Google Health

I've been a bit lapse in blogging of late, partly because it's been one of the few occasions when I could spend time with Laura (and it will be weeks before I can see her properly again, something that I'm not happy about), and partly I've just been completely overflowing with procrastination. Never mind – I'm looking to blog every day until the new year. Plus do 'other stuff'.

Now to ambulance things.

I love Google, I really do. It does a wonderful job and helps me out in nearly endless ways.

But.

It seems that more and more calls that I go to have a computer running in the background. These computers are often displaying a 'health information' webpage. While I think that having readily available information is a good thing, it is important to be able to interpret that information. It is not enough to read and understand the words that are shown on screen, it needs to be filtered through some form of expert knowledge, even if it is just the skill to use a bit of common sense.

Take for instance a job I went to recently. The patient is a fit and healthy 25 year old. He works on a building site and this involves plenty of heavy lifting. For the last two weeks he has had pain in his left arm. He'd already been to A&E because he was afraid that it was something serious. The hospital did plenty of medical tests, all of which came back normal.

So, why was he calling for an ambulance when the illness was so old? He'd looked on a web-site and it had mentioned that left arm pain can be caused by having a heart attack. He'd read this, then started to have a minor panic attack, as he continued reading it also told him that difficulty in breathing is also a symptom of a heart attack.

Now – most people would realise that, given his history, it would be very unlikely that he would be having a heart attack lasting two weeks. But this patient read the webpage uncritically and so convinced himself that the cause of his pain was cardiac in nature.

Obviously this was one of our high priority calls, so the FRU car was already there although we weren't too far behind. All I could really do for the patient was to reassure him, check his vital signs and symptoms, and then drive him to hospital so that he could be 'checked out'. He was a nice enough bloke and he accepted that some of his symptoms were caused by his fear, so for me it is an easy job and one that got me off shift on time.

I think that you need to develop an easy-going attitude to these sorts of calls, you can get very annoyed by these calls that seem like a waste of time. I just put it down to fear and lack of knowledge, not something a lot of people can do much about.

however with that lack of knowledge rather unfortunately often comes a lack of critical thinking about what turns up on an internet search. While Google can be helpful, it isn't the be all and end all, you still need people who can interpret it, after all 15 out of 26 diagnosis isn't that good a hit rate.

30 thoughts on “Google Health”

  1. Tom, I was thinking of the same news article as you! (with the same opinion)I suppose it depends on the user though. NHS direct wanted to send an ambulance for Mr Man when he had heart burn! Obviously we refused, but I'm sure some people would have accepted!

  2. I'm new to this, and to this site, so to start with, I just wanted to say how much fun I've had reading it! I'm an EMT of nearly 5 years, and after reading some of the entries, I noticed just how many people you take to hospital, who in my area would probably be left at home. I know it isn't right to particularly discourage people from calling ambulances, but a bit of 'educating' doesn't hurt. For a panic attack who's obs all come out ok, I would be reluctant to take them in. I'd obviously give them the option to go to hospital, and I'm by no means saying that I'm qualified to say there is nothing wrong, but I notice how many people you seem to transport to hospital, and I just wondered if it's that much of a common thing in LAS….especially with drunks etc!!I know it can border on dangerous ground, leaving someone at home, and I wouldn't do it if I had any doubt, but I honestly believe the more you take people in to hospital for 'check ups', the more they will think it's ok to call an ambulance for non-emergency conditions. These people generally have ways to get to hospital, and we are more often than not a glorified taxi service. It annoys me!!!!!

  3. My husband has Crohn's Disease and he will frequently get some different ache or pain and rush to Google to look it up. He invariably ends up convinced he's got a brain tumor, Lyme disease or some other evil thing that coincides with whatever symptom he was looking up. I spend the next week telling him he's crazy, that a CAT scan will not find dead clumps of brain when they run it (and they did – just like he had the Lyme panel done)…. So yeah, I'm right there with you on health matters and the Internet.

  4. Isn't it the same lack of success given by “old wives tales” though – basically, gullible well-meaning people who will listen to anything and everything, and then panic?I've found loads of useful info about a couple of long-term health conditions I have online though, so guess I'm prejudiced. And by the way, I knew the “left-arm pain/difficulty breathing thing” long before Google, I think it was mentioned on Dynasty or something… :o)

    A short caveat might be, for chronic/non-lifethreatening conditions the opinions and options online – and yes, even the anecdotal stuff – may be very valuable, used with discretion – for acute conditions (I'm not medical but I think a heart attack may just fall in that category LOL) then hospital guidance and the regular services are surely more appropriate.

  5. Oh, that reminds me of a line in Sex & The City – “you just type in your symptoms, and wait for the word 'cancer' to appear on the screen”…Still, the days when we had to stay ignorant so the Big Medico could display his wisdom were also dangerous, especially if you happened to be a post-menopausal patient of someone like Harold Shipman.

  6. I certainly know one or two hypochondriacs who could do with staying away from google!I seem to remember from my studies that the precise language people use to describe pain can be reasonably reliable way of working out what's wrong with them, so I guess that would account for google's hit rate. I suppose I'm a little surprised that things haven't moved on in six years to build some sort of application to allow doctors to use this to help them diagnose difficult cases and that they are using google rather than something that's been refined a bit for this purpose.

  7. I guess it depends on a person's mindset. Google just means the hypochondriacs can be better informed. Others might just end up reassured.A while ago I found a small lump in my armpit (I didn't have a cold or any other illness) and like any woman was aware it could be a 'problem'. Yes I saw my GP, who referred me to the breast clinic for a mammogram and ultrasound. But instead of being too worried I felt fairly reassured it wasn't likely to be anything 'sinister' as I had googled it and saw most people with the same problem had found it ended up being just a cyst.

    That's what mine turned out to be too, but in the days before I could see my GP and the weeks before the clinic appointment the Google info did save me a lot of anxiety.

  8. Of course I would never leave anyone at home if they didn't have anyone with them (the drunk that aspirates on his vomit), but the panic attack that has calmed down, has no further symptoms and calls for the attention? A lot of the patients we bundle in just want a lift to the hospital because they live in the manky area across the road. Or the cut finger? I will more often than not take a patient to hospital, because like I say, I'm no expert, and I certainly don't glorify my position like some in the service, but taking those time-wasters to hospital, who will just get pissed off with the waiting time and walk out anyway, just gets me. A prime example. A regular caller of ours calls with breathing difficulties or chest pain because she knows it will get her an ambulance quicker. And it does. Except when we roll up, she is outside smoking a fag asking if we can check her bloodpressure and do 'one of those ECG thingies'. She maintains she has breathing problems, but is quite able to inhale on that cigarette as if her life depends on it, or back pain which has been there for 6 months. I KNOW she is lying, she wants the attention. She has even told me that in the past….that she's lonely and knows we always come out. So it's my 5th back to back call, I haven't eaten or drunk anything in ages, but mainly I'm about to explode from not being allowed to go to the loo (personal safety!). So, yes, I do tend to try and explain to her that back pain for 6 months is not an emergency or an accident. However, I do also sometimes take her in. Mainly because I don't want to be mistaken. Then I get that look from A&E staff, who know as well as I do that she shouldn't be in there.I would never leave someone at home if I had any shadow of a doubt, and they always sign the form (unless they storm off!), and its generally their decision. I value my job (even though I moan about it) so would never do anything to jeopardise it. I was just interested in the differences in services. For example, another service turned up to an RTA of ours, with a fatal child on the back seat. They took the child next to him, and didn't even board him. Now that's ruddy lethal.

    You can rest assured that people will continue to call for ambulances for sore toes, and if they want to go, I take them. One example of a genuine patient who would still get left at home is a diabetic. If the patient has a reason for going hypo, and we have brought their levels back up sufficiently, and replaced the stores if glucagon has been used, we don't tend to take them to hospital. There is, of course, the GP if need be, and we have Emergency Care Practitioners who allow another level of care, with the ability to come out and assess, then to refer on to different wards. Mainly to avoid the continual back-up in A&E that seems to occur on a day to day basis. And no, nobody ever lost their job for taking someone to hospital, but the poor uncomplaining lady who is genuinely poorly, has to wait to get treated because beds are filled up with people who don't need to be there. People if they just saw their GP intead of calling an ambulance would be also treated quicker.

  9. “Blood, Sweat and Tea” makes a great double bill with “Hotel Babylon” and WHSmith at Euston are doing “buy one, get one half price” for both these great titles…. to wander madly off-topic for a minute here. :-(Both involve professionals trying to deal with a human race that imbibes, inserts, inseminates and just plain acts up in ways that no-one on Horizon, or Panorama, would mention. :o)

  10. I agree – you don't go online as a first source during an emergency, you get proper medical advice. But like everything, the internet can be useful for both acute and chronic conditions – but a little knowledge is a very dangerous thing, especially when combined with fear, panic or lack of common sense. Certain people are more prone to assuming the worst when it comes to their health and will self diagnose with every illness they find described (much akin to medical students, allegedly!) but in other cases it can be literally a lifesaver (or quality-of-life-saver). And there is the other side of the coin – doctors dismissing a patient's symptoms and diseases going undiagnosed (sadly, all too common). For those cases, getting some reassurance that your symptoms aren't necessarily psychosomatic is vital in getting the right treatment.Unfortunately, it can be very hard for people to judge how accurate, safe or honest the information is on websites – and especially with chronic conditions, people can be so desperate for some kind of hope or relief that they will swallow anything (literally and figuratively). That can be potentially lethal, considering some of the things suggested out there.

    However, like has been suggested, when you are at the mercy of the medical profession who perhaps can't offer you the kind of support you need for a chronic condition or who dismiss you out of hand, it can give you the support and advice you need to seek treatments rather than simply accepting that “doctor knows best” when they clearly don't. I'm not sure how you balance both sides.

  11. Good to know you've had some time with Laura and you've managed to stay away from blogging whilst you did so.I've found Google very good for providing sites that can explain more about the conditions I suffer from – and the main ones are now on my “favourites” list.

    I agree that it can cause problems when looking up symptoms – the NHS Direct site is guaranteed to make you believe you've something more serious than heartburn or a cold. Still, it gives hypocondriacs something to do in their spare time.

  12. Hello,On the other hand, a colleague of mine, 36, experienced chest pain at work, googled it, and took a massive dose of aspirin, which gave him enough time to then get to the hospital and receive treatment for his heart attack.

  13. This discussion brings to mind the first chapter of Three Men in a Boat by Jerome K Jerome. Google health may have made it easier for the lay community to get their hands on medical information to mis-interpret and mis-disagnose themselves with, but it certainly did not start the trend. I think it might just be a fact of human nature.

  14. The search for information is required when making a gp appointment is almost impossible. If I want a non urgent appointment its a two week wait, otherwise phone in the morning for same day. Unfortunately my children's school is 12 form entry, so its definitely easier to either use A&E, the walk-in centre or research on google! I know I am not alone as last time the A&E at the children's had plenty of gravel rash knees.

  15. If I were inclined to casual mockery of the NHS, I might say that 15 out of 26 is at least as good a “hit rate” as NHS Direct…I reckon google is fine for learning about some of the mystifying terms you might get in a letter from a doctor or hospital, and for finding out more about practicalities and support for people with Your Illness once you've got a diagnosis.But for non-emergency symptoms, googling can only upset people. Seeing your GP is a much better idea.

  16. Having just subscribed to this blog I thought I would share a little story which vaguely realated to this (and incidentally a lot of stories on here) which is indirectly the reason why I happened to stumble upon this blog in the first place…Well last night I was sitting in bed reading email on my laptop, when I began having a bizarre chest pain, like a dull ache in the centre of my chest between my shoulder blades. I thought nothing of it at first, but it got a bit worse, and after an hour or so, I decided to phone my out of hours GP to see if they could shed any light on the problem. Now I was quite calmly explaining my symptom, there were no other symptoms other than the pain, but the GP became very agitated and urged me to call 999 for an ambulance immediately. Of course I became slightly worried at this point, although to be honest I still didnt think that I could warrant calling an ambulance as I certainly didnt feel seriously ill in any way. I considered not bothering altogether, or just making my own way to the hospital, but I dont have a car and I live well out of walking distance from it. After half an hour of wondering what to do, I phoned for an ambulance anyway. When they turned up, they took me into the ambulance and did a 12 lead ECG, which showed a perfectly normal heart rhythm. At this point I began to feel rather embarrased at having troubled them, but they listened to my breathing and rubbed my back a bit to see if it was lung/muscular related. The two kind chaps were rather puzzled as to what was causing the pain, but after calling someone else at the hospital to check things (I didnt particularly want to go to hospital myself) I agreed to take some painkillers, and get a friend to stay with me for the night, as I live on my own.

    Once I got back into my flat, I was half wondering why the ambulance chaps didnt think it anything out of the ordinary that I didnt appear to be very ill, so I did a bit of googling to find some statistics for ambulance call outs. One of the first sites I found was this one, and I became so engrossed in reading that I read the entire blog archive last night before I went to bed, (a rather delayed getting up this morning followed :s) The stories I read were a real eye-opener, and like most members of the general public I was surprised to find out that real emergencies make up a rather small number of ambulance call outs. Of course, I understand why the GP I spoke to wanted to be on the safe side, especially with a chest pain and all, but it was the utterly calm and unsurprised attitude of the (very kind) ambulance crew that got me wondering… now I know!

    I have never read a blog before , but I shall be following this fascinating account of the life of an EMT very closely from now on!

  17. Sorry Tom, but ongoing left arm pain can be symptomatic of a heart problem (although not likely for a 26 yo, of course), without being part of an acute heart attack.The first indication that my father had a serious heart condition (at 46) was an ache in his left arm and a “sore throat” that had been bothering him all week. We were on vacation and my mother made him go to the doctor when we got home. Similarly, my mother (age 60) went to the doctor on a Friday when she began having an ache in her left arm, although she was on a rug-braiding kick at the time which seemed like a more likely cause for the pain. He scheduled her for a stress test for the following Monday, but she dropped dead in church on the Sunday, presumably from a massive heart attack.

  18. GJ – Sorry to hear about your mum.It is my fault (that I didn't make clear in the posting) that left arm pain can be long term cardiac in nature, such as with angina, but the presentation of the pain, coupled with the age of the patient pretty much ruled out any of this.

  19. We bounced through the door at a “chest pains” call. The room was full of fag smoke, the ashtrays were overflowing, and the lady was dragging on a roll-up. On the table was a wrist-type sphyg (on offer from the Daily Mail – I know, 'cos I'd bought one too!) along with the box and the instructions. “Me BP keeps going up and down (BP?); I've got this grippin' type central chest pain (Wot?!), an' it's referred (Referred??!) to me jaw an' all down me left arm. I'm clammy, breathless (Koff, Koff, Koff – no surprise there!), an' I've got a feelin' of impendin' doom.” (OK, I made the “impending doom” bit up; the rest is true.) By then, we had spotted all the “Family Heath” guides as well as a couple of medical texts.Oygen, GTN, etc, and off to hospital. Discharged 2hrs later. Collected by her son, whom she did not see often, and who was not best pleased to be dragged out of his bed at 0200am.

    She became a regular, and her medical vocabulary progressed by leaps and bounds. One night, one of the auxiliaries in A&E collared me. Apparently “our” lady had been brought in the previous night by another crew. The routine had been the same, but when she had gone to contact her son, she had only been able to get him via his mobile. He was, apparently, at an important function, had had a few drinks, and she would have to find her own way home.

    She had demanded NHS transport, had received a dusty answer, and had become stroppy; after being threatened with arrest, she had calmed down, and had agreed to the auxiliary's calling a taxi for her – for a 44-mile round trip, at 0330am on a Sunday, costing her 60 – 80, depending on how much she upset the taxi driver. We haven't seen her since (touch wood).

    Beware the home diagnostician!

  20. Of course you have to be careful about chest pains but I have learned now to ask myself whether I have any unusual stress that my body is telling about. If I can identify that and sort it out all is well. It must be very difficult when it comes to people (like me) with mental illness to identify what may be psychosomatic and what does have a physical cause. I've known a psych patient with a pulmonary embolism be told that it was “all in her mind” and conversely my bro-in-law went through a phase of chest pain and breathlessness and was very thoroughly investigated but no cardiac problem was found. I think that the trouble was caused by stress that he was going through at the time. To give a graphic illustration when I was still able to work I had trigeminal neuralgia and ended up at the UCH face pain clinic where they asked if I'd been under any stress, clang, the penny dropped and I asked my GP for help. As soon as I got it the neuralgia disappeared. Pain in the area of my sternum is a sign of stress for me. However, anyone else who has chest pain SHOULD get it checked out.

  21. Ahh, but picture the scene Cookie – you're called out to a drunk, after doing all the tests available on scene you decide to leave him at home. Next morning his friends find him dead – choked on vomit. Yikes, next thing you know you're stood in front of a coroner and his family trying to justify your actions, not good. It's so much easier to take them in and easier to sleep at night knowing that you weren't the last person to see that particular patient alive. Therefore I also take 99% of my patients in, if they're really not ill a nice long wait in triage can work wonders! Over half of all Londoners still believe you'll be seen faster if you go in by ambulance – it's not true! (Unless you really are seriously ill obviously!)p.s I'm a LAS emt

    Hugs to you all from Laura x

  22. 4 months ago I had an intense ache in my sternum both arms went heavy when i was walking up hill or walking quick, I `ignored` it for 5 days believing it could not be what i really suspected!! as i was only 46 I thought nobody would believe me!!kept it to myself, and didnt want to bother anybody! but eventually went to GP and 7 weeks later ended up with stents (99% blocked)

  23. i had a frequent caller (First Aider at work, johnnie on the weekends) at work, noticed he had google open with the symtons of that days problem. as i work in the IT dept i checked his, logs for set times, just before my FA calls to him. yes, he had googled all the problem i was called to on them days. so i planned a little wake up call. with a fake google page and a few fake webpages hidden on my webspace with a little change to his pc i was ready for him.call out, leg pain. his thoughts (googled) DVT. got there google was minized at the bottom. i asked if he looked up DVT, he said he did google the leg pain, cause google is always right (great my shot) i open what he thought was google.com (was google.CON) my fake page.

    when to the mussel pain page (need to know he really hates gays) it said, the pain is due to homosexual practices, so get the toy from up your *** and the pain will go away.

    i told him is google is alway right then he is gay

    he was upset, next page, the pain is due to sitting or standing in a set way for too long is mussel needs moving.

    “googles got two diffent answers they cant both be right. about you!!” i said as i pointed to the screen. he mutter ok. checked his leg and said he needed to get this workstation set up right, told him how.

    Not had a google problem from him since. he has asked me med qustion from time to time.

  24. Oohh, Cookie. SeeShineynewrelief's comment above for sound advice. It's not “dangerous ground”, it's downright ruddy lethal! Remember how the basics start – “Crew and patient safety”? Well, you are the “crew” and your safety is paramount. Leave someone at home if you really must, but make sure that they fully agree with you (better still, convince them that it was their idea), and ALWAYS get a refusal signed. Best of all, just bundle them in and take them in. Judging patients' motives really isn't our job (though moaning afterwards IS mandatory), when you're marching you're not fighting, and it's probably quicker anyway. Console yourself with the thought that they'll have to get themselves home, and that – if they are time wasters, they face a long stay in the A&E waiting room. Finally, the fact that your vehicle is unavailable for calls is the EMDC's problem, not yours. Don't worry; be happy!As Tom says “Nobody ever lost his job for taking somebody to hospital”.

    This advice does not come from London. I live North of the Border, but you'd be amazed at what we all see eye to eye on!

  25. Quite on the contrary. You can have SO MUCH fun finding out all of the things that could possibly happen to you by Googling random odd anatomical phrases and seeing what comes back (“Left Foot swollen puss” returned an article on getting bitten by a Brown Recluse spider. Hmmm.)I know I'd rather go to a 'nothing' call and feel good about myself, than find out that someone in my community died because they delayed calling 911.

  26. In the light of new evidence (your new post above), I apologise for patronising you, but re-read your first post from a stranger's viewpoint!Frivolous callers are a pain and we all have them; maybe it's because I'm getting old, but nowadays, I find it easier just to accept them as facts of life, and not to get stressed by it. I don't even get irked by the caller who finds one of our alcoholics asleep in the street, and thinks she has done a Good Thing by calling the police and us. I just concentrate on getting this job finished. I resist the temptation to suggest that a true Good Samaritan would rouse the patient, take him home and feed him nourishing soup, and prompt the police to make the first move in the game of “Pass the Punter” via their usual opening gambit of “He's not really our problem, is he?” Countering with “He's not ours either, let him sleep it off in a cell.” is a hopeless bluff; they don't do that with drunks any more, and – even if they did – they'd just palm him off to us via a call to the FME. So we take him – noting, as we do, the speed with which the Good Samaritan pushes off.

    Then we punt him on to A&E; shrugging of shoulders; sorrowful looks. With luck, A&E staff's attention may be briefly distracted, allowing ambulance crew to disappear even faster than Good Samaritan. Patient eventually awakes, realises where he is, gets understandably stroppy; police are called; patient is arrested; and on it goes.

    There is no answer; we just have to grin and bear it; occasionally a paramedic chum may have the opportunity to stick a 14G cannula (better still, two of them) into someone whose alleged condition warrants such intervention. But that is about the limit of it. Norman Stanley Fletcher's “little victories” feeling is the best we can hope for.

    Nil illegitimi carborundum.

  27. Just wanted to post my comment as a random health Googler that stumbled on to this site after looking up chest pain. Before there was Google, there was Mom. I am a female in my mid 20s, a smoker, with dull pain for the past 2 weeks. I told her of this, and she said to go to the ER. Well, I think if something were going to happen, it would have by now, so I Googled. It seems that 99.9% of these sort of things are nothing so I'll just call for a non-urgent appointment. But I good ol' Mom assures me that the doc will send me to the ER anyway, just because they can get labs and scans done in one day instead of having multiple appointments and insurance pre-authorizations. (I'm in the USA). So it's not just the paranoid patient, but overly concerned family members and doctors who convince people to go to the ER when it's probably unnecessary.

  28. I looked on NHS direct the other night as I was having pain in the back of my ribs, chest, down my side etc and it basically came up telling me to ring an ambulance as I was probably having a heart attack. Thought to myself was 'Im sure Tom would love that if i rang an ambulance for pain in my ribs.

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