Double-ALS-night-shift-overtime. Half good, half bad. I don’t know why I agreed to work a night shift.
It’s going easy enough until around 3 in the morning. Diabetic call at the local premortuary sepsis factory decubitus plant nursing home. Easy enough, right? Throw some dextrose up in there and be done with it, right?
Wrong.
The staff says he must go to the hospital to be evaluated because the doctor says so. To complicate matters, we can’t get a line on this guy, who I swear, must have served in the first World War, and he has a long history of dementia, so who is to say what his normal mental status is, anyway?
Fine. No biggie. Stab him with a bit of Glucagon, move him to the stretcher, and drive him to the hospital. No big deal, right?
Wrong.
It’s my turn to drive. It’s going just fine. I’m listening to George Noory talk about aliens over the Pacific Northwest. It’s an easy drive over two lane roads dappled with houses. When all of a sudden…
“Hey, C, light it up, okay?”
“Dowhatnow?”
“Turn on the lights and sirens.”
“Huh?”
“Let’s go emergency!”
“Why?”
“His mental status isn’t improving.”
Taking a glance at my watch and doing some quick calculations, I realize ten minutes isn’t necessarily enough for Glucagon to work, and this guy has dementia anyway.
“Umm, you want me to get back there and ride this call?” I ask.
“No, I’ve got it. We should just get there faster.”
“I have faith in you. And the next three traffic lights won’t hold us up too much.”
—–
I’ll stop the story here, because the conversation became fraught with animosity. Suffice it to say, I don’t believe in traveling emergency to the hospital, except in extreme circumstances. I won’t judge someone who chooses to use the lights and sirens during some calls, but during a hypoglycemic episode, when there hasn’t been enough time to allow the drug to work, and the vitals are better than mine? No way does that warrant lights and sirens.
Especially not at three in the morning.
Let’s not trick ourselves into thinking we are heroes by running people off the road to get to the hospital.
Maybe services could review the calls in which the medic decided to utilize lights and sirens during transport. I bet there is some interesting information out there.
“Maybe services could review the calls in which the medic decided to utilize lights and sirens during transport.” You must mean the calls where they DOCUMENTED utilizing lights and sirens >.>
Out of curiosity, as a man who’s used some Glucagon in your day (notice I didn’t say crusty old fart), how long do you usually expect until you see clinical improvement? I’d thought it was a pretty quick drug.
I’m not crusty yet, Brandon. I’ve seen glucagon work in as little as 5 minutes, and as much as 15-20. I think it’s hit or miss, really. Probably depending on the stores already present and the blood glucose level. Maybe depending on whether or not I have tied my shoes yet when I administer it.
Our dispatchers are notified by a tiny gnome each time one of our units activates their lights OR siren, and if on a call, that info is put into the notes. Not when we use the air horn when we see hot chicks, but when we actually turn on the “wail” mode. We also have a camera that begins recording the inside and outside of the vehicle when it is using lights and sirens, much like police officers.
Ah, neat. From the perspective of the folks on the road, where do the cameras fall on the useful vs obnoxious spectrum?
People don’t talk about it much, really. I don’t think it’s obnoxious at all. The whole thing is a pretty small setup, and not intrusive at all.
I am very mindful of what I say in the ambulance at all times, and my partner and I will frequently get out when at post if we want to have conversations…
You would love seeing what the do in NYC. Can’t tell you how many times I’ve seen a BLS ambulance race into the ED lights and sirens, then have the driver get out, walk inside and get a wheelchair, and have the patient walk out of the back of the ambulance and sit in said chair. Also, when a BLS and ALS unit are both on a call, you will often see the second vehicle, with no patient and just the EMT driving, possibly with a family member of the patient, chase the first vhicle while going lights and sirens too. I’m not looking forward to the accident one of these vehicles gets into. It’s bad enough they require us to go to virtually every call with lights, there is no excuse for them doing it after they’ve determined a patient to be stable or have no patient at all.
They don’t really have enough units to let BLS trucks sit in traffic for half an hour plus.