*Disclaimer: HIPAA prevents me from disclosing names and places. Ergo, this istory s merely a conglomeration of events and calls.....or is it? Names have been changed to protect the innocent and please the HIPAA gods*
It's 2300-ish at night and we have been called to a private residence for a female with what we are told is 'altered mental status'. That's a slightly alarming thing for us; it can mean anything from ETOH (alcohol) intoxication to drugs to a stroke to low blood suagr (hypoglycemia) and even an active or brewing UTI in elderly patients. We have to go figure out by process of elimination what's going on with our patient.
In this case, though, the cause was very apparent, as you'll see:
Me: Hello ma'am, I'm Dharma with EMS. What's going on this evening?
Patient: I'm feeling odd...woozy and sleepy.
Me:Ok...do you have any medical conditions I should know about?
Pt: No.
Me: Have you taken any medications, or are you allergic to anything?
Pt: Yeah. I've been having trouble sleeping, so I saw my doctor earlier today and he gave me some pills to help me sleep.
Me: And have you taken those pills this evening?
Pt: Yeah.
Me: How many, and when did you take them?
Pt: I only took one like I'm s'posed to, and I took it about half an hour ago.
Me: Ok...and now you're feeling sleepy?
Pt: Yeah. I want to go to the ER and get checked out.
Me: Ok, so... just so we're on the same page: you had a hard time sleeping, and your doctor gave you some Ambien. You took and Ambien and now you're feeling sleepy and woozy....
Pt, interrupting: Yes! Can we go now? I feel really tired and odd.
Me: You do know that that's what Ambien is supposed to do, yes? That it's designed to make you feel sleepy?
Pt: Yes, but I want to go get checked out, just to be sure.
Me: ........
Pt: I could be having a stroke! I don't want to die!
Other medic on scene, somewhat dejectedly: Get your coat and get in the back of the ambulance.....let's go.
You might laugh reading this, but this is the kind of stuff we get called to all the time. People who have earaches for half an hour, haven't taken any OTC stuff like tylenol or motrin and who call 911 for an emergency response. People who vomit once and call 911, but when we get there are eating Doritos and drinking Coke. People who watch 'House' or 'Grey's Anatomy' and who think they have the same exotic or rare disease and who HAVE to go by ambulance to the ER despite having a perfectly good vehicle sitting in their driveway. But, it's not my job to tell folks they don't need to be seen, it's my job to treat and stabilize to the best of my ability and transport. They're clearly concerned with their physical health (unless they're attention or drug seekers) so I try my best to put myself in their shoes and understand how they feel.
I sometimes wish I could tell them that they're incurring a $500 taxi ride by calling us, though.
Next time, I'll tell you about one of the calls that really did require EMS.....