What I Would Want

One of the comments to a recent post was from Henrick, who wrote: “Maybe I´ve misunderstood your post ( english isn´t my first language)and so this could be a reallt stupid question… But I have to ask! Do you really schock people who are awake and talking?”

The answer of course is yes, we do, if we can’t avoid it. If we think we have time and we think that it will work we can give a round of medicine. If we don’t, we shock away.

This all set me to thinking.

What would I want if I were the patient?

I would want medicine first if there was time. And I would want a seasoned medic taking care of me. I would want a medic who had gone to a good medic program and who was subject to a rigorous QI program, a medic who got a lot of continuing education every year. And I would want a little luck and good fortune. I would want the medicine to work.

And then I thought, what else would I want if I were a patient in the 911 system?

I would want:

Morphine if I broke my leg or arm or hip, or cut my fingers off with a snow blower or spilled boiling water on myself or had kidney stones, or even abdominal pain of unknown origin, provided I was hemodynamically stable.

A pillow and enough blankets if I was cold. Working air-conditioning in the summer.

A smooth easy ride, a rig with good shocks, a smooth experienced driver, and no lights and sirens unless I was dying of a correctable cause.

A paramedic or EMT who was nice and asked my name and told me what they were doing before they did it.

Amiodarone instead of lidocaine.

A family member sitting in the back with me unless I was out-of-control or I required much active care by a medic on each side of me and one at the head.

Phenergan if I was nauseous.

Here’s what I wouldn’t want:

Ten people from three different services: EMS, fire, police, coming charging into my house (unless I was in cardiac arrest).

Drugs down my tube.

RSI if I could be bagged, or if I was conscious.

C-spined unless I couldn’t move my neck due to the pain.

An IV unless it was necessary to give me fluid or medicine (same goes for the hospital) or unless I was really sick. (Same goes for in-hospital).

To be flown in a helicopter if I could just as easily go by ground.

An EMT who answered his cell phone while treating me.

And finally CPR if I was dead.

I’m sure there is more, but that’s what immediately comes to my mind. Some of what I would want, conflicts with what I would want to provide my own patients, but not much of it.

9 Comments

  • Anonymous says:

    ..CPR if I was dead….Interesting. Especially in light of how futile CPR is. You talking drug resus, airway manuvers or full blown let’s run thru ACLS to the end of the algorithm CPR and then some ?

  • Henrik, Sweden says:

    Thank you for the answer! The reason I was asking is that here in Sweden we don´t schock patients in VT as long as they have a pulse or are conscious…

  • PC says:

    I would want CPR only if I had just dropped on a street corner and the defibrillator got there in 3 minutes, or if I was in the operating room and during surgery I briefly coded, or if I choked on a sandwich, and I had just bradyied down when they pulled the bolus out with the McGills. Thatt’s about it.On the VT shocking, I think I would rather be in Sweden if I was a patient in VT.

  • Anonymous says:

    What I would want if I needed CPR:People bickering about how to do it correctly, delaying CPR so it never got done and they just gave up.Little ham sandwiches with some good coleslaw at the funeral. A good preceptor medic who said to the student, “There will be better people to work a code on. He’s gone.” I’d hate to be someone’s “practice” even if they needed it. As a patient I’d want:Fentanyl instead of morphine. Titrated to my pain, not encumbered by stupid and out of date protocols that only allowed for enough narc to go from an 8/10 to 7.75/10.Relief for nausea straightaway.Someone who will tell me their impression immediately. If I have a-fib on the monitor, tell me it looks like a-fib and explain what that is. Don’t say, “Well, it looks like there’s something going on with your heart.” If I have a 190/110 BP, tell me my BP is high. Someone who will turn down the lights and let me sleep if I’m stable and we have a long ride. A medic who doesn’t need to stick me with the biggest needle possible just to brag to the ER nurses, “Go big or go home.” If I’m not a trauma patient, please don’t stick me with a 15 just to run NS at KVO unless there’s damn good reason to start that IV.Someone who will talk to me during the ride. I hate to see medics just sit on the bench and never say a word to the patient. Ask me my name and remember it. I’ll be tolerant if you forget once, as I’d hope the same from you. A medic who will understand I want to questions of him or her. If I ask how long you’ve been a medic, it’s not because I think you’re an idiot; it’s because I’m nervous and feel a bit out of control. Asking questions helps me feel a sense of control. If I ask you if you’re married, I’m not a stalker or a perv. It’s conversation.One person directing my care. I already told the dispatcher, the firefighters, the police, your partner, and now you what I ate, when my last BM was, and that I was into the clinic two days ago for this. Someone please remember it so I don’t need to repeat it. And just have one person assume control. I want to talk to one person, not 10.NO RSI. Please don’t RSI me. I want that tatooed on me.A ride in an ambulance that had been cleaned, at least LOOKED aseptic, and didn’t smell like the last person.

  • Stacey says:

    Nothing pisses me off more then people who answer their cell phones while they are treating a patient. That is so unproffesional. It shows the patient that your personal life is more important than taking care of them. Even if it is just a quick “I am with a patient I’ll call you back” that is what voice mail is for.

  • Anonymous says:

    i keep my cell on silent…. i wish more people would do the same while on the job!

  • Dislocated Gumby says:

    I would want. . .Someone to specifically check for medical ID if I was unconscious or unable to communicate. My disorder can cause serious complications and is quite rare, so my medical ID may be the medic’s and the ER doctor’s only immediate source of information.If I won’t be getting any pain medication for a dislocated shoulder with obvious deformity, how about at least braking before potholes, slowing down a little on the curves, and maybe not grabbing the affected arm to take a BP? :-Dand. . . A D.N.R.C. order: Do Not Remove Clothing 😛

  • Anonymous says:

    Can you make this list in the form of a decent looking tattoo?

  • Anonymous says:

    So why don’t we (I include myself, my staff, and every provider I’ve ever worked with, save 3) practice these things? Yes, most of us strive to have someone in charge, to talk to our patients, and some of the other recommendations. But how many of us follow the rest? We’ve gotten so used to “yes, you can come with us, in the front” that we don’t think about it. We worry more about staying in protocol than the fact that the patient we are supposed to advocate for will now likely be kept in that collar for hours. We routinely practice VOMIT, despite the fact that the mask is nauseating the patient and the IV is unnecessary, and the patient has a lot of chest hair to pull off with that unneeded monitor sticky. In one county where I work, we have to call in for any patient that we provide any ALS care or assessment to, and when I try to avoid unnecessary sticks, I often have to fight with the medical control technician (we speak to paramedics who transmit the information to doctors.) Forget about practice CPR – why the hell are we practicing IVs on patients who don’t need them?

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