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maggi90w1
01-01-2011, 01:07 AM
Let's say you and your fiancée find your Uncle injured and unconscious, so you call an ambulance. Would the paramedics allow you to stay with him in the ambulance? How about the fiancée? Would they at least tell you where they are going? And how about the doctors? Would they inform a nephew about the health status of a patient?

stormie
01-01-2011, 01:18 AM
Let's say you and your fiancée find your Uncle injured and unconscious, so you call an ambulance. Would the paramedics allow you to stay with him in the ambulance? How about the fiancée? Would they at least tell you where they are going? And how about the doctors? Would they inform a nephew about the health status of a patient?
Usually they don't like anyone riding in the ambulance with them. They ask family members or good friends to follow in their own cars, esp. if it's a life or death situation. And you, in your own car, can't run red lights. So you have to know where you're going. BUT there are exceptions. One of the times I got to ride was when my father had to go, they let me ride with them because he wasn't clear-headed and I had Power of Attorney. I rode up front each time. Most of the time, though, I'd follow in my own car. (Again, you have to know where you're going. Once I did get lost. They quickly will give you directions.)

At the hospital, in the emergency department, they usually let only one or two family members or friends be with the patient. UNLESS, again, it's a life or death situation, then everyone waits in the waiting room. The closest member there is designated the spokesperson. So it would be the nephew, in this case. They prefer a spouse over any other familiy member if it's a life or death case, but will talk to the closest family member there.

I've been to many EDs at different hospitals with different family members and friends, with different ambulance services, and different medical problems. They all can differ, but this is what I've noticed and also learned from first aiders.

maggi90w1
01-01-2011, 01:24 AM
So it would be the nephew, in this case.
Would they somehow check if he he really related to the patient or would they just believe them?

stormie
01-01-2011, 01:27 AM
They take him at his word. I've never been asked for credentials, and I've been the only one to be with my sister, mother, father, sons, husband or friends over the years.

ETA: I just realized--you're in Germany. Don't know if it'd be different than the US.

maggi90w1
01-01-2011, 01:32 AM
Don't know if it'd be different than the US.
That's ok. The story takes place in Alabama.

stormie
01-01-2011, 01:37 AM
Then what I said above should be fine. Emergency departments (they're getting away from calling them "emergency rooms") and first aid are mostly about the same throughout the states. Busy places, only enough time to rapidly ask questions, answer questions, and the billing dept. of course comes over for pertinent info. (Uncle's health insurance, uncle's ID like a drivers license.) If that can't be given at the time, they ask for an address to send the bill to.

jclarkdawe
01-01-2011, 02:59 AM
Let's say you and your fiancée find your Uncle injured and unconscious, so you call an ambulance. Would the paramedics allow you to stay with him in the ambulance? The question would be why. The working area in an ambulance is very small, and you don't want people in the way. You can throw them in the front seat, but usually there's a reason.

If a patient is unconscious, I probably would not let someone ride in the rig. Even if the patient was a child and the person was a parent. We want to work and talk in private. Family members can get upset when someone in the rig screams, "Get a goddamn airway going." or something like that.

Normal ambulance ride is less than ten minutes, and you've got a crap load of stuff to get done for an unconscious patient. We'll want to get a strip on the heart from the monitor, get an IV going, get an airway in, strip the patient (we don't know where they're hurt and they sure aren't telling us), two or three blood pressures, get O2 set up, call the hospital, check for responses, and a few other things.

Realize the ambulance crew is going to set up for the patient to crash. Better to be prepared and not need it, then to need it and not be set up. Again, this get the family upset. Like in, "Why are you putting those big pads on him?" "Oh, that's just to shock him in case we need to."

How about the fiancée?

One person is all I've ever allowed in the rig. And that's only when the patient is flipping out on me, either because they're a child or some other mental defect.

Would they at least tell you where they are going? Absolutely, though usually we rely on someone who isn't going with the rig. Directions are provided. And subtly we delay them enough so they don't try following the ambulance.

And how about the doctors? Would they inform a nephew about the health status of a patient? HIPPA says no. On the other hand, the patient in unconscious and there's a lot everybody wants to know for medical history.

Best of luck,

Jim Clark-Dawe

maggi90w1
01-01-2011, 04:52 AM
HIPPA says no. On the other hand, the patient in unconscious and there's a lot everybody wants to know for medical history.
So,I guess the medical personal wouldn't be very talkative (suspicious even?) if the nephew can't provide any information?
Because the young man only claims to be the nephew. He really doesn't know anything but a name.

jclarkdawe
01-01-2011, 05:25 AM
So,I guess the medical personal wouldn't be very talkative (suspicious even?) if the nephew can't provide any information? Technically, the doctor can't talk to me about my wife without her consent. Practically, there's so level of fudge here. For example, when my son was 18 (technically an adult), his appendix burst. Nurse couldn't tell us what his post-op care should be, but could tell us what the "typical" post-op care should be.

Medical people are going to want to know the patient's history. If the patient has an extensive history at the hospital, it might provide the answers. But as well as what happened just before he became unconscious, we're going to want to know whether he's had a stroke, blood pressure problems, medications. How much a nephew would know about this stuff is questionable. But as the nephew can't answer this stuff, you assume the patient hadn't been sharing with the patient, and you're not going to share with the patient either.

For example, someone who knows the patient's meds probably know what's going on with the patient. You'll share to get info.

Because the young man only claims to be the nephew. He really doesn't know anything but a name. The lack of info would result in requesting a contact person, assuming the hospital doesn't have it in the records. Person in a position of trust knows a lot about the person. His lack would result in assuming he's not the closest person to the patient.

I doubt anyone would doubt whether he was in fact the nephew or not. Nor would anyone probably care. I would have problems remembering the names of my nephews on the best of days, never mind anything unique about them.

Medical people don't talk for the sake of talking. If we're not getting information from someone, we don't talk to them.

Best of luck,

Jim Clark-Dawe

PinkAmy
01-01-2011, 10:52 PM
If your story takes place before 2003- HIPPA wouldn't apply although most places were tightening up in anticipation a few years prior.

Stlight
01-01-2011, 11:41 PM
jclarkdawe, I can see a huge problem. What if the person with the medical history info for the unconscious patient is following the ambluance, loses sight of it, has trouble with the direction and gets lost? Do the hospital people just wait to do anything until the next-of kin with the info finds their way to the hospital? If they have to wait to do anything what's the point in getting the patient crash ready and then separating the person who gives permission to work on him/her from them?

I'm not mentally deficent, but I can't do directions without strip map, it's a mental glich. Not everyone could afford to buy a new car with the on-st*r talking GPS in it. So this is a possible situtation.

Stlight
01-01-2011, 11:54 PM
Maggi, this is experience not from reading rules. My mother was in a car accident and insisted the police call my sister rather than an ambulance to take her to the hospital. At the hospital, the made my mother, who had a broken collar bone among other injuries, fill out all the insurance and billing forms before they would let her in the emergency room.

She was in Atlanta, which is the biggest city in Georgia. Georgia is right next to Ala. and the two states are alike in many ways. Somebody would be filling out those forms. Hope this helps.

jclarkdawe
01-02-2011, 12:32 AM
jclarkdawe, I can see a huge problem. What if the person with the medical history info for the unconscious patient is following the ambluance, loses sight of it, has trouble with the direction and gets lost? Do the hospital people just wait to do anything until the next-of kin with the info finds their way to the hospital? If they have to wait to do anything what's the point in getting the patient crash ready and then separating the person who gives permission to work on him/her from them?

I'm not mentally deficent, but I can't do directions without strip map, it's a mental glich. Not everyone could afford to buy a new car with the on-st*r talking GPS in it. So this is a possible situtation.

First off, with an unconscious patient, the EMTs and the hospital has implied consent. In other words, we work with the assumption that the patient would agree to what we're doing, as we're following reasonable and normal procedures. Bottom line with an unconscious patient, it's going to be a while before you get to make medical choices (other than if the patient is a Do Not Resucutate).

There's a basic procedure you follow, starting with does patient have airway? If yes, do this. If no, do that. If sort of, do a third thing. We may make judgment calls, but no choice is being offered, either to the patient or the EMT.

One reason the ED is so expensive is because even with a known medical history, you have to run a bunch of tests to rule out anything it possibly could be. So although a medical history is nice, it doesn't make a whole lot of difference. And implied consent can work for quite a while.

So getting the family to the hospital is not a big deal. And following ambulances is dangerous. We know people get injured and killed following ambulances. People do not usually get injured or killed getting lost (yes, it can happen, but a lot more rarely than getting hurt following an ambulance).

Other alternatives, such as a family member or neighbor doing the driving, the police, or even a taxi work. And are safe.

Best of luck,

Jim Clark-Dawe

Stlight
01-02-2011, 01:24 AM
Thanks Jim, you always explain things well. It's a relief to know about the assumed conscent for reasonable stuff. It's bad to have to drive when upset and worse to feel that if you aren't there in time your relative could die.

shaldna
01-02-2011, 02:54 PM
I've gone twice in the ambulance, and once following in a car.

Of the two I was in the ambulance, one was to keep my daughter calm because she was three and having breathing trouble, and the second was with a friend who'd fallen on a night out and hit her head on the pavement, she was conscious, but a bit delirious.

They will usually let you ride with them if it's not a crisis situation, for instance, if patient is conscious but has, for example, a broken legs but with no real bleeding, and has been stabilised and there's nothing that can be done until hospital, then that's usually fine.

However, if the patient is bleeding out, or it's been a heart attack or breathing issue, and they will most likely need to work on the patient on the way, then you usually have to follow.

That said, sometimes, situation permitting, they let you ride up front.

maggi90w1
01-02-2011, 03:25 PM
Thanks guys, that was very helpful. It's a bit embarrassing how little I know about this, studying medicine and all :)

blackrose602
01-08-2011, 11:27 PM
I can't speak for ambulances, since thankfully we haven't had that one come up yet, but as far as the hospital itself, the squeaky wheel absolutely gets the grease. My dad has a few complicated medical conditions and after a couple of nightmarish almost-oops situations in the hospital (like them coming to pick him up for open-chest lung surgery that he had expressly said NO to, and was in the middle of a non-invasive treatment for the condition--which worked perfectly by the way, despite the surgeon swearing it wouldn't), I will NOT be told to stay in the waiting room or go home and get some sleep.

Dad goes in for something, I'm right there beside him. Somebody does something, I'm asking why. It annoyed the crap out of the hospital staff at the place he used to go (the almost-oops surgery place), but it was necessary. And the doctors appreciated it. The non-invasive procedure I mentioned required a lot of time-consuming management and several of the nurses didn't like doing it. So the doctor taught me to do it myself. He also let me watch the fluoroscopy, and explained what he was doing at every moment.

Now Dad uses a progressive new hospital that ENCOURAGES the family to participate. Every room's a single with a comfy sofabed. When Dad had his stent placed, obviously I wasn't in the OR, but they gave me a pager and beeped me the second it was over. And the doctor waited till I got up there to talk to me himself, even though it was perfectly fine. I got directions and made it to Dad's room before he did.

So...if the nephew wants to be involved/get information, all he has to do is be persistent. Now if the guy wakes up and wants to kick him out, he has that right. But while he's unconscious, the hospital will let him stay if he makes enough noise.