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grumpy reluctant elderly man with heart problems


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**********************ALERT TO all the helpful people here at EMTCITY*******************************************

STOP HELPING THIS GUY or GIRL

STOP STOP STOP he's asking us to do his homework for him.

Ellominero, this is the 2nd scenario that I've seen where you have cut and pasted a scenario and asked us to do your homework. Buck up buttercup and be a man or a woman and do the freaking work and post it here for us to review and let you know what we think of it. That is the way to learn.

You are basically cheating.

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It's called Laziness Jaymazing, pure laziness.

By golly, I believe you're correct!

One of the most advanced cases I've ever seen in my career. The prognosis is grim...Unfortunately, the best treatment is still prevention.

Open and shut case, my good man :)

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  • 2 weeks later...

Regardless of the OP, I have a question for everyone who said they would immedietly intervene when the patient loses consciousness:

What are you going to do when the wife starts screaming "Get you hands off him! He said he didn't want any help!"

The patient clearely refused care when he was consciouss. If you had allready explained the risks of not being evaluated further and the possible causes, and he was in a sound state of mind...do you think that changes things?

Apparently he has some advance directives...should you inquire further about that before rendering advanced care?

The patient was told he needs a heart transplant...should you consider that he may have decided that he doens't want that to be done, and/or is not a candidate and has decided that he'll pass peacefully in his home?

The patient needs a heart transplant and refused care...should you be having a very direct and straightforward conversation with his wife about what you would be doing to the patient, and what care he would actually want?

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Uh the wife is the one who called even after he told her not to. There are no papers at all anywhere you can read.

There is nothing else you can do but go off implied consent once he goes unresponsive.

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Uh the wife is the one who called even after he told her not to. There are no papers at all anywhere you can read.

There is nothing else you can do but go off implied consent once he goes unresponsive.

And when the wife changes her mind? Or says she just wanted him checked out? It's a very realistic situation; what are you going to do when she says to get your hands off him?

There are no papers there; but there are some. Should you ask if she knows what is in them?

I guess what I'm getting at is that there is more than should go into this situaion that just a blanket "he can't talk so I'm gonna do what I want." The final outcome very well may be that you start providing all the care you can, but there is more that should go into making that decision.

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You need to go by your state laws. You can let him die, then what happens when she changes her mind then?

My laws tell me unless I have papers in hand, I have to do what I have to do. He is not in a state of mind to be making decisions now

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  • 3 weeks later...

Since I don't see any advanced directives, they don't exist (In NY you have to physically see them).

As someone said earlier, calmly convince the patient to let you check vitals, since he is actively in distress.

This is definitley something I would want to get medical control involved in. I only feel this way because the patient is AOx3 and is resisting transport, (unless he goes unresponsive)

For the sake of our EMT student, what did your instructor think of the answers that were given here? It was pointed out earlier to consider some of your own solutions then come here with them and let members advise you. I personally like to see that you put effort into it on your own.

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