Patients Define Their Emergencies (Part 2)

True Story…

The dispatch information was updated before we had even rolled our rig out onto the pad. Eye injury, no serious symptoms. Jodie shut down the lights and I informed dispatch that we’d be responding non-emergent.

Up stairs and inside the small two bedroom apartment, Samantha, our patient, was waiting on the couch, holding a hot compress to her swollen right eyelid. Mom worked calmly in the kitchen finishing diner for her other two children. Alan, Samantha’s father sat on the edge of his seat next to his daughter in a state of barely containable anxiety.

He had recently arrived home from work and his wife had informed him of the apparent infection in Samantha’s right eye. One look and he was on the phone to us. Now he breathed rapidly as he fumbled through a list of questions. What caused it? Could it damage her vision? Could she lose her eye? Could she go blind?

I cleared the engine to go back in service and sat down next to him. Over the next ten minutes we both explained what pink-eye was and how to take care of it. We talked about hot-compresses and how contagious the bacteria was going to be. We reviewed the typical course for such and infection. How to prevent it in the other kids. How likely it was that one of them already had it. And we discussed his plan for morning. (It involved asking a neighbor to drive them to a near-by clinic.)

Alan called 911 for pink-eye. And…(This part is bound to be controversial, depending on what kind of system you work in.) I never offered to take him to the emergency room. And he never asked.

Read This Entire Literary Masterpiece…

Do not stand at my grave and weep;

I am not there. I do not sleep.

I am a thousand winds that blow.

I am the diamond glints on snow.

I am the sunlight on ripened grain.

I am the gentle autumn rain.

When you awaken in the morning’s hush

I am the swift uplifting rush

Of quiet birds in circled flight.

I am the soft stars that shine at night.

Do not stand at my grave and cry;

I am not there. I did not die.

                     – Mary Elizabeth Frye

_

Just Call 911 – A Novel Idea

Now here’s a novel idea. I wish I was being sarcastic but I’m not. Personally I think someone should have tried this a long time ago. In Minnesota, the local dispatch center ha decided to tell people to just call 911 any time they think they need a police man, a fireman or an ambulance. They’ve dropped the whole idea of asking people to only call for emergencies and to find a non-emergent number somewhere if they have a non-emergent need.

Apparently they started routing all the calls into the same center some time ago and now they’ve just decided to screen the calls themselves. I suspect they were doing that already. If a caller called on the non-emergent line with chest pain I suspect they got routed over to the emergent side. If a called needed non-emergent service, I suspect they received them even if they called the emergency line.

So now, instead of investing countless dollars in ineffective public education programs and getting upset when people still call on the wrong line, this center is going to stop swimming upstream and just tell folks, “hey, call us and well figure it out.” You might even say they’re going to let the patient define the emergency. Revolutionary.

This runs counter to everything we’ve been trying to do with 911 dispatch for over 20 years and I commend Minnesota for being bold enough to try it. Way to think for yourselves guys.

Steve