seizure in L.A. county

[RichEMT]

Today we were called to a psych facility to transfer a recently admitted pt. to the hospital to be evaluated for the cramps he was having that day. we could not get any medical much medical history from the pt. or the facility other than a Hx of alcohol abuse. pt's vitals were WNL except his skins were a little flushed, a little clammy and slightly elevated temp. he said he felt shaky and had severe abdominal cramping. pt. not on any meds, no med Hx, bla bla anyhow loaded and started to transport. about half way through transport patient started siezing i figured it was dt's so we lit it up and continued to hospital. only 5 minutes to hospital. i radioed dispatch to ley them know we upgraded and as i pilled into the hospital i got a cell call from the screaming supervisor saying we cant transport a witnessed siezure. the problem is we were allready en route am i supposed to pull over and call fire when the hospital was less than 5 away. im sure fire would love that what do u think. u guys have experience. everybody said i was in the right but she was mad lol

[medicgoddess]

One question...WHY can't you transport a witnessed seizure?

[RichEMT]

she says it protocol i asked her to show me she couldnt. i tried to find it, i have not seen it she was also throwing out goofy rules. for instance l.a. county says if we can make it to the hospital faster than a medic can get to us we can transport. but she said if we pass a fire station we can get in trouble. well not all stations have medics from what i was told, some are bls. anyhow do i just pull to the curb and call fire while the guy is rockin da bus haha thats freakin lame

[RichEMT]

i can understand calling for als if we were on scene when it happened. its just we were enroute thats what makes the difference here, as it was a short transport

[medicgoddess]

I would think that stopping would have delayed patient care due to the fact that fire would have had to be paged, load up, drive over, transfer care, etc... Kudos to you for thinking of the patient first!

[PSYCtest040]

Here in New York (MLREMS in paticuler)

1. ......if enroute and closer to the hospital than ALS we continue to the Hospital.

2. ......if enroute and more than 10 minutes from a hospital start ALS and continue to the hospital and meet enroute.

3. ......If on scene and ALS is more than 10 min out we load and meet in route.

[strwblue]

Ok.. Here is the thing.. As long as you are a certified Emergency Medical Technician and you are acting within your level of training to the best our your ability, you are doing the right thing.

In the above case you always have the option to call dispatch (no matter were you work) and request ALS back to MEET you some where between your location and the hospital. Any Paramedic worth his or her salt will load up onto your rig and begin treatment as your continue to the nearest appropriate emergency room.

As far as your supervisor is concerned, advise him or her that anyone can have a seizure at anytime for any one of a hundred reasons. Had the call taker done their job you would have had an idea that your patient was in the middle of detox and had get potenial for siezure activity.

If you are an emergency medical technician you are trained to handle siezure patients. (At least I was in my EMT class). Creating a protocol that say you can't transport actively siezing patients is stupid, what if there is no ALS unit avail? Do you just wait and hope the patient stops Siezing? What if the patient turns into a status epilepticus patient, do you wait until the patient is in respiratory arrest or cardiac arrest? I'm sure you supervisor will get the point.

Battle on.

[wvditchdoc]

Here's the thing, some Medics in some stations want to be glory hounds. What you did was correct no matter what state or region or what ever you were in. You continued supportive care and got the patient where they needed to be. I speak from many years in a rural EMS service and worked many days when I was the only medic in the county. The idea that your supervisor called and reamed you out for doing what was right for the patient makes me wonder what her idea of good patient care is. The only thing you may have done is advised your dispatch to go ahead and tone a medic. Once they figured out they were never gonna get there in time to do anything for the patient, they probably would (or at least should) have cancelled. Although I have seen some medics meet up with a BLS crew and have them stop on the access road to the facility to do ALS, which is completely asinine. So next time have dispatch officially tone for an BLS intercept and that way you have done everything in your power to provide "appropriate" care. That way no one will have anything to bitch about. :glasses2:

Keep up the good work and always err on the side of your patient, if you do that, you will never have trouble sleeping at night wondering if you did everything you could for them.

[CornholioMedic]

I'm thinking that, with a great deal of confidence that almost every state has laws regarding the delay of patient care. If you are in transport, why would you pull over because someone is having a seizure? I would have told that boss to blow me and charge him or her with delaying patient care. This is why ALS intercepts or ECHO units do NOT work in an Urban environment.....we tried it once and it sucked royally. The city wasted valuable resources and tax payer money on a program that department doomed from the start. Not to mention it put patients lives in jepordy as well as our personnel.

[RichEMT]

ya everybody says the supervisor was wrong. i was embarrassed when trained by her. crappy patient care/ attitude so i just look at the source. Plus her lack of experience. but thanks guys i just wanted your opinions. there is a ton of experience her i figured u guys would know. thnx