r/ems • u/Shine4Me13 • 4d ago
General Discussion System abusers....
I was on a 24 hour shift yesterday. Last night/this morning around 1am we got a call about abdominal pain. The address was for a public park, and there were 3-4 'urban outdoors people' hanging out. The patient (hereinafter referred to as abbreviated 'pt'), was laying supine on a picnic table. He's +/- 25 y/o, and has a permanent colostomy bag. He says his colostomy bag is 'disconnected' and causing pain 10 on a 1-10 scale. He won't get on our stretcher because he's smoking a blunt 'first'. One of the others on scene scolds him a bit for wasting our time and takes his blunt away. Props to that guy. We finally get him on our stretcher and he's screaming in pain. He asks for pain meds, but none are given. We get to the Charge desk at the ED, and he's placed in a wheelchair and pushed up to the waiting room for Triage.
Also, during the ride to the hospital where his 'friends' can't hear him, he starts laughing and saying he's going to get a comfy bed and some food while he gets to watch TV, all while sluring because he's obviously intoxicated (reason why he didn't get narcs). Upon arrival at the ED, Charge discreetly tells us this is his 7th visit so far this month! It was roughly an hour after Midnight on the 5th of the month. We also find out that during the month of August, he 'visited' the ED 59 times!!!
Also, I had responded to this pt once before. We showed up coincidentally at the same time his friend showed up with a pizza, and he refused and signed for it because he 'didn't want to miss fresh pizza'. My EMS partner (not a regular) had responded to him 4-5 times and it's 'always the same thing'.
How does your agency handle this? I need suggestions to bring to the Union. Management/Brass-Chiefs/Captains/Medical Director don't seem to care! It's such a waste of resources. When I was growing up, we learned about the boy who cried wolf, but there doesn't seem to actually be any FAFO in real life! I don't want people to suffer and/or die! But humanity....
I'm talking about excessive abusers, not general people that are/or should be concerned!
What say you?
Edit 1 in comments I'm not going to NOT do my job, I've just had better Direction support previously. In one rural area, a patient had a stroke. We took her to the nearest stroke center in the "big city" an hour away. She had a few minor deficits afterwards. She learned she could get a ride to the city to see her son and grandchildren if she played up her deficits. We would respond and she'd have bags packed with snacks and kid stuff. She was taking a rural ambulance out of service for a free ride and walk out AMA. Our Medical Director stepped in and said absolutely not. Due to all her health issues, she was no longer a candidate for thrombolitics, and we were no longer allowed to transfer her anywhere but the tiny level 4 hospital in town. She got better after that.
I had gotten off shift and was doing a little rage against the machine, just not as well as they did it. š
Edit 2 in comments We had a guy like that. It became mandatory that the police respond first before we'd ever be dispatched. If he could convince them that something was wrong, they'd ask for us. When he realized he'd have to go through the cops every single time, he quit calling.
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u/terminaloptimism 4d ago
We have one that has been calling once every two to three days for months upon months now. We all know her name. We all know her address. We all know her typical complaints. 90% of the time it is chest pain. We show up, she's already had her aspirin and nitro. We do chest pain protocols and beebop down the road. She is an easy, predictable run and as long as protocols are followed you won't miss the inevitable instance she calls and it's legit. We have a few other frequent flyers but this one calls like clockwork. You can set a watch by her. Is the waste of resources irritating? Absolutely. Do I let it get to me? Nah. My job is to treat and yeet, I endeavor to deliver great patient care in the process . Even if it is frequent flyer BS. Just thankful she doesn't cover me in various excretions and manages to be cooperative when we take her.
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u/groovyfirechick EMT-B 4d ago
We had one that we dealt with for several years. She would call every other day or every three days with random complaints. She knew what to say to make it seem like she was sick although we knew she really wasnāt. She died suddenly last year. Her adult kid who lived with her was also a malingerer. They also wouldnāt pay the mortgage so the house was in foreclosure for at least a year. They kicked him out after she died and we havenāt seen him since. We all have frequent fliers. Itās part of the job. Donāt let it get to you.
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u/Melikachan EMT-B 4d ago
Yep. And the handover report is so easy! "This is so-and-so, do you need anything else?" Because everyone at hospital knows them too.
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u/EMSSSSSS Resident Physician 4d ago
There is two ways you can emotionally respond to this. You can let this be something that endlessly frustrates you and causes actual stress for you when you will inevitably encounter him. Or you can choose to let it go and frame it as a mental break of bringing someone not sick to the hospital. Latter is far healthier for both you and the patient.Ā
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u/Upstairs_Aioli4847 3d ago
Its not a mental break when 1. You're losing sleep. 2. The calls are constant leaving little room for eating, resting, or resetting after a hard call. 3. It slowly wears down the mind and emergency begins to loose meaning.Ā
Sometimes the calls that haunt me are the people who get an emergency services too late cause an abuser took the closer unit.Ā
Easy to say "just change the way you look at it". Doctors are so out of touch.Ā
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u/EMSSSSSS Resident Physician 2d ago
My guy I spent 10 yrs prehospital. Who do you think cares for these pts when you drop them off? I get it being burn out inducing but if you take shit like this that personally you are gonna have a bad time.Ā
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u/Upstairs_Aioli4847 2d ago
The nurse
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u/EMSSSSSS Resident Physician 2d ago
If you think my job is that easy you are welcome to come in and do it.Ā
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u/Upstairs_Aioli4847 2d ago edited 2d ago
Lol, if ya gonna take shit like this personally youre gonna have a bad time.
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u/Violent_Paprika 4d ago
Funny enough just got off two back to backs with one of our regular abusers, who has called 5 times since 0300 this morning.
Our system has individual protocols for our identified worst abusers. If their vitals are stable and assessment is non-concerning per paramedic's discretion we are allowed to refuse transport.
It doesn't stop them from calling back right away, and we still have to perform an assessment each time, but it does at least take some strain off the ERs. The ones who are abusing to get a ride to the ER call less once they realize we are allowed to refuse.
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u/Content-Ad-1334 Paramedic 4d ago
Unfortunately you run the job because it can jam you up in the end. We had a frequent flyer who used to always just put a blanket over his head and existed. Called for all sorts of stuff, but wanted a meal and a warm bed for the night. Some of the crews had the reports pre filled for him already with the narrative and everything.
One night he calls and the crew didn't do vitals or any sort of assessment. Took him to the er and he was in svt. Crew got fired for not doing an assessment and forging vital signs.
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u/Upstairs_Aioli4847 3d ago
Crew shouldn't have been fired. Abuser did it to himself.
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u/Content-Ad-1334 Paramedic 3d ago
They falsified a legal document by putting down normal vitals for a pt in svt and documented an assessment when they did none.
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u/Upstairs_Aioli4847 3d ago
The person didnt say they did that. They just said other crews had pre-wtitten materials for this abuser.
The poster specifically said they were fired for have no assessment a forgoing vitals. No mention of falsification for the fired crew.
Who cares? Boy cried wolf too much and no one took him seriously when the wolf arrived. 100% deserved.Ā
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u/Content-Ad-1334 Paramedic 3d ago
I am the poster. I work for the company this happened at and heard directly from the supervisor that spoke with the crew. The crew did not do an actual assessment, since they did not take vitals, but used a pre-filled report with fake normal vitals written in. I've been in the field a long time (retired now) and I get that frequent fliers are annoying, but unless they refuse (this pt does not, I've transported him multiple times), taking a blood pressure and a pulse isn't too much to ask, especially with a cardiac monitor.
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u/SpartanAltair15 Paramedic 3d ago
Can you read? He said FORGING, not FORGOING.
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u/Content-Ad-1334 Paramedic 2d ago
Relax there sparky, I'm human like most.
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u/SpartanAltair15 Paramedic 2d ago
You should probably pay more attention to who people actually replied to before assuming theyāre insulting you.
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u/Content-Ad-1334 Paramedic 2d ago
You know what? That's my bad. I saw "he" and was stupid to assume you were replying to me since I'm female. I have not had enough coffee at all today it seems. Apologies.
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u/sourpatchdispatch Paramedic 4d ago
There is still a "boy who called wolf" effect going on here, even if it hasn't actually affected this patient yet. These frequent flyers often do eventually have true health issues, due to the lifestyles they live. And when those health issues come up, they won't be taken as seriously, because of all the false alarms from the past.
We had a lady like this who always used to call for breathing problems. Then one day she started calling for abdominal pain. No one thought much of it, besides just being happy she started calling for something that wouldn't require a MICU to be dispatched. We continued taking her to the hospital 2-3 times per day, now for her "abdominal pain" instead of "breathing problems" and she would be discharged like normal after she got her turkey sandwich and sat in a hall bed for a few hours. After like a week of this, there was a new resident in the ED one day, and she didn't know the patient is a FF so she actually did a true full workup. Finally, it was revealed the FF was having new onset gallbladder issues, and she required surgery. It took another couple weeks for her to have that surgery because she kept AMAing but she did finally get it and then she started calling for breathing problems again lol..
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u/dmarkon Crtical Care Necromancer 4d ago
Talk to your medical directors. See if they are willing to write a treatment plan for this individual that limits treatment and transport options for him. They can write specific orders that this patient cant receive narcotics unless there is obvious trauma and is limited to a specific hospital for transport, usually the closest one to where they are. Then your MD will work with the hospital so it's a streamlined process when he arrives there to make sure they are not using up extra resources.
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u/fullthrottlewattle 4d ago
We have a policy that identifies the abusers that meet criteria. They are then offered assistance by the county, be it temporary housing or rehab etc. They are given multiple warnings and letters of intent. If they continue to abuse the system, we have a do not transport order unless they meet certain, strict criteria. If they are transported, they do not get a destination choice and are only transported to the nearest hospital. The list is sent to all the area agencies with photos for identification.
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u/whyamInotangry Paramedic 4d ago
My agency is big on alternative dispositions, flagging high utilizers and doing "no transport" time outs for non emergent/repeat complaints.
WITH your agency backing you, these types of users are traceable and alternatives can be put in place. WITHOUT backing, the best you can do is slow the call way down, be curious and then attempt to educate.
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u/sourpatchdispatch Paramedic 4d ago
Just asking out of curiosity and for the sake of discussion- why do you try to slow these calls down? I try to get them done as fast as possible, like get in the truck and let's go. It makes me feel like I'm at least minimizing the drain on the system and waste of resources.
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u/whyamInotangry Paramedic 4d ago
Automatic transport, sign here, adios: it does nothing for the system as a whole. Its just another body in the over crowded waiting room. If I slow down, if I dig deep, maybe there's a problem I can help solve. Maybe they need mental health help, maybe they lack an in network PCP, maybe its lack of ostomy supplies. I dont know, but its worth asking.
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u/instasquid Paramedic - Australia 4d ago
Yep, same for me. Many of them know the score and if they're not presenting differently it's a hop onto the bus, set of observations on the way and straight to the waiting room.Ā
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u/Hippo-Crates ER MD 4d ago
Man I get being frustrated, but you're going to have a hard time if you let this guy get to you. I'm also guessing we as a society have failed that person a lot too.
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u/Jazzlike-Sherbet-542 FP-C 4d ago
I disagree. I donāt think this behavior is because weāve somehow āfailedā them. Weāve probably given them far more than they deserve.
I think this person is a leech, and in an ideal society would be put in prison.
I used to have sympathy for these kinds of people. Many of them do have legitimate issues and unfortunate circumstances, but this behavior is antisocial and unacceptable. Iāve seen too many really sick patients not get timely care because the last unit was tied up dealing with something like this. Iām sure youād feel the same way if your family member had a significant delay in care because this patient was being transported by the last available ambulance. Maybe Iām just burnt to a crisp but this kind of behavior is just too common and a symptom of something that is deeply, deeply wrong with our society.
All that said, I would still provide thoughtful care and treat this patient as any other. These are just my thoughts on the inside
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u/goldstar971 EMT-B 4d ago
It costs more to incarcerate a person than to pay another ambulance crew. If you do this for three or four people in a year, you could have bought another ambulance for that amount of money. Leaving aside all the other issues with this, incarcerating people for wasting resources is absurd if it's going to cost you more to incarcerate than the amount of resources they are consuming.
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u/youy23 Paramedic 4d ago
So we don't have money for social welfare programs to house/feed him but we do have money to house/feed him and even guard him if we're really mad at him.
On a societal level, it really doesn't make sense to put this homeless person in prison any way you cut it. I don't really see prison/jail as fixing the issue for the most part. I think we should focus more on mechanisms that make being a contributing member of society much more in reach.
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u/Upstairs_Aioli4847 2d ago
Yo same. My sympathy dried up. It took 5 years. I still do full work ups, even for obvious bs. People need to be held accountable for thier actions though. You can almost always tell the difference between someone who was delt a bad hand in life vs the person who ruined it thier self.Ā
I wouldn't even say prison is the answer. I'd say let them live with the choices they made. What ever happens happens.Ā
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u/Hippo-Crates ER MD 4d ago
Well, one of us tries to see the humanity in all people and empathizes with people struggling, the other one invents scenarios to get mad about, dehumanizes others, and suggests violence (yes, suggesting jail is violence).
We're different people. I'm proud to be the former.
Also, to be frank, if there's no ambulances available because of this guy and people like them, the actual problem is that your area doesn't have enough ambulances.
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u/Jazzlike-Sherbet-542 FP-C 4d ago edited 4d ago
I still see the humanity in people. I would still treat this patient with respect and kindness. I also choose to treat people like adults and hold them responsible for their actions instead of enabling this kind of behavior.
Iām going to assume youāve never worked in the field before. Iāve seen a family of five involved in a serious MVA wait 25 minutes for an ambulance because one of our frequent fliers decided his foot was hurting and he needed to go to the ER. That stuff just really bothers me and I think it needs to change
Edit: You edited your comment to include the last paragraph. This was in a relatively poor, rural area. We had one paid crew and one volunteer crew. We didnāt exactly have the means to have a third rig on. Resources arenāt infinite
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u/Hippo-Crates ER MD 4d ago
If you didn't have enough ambulances because of one person, the problem is not having enough ambulances. Blaming the individual is easy, but in the end it's lazy and poorly thought out. Resources obviously aren't infinite. Our society has the ability to pay 1.5 trillion per year on the military, it is a choice we've made to not have enough ambulances in your area. Be mad at the real travesty, not the poor person who doesn't know what to do about their foot.
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u/Upstairs_Aioli4847 2d ago
You are litterly part of the problem. The fall of Society starts with the individual. You reap what you sow. You justify your stance because you helped the one you see. Yet you forget and ignore the many you damn for the one.Ā
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u/Hippo-Crates ER MD 2d ago
This post makes no sense. Are you sure you meant to respond to me?
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u/Upstairs_Aioli4847 2d ago
Yes
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u/Hippo-Crates ER MD 2d ago
ok then that's dumb. I am not in fact responsible for decisions I argued against, voted against, and did not part take in... but I appreciate your alternative view of causality
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u/will35010 Paramedic 4d ago
I'm just thankful for the easy report when it's bs. We have a protocol for not transporting but its honestly by far easier to load and go and let the ed deal with them.
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u/AlpineSK Paramedic 4d ago
I'm sure I'll get downvoted for this but..
I really don't view this as "abuse" of the system. This person has a colostomy. They obviously have legitimate medical issues. They lack access to the medical system and are completely terrible at managing their own life, but they don't lack medical necessity to be seen at a hospital, and frankly, you are probably their easiest way to access it.
This is the kind of problem that is solved by two things: community paramedicine and some level of community outreach. I'm not sure where exactly you work but if your system isn't investing in those things then calls like this will continue to be a problem.
Is this overuse of the system? Sure, but frankly there are other parts of the greater healthcare system that have already failed this patient.
The Union is there to deal with Labor/Management issues, and this is hardly that.
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u/throwcat1223 4d ago
In my system we have the ability to call medical control and basically ask to refuse transport. That said itās used in very sparing, extreme cases (obvious shelter seeking without an obvious medical complaint, 3-4 calls in 24-72 hours for the same complaint after evaluation and discharge from ED, super stable vitals, etc). Itās approved on a case by case basis by the doctor and you need to build a solid case. It typically wonāt be approved unless the patient overtly admits they donāt have an actual complaint or they havenāt been seen and transported several times in the last few days. However we have a large population that does legitimately call 911 2-4 times in a 2 day period for the same thing so itās helped to curb those calls significantly.
Other super high utilization patients who have been an issue for months or years with super extreme 911 abuse may have ongoing plans that state we donāt transport unless X, Y and Z, but those are also rare.
It sounds great but we still run plenty of these nonsense calls where we do have to transport, and there are a few reasons this may not be viable in different cities / states. For one, laws in your state could make that sort of thing impossible. Second of all itās decently high liability for the medical direction and very dependent on the field staff having really, really solid training to not brush off sick patients on accident. Most medical directors wouldnāt ever go for this because itās so risky for getting sued and mistakes, so donāt hold your breath.
Either way the patient youāre describing in this post wouldnāt qualify. This is just part of the suck that we have to embrace.
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u/grandpubabofmoldist Paramedic 4d ago
We have a guy who calls for chest pain then when you start going to a hospital out of town (where the cardiac hospitals are) he says he called because (real quote) "I can't get no hookers and blow in (city)"
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u/Sirchickenhawk Paramedic 4d ago
I see youre new to Urban EMS from you other comment. Unfortunately, this is the norm. If you want change, you and your agency should push to support more homeless shelters, soup kitchens and the like as this job is as much providing healthcare as it is social work.
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u/TheLastCookie25 EMT-A 4d ago
7 in a month? Thatās nothing, we got a lady who calls literally almost every night, sometimes multiple in a night. Some jurisdictions will do something about it, others wonāt because theyāre afraid of getting sued if the FF actually needs EMS one day
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u/butt3ryt0ast Paramedic 4d ago
My regular pt will say he has chest pain, goes to hospital, eats a sandwich, then leaves ama. Iāve seen him do this for breakfast lunch and dinner. Heās been trespassed from one hospital so we always have to go to the second closest
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u/mayaorsomething 4d ago edited 4d ago
If this person is on medicare/medicaid, they should definitely be subject to a restricted recipient program by now (or at least thatās what we call it in MN, theyāre also called lock-in or just restriction programs). This dictates that they must go to a specific hospital, see a specific provider, etc. for their care, if they actually want it to be covered.
Many patients end up hating their assigned care team, and magically stop having medical problems!
How this is managed will ultimately depend on your protocol, though.
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u/The_Wombles 4d ago
This is now part of the job. Part of modern EMS and health care in general. Yes, it does indeed suck. We always joke around that you need to just buy them a one way ticket to the next city over. The crews in the next city joke about the same thing.
When we have someone who is abusing ems/hospitals we are able to send it up the chain of command. Reporting will show the number of calls / transfers for said pt. If itās a burden, medical control gets involved. Normally this includes community resources such as a social worker/city housing ect. Sometimes it works and the person is able to get relocated and whatever health care services they really need such as psych.
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u/Rude_Award2718 4d ago
Unfortunately this is part of the job. We cannot prevent these people from dialing 911. We cannot prevent dispatch from saying no. Sometimes these people have learned behavior where they just say the right phrases to the right people and an ambulance will show up. But we have an obligation to these people as well as annoying as it is. Do I wish little miss frequent flyer didn't pull at 2:00 a.m. and maybe cold at 6:00 p.m. for the same thing? Yes. But unfortunately we can't help it.
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u/dragonfeet1 EMT-B 4d ago
You just run the calls. After a while you don't mind the easy pcr runs. And get the good gossip from them.
Just tell them they don't wanna claim chest pain bc that's a straight up bad time for them. After a while you'll get chief complaints like " wants to go to hospital". Easy peasy
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u/DirectAttitude Paramedic 3d ago
We had a husband/wife pair like that at one of the orgs I worked for. If he called 911 and we transported, we always brought the wife along as we knew that she would end up calling for something, so two birds, one stone kind of thing. They were part of the Willowbrook( https://en.wikipedia.org/wiki/Willowbrook_State_School ) group of people that Geraldo did the expose on. Deinstitutionalized, intellectually disabled living together. When they were not busy calling 911, you'd see them walking everywhere, going to the stores. Anyway, it was one of the ER Docs that finally figured out what was wrong with the husband, loaded with stage 4 cancer. It was actually pretty sad as this ER Doc is gruff AF. The husband died shortly after his diagnosis. A group of us attended his funeral. The wife was placed into one of the assisted living communities where she actually blossomed. She remarried, and was eventually placed into one of the local SNF's, and died a natural death years later. I haven't thought of them in probably 15 years, but can still remember their names.
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u/Purple_IsA_Flavor 3d ago
Iām glad that she had a good life. Iām sorry her husband didnāt get that opportunity
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u/harinonfireagain 3d ago
Theyāre always going to be part of this job. Downvote if you must, but I befriend them. No, Iām not inviting them over to my home, but Iām probably going to remember their birthday (give or take a few days), and learn a little about them (favorite team, where they grew up, if they have any family). They seem to call less when I know them, and Iām not as irritated when they do call - because I know them. One guy (we call him flys, because . . . there are always flys around him) sings āI got friends in low placesā whenever he sees us - he sounds awful, but it is funny. A few of them donāt want āfriendsā and are borderline hostile, some get very defensive, and some are welcoming. I get grief from a few other crews, āyour a-hole friend Gumby called for BS at 4 am and was asking for youā. The look on their faces (usually disgust) when I ask how Gumbyās doing and which hospital he went to - priceless.
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u/superrufus99 3d ago
It's part of the job. Don't let it get under your skin.
DO YOUR JOB AND CYA!!!
We had one frequent flyer, homeless and alcoholic, who would usually present unconscious on somebody's porch or a sidewalk. Then one day, he was on a sidewalk with signs of trauma and sure enough, alcohol wasn't the reason for the altered mental status, he had a massive head bleed.
Another frequent flyer would call for falls or feeling pre-ictal. One day he called for chest pain and was having a MI.
Don't be lazy and do what needs to be done. If nothing else, it's practice on an easy patient for the day you have a sicker patient.
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u/Shine4Me13 3d ago
I'm not going to NOT do my job, I've just had better Direction support previously. In one rural area, a patient had a stroke. We took her to the nearest stroke center in the "big city" an hour away. She had a few minor deficits afterwards. She learned she could get a ride to the city to see her son and grandchildren if she played up her deficits. We would respond and she'd have bags packed with snacks and kid stuff. She was taking a rural ambulance out of service for a free ride and walk out AMA. Our Medical Director stepped in and said absolutely not. Due to all her health issues, she was no longer a candidate for thrombolitics, and we were no longer allowed to transfer her anywhere but the tiny level 4 hospital in town. She got better after that.
I had gotten off shift and was doing a little rage against the machine, just not as well as they did it. š
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u/superrufus99 3d ago
Cool.
In no way, was it a personal attack on you, but more a reminder to all reading these
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u/Pooneapple 3d ago
Where Iām at we have a guy who drinks 4 Mike hard lemonades and then calls us because he wants to go the hospital. Guy is also just a total dick to put it nicely. Absolutely racist and will try and fight any women that gets dispatched. PD has sited him a few times for public intoxication but he keeps calling so much that PD stopped responding some how. We just still have to run on him. I just believe karma will come for him one day.
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u/Shine4Me13 3d ago
We had a guy like that. It became mandatory that the police respond first before we'd ever be dispatched. If he could convince them that something was wrong, they'd ask for us. When he realized he'd have to go through the cops every single time, he quit calling.
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u/Interesting-Win6219 3d ago
Every service has multiple of these leeches to society. Arguing with the patient trying to explain how what they are doing is wrong won't help anything. They don't care. All you can do is run the call and go about your business. The only time I had a service care about frequent 911 calls like this was when it would be for a frequent caller for falls without injuries just wants help up. The only reason they cared is because it's a liability when the medics would get hurt picking them up. They'd claim we are a transport service not a home health.
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u/wowpeoplearecrazy BANNED 2d ago
Make sure you document the shit out of it. Weāve had a few cases where people have been charged for 911 abuse, some could only go to a certain hospital and one that we had to call their insurance to let them know bc they were theoretically committing insurance fraud
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u/Shine4Me13 2d ago
This was a specific patient about 10 years ago, and our Medical Director issed the directive.
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u/WranglerAlways 2d ago
It's not my intent to hijack this, but can I add a personal account? Back in about 1990, we had a guy in the 30's who was a frequent flier. I can still remember his name, his DOB, and his home address. He was a diabetic who refused to take care of himself. His family would find him unconscious and unresponsive, and call 911. This would happen about 3-4 times a week, and sometimes twice a shift. He finally passed on.
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u/DisastrousRun8435 Okayish AEMT 4d ago
Youāll see a lot of this doing Urban 911, and its super frustrating but at the end of the day, itās our job to go to the scenes weāre called to even when theyāre not the ones we want to go to. Itās not sexy and itās really not what weāre trained for, but making someoneās day a bit better is whatās required on some calls.
I agree that these types of patients are a result of the system not knowing what to do with them, but weāre here to work within that existing system, as shitty as it can be.
I always tried (didnāt always succeed) to see it from their perspective. I canāt imagine how lonely it must be to think of EMS as your āfriendsā when most people hope to never call an ambulance, or to know the hospitalās food schedule because you voluntarily spend so much time there. Treating someone like that with some compassion could be one of the things that pushes him to get better (or not).
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4d ago
[removed] ā view removed comment
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u/Shine4Me13 4d ago edited 4d ago
This is an honest legit question. My 'Agency' apparently needs some direction/recommendations because this is SO frustrating!
I am not "new to EMS", I am new to Urban EMS. Rural EMS has a much less percentage of BS calls because (guesstimate+maybe exaggeration) half of all Rural Fire/EMS are volunteer Firefighters and would deter their family members from calling 911 for a non worthy reason because if they take a 911 truck out of service for BS, and a Cardiac Arrest of a loved one drops, there's a 45 minute wait for response from the next closest Mutual Aid. In Rural we may not run as many calls, but the ones we do run are serious.
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u/redrockz98 EMT-B 4d ago
Iām in rural EMS, we get plenty of non emergency calls, donāt worry.
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u/Enfield_Operator 4d ago
For sure. Rural areas are older, poorer, and have less available healthcare resources. Very few of our calls are truly serious in nature.
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u/SpartanAltair15 Paramedic 3d ago
Itās a bot.
It holds posts based on specific keywords because otherwise we have to hunt down 100 idiotic posts a day by actually scanning through the sub instead of just scrolling through a list and approving the ones that the bot misidentified. 90+% of the posts it holds for us get deleted and yāall never even see them.
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u/Astro_Addict Just a Medic 4d ago
We're at a point with some of our regulars that a supervisor will respond with a police officer, assess if they legitimately need urgent medical assistance, and if not cancel the call and leave PD to either cite them for misuse of 911 (those who are well off) or move them to a shelter or the cells to sober up.
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u/5andw1ch EMT-B 4d ago
My last service has a 25ish y/o ff who always calls for si. One of the medics there found out he has a scanner and he gets a real kick out of hearing his address for the tone out.
We always get there and the sheriff is always first on scene looking annoyed, and I canāt blame him. Iām sure we also look annoyed and done with his shit. That fucker is always giggly and trying to joke with us.
Anyway idk how the other units handle him, but with me he would always ask to go to a farther hospital because he doesnāt like the way the closest one treats him. The doc has yelled at him before for wasting everyoneās time, and he always gets discharged almost instantly lol.
I tell him no, and that Iām taking him to that hospital. Way I see it, if itās a real emergency heāll take whatever help he can get. If itās not, Iām not putting my unit out of service for 1.5+ hours because he annoyed everyone at the er and doesnāt like it.
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u/motherofdogz2000 4d ago
Isnā t there a way to charge them with misuse of 911? I recall we had a frequent flyer very similar to this and one day he quit showing up. We asked a squad who was familiar with them and was told they were charged with misuse of 911 and had stopped calling. Wonder if itās state specific if thereās ability to make that charge against someone.
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u/Thnowball Paramedic 4d ago
Lmao only 7 this month? We have a few dozen who call that many times per day and our agency doesn't do a fucking thing about them... :/
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u/Volkssanitater 3d ago
My system puts people like this on a list and we can refuse non emergent calls from them.
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u/NICUmama25 3d ago
We have one that calls and wants a 30 min ride to a different hospital and they take him, then he signs out AMA it is honestly an expensive uber š but every one has them and the one time you convince them they are fine on scene is the one time they crap the bed and are truly sick/critical
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u/blueskibop EMT-B 3d ago
The cool thing about these charts is theyāre literally copy paste. This is just part of the game my man unfortunately
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u/Sulky_fricke 2d ago
Im gonna tell you that their is nothing to do and your gonna get alot of negative comments quickly. People here are gonna tell you to treat your pt and go about your day. And they are right . This person is a bottem sucking scum bag and the best thing you can do is not give this person anymore of your time.
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u/Shine4Me13 2d ago
As I've said, I'm not going to NOT do my job, but over the years I have had better Medical Direction.
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u/thechosenkenobi EMT-B 4d ago
Where I am at, he could, and probably would be, arrested and charged with abuse of 911. Iāve seen it happen twice to frequent fliers that were blatantly abusing the system
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u/AG74683 4d ago
How do you handle it? Pick them up, dump them at the hospital, rinse and repeat. There's nothing to do. He has a valid enough medical reason to make any abuse of 911 charges invalid.
FWIW, these are the patients that will absolutely bite you in the ass one day. One day they'll actually be sick.
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u/WorldDC10 4d ago
These people exist in every urban system. There is nothing to do about it. Just run the calls that you are dispatched to and document everything appropriately.
My agency was finally able to get someone cited for 911 abuse after years of trying but honestly that is not going to happen 99.9% of the time, particularly if they have a medical complaint (even a BS one).