Tuesday, November 22, 2011

Why family can sometimes be really helpful

Often times EMS providers can find family more of a hinderance than a help. Sometimes I will tell family members if they can find a medication list or a bag for the patient, in part because it is helpful but more often than not it is so I can talk to the patient without interruption or fear of outside influences.

Now, there are times when having the family around is absolutely essential.

We get dispatched for an altered level of consciousness at the local incredibly frustrating apartment complex (its a nightmare to get anything other than a stair-chair in and out of) and find a worried family with an elderly man lying on the back bed.

First impressions for me where that he was very ill (medically speaking) or that he may have had a stroke. Then the family pipes up. "He fell down a full flight of stairs to the basement and a neighbor brought him back up. He normally is not like this."

Hello red flag! He fell down a flight of stairs?! And he was moved?! Now this is no fault of the family themselves, they were not present during the fall, but one of my biggest pet peeves is possible head/neck injuires that decide moving is a brilliant idea (more on rugby players at a later date).

A quick assessment gets me very little response from the patient, something about chocolate was all that was audible. His vital signs are stable but I do not like the fact that he is so out of it. The ALS that is on the way is not getting canceled at this point.

I get my partners to hold C-spine and go grab the backboard. I start asking the family more questions (including that drug list!) as we start to get him ready to for transport. Beyond his current state, he sounds pretty healthy. The wail of sirens lets me know that ALS is here and I start mentally prepping for the report as the family tells me this lovely detail: "He is typically more lucid than you or I." Red Flag! Red Flag!

I do a quick hand-off to the medic and am getting quizzical looks as to why my partners are now trying to get a C-collar on this poor man. The medic even tries to shoe them away and not call it a trauma, as if I am crazy and don't know my own BLS protocols.

I may be less experienced than you but I do know this, when family says that this is vastly off his normal mental status AND that he fell, I am NOT letting you take off that collar. After a quick re-emphasizing of those two points (especially how off this is for him from his families standpoint), the medic gets it and agrees with me on the board and collar.

We of course help ALS carry him down the stairs (they may not be my favorite medics from that station but I am not one to let personal taste get in the way of professional care) and he is off to the local trauma hospital.

Even when you are out ranked and have less experience, when the family is rattled by his lack of mental awareness, or rather the sudden drop in it, you list to the family hands down. If it were not for them, I would not have been nearly as persistent as I was with the medic. If it were not for the family, I am not sure anyone would have realized he may have been a head trauma until it was too late.

Sometimes, family is your saving grace on a call.

No comments:

Post a Comment