When we ask, please tell us

[crazylegs]

I'm three months into my two year paramedic training and during that training we undertake placement shifts on ambulances. [/back story]

On a recent shift we get called to a male with chest pain - prior MI several years ago.

We get there and start asking the questions, including the 'any prior medical conditions/surgery ect' , to which the gentleman replies 'no' (he was lucid, pain score 1-2/10 so no source of confusion) which is the same reply we get to 'do you take any medications?'

So we load him onto the truck and get him onto the bed at which point we here a knock on the door - one of his relatives opens the door and hands us 'his medicines'.

Another knock on the door and another relative hands us his prior discharge notes including his stent and a number of other procedures.

Ladies & gents - please tell us everything, we're trying not to do anything with drug interactions that'll end up causing you (in some cases) massive harm.

[NateTheChops]

With the exception of my one visit to the hospital this past year, I honestly forget anything major that has happened to me medically. I actually have to call my mother to verify some stuff, especially if a medical history is required.

Not saying that's an excuse. I do have a hard copy of all of my hospital visits and the various write ups done by any doctors or nurses involved at the time.

[kpzra]

Get used to it, people don't tell you jack most of the time. Then you get the ones who have a huge file and and a tackle box of meds. Sometimes they just forget, but I've had some tell me they are embarrassed about an ambulance taking them to the ER. I used to tell them it would be worse if they didn't tell us about their history and end up in the morgue.

Wait until you get a hart pt who takes Viagra, those are fun when they won't tell you WHAT they took, you have to kinda guess.

[Dytchdoctir]

This is why you document - in detail and at length.

I've worked with so many people over the years who don't document adequately. I tell them, this is why attorneys don't often call me to the stand, because they run screaming when they read my explicit and detailed WRITTEN documentation.

Many people are so used to living with their (diabetes, congestive heart failure, asthma, etc.) that they will in all honesty say they have no medical history, because their medical condition has become normal for them.

On the other hand, many people engage in a paradoxical little behavior meme I call, "trying to suit the story to the perceived audience". We often joke that the paramedics get one story from the patient, the nursing staff get another, the attending physician gets yet another. The person who gets the story that is the closet to the actual truth, is the housekeeping worker who gossips with the patient while mopping the floor.

Many times, I've been made to look like a boob by patients. I have several times asked, "are you having chest pain?" and am told "no." On arrival at the emergency room, the MD asks, "are you having chest pain?" and the answer is now "yes". I can only guess that the patient feels that I do not have a "need to know" about their personal medical details, and they should save that tidbit for the doctor's ears only. Sheesh!

[Seshat]

I've worked with so many people over the years who don't document adequately. I tell them, this is why attorneys don't often call me to the stand, because they run screaming when they read my explicit and detailed WRITTEN documentation.

Note to self:

Make up three pages of medical info, one for each of us. Keep up to date, attach to the back of the front door.

(There's no way known to man we'd remember every detail for all three of us, in an emergency situation. Oh, we'd get the major stuff - but I, for example, have about sixteen distinct conditions.)

[trailerparkmedic]

one of his relatives opens the door and hands us 'his medicines'.

My absolute favorite patients are the ones who bring their meds with them. I have no problem sorting through their giant ziplock bag if it means I get accurate medications doses. My least favorite ones are the ones who say "I take a white pill and a blue pill for my heart." What's wrong with your heart? "Oh, I don't know. I just take the pills."

I'm going to have fun in the ER.

[raudf]

Note to self:

Make up three pages of medical info, one for each of us. Keep up to date, attach to the back of the front door.

(There's no way known to man we'd remember every detail for all three of us, in an emergency situation. Oh, we'd get the major stuff - but I, for example, have about sixteen distinct conditions.)

Don't attach it to the back of the door. Put it in a binder with your name on it and put all information inside the binder. I included insurance info, blood type, allergies, list of meds (types/doses/condition requiring them,) medical conditions past and present. We've affectionately nicknamed ours the Footballs, because in an emergency, you grab 'em and run. Just gotta remember where you put them... I've told my parents where mine are.

Nothing worse than having to take an older relative to the ER, only to freeze up on the simple things. Like, you might call her Aunt Sis, but her actual name is Caroline. Plus, is it shellfish or peanuts she's allergic to?

[dragon_wings]

Like, you might call her Aunt Sis, but her actual name is Caroline. Plus, is it shellfish or peanuts she's allergic to?

QFT. My sister too has a laundry list of mental conditions. And she also has a binder (or 2) with all her medical history, medications, etc.

[jedimaster91]

Many times, I've been made to look like a boob by patients. I have several times asked, "are you having chest pain?" and am told "no." On arrival at the emergency room, the MD asks, "are you having chest pain?" and the answer is now "yes". I can only guess that the patient feels that I do not have a "need to know" about their personal medical details, and they should save that tidbit for the doctor's ears only. Sheesh!

I had something like that happen to me when I was a student and I will never forget it. Guy came in for a bone scan and when I took his history I asked him if he'd broken any bones or had a recent fall. The answer he gave me for both questions was "no."

Well, his ribs were lighting up on the scan with hotspots right in a row. Normally when hot spots are lined up like that, it more indicative of injury (like maybe a seatbelt from a car wreck) than a metastatic disease. So I asked him again if he was sure he hadn't been in any car wrecks or fallen. He again told me no. So I went and got one of the techs to look at the images.

Tech: Sir, did you fall recently or have a car wreck?
Patient: Well, about two weeks ago, I fell off my ladder....
Me: I swear <tech>, I asked him that several times and he told me no.


Patients. What're ya gonna do with 'em?

[kpzra]

Patients. What're ya gonna do with 'em?

Use a larger gauge needle

A list of meds and medical history is nice but keep it somewhere it is visible, I remember one pt that had theirs taped on a mirror right by the door. We saw it as soon as we walked in. When you right out a list of meds, don't forget to list any OTC meds, vitamins, or herbal supplements.

[dalesys]

Use a larger gauge needle

If it was sized proportionately some patients could walk down the bore...

[Mishi]

I need to sit down with Nan and make up a medical folder with her, including a certified copy of the enduring power of attorney and a witnessed/certified list of her preferred medical treatment. Its hard to explain to her that it's one thing for her to tell us what she wants, and quite another to explain why Rugz asked for no heroic measures and DNR when he's the main beneficiary listed in her will (Her kids will contest it so Rugz is covering his ass). The other thing that's hard to get through to her is that she MUST tell the doctor everything! Telling them about an allergy to iodine isn't being annoying, neither is telling them that the morphine is making you feel fuzzy, sleepy and breathless but not doing anything for the pain. I love her dearly, but they can't help her if she's too shy and I can't speak for her as I'm only her granddaughter-in-law and do not hold power of attorney. Thankfully she has a current list of medications and the matching conditions stored with her current meds.

[Seshat]

I want to make a 'grab and go' kit that includes not just the medical info, but stuff like mortgage paperwork and certified copies of ID documents.

I guess a 'grab and go' kit like that with the medical folder brilliantly and clearly marked would do the job.

(Perhaps red, with white crosses blazoned on it, and the relevant names prominently marked.)

[kpzra]

Please, please, PLEASE have a certified copy of a DNR readily available if there is one. There is nothing worse than having to work a code when one is in place, but no one can produce it. One family member was taken away in cuffs for assault when we were just trying to do our job. No paperwork, we have to go all out.

[raudf]

Please, please, PLEASE have a certified copy of a DNR readily available if there is one. There is nothing worse than having to work a code when one is in place, but no one can produce it. One family member was taken away in cuffs for assault when we were just trying to do our job. No paperwork, we have to go all out.

In My MIL's we had the POA and the DNR copies in it. Plus all contact information for relatives and friends. Saved us hours the one time we had to take her in for altered mental status. She was horribly mean the entire time, refusing to tell anyone anything, threatening suicide, murder and bodily harm on all and sundry. I just quietly handed the folder over to the admissions person. And the nurse. The looks on their faces.. My hubby apologized to everyone who came into contact with the old cuss. Needless to say, she was admitted and spent a week in the dementia ward.

*sigh* The nurses in the ER and then the ward said it was the Alzheimer's, but my hubby's aunt (MIL's sister) says that the illness was only an excuse to be a horrible EW, because she was that way her entire life.

And I lost an aunt on my mom's side because her husband refused to tell the ER crew the entire truth about what was going on. They were both drug addicts. She died from a rupture in the intestine went incredibly septic and.. well, drug complications didn't help. So... yeah.