If, in moving through your life, you find yourself lost...go back to the last place where you knew who you were, and what you were doing, and start from there. Bernice Johnson Reagon.

09 August 2012

Sometimes You Gotta Do What You Gotta Do


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Road Trip!
The agency I work for has a transport policy that states to the effect that we will transport a patient to the hospital of their choice within our county, as well as any county that borders ours, plus one that houses our regional burn center. It is a pretty large area. Sure, we have specialty destinations for trauma, STEMI, and stroke, but outside of those, as well as L&D capabilities, it is up to the patient.

And in the end…it is still actually up to the patient.

So what’s the big deal? A few days ago I responded to a call for a patient that was…well…sick. Not “fixin’ to die” kind of sick, but sick. Trouble breathing, overheated I think, and just looked and felt like crap.

Seems that the patient wanted to go to a hospital that we did not go to. And they were pretty adamant about it. I pointed out that it was 60 minutes or so away, that we did not transport patients there, and she would be better served by the hospital that was less than a mile-and-a-half away.

Nothing doing.

Now this was one of those patients that I just did not feel comfortable leaving. So I pulled out all of my tricks about potential consequences in the delay in care, her impending potential mortality, etc.

Still adamant.

So... I "phoned a friend" and called up the "Head Medical Director". I told him what was going on and what the patient wanted. I am sure he kind of foresaw a couple of things I thought about, not the least of which was that something might go 'south' on that long stretch of nowhere between where we were and where the patient wanted to go.

It's a long stretch with very spotty cell phone coverage, no stores and such along the highway (no houses for that matter- it is a controlled access road), and we would be out of touch of our digital radio system (the counties out that way are still on VHF and, well, I don't have a way to talk directly to them).

Now I am pretty confident in my abilities, but still, I admit I did have an image of something bad happening and having it plastered all over the local media.

So in the middle of all of this, the patient received a phone call (those pesky cell phones) and after talking with someone she asked "what about Little Hospital Not On The Other Side of Yonder?"

Well, it met our protocol criteria. But it was still 45 minutes away.

In the end, it came down to "what was best for the patient".

We went to LHNOTOSON.

It was good. I used to work there years ago. Saw some ED staff I had not seen in a while as well as a couple of EMSers I used to work with.

Plus apparently, it is the first time a unit from my agency has been to the ED.


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