101 Things the Fire Department wishes you knew



Friday, February 6

...for the sick eval...

Just like being intoxicated, somewhere along the line having the flu became an emergency worthy of a call to the ambulance. It seems folks have forgotten that each year little tiny organisms wander the earth, making us sick (to expel the foreign organism). I'd have to say 95% of my "sick eval" patients fall into two categories:
"I need antibiotics"
and
"It can't be the flu, I got a flu shot"
The other 5% fall into both categories. This drives me so nuts, I can't even give this category of patient a medic unit icon for the post. Just can't do it.

I will walk you through the standard call.

THE EMERGENCY
Never really is. Its often a point, late at night or early in the morning, a person "gives up" on trying to help themselves and calls 911 because they are sick.

THE ACTION
He or she will be in bed, buried in blankets, eyes red and overplaying symptoms. They'll be writhing around under the blankets, refusing to allow us to take an assessment, asking that we just take them in already.

He'll mention something about a report on the local news about an outbreak of something serious like e-coli and infer, never claim, they may be infected.
When asked what medicine they have been taking, they'll say, "none" or tylenol, but never a cough supressant, expectorant or anything else useful.
When asked what they want to do they'll give an almost roll of the eyes and say they need a doctor to give them antibiotics.
When folks self prescribe, I enjoy testing their medical knowledge.
"So you think this is a viral infection?"
"Oh yes, it's horrible!"
"Good, antibiotics don't work on viruses, so you can go to the store, get some medicine and feel better by morning."

Or they'll try the flu shot line.
"It's not the flu, I got a flu shot."
"Well, good for you. Bad news is the flu shot is only a mixture of what the drug company thinks the next flu might be and they haven't gotten it right yet."
"Well, its not the flu. Can't be."
"Well if you won't listen to reason and do the responsible thing, I guess we're going to the hospital. I need your billing information before we go."

If only I could make these folks see the err in their ways. They rely on us, not for our opinion, but for our no cash up front service.

I long for the days when we can charge a "non-emergency" premium to people who abuse the service. Abuse is the wrong word there...misuse is better, but abused is how I feel taking $150,000 of equipment and two Paramedics to someone who refuses to help themselves and demands we literally wipe their nose for them.

FLU does not equal EMERGENCY. There, someone finally put it in writing. Now if only they'd put it in the evening news, I'd be all set.

1 comment:

medicblog999 said...

I'm with you on this one too mate!
I've always thought it would be good to have a system where anyone can phone 999 for anything. We would turn up, if our wonderful NHS pathways deems it appropriate to send an ambulance. We would take the patient to hospital ( or just point blank refuse). If once at hospital, the doctors decide that it was a problem that could easily have been handled by their GP or isn't need medical attention at all then the bill will come in (£100 should be enough deterent).
Charging up front would only put off the genuine old dears who will sit at home having an MI because they don't want to bother anyone.