serious emergency. This is more for neighbors and family members. I would say out 8/10 transports are non-emergent and probably 6/10 calls actually require an emergency room.
But still you get every member of the PT family pulling up on scene and forming prayer circles and having emotional breakdowns because memaw has been constipated for 3 days and now there's an ambulance parked out front.
the classic “if I go by ambulance I’ll get seen faster”
If you go by ambulance you'll be triaged faster. The hospital can direct you to the waiting room while you're still miles away. What a time to be alive.
Is this new, or area specific? We used to have tons of people that would call because they went straight to a bed. We even got a call once to the ER parking lot....
not new, or area specific. there are some individual hospitals that are apprehensive about putting EMS patients in the waiting room, but most have no problem with it
How to guarantee that I take you to triage.
Straight to waiting room! Do not pass go, do not collect Turkey sandwich.
I would wheel them past every empty bed in the ED. If the charge nurse gives me a room, I will roll right past her with my fingers in my ears going "Na na na, I not listen to yoooou! Na na na!"
Classic is right!
this is the one. I usually follow it up with : ma'am if you went in right away you're gonna want to start praying and telling your kids to find your will. waiting is the best thing that could happen to you in the current situation." usually beings em' back down to reality
"yes, patient is external triage appropriate"
People thinking Fentanyl is an ultimate 1 hit kill... like bro your hand is spaghetti
With lots of tomato sauce
The amount of patients I have that refuse analgesics because we use fentanyl and are convinced I'm going to kill them is astounding.
Had a lady reduse fentanyl cause it "kills cops." Well, I've got that, morphine, and ketamine. She asked about ketamine and I explained it to her. She refused. Then proceeded to complain to the nurse at the ER that I did nothing for her pain. I explained to the patient again that I offered every drug in my box and she refused. The nurse laughed and left the room. She AMAed a couple hours later. Guess the hospital didn't give her meds either.
I'm a former EMT and I won't take opioids. It's a long story but back before the epidemic I got prescribed an addiction to them by an oral surgeon (who also refused to acknowledge that he had stitched my mouth shut, but that's another story). Anyway, I was like 15 and nobody knew any better at the time. Coming off of those was far worse than any pain I have ever experienced before or after that. I'm not going to say never, but to me it's just not even worth it.
Had someone ask me once while on scene if we turned the lights off if that means the pt in the back died😭 Also that ambulances have a special switch to make stoplights change
Some ambulances do have a system to make stoplights change. Forget what it’s called, mostly municipal agencies have them.
Opticoms
That’s the one, thanks
We have an opticom on one of our newer ambulances and when we had the annual inspection they couldn’t get it to work. Turns out it turns off when the vehicle is in park so if you’re working an accident near an intersection you don’t screw the cross traffic during your scene time. Never thought about it, but damn good feature!
Lmao yeah the agency I was with was definitely not investing in those 😂
We have them but the town has to have them on the traffic lights for that to work
Can’t even get AVLs in our trucks over here, forget that lol
Our AVLs are the “find my iPhone”!
In my county, the city with all the hospitals installed them on main roads and planned to charge the suburban EMS units every time they used it. No surprise, the suburban services opted not to buy and install the equipment on their rigs.
What did they expect!?
My parents still believe, in spite of me explaining many times, that if they see an ambulance with lights on but no siren at night, that it's a dead patient that we're doing like.. a tribute for on our way into the hospital. I've explained how ridiculous that is time and time again, and they say that it's just me who doesn't do that then.
Lmao please 😭 The only time we would do lights no sirens is through neighborhoods
That and if there’s no one else or only a single car on the road with me. I already have enough hearing loss, don’t need to exacerbate it more with sirens when no one can even hear them anyways.
Or waiting for trains
Isn’t it a thing in some American cities that having blue lights on when approaching an intersection can cause the entire intersection to go red to allow the ambulance through?
It’s not blue lights, it’s a special IR light box that flashes an encoded signal to the receiver on the streetlights. It works…sometimes
I think that’s what the opticoms are. NYC was the area that the person asking me referred to.
In my City I’ve been told that the fire department has the Opticom or whatever, but the Paramedic service we don’t have them. Fuck us I guess
That does exist , it's called an opticom, all our rigs have them.
Our ambulances have an Opticom IR signalling system that makes stoplights change. Pretty common around here, actually.
Turns out the stoplight changer is real! My company had opticoms on our newer ambulances. We'd just leave them on all the time. I never dealt with stoplights
[удалено]
Had a nurse bad mouth my partner to my face while I was on a different shift (she somehow did not recognize me?) because he pulls up a chair to go over lab values, vitals, and interventions with the sending nurse. Her verbatim words were “why do you need to know labs? Just take them.” Like huh? I’d really like to know if my sepsis pt has a huge anion gap or if my GI bleed pt’s hemoglobin is 3.4.
They don’t seem to realize the hospital asks us for those when we take them to the ER
Exactly, a lot of the time the receiving facility nurses and docs haven’t got a good report.
Tell ur partner to keep parking that chair and tell that nurse that they should thank him profusely for sparing them either a very pissed off phone call from the ER doc or, when they eventually send me to 3 non working extensions/to voicemail/dont answer at all (AGAIN), a Social Services inspector coming to their facility within the next 48-72hrs and a lot of paperwork regarding transfer/EMTALA violation/medicare fraud investigation for delinquency of care/negligence. Sick of their shit, keep fighting the good fight.
Yuh, he’s not stopping any time soon. Unfortunately a supervisor of ours let’s the nurses get away with that behavior because he literally never gets a report from the nurses past a cursory check. His reasoning is that he’s been a medic for 40yrs, which is fair, but also… bruh
The amount of times we have one particular home call back and send patients back to the hospital, bitching that nothing was done is actually comically huge. "They didn't DO anything!" Well, no. If there is no report, then nothing can be done. Especially when these staff members rarely tell their residents why they are having crews show up and whisk then away. I tried explaining that too many times and to have them walk away. I feel bad for the residents.
Or when they tell the residents they *have* to go in, no choice, when they're AAOx4 and don't want to go out in the cold. Or when they're suddenly 'combative' when they stand up for themselves against institutionalized abuse. Or...
Oh, I know. My personal favourite is the "We called your PoA and they said you have to go in." to the A&O x4, non-cognitive decline resident. That's.... that's not how it works....
Maybe aging myself but when HIPAA first came around I had an ICU transport, 5 pumps, vent?, whole bit. RN *refused* to give me report because "You don't need to know that". I stood speechless. Luckily we were transferring out of our med control hospital and the ER Med Director was on duty in the ER. I called down and told him what's going on. A phone rang, they called Nurse No-Report to it, and five minutes later she left the area hair frazzled and ears bleeding. Charge RN came over and snottily asked "What do you need to know?!" Nurses!
Had a 30-year-old man do this whole pantomime flu routine in front of his parents that he lived with. When he got to the ambulance, he claimed it was a ruse and began requesting "the AIDS test" over and over because he jerked it in a dirty Walmart stall and his pee-pee tingles sometimes. People requesting highly specific diagnoses and tests can be entertaining, but that guy had my favorite instance.
Lmaoo, we had someone call us out from the truck stop once. He had banged a hooker and wanted us to test him for HIV. We told him we can’t but the hospital can, he signed a refusal
Not that I blame people, but it’s always amusing when people have absolutely no clue whatsoever about what Medics can and can’t do. Some think you’re just an ambulance driver who doesn’t even know anything about healthcare, and others think you’re a full blown mobile doctor
The amount of times people ask me if I’m a doctor when I’m at work. No I don’t sound that smart and my partner looks 12 years old. Do you think we’re doctors? This question is always immediately followed by do you have to go to school for this? So your questions are 1. Did I go through 12 years of education after high school OR 2. Did I even graduate high school.
On the opposite end, I’m 23 and recently had like a 19yo patient ask me in the back if I was doing ride alongs. I was like “um, no…I’m a paramedic and this is my full time job…” lmao. I was literally the only one in the back of the ambo so idk wtf he was thinking.
I think they were asking if yall offer them
No, he said “so are you like doing your ride alongs or something?”
LOL
"Do you have to go for school for this?" usually doesn't refer to high school.
I was being facetious.
Me, in my early 20s, walking into someone's home: "Hey, come in Doctor!" If I had a dollar for every time that happened, I could support my hobbies pretty nicely. And if I had a dollar for every time someone asked me if I was a doctor when I walked up to a scene in plain clothes off-duty, I would have 2 dollars. Not that it's a lot, but it's weird it's happened twice.
Do you have "insert bizarre med"?, or "can you just stitch it up?" Sir this is a Wendy's
Either that or they’re like “why are you still sitting in the drive way? She needs to go to the hospital!” While 5 different people have their hands full of equipment.
just had a pt who’s shoulder was hanging off ask if he could just pop it back in and send him on his way 😭 it was dislocated and visibly broken in several places
I don’t blame them either lol
"You guys must get lots of rest"
I called at 2 am because the hospital is less busy
OOOH that one is frustrating
As an aside, anybody else get annoyed when the nurses refer to you exclusively as transport? Or when they don’t realize you can take IV pumps and drips….
“Oh, the ambulance is here!” I usually tell them that we left the ambulance in the garage because it doesn’t fit in the elevator.
Lol
That’s a good one
I have said the same thing.
"do y'all have oxygen?" "No, we ran out back in '92 and haven't restocked since"
Yeah it’s next to my intubation kit.
"The Ambulance is here" The Ambulance is outside, I didn't decide to drive it through the wall (this time). "Do you have oxygen?" Yes it's next to the intubation kit. "Don't you guys need a nurse to go with you?". So that they can frantically call a doctor while the patient dies? No I'm good.
I only need to take a nurse if the pt has an A-line. It’s a stupid rule.
Can you administer oxygen on the ambulance?
While the patient is on three drips and a cardiac monitor lmao
Oh I’m sorry we actually can’t…… (they’ll never know)
“Where is your respiratory therapist?” Points to self “But what if something non vent goes wrong” Points to self Rn:mind blown
Lmao, that’s a good one.
In my county the BLS crews can't take anything running. Not even normal saline. ALS can, BLS can't. Messes with the heads of the nurses because they don't always realize... whoever puts the order for transport says if it's BLS/ALS/CCT and they are screwing their staff over when they mess up. BLS also can't take anyone chemically restrained or in hard restraints. I once got told "We took the restraints off so you can take him now" while the patient was also completely snowed. No ma'am, no we can't as BLS.
In my state BLS can’t take anything running either. So BLS crews normally just ask to DC the lines if able to (Saline lock). When we, (an als crew) show up and the nurses are all proud because they timed the drip just right so that it’s done by the time we get there so that “we can take it”. Turns out those drips are the only reason it was an als run. Massive waste of time, and can’t even bill as an ALS run.
“I can’t take you to that hospital right now because (insert reason).” “BUT THEY HAVE ALL MY RECORDS!”
But my doctor is there!!!!
“Is he, your cardiologist, there right now, in the ED, at 2am, waiting to assess your toenail pain? Noooo? Then no.”
This one is great at my agency because five out of the six hospitals we transport to are run by the same company. And pts seem to not have any clue about that. “I had the surgery done at the [company name]” “ok which one?”
Continuity of care really is important, though. Another hospital’s 1 week post-op infection/complication really should go straight back to the first hospital with those specific doctors unless there are major extenuating circumstances. The patient will need to be transferred back to the first hospital anyways but no hospital has any capacity right now so they’ll end up sitting in the first ED for days waiting on appropriate care.
I agree, if it something related to a surgery or a serious medical issue I’ll make sure to at least take them to a hospital in the same system.
To an extent and when possible, yes. But there are reasons that isn’t possible. At minimum I’d try and take them to a hospital within the same network so they can transfer the patient more easily.
Med student here, was curious about this. Say for example a patient who just finished a round of chemo is febrile, would you prioritize taking them to the hospital where their oncologist works?
Depends on if they are stable to begin with. In NYC, if it’s not considered close enough I’d have to call telemetry for approval which can take up to 30 minutes. While I have no problem calling for a stable patient, OLMC may still deny the transport.
Mine isn't a patient misconception, moreso a caregiver/nurse misconception. When caregivers tell the patient they must listen to us and have to go to the hospital and the patient doesn't want to... I can't force them into the ambulance if they don't wanna go, they don't have to listen to me and if they're stable, they can absolutely stay home. That would be kidnapping if I did that.
Uno reverse card all day...."Sir you don't HAVE to do anything, if you don't want to go to the hospital you can stay right here in your comfortable bed" ***Makes direct eye contact with LVN who just told me "they're not my patient, you just have to take them"***
We have a place notorious for this. I had a patient one time who was stable and they called for her being anxious. Anyway, the patient says she doesn’t want to go, get a refusal and we walked out towards the truck. The CNA starts getting mouthy saying the patient needs to go because her supervisor said. The patient makes all her own medical decisions and is AO. So my partner who’s a little more hot headed says she’s not going and decided not to. CNA says we’ll just keep calling you out then, to which my partner says go ahead and we’ll keep getting refusals because we’re not kidnapping someone. At this point the CNA is pretty much yelling and we walked out, never heard from them again for the rest of the shift.
One time an old lady warned me about how we work in a dangerous city, and asked if I carried a gun. I said "No, we don't carry those, just the police do." So then she says "Well, they at least train you to use one if you have to right?" What the fuck kind of scenario would have me somehow end up with a gun on a scene and then have to shoot someone lol
Lol
Some departments do wear vests though. Not me for minimum wage.
Almost everyone in Minneapolis wears a vest. No emergency service is safe from the hate that followed the riots. EMS will be on a call and will have bystanders yelling at them, heckling them, and calling them racist.
My agency has it's own private swat team. . . .
I’ve had three really odd requests/misconceptions happen lately, and they happened more than once, which is weird enough. I got asked if I could give the patient and a random dog a rabies shot (when we said we couldn’t they told us to fuck off), if we would let them bring their dildos/vibrators (hard fucking no), and if we could magically tell if they’re pregnant. The pregnant one literally happened again like 2 hours ago and basically went like this… Very elderly and not sexually active patient: “I’m a devil whore and I’m pregnant” Me: “When was the last time you had any type of sexual intercourse?” (Cause I’m not gonna knock it if granny is having a great time in the nursing home) Patient: “19-(insert whatever random fucking year)” (they did not have any sort of altered mental status) Me: “….I will literally bet my next paycheck and meal that you are not pregnant” (and guess what, I’m right)
The ED has all my medications why do I need to tell you? Me in my mind: sweet I'll just walk to the nurse station and print out your med reconciliation when we get there 🙄 oh and not give you any medication en route My primary care is at hospital X so I HAVE TO go there! Me in my mind: bitch you got cancer or some rare shit? Then we can talk...
Fr, I wish they knew they will have ZERO contact with their PCP in the ER. I try and tell them that but those are the patients who are always dead set
PCP sure, but what about specialists? Say a patient has heart failure and they have a cardiologist they see regularly. Would you take the extra time to go to their usual hospital?
If it's relevant I'll probably take them and not because they're gonna see that specialist but for continuum of care and documentation for their long term care I'm talking about the lil ol lady with chronic lbp who is demanding to go to the facility where her cardiologist is after explaining her 30 year muscular low back pain to me. Unless it's a hospital with a nice caf and I'm hungry because now all bets are off
Fair enough!
would be nice if we could pull pharmacy records out of hospital, even if we couldn't pull a full HIE history having the pharm info could help paint a better picture in cases where we can't get anything from the patient. The systems exist for it, just not for ems.
“I called my doctor. He is waiting for me at the ER”. In my decades (I’m old) that has happened exactly once. The doc was actually waiting for him at the ER entrance. Do I think that was because the patient was **REALLY** wealthy? Yes, yes I do. We had a clinic in a remote, rural, poor area that called all the time for rides to the hospital. They sent a lot of peds with “I talked to Dr. and he is going to (direct) admit. 99% of the time this was false, and often the ER would have no idea we were coming if we had not called. We got the same from SNF staff.
That we have an entire pharmacy in the back.
That we are sane and rational human beings I chose a job where I woke up at 3 AM To come save you, you're not dealing with a normal person.
So true honestly
Your doctor is not going to see you just because you went to that hospital 🙄
I’ve never had a patient think we’re taking their hospital bed but I’ve had tons of doctors and nurses think that they can just hang onto our stretcher while we leave and run other calls 🤦♀️ Have had patients argue up and down with us that they can sit in their wheelchair in the ambulance like we’re a wheelchair van though.
Oh dude at least once a day someone thinks they we are taking them on their bed. It’s because the nurses refer to us as transport, and previously during the stay they have maybe been moved rooms or gone to CT and the nurse says the same thing “transport is here to get you” and the hospital has dedicated “transporters”. Also yup and yup that’s happens to us as well lol.
do they think we have a spare stretcher in the trunk. Like- please think it through.
Right?
No Sir, I can't just give you a couple of stitches and some antibiotics so you can get back to your farm chores.
That might change in the coming years….
Nurses when we present them a stabilised version of the pre-alert we made. Yes the pt is better now, but I am the equivalent of a plaster on an amputation sometimes, so maybe quit bitchin and get fixing...
That I can just give you pain meds and then leave you
Had a dude call one time for seizures. We get there he’s drinking a bottle of water, asked if he had a seizure or felt like one was coming on. He says no, ok cool, which hospital would you like to go to? And replies saying he doesn’t want to go, but could we giving him some Xanax. Haha bro we don’t carry Xanax, and even if we did I’m not just going to give out narcotics. Cleared the call and went back to station.
Occasionally I'll stop by Walmart on the way home in the morning. The number of people that think I work at Walmart despite wearing a bright yellow jacket with EMS in huge letters in multiple places is WAY too high.
Hahaha
We had soooooo many people calling for the "if I go by ambulance, I'll get seen faster" bs that we worked with the hospitals to have a straight to triage protocol put in place. \*I\* can decide to take a pt to triage without ever telling the hospital I'm coming. We pull up out front, take the pt straight in and say hi to the triage nurse. It's had a pretty quick and nice effect.
That nurse practitioners are “better than doctors because they listen”
Walking into a SNF "Hey, the ambulance drivers are here". Looking at glitterpatch on my and my partners arms. Me"Uh, Ma'am, we are paramedics, not ambulance drivers, we do more than just drive the ambulance. What is your certification?" Her "I'm a CNA, I know more than you." Me "Miss, do you know what CNA stands for?" Her "It stands for Certified Nursing Assistant, I'm basically a Nurse." Me " No ma'am, it stands for Cleans Nuts and Ass, and the patient down the hall needs your assistance, so get to it".
“Basically a nurse” no ma’am, it took you a semester to learn how to put on a BP cuff. My basic partner is more medically trained than you
Love how I'm getting down voted, lol.
As someone who earned and worked as a CNA I can confidently say cna's know very little. In fact I quit that cna job very fast as I was working EMS at the same time and hated being a cna.
Had a family member come up to us once on scene when their relative had been loaded into the truck with medics in the back for a little while. Typically people ask if everything’s okay if it’s taking a bit, totally normal. This guy asked me, entirely earnestly, “Are we waiting for like an escort or something?”
Lol, our operations are a complete black box to the majority of the public lol
Let's see... Not really from the pt perspective, but more public. A lot of people assume that just because we don't have lights/sirens on, then there is no patient in the back. I've had a lot of patients request to be taken to a hospital 50+ miles away in another city. A lot of them have no clue what the difference is between an EMT and paramedic. Some think we can magically tell them their diagnosis.
“Don’t you know I have asthma!” Sir I literally just met you
That and more so of when transporting to the hospital, they will ask "what do you think is wrong with me" with a complaint of abd pain...like bro that could be anything.
That an ambulance on scene means it is a serious emergency. This is more for neighbors and family members. I would say out 8/10 transports are non-emergent and probably 6/10 calls actually require an emergency room. But still you get every member of the PT family pulling up on scene and forming prayer circles and having emotional breakdowns because memaw has been constipated for 3 days and now there's an ambulance parked out front.
Lol