[caption id="attachment_3579" align="alignleft" width="240" caption="Drunk Girl - Crossfirecw"]
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When people call 911 for an intoxicated person, which amazes me to begin with, I have to wonder why the badges start to bump into each other.
"Code 3 for the PD request" is a call classification I hate hearing because it means the call taker has not completed a triage of the call. There is a glitch (yes, I'll call it a glitch because if this is done purposely I need to fix it) that allows PD to bypass call triage and get an amulance immediately.
There is no reverse for this system. When I request PD code 3 I get barraged with questions. And when I'm fighting someone no less. When I get on scene to the PD request, they are most often standing, looking at someone. Not providing care (which they usually don't need to and are not trained to do), so why not take the time to classify their call too?
Who knows.
The reason this is fresh in my mind is because on a recent run with our boys in blue I was told "We're not arresting him, it's too much paper work and too expensive for the department to hold him until he sobers up."
I stood up and cocked my head aside.
I responded that our paperwork is just as burdensome and the cost was exponentially more to the same city for what he was requesting.
Drunk is not an emergency, nor is it necessarily an arrestable offense, so what do we do? If a person is unable to refuse transport (meaning unable to sign, not that they don't need an ambulance, which they don't) we're trapped in a way. We HAVE to take them and the ER HAS to accept them, meaning the actaul patient we bring in later has no room and has to be diverted. This is not an argument to have on scene. When on a run THAT patient is your concern, not the next one. Let me worry about the next one.
This is an opportunity for a third service to step in and handle intoxicated individuals. We do have "sobering centers" although I'd reclassify them as ambulance drop-in and pick-up zones with a 2 hour waiting period. We take people there in an ALS ambulance, then when they awake and vomit, the center calls us back code 3 for the "unconscious."
Public intoxication is more common in my area than sudden cardiac arrest, yet there is no tool in my kit or on my radio to help. The van service for shelter and detox requires a person to be ambulatory and climb in the van unassisted. Most folks that meet that metric wander away when they hear us coming.
So why not let them sleep it off in the holding cell at the local PD? I'm sure there's a person there to monitor them and it is remarkably less expensive than an ALS transport and hospitalization.
But that's not where they belong. That is not the right place for them.
But the hospital is the more inappropriate place for them. Why not check them out in the field, clear them of life threats (which the triage nurse will do from 100 yards) and let them sleep it off somewhere less expensive than an ER?
Motorcop? Trauma Pig?
Turfing them to me is easy for you, but not for us, nor for the citizen.
Fodder for a Crossover indeed!
[/caption]When people call 911 for an intoxicated person, which amazes me to begin with, I have to wonder why the badges start to bump into each other.
"Code 3 for the PD request" is a call classification I hate hearing because it means the call taker has not completed a triage of the call. There is a glitch (yes, I'll call it a glitch because if this is done purposely I need to fix it) that allows PD to bypass call triage and get an amulance immediately.
There is no reverse for this system. When I request PD code 3 I get barraged with questions. And when I'm fighting someone no less. When I get on scene to the PD request, they are most often standing, looking at someone. Not providing care (which they usually don't need to and are not trained to do), so why not take the time to classify their call too?
Who knows.
The reason this is fresh in my mind is because on a recent run with our boys in blue I was told "We're not arresting him, it's too much paper work and too expensive for the department to hold him until he sobers up."
I stood up and cocked my head aside.
I responded that our paperwork is just as burdensome and the cost was exponentially more to the same city for what he was requesting.
Drunk is not an emergency, nor is it necessarily an arrestable offense, so what do we do? If a person is unable to refuse transport (meaning unable to sign, not that they don't need an ambulance, which they don't) we're trapped in a way. We HAVE to take them and the ER HAS to accept them, meaning the actaul patient we bring in later has no room and has to be diverted. This is not an argument to have on scene. When on a run THAT patient is your concern, not the next one. Let me worry about the next one.
This is an opportunity for a third service to step in and handle intoxicated individuals. We do have "sobering centers" although I'd reclassify them as ambulance drop-in and pick-up zones with a 2 hour waiting period. We take people there in an ALS ambulance, then when they awake and vomit, the center calls us back code 3 for the "unconscious."
Public intoxication is more common in my area than sudden cardiac arrest, yet there is no tool in my kit or on my radio to help. The van service for shelter and detox requires a person to be ambulatory and climb in the van unassisted. Most folks that meet that metric wander away when they hear us coming.
So why not let them sleep it off in the holding cell at the local PD? I'm sure there's a person there to monitor them and it is remarkably less expensive than an ALS transport and hospitalization.
But that's not where they belong. That is not the right place for them.
But the hospital is the more inappropriate place for them. Why not check them out in the field, clear them of life threats (which the triage nurse will do from 100 yards) and let them sleep it off somewhere less expensive than an ER?
Motorcop? Trauma Pig?
Turfing them to me is easy for you, but not for us, nor for the citizen.
Fodder for a Crossover indeed!
Comments
We've been trying like hell to get that PD policy changed and it's getting there but we still have a ways to go.
Another part of this is that I , like you, find it amazing that people call 911 for an intoxicated person. Most of them, by far, don't need a hospital. And the few who do? Seems like people don't call for those.
It's a mess.
So, what happens? We get called. Unlike you, our bypass works both ways. The only question the cops are asked (by their dispatchers) is if the patient is conscious and breathing. Which is about all we expect and often more than we get from our own call takers.
Our only saving grace is that we send a much less expensive to operate BLS ambulance most of the time.
i miss "get out of my beat or i'll thump your skull."
Usually drunks are triaged by whomever arrives first in three categories:
1. walking and "alert": PD or cab to his flat
2. requires help walking: PD or Hospital, depending on how swamped is either, and how cooperative is the patient (and the medic or cop)
3. different levels of unconsciousness: Hospital
All drunks get a normal assessment so there won't be bad surprises.
Fortunately we don't need a physician for treat and release, although in difficult cases the emergency physician or primary care physician will be called to the scene for further assessment(or to turf responsibility).
A physician is also called in cases that have court potential, because to claim doctors confidentiality a doctor has to have been on scene.
Formally PD runs through the same questionaire at dispatch as does EMS with the police. In favor of good relations this requirement is often relaxed an when a crew request police backup or a cop an ambulance with lights and sirens they usually get it.