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Tuesday, December 13, 2011

Miscommunication

We were dispatched for a man feeling ill. The RP was a home health care nurse that stated her patient had a low temperature. Yeah, I was suspect too.


We walked in the house and found an old man laying in a hospital bed in the front room. It was probably the only place they had that would fit the bed without some major rearrangement of furniture. At the head of the bed stood the wife of the patient. She appeared very concerned. At his bedside, the "nurse" (I'm not sure if she is an CNA, LVN or RN).

The home health care worker, as I will refer to her, informed us that the patient had a temperature of 94º F. I quickly placed my hand on the patient's head to see how he felt. He felt like someone with a normal temperature.

The worker then informed us that his blood pressure was low, 94/52. I again touched the patient. This time I checked for a radial pulse, which I easily found. Nice and strong.

While we were getting a proper BP the worker then explained that my patient was altered (our BP was 142/82 by the way). Knowing that that phrase can mean something totally different to someone that doesn't practice emergency medicine I asked for clarification (also because he seemed to be acting normal to me). I was informed that the patient had not been responsive for the last 30 minutes of the 90 minute visit. I then asked the nurse how well she knew the patient and she said this was her first visit.

At this point I turned to the wife and talked to her. The home health "professional" was useless. His wife said that he appeared to be tired. The nurse kept interjecting that she was worried about sepsis. Every time I acknowledged her concerns but she didn't get that (there was a major language barrier).

About then AMR showed up. The CNA/LVN/RN told the AMR medic that the patient was altered. He looked to me for confirmation and didn't get it. The transporting medic was again told that the patient was altered. He looked to me again and I did a quick eye roll. He immediately got the picture. We loaded the gentleman onto the gurney and helped the guys out to the ambulance. After making sure they were all set we headed out.
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