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Sat Mar 3 22:15:56 GMT 2007

If you work EMS in the Greater Toronto Area, it is a common practice to have patients wait with you for hours at a time for "non-emergency" situations.  I think I have waited 7 hours before, and it is not uncommon to wait for 4 or 5 hours.  I have found that quite often, the triage nurse, even after taking our report, doesn't tend to "believe" us when we try to suggest that the patient is in need of urgent care.  Without disclosing details, I had a patient that I suspected to have a bleed; sit on my stretcher for 2 hours, while they continued to deteriorate.  We continued to document the patient's vitals, as well as notify the E.R. staff of the changes. The staff didn't seem to want to hear what we had to say. The patient ended up going unconscious while waiting, which we caught right away and then informed the staff. Patient was rushed into the resuscitation room and a code was called. Patient died a few hours later.  I have spoken to crews that have had MI patients wait
 for a couple hours on their stretchers. I personally have had CHF patients in acute pulmonary edema sit on my stretcher while I assisted ventiliations with the E.R. staff ignoring us, even after being advised of the situation on the patch. 

  Although this is normal that patients will sit with EMS crews for hours at a time around the area that I work in, most other areas find this to be unheard of. With the aging population and the hospitals being overcrowded, the problem is probably going to increase. One of the other problems that I have encountered is that the ER staff will use the paramedics as extensions of the emergency room. I am not just coming up with this on my own, I have been told by E.R. nurses outside of work that they do this on purpose. They say "why would I want to give your patient a bed and make one of my nurses have to attend to them when they are in your care and you can attend to them?"  Clearly, it is not understood that although we would love to be of assistance to the E.R. staff, we have a job to do in the community.  I think this would be an issue for hospital management and EMS management to discuss. 

  That's my two cents. 

David Sullivan <fpcems at yahoo.com> wrote:
  If we have a pt that is going to "triage" then we are told that when we give our CMED patch to the hospital. 9 times out of 10, our pts are brought into a room and treated by the staff, depending of the priority of the pt of course. 

KMATTOX at aol.com wrote:

In a message dated 3/3/2007 11:03:54 A.M. Central Standard Time, 
bryanboling at gmail.com writes:

I don't see a problem with that as long as they were screened by a nurse
just as they would have been if they'd walked in...

Hospitals all over this country are not doing a triage prior to sending 
patients from an ambulance to the waiting room. In the case which prompted my 
post, an EMT was left on an ambulance stretcher in the waiting room for several 
hours with a diagnosis of appendicitis. 

k

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