Chest pain at an urgent-care facility. A female in her 40s, according to the dispatch notes. For all we know, this could be a 93 year old male with a bunion. Silly call takers.
This time, they got it right.
“She is 43,” the physician on staff informs us. “Her chest has been hurting since 11 o’clock last night, and she needs to go to the emergency room. Her EKG is abnormal” he goes on, as he hands me a 12-lead.
It’s a sinus rhythm in the 70s with not a thing wrong. I couldn’t draw one better with a ruler and 6 hours of practice. But it says “Abnormal EKG” at the top.
I guess ‘reading EKGs’ is the same as ‘reading the words at the top of the EKG’ to some people.
“Hi, I’m C from the ambulance, how are you doing today?” I ask the very matronly, middle-eastern appearing woman in the room. I notice she is fully clothed, and wonder how an accurate EKG was obtained through a sweater, long sleeve shirt, and bra.
I suppose she could have gotten dressed after disrobing, but I doubt it.
“I’m fine, I guess. What are you guys doing here?” She looks genuinely puzzled.
“Well, the doctor called us and thinks you should go to the emergency room because your chest hurts.”
“I threw up 5 times last night and it made my throat burn. Where did he get chest pain? I don’t want to go to the hospital.”
The doctor walks in the room; “Yes ma’am, these nice ambulance people are going to take you to the hospital to make sure everything is alright.”
“But I don’t want to go to the hospital!” she retorts.
“I really think it is in your best interest” the doctor replies as he walks out of the room.
She acquiesces to the suggestion, but seems hesitant. I’m not too concerned just yet.
“Let’s move you into the ambulance, and get a few things done, and just go from there.”
After loading her in the ambulance, and several uncomfortable moments while she undresses from the waist up, with her modesty maintained, of course, her EKG still looks better than mine. Try and try, I can’t find anything wrong with it. Her vital signs are more than fantastic. Excellent, actually.
We determine that she vomited several times during the night after eating sushi and having drinks with her friends. Her throat and nostrils were burning, but her pain was gone now. Drinking milk or cold liquids seemed to help the situation. Then she says the magic words:
“I don’t want to go to the hospital.”
We do the whole rigmarole with the refusal paperwork, and she signs the form, saying she will go to the hospital if she ever needs to, but will never come back to this place.
I don’t blame her.
She gets dressed again, and steps out of the ambulance, walks to her car, then drives off. After we rearrange the ambulance and put the equipment back, I step out of the side door, to be met by the same doctor from inside with a very disapproving look on his face.
“Just what do you think you are doing?”
“Getting in the ambulance, and going in service” I reply. “The patient didn’t want to go to the hospital.”
“She has to go, I’m the doctor, and that’s why I called the ambulance.”
“Maybe if you had explained to her that you wanted to go to the hospital by ambulance, she could have told you she didn’t want to go, and you wouldn’t have wasted her time.”
Paramedics-1 Urgent Care-0