You Decide

Still no drunks – but, the weekend starts today and my shift ends at 2am…
I'm going to describe a job I went to last night.

The patient is female and 30 years old. She is married and is attempting to get pregnant. She is currently only taking fertility treatment, and having unprotected sex – she is normally fit and healthy and has no allergies. Her normal menstrual period is regular, however her period is over two weeks late this time around. She has been having nausea and vomiting for the past three days. She has no abdominal pain, and is not tender or guarding. She has no pain or increased frequency of passing urine. All vital signs are within normal limits.

So – given this information…

a) What do you think is 'wrong' with her?

b) Does she need a trip to hospital in an ambulance?

c) Why do you think she hasn't done a pregnancy test?

16 thoughts on “You Decide”

  1. I have been following this blog now for a number of months and I firstly have to say – it is an incredibly refreshing outlook on life and I can honestly say that it makes me take my hat off even more with all of you in the ambulance service.In terms of this case – you have to wonder about some people! Was she alone? Did she have a partner who was putting 2 and 2 together? Wouldn't it be nice for you to be called back next summer when she's in labour??!!

    Keep up this great blog – it puts my daily office life into context…

    Alan (London)

  2. a) There is a chance she might be pregnantb) Of course. I am sure a+e would like you to make their day by bringing in somebody with such a clear medical need. How do you spell trepanation again ?

    c)'cause she did not want to fork out a fiver when she could get it free at the hospital.

  3. Husband was there, and yes, I imainge that in 8 1/2 months I shall be back there to taxi them into hospital…Cheers for the compliment as well.

  4. Trepanation – I need that like I need a hole in the head.And yes – pregnancy tests are free at the hospital – well free except at cost to the taxpayer.

    *grinds teeth*

  5. er, forgive me if i have missed something, but why did she think she required a A&E vehicle and crewdon't these calls get filtered out or something?

  6. I would guess that the offending woman decided to tell the call taker that she was having some kind of difficulty in breathing. As people do when they want to get an ambulance quick despite there being bugger all wrong with them. TAS (a paramedic with a telephone) does try to call back all these rubbish calls and get rid of them, but patients have a wonderful tendency to get a lot worse when they realise they are not getting an ambulance (and then get a lot better before the ambulance arrives).

  7. Congratulations for the mother to be, im glad she spent my money, and a lot of peoples time finding out shes preggers. Perhpas anyone, who wants to get pregnant, would actually realise what the symptoms are, and perhaps spend a fiver doing it themselves. (can anyone detedt sarcasm)BTW what sort of hour was the job? Did it get you i the middle of a feed or something?!?!

  8. 'Not alert' due to 'Fainting' and 'Vomiting' – at least I think it was as I'm sure it was an Amber1 it may have been 'Dizzy'.And agreed on the Tas comment – we rushed to a 'Swollen tongue' which turned out to be a cold who couldn't taste anything… I'm of a habit of asking people why they aren't unconcious as it clearly says so on our MDT. The normal answer is “But they were”, which is funny because I've never passed out from a 3 week history of bugger-all.

    Teq – a question. We were sent out of area for a Green2 Maternataxi which had an ORCON of '19 and Dispatched at '20. I thought that Green2's were Tas'ed and that we weren't supposed to be doing Maternataxis 'Without Complications' (As this was, at least it was on the MDT).

    Am I mistaken, or was there no-one on the Tas desk last night?

    Apologies for everyone else for using Ambo terms without explaining them

  9. It was about 10:00-10:30pm. I tend not to eat on the 8 hour late shifts, it's not good for the figure.If I was in charge of hospitals, I'd charge them a prescription charge for the pregnancy test when it is quite obvious that that is all they are there for. Except, where do you stop charging for tests…?

    Might stop the people calling us out for a pregnancy test and asking if we can take them home as well….Grrr…

  10. All timewasters should be charged. But problems being where do you draw the line, who makes the desicion and who takes payment/how is paid.I whole heartedly agree though that unless they are exempt from prescription payments, they should be charged for the preggers test

  11. This sounds ridiculously familair. A related story is one a friend of mine, an ER nurse in Austin (Texas, where they have abstinance-only sex ed, etc.) tells. Every so often, she gets a female patient who comes in terribly confused – she's not had her period in a while (once as long as six months!), she feels sick and tired, and has been gaining all kinds of weight (gasp!).When informed that she is pregnant, the response is typically along the lines of “But I ain't married!” They have no idea that just not being married to the guy they're fucking does not mean they can't get pregnant. They do not know how it works At All!!!

    However, most of these girls don't ride the ambulance because they'd have to pay for it.

    Cheers!

    Michael

  12. The lack of ability to “join the dots” never fails to amaze me. Have lost count of the number of women I have seeen fronting up to A&E with abdominal bloating getting progressively worse, no periods for 9 months and now abdo pain getting worse and worse coming in waves…..nice to know it's no difference in the UK

  13. OK, I'll bite:a) What do you think is 'wrong' with her?

    I think she was raised in a “me first” environment and never taught to respect other people's time and money. (is there a box to check for this on your Patient Care Report forms?)

    b) Does she need a trip to hospital in an ambulance?

    Yes, because if you don't and something terrible happens (which will 1 time out of 1,000,000) the public freaks out.

    c) Why do you think she hasn't done a pregnancy test?

    See answer to a).

    DJ

    http://psychonomic.blogspot.com

  14. Really seems as though somewhere in the administration a review should be performed regarding people's use of the ambulance system. If they call for a runny nose or other non-emergency reason (or if they could have been transported by ambulance-following relatives) they should receive a bill for the service.

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