Tuesday, September 22

Losing Independence

Not a political post, I assure you. This is about a section of the population that needs to come to terms with their limited abilities. And to remind PAs that I am in charge of patient care at a scene.


Caller states there has been a car accident and one person appears shaken up.


Shaken up. OK. Out the doors and a few blocks down we see a large SUV into a light pole, newspaper machines and trash cans in the sidewalk, 2 parking meters down for the count and a little old lady seated behind the wheel of a little hatchback behind the SUV.

Blink. Blink.

The SUV was empty and parked, our little friend is alert and oriented, sitting behind the wheel, clearly upset at what has happened. I think she would likely get out of the car and be fine if it weren't for the half dozen samaritans encouraging her to go and get "checked out."

I introduce myself to the group and they all start to tell the story, each pointing different directions and saying different things. Quickly, I duck down and make contact, she is not injured and has no complaints. She describes not having parallel parked in years, let alone on a hill like this, and hit the gas a little to hard backing up (she points over her shoulder to the uphill parking meter). Then she gunned the gas a little too much instead of letting the car roll forward. (She points forward towards the mess down the hill). When she realized what was happening, she tried to hit the brakes, but her foot was still on the gas. She pushed that SUV right up off the street and onto what is usually a crowded sidewalk.

As I completed my assessment and she blushingly refuses an ambulance, a man approaches to ask me if she had a TIA.
"I don't think it appropriate to discuss her condition with strangers, do you know this man?" I asked her seeing her shaking her head.
"I'm a PA," he advises, removing his sun glasses, "Are you OK Dear?" He asked her as if talking to a three year old.
"Sir, I have this scene under control, and she has a name if you'd care to ask." Was my smart ass response that got his attention off of her and onto me, as planned.

"You guys sure have a lot of attitude," he observed looking me up and down, perhaps looking for my Registry Certificate, State and County Licenses, 48 hours of continuing education, Bachelor's Degree, instructor's certificate and years of assessments. I keep them in my other pants.

"I would have her checked out if I was you." And away he went, placing his sunglasses back on as if nothing was wrong.

"Who was that man?" my client asked looking up at me from the seat of the car, holding her insurance information and license.
It was then that all the BS around that man faded away and I saw what was going to happen to my friend. There is no way her insurance rates will stay affordable, likely resulting in her losing the car. The freedom she has known for close to 70 years of driving will be gone. Then she'll have to walk to the market, that is until her knees give out. Then she'll be stuck at home. And the PA so concerned for 80 seconds will never stop by to lend a hand.


TOTWTYTR said...

I really hate helpful bystanders, because they are usually anything but helpful.

I've had people claiming to be doctors or nurses interfere with calls many times over the years. At best, I'll give them a polite brush off, if they're really obnoxious, I'll have them talk to the nice police officer. For some reason, they never seem to want to hang around to do that.

Capt. Schmoe said...

Usually the statement "are you willing to assume responsibility and liability for this patient, including riding with the patient in the ambulance to the hospital?" is a deal breaker for most proctologists,
podiatrists urologists and psychiatrists. I imagine that it might work on PAs too.

True EMS professionals quickly assess if there is a need for their services, do what is necessary and move on as quickly as possible. Usually without identifying themselves too specifically.

My guess is the PA never got the memo.

Anonymous said...

We carry physician release forms in our clipboards. When you ask them to sign and assume responsibility (including treatment and transport) they back right down. If you really have a big one, the question we ask is "are you and E/R Physician?". If they say no, we ask them to hold stabilization, if they say yes, and we need it, we accept their help, but not advice.
On the other hand some of our local GP's will stop asd ask if we need a hand when we are working a big accident. We always say thanks, but we've got it under control. They wave, say "be safe" and roll on down the road. It is nice of them to ask, and respect our answer.
Capt. Tom

klynfire19 said...

I had a call recently where we arrived on scene and a man who announced himself to be an ER doc from some hospital I'd never heard of proceeded to storm past me and tell my male partner what had happened and what treatment the patient should receive. My partner looked at him, said "she's the paramedic, I'm just driving".

Ralph said...

A local college football game. A safety has a leg just hammered by his own teammate. Yep, it`s broken. Obviously painful tib-fib. Per local protocol the BLS standby unit called for an ALS car. The pt was assessed, splinted and removed from the field. An "I`m a DOCTOR" wearing the visiting team`s logo on his shirt screams!! "Why are you NOT throwing him in the truck, turning on the damned sirens and taking him to the hospital!?!?!?!" I politely explained the why`s and how`s of this young man`s treatment and closed the rig`s door to give the young man crying in pain, a little privacy. The "doctor" opens the rig`s door, hops in and starts taking the splint OFF!! My "DOCTOR, what do you think you are doing!" He replies, "havn`t you heard of compartment syndrome you idiot?!?!" I was like, OK, this how we`re going to play, eh? "Doc, the injury is 5 minutes old, we are GOING to follow local protocol and manage this man`s pain THEN transport. Are you a lisenced physician in(this state?) or YOU prepared to take over medical control of this patient? If so, get in and SIGN HERE! If not, get out of our rig" He was appauled that someone, let alone an EMT talk to him that way. "Make sure the ER doctor calls me as soon as this player GETS to his ER!" Oh, I will make sure of it jughead. Our medical control doc happened to be working in the ER that day. I would have LOVED to be the mouse on the other end of THAT phone call. Our MedControl doc stands behind us 100%. BUT, you better be treating acording to his protocols. That said.....why would this so called "doctor" want the pt`s pain NOT managed before moving him? DEMAND lights and sirens for a non life threat injury? Go back to school "doctor" Maybe take a PHTLS class......

MotorCop said...

And now an opinion from the other side...

I sure as hell hope the investigating officer filled out an emergency retest for DMV for your patient. If you confuse the f'n brake and the f'n gas...time for your license to go bye bye.