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Sat Nov 4 19:05:00 GMT 2006

Young Man (mid 20's),thin and healthy appearing, working in night club, 
crashes at the club. He is unressponsive to voice or pain (GCS score=3), but 
has a patent airway, is breathing Spontaneuosly and has a strong pulse at 
around 70 bpm. According to friends, he didn't take drugs or drink excessive 
alcohol, but might have been hurt by another clubber. I order the activation 
of the EMS. within ~1 min. he starts waking up and vomits. We take him 
outside, where I learn his boss canceled the bus since "his Ok now". He 
keeps on vomiting, has a thready pulse, is shivering, and has retrograde and 
antegrade amnesia. Claims are he had been stuck in the head. Finaly,I manage 
to convience him to take the bus to hospital. When the bus comes, the boss, 
once again, insissts that the owner will take him to the hospital. Ambulance 
personnel don't even argue and get away, inspite of my attempts. Finaly, we 
get to the hospital by car, at least 40 min post injury (?).

The first dillema is- should EMS personnel (EMT-B'S, in this case) insist 
with such pateints? I tried conviencing them to "talk some sense" into him, 
but they refused,despite my description of coma and amnesia, saying they 
couldn't force him and that "he looks fine now", and left the scene.

What are your thoughts?

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