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Call Review, feeling bad…


Timmy

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Had a 65yo male present with Epistaxis that had been running on and off for 12 hours (overnight). Pt had hx of cardiac + hypertension, had taken his Benzodiazepine and cardiac meds as prescribed. Pt looked pale BP: 160/95, GCS 15, everything else was reasonably normal. Wife stated that pt had been making a gurgling noise throughout the night. Pt was the head of catering at a 3 day event. I call the ambulance, IC paramedics rock up, they were quiet abusive and hostile towards me for calling them and wasting their time, made me look like a moron in front of the family. Pt had refused to go to hospital or see a doctor so I called the ambulance mainly to cover myself and to be sure that he received proper care as he would have continued to work in extremely hot heat. After quiet a lengthy and heated debate between myself, the medics, the patient and his family we all finally agreed to disagree to go to hospital. The pt returned to event next day after having gauze packs and meds review.

My question is did I make the right decision about calling the paramedics, they’ve kick up quiet a stick about it and I’m kinda feeling bad… :(

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Timmy IMHO yes you did the right thing. Epistaxis for long duration or with a history of hypertension is a good indicator of an underlying issue that needs to be checked, not to mention the fact that the bleeding while the patient is sleeping presents a risk of aspiration.

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Yes timmy you did the right thing mate, just think when your a medic down the track about how much better you will get along with people having been on the recieveing end of this BS :?

I can tell you a few stories where ambo's have done this, one of them when i asked if i could have a replacement cc0collar, took it off the patient and gave it back, then put another collar on the patient :!:

Dumbasses! Good dose of civility for their over inflated sense of self imprtance would go along way, or a smack on the jaw

Its nice to know that this doesn't just happen in NSW :(

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They made themselves look like morons. You did exactly what you should have done. Now you can look back on this, after you have become a medic, and continue to treat your peers with the utmost respect, because you know better:) Good job, and don't forget to hold your head up a bit higher for knowing you did the right thing!

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well hold on there, were you working on a BLS ambulance? It sound's like you were maybe doing some sort of first aid station at the event? If you were doing a non-ambulance standyby, than sure you did good in calling for ems to cover yourself. If you were on a bls unit, I'd think it was a bit unnecessary since he did'nt have any imminent/signs of cardiac issues that would require ALS. That's what I gathered from the information anyhow. :wink:

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Thanks for that guys, appreciate it.

Yes I was working as a first aider… We don’t have BLS Ambulances here it’s either ALS or IC so I guess the IC guys just got the short straw, I most certainly didn’t request MICA.

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Timmy if things went down as you say they did then complaining about it on an US website is not going to help. Regardless of if the medics or you were right about the patient requiring transport the behaviour you described is cause alone to complain to the ambulance service the medics were from about their behaviour. I can assure you that all complaints are investigated and followed through. One thing that concerns me is the heated debate that you described as occurring in front of the patient. If you had any part in this then you are also guilty of unprofessional behaviour as there is never any excuse for this. This may go against you in any investigation as you will be portrayed as the instigator of said behaviour. Please don't think that I am putting you down for being a patient advocate but there are many ways of handling conflict besides arguing on front of a patient. You are young and have not had a lot of time to develop these skills yet so don't feel too bad :( What I am offering you here is guidance not criticism so don't take it personally. If it was me I would complain, we all need an attitude adjustment from time to time (god knows I have).

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Timmy,

I think the frogs here need an attitude realignment.

The pt has a Hx of Cardiac Illness, I would guess he is on aspirin or similar, so he is going to bleed. Having said that, if it has bled for that long, I would be doping everything possible to look @ why & Tx to hospital.

He was probably more Hypertensive with the stresses of the event.

Dont feel bad Timmy, I think u got a couple of Paramedics with the preverbial carrot in their bums. U did the right thing

Phil

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