seeler's picture

seeler

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How do you know when to call an ambulance?

Its been a couple of years now since I asked the question of how do you know when you are sick enough to go to the emergency room?   This is a similar question and it came to my mind because in this province there is a discussion now about whether to drop the $150+ charge for ambulance services.  It seems to change with the government every few years.   Covered by Medicare - then a charge - now a proposal to drop the charge.    Can we stretch Medicare dollars to cover it?   Or does having a charge discourage people from taking advantage?

 

Apparently when the charge was introduced a few months ago, the number of calls for an ambulance dropped drastically.   One argument seems to be that this is because people took the ambulance when they could have called a taxi or gotten a neighbour to drive them.  The other argument could be that this is because people who really should be calling an ambulance are not doing so because they can't afford the charge - instead they drive themselves, or get a neighbour or family member to drive them, or they stay at home and hope to get better on their own. 

 

So the question - presuming that you are a responsible person who doesn't want to take the ambulance unless it is necessary or advisable, regardless of whether there is a charge or not or regardless of whether you can afford it, how do you decide to call for an ambulance as opposed to finding some other way to get to the nearest hospital?

 

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revjohn's picture

revjohn

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Hi seeler,

 

seeler wrote:

So the question - presuming that you are a responsible person who doesn't want to take the ambulance unless it is necessary or advisable, regardless of whether there is a charge or not or regardless of whether you can afford it, how do you decide to call for an ambulance as opposed to finding some other way to get to the nearest hospital?

 

In the case of a seriously erratic heartbeat or respiration problems I would call an ambulance.

 

Wounds with heavy bloodflow and dizziness.

 

Shock.

 

In the event of my losing consciousness I hope somebody else does.

 

Grace and peace to you.

John

 

 

seeler's picture

seeler

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Hi Rev.John.   Some cases seem quite clear.  But when my neighbour showed symptoms of a heart attack his son-in-law (who was present) drove him the 10 minute trip to the hospital.

 

Seelergirl called her dad and me, when the pain from cancer treatment escalated beyond what she could handle.

 

What about a child who falls off a rocking horse and breaks her arm?  Is it alright to put her in her car seat and drive to the hospital?   Or an adult who trips on a piece of ice and breaks her ankle - should her friends try to get her into the car and drive her over - she's conscious, she didn't hit her head?    Or the healthy young woman who gets up in the night, faints, comes to but doesn't feel quite right?  

 

I think there are a lot of cases where the person has to exercise some discernment.  I guess I'm just concerned that the question of cost shouldn't be a major factor in making a medical decision.  

 

 

 

kaythecurler's picture

kaythecurler

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Generaly speaking I'd call an ambulance for a true emergency - 

Person is unconsciousce.

Heart attack symptoms.

Sudden, severe, 'doubling up' gut pain.

Severe injury requiring immobilisation. 

Severe bleeding - safer to try to control and wait for medics to help.

Suspected back/head injury.

Probable broken hip.

Broken leg (unless small child when I'd immobilise and carry them to vehicle.)

Most lesser injuries can often be transported by family member or other adult -

broken arm - apply sling and transport.

Broken ankle - immobiise - provide support or carry to vehicle.

Cuts, bumps, bruises - regular Ist aid then transport if it seems necessary.

Bad unexplained  tummy ache.

 

In some areas of the country is is faster to transport the patient with a car or van than wait for the ambulance.

A country cousin once told me that for farm accidents the best bet was to phone for the ambulance, phone neighbors to come and help, phone someone to lead the ambulance to the farm.  Medics know the medical stuff but not the 'how to lift this machine off this person' stuff.  Often in these cases the RCMP also attend.

jon71's picture

jon71

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I'd say if you need emergency care and can't get to the hospital fast enough any other way.

DKS's picture

DKS

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I called an ambulance this week for my wife bcuase her back had seized up and she couldn't move. We call an ambulance at church if someone collapses. No exceptions, whatsoever.

seeler's picture

seeler

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Jon - I think that advice is only good in some cases.  I live ten minutes from the hospital.  No doubt, if the person is mobile or small enough that I can help him get into the car, I can reach the hospital faster than an ambulance could make the return trip.  However, the ambulance has trained medics and life saving equipment on board.  They can start treatment and stabilize the patient for transport easier than I can. 

So it is still a judgment call.  Will moving them cause more injury?  Do they require first aid (maybe the shock paddles to restart the heart) right away?

 

I know of a case where an elderly woman fell and broken her thigh bone and her friends helped her into a pick-up truck and drive 30 klms to the hospital.   I think of the pain and the possibility of further injury.  They thought they were doing the right thing and she agreed - it was not an emergency (not a life and death situation).  

 

seeler's picture

seeler

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DKS - if someone passes out in church and you call an ambulance - in a province where there is a charge - who would pay?  the church responsible for making the call? or the patient who was not consulted about her wishes?

 

DKS's picture

DKS

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BTW, what province charges $150 for an ambulance ride? It's $45 in Ontario

seeler's picture

seeler

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NB did, then dropped all charges, and is now reconsidering.

 

DKS's picture

DKS

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seeler wrote:

DKS - if someone passes out in church and you call an ambulance - in a province where there is a charge - who would pay?  the church responsible for making the call? or the patient who was not consulted about her wishes?

 

 

The person. The wishes of the person are irrelevant. They may also be unable to make a decision, so we become the "good samaritan" who makes that call.

revjohn's picture

revjohn

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Hi seeler,

 

seeler wrote:

What about a child who falls off a rocking horse and breaks her arm?  Is it alright to put her in her car seat and drive to the hospital?

 

It can be alright if you know what you are doing.  Basic first aid is to not move that which is broken.  Elementary first aid is to immobilize that which is broken so that it cannot move.  If elementary first aid is beyond the ability of the responder then yes, call an ambulance.

 

seeler wrote:

Or the healthy young woman who gets up in the night, faints, comes to but doesn't feel quite right?

 

Dizzy spells, particularly in individuals who have been prone or seated and then get up to quickly are not necessarily life threatening.  If respiration and pulse seem steady I would observe for an hour or so.  If the dizziness lasted that long I would seek emergency treatment, that seems, to me, out of the ordinary.  Although I suspect it would be something to do with the blood pressure of the individual I would get it checked out.  Better safe than sorry.

 

Would I call an ambulance?  Depends on whether I could assist the individual to some other form of transportation easily.  If I couldn't then yes, I'd call.

 

seeler wrote:
 

I think there are a lot of cases where the person has to exercise some discernment.  I guess I'm just concerned that the question of cost shouldn't be a major factor in making a medical decision.

 

Well there is cost and there is cost.

 

An ambulance ride might cost me say $300 bucks.  If that ride saves my life or any life I'd say that is $300 bucks well spent.

 

If I couldn't afford that $300 bucks I am grateful that I don't have to pay for the ride upfront and the cost to the politicians who put the legislation into effect charging for that particular service will be more than $300 bucks if they strong-arm me into paying it.  I'm sure all forms of news media would love to have me take swings at the government for being so callous.

 

Grace and peace to you.

John 

chemgal's picture

chemgal

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 $45 or $150 for an ambulance?  That's cheap!  Here it's about $350 just for the ride.  I don't know how any treatment in the ambulance is charged.  That's what health plans are for.  The province does cover the cost for low-income people and seniors.  I've had medications that with a plan cost more than that in a year.  If you're not low income I don't understand why someone wouldn't have a health and dental care plan.

 

As for when to call: for an emergency.  A simple broken leg? No.  A broken femur where someone has the possibility of going into shock, yes.  Heart attack symptoms, stoke symptoms, etc I would call.  If one of my relatives had indigestion and someone called an ambulance because they thought it was a heart attack (it happens!) I would be glad that it was called.

mrs.anteater's picture

mrs.anteater

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This is it in NS:

 

EHS Ground Ambulance Service Fees (As of April 1st, 2009)
  Medically Essential Transportation Inter-facility Transportation
Most Nova Scotians with a valid health card $134.52 $0.00
Non-Nova Scotians $672.57 $0.00
Non-Canadians & New Canadians $1,008.84 $1,008.84
People who are third party insured
(This includes people covered by motor vehicle insurance, Worker’s Compensation, or the federal government.)           
$672.57 $672.57
Nova Scotians who are mobility challenged $168.14 N/A

The 134.52 are for "medically neccesary" cases. Otherwise, you might be charged more. If you are in a car accident and someone calls an ambulance, but you don't need it, you can refuse to get on and save youself some money.

I think the main problem is the charge for people who are immobile. On  one side, we appreciate that relatives are taking care of their loved ones at home, avoiding the costs for hospitals and nursing homes, on the other side they are likely to need more ambulance drives to appointments or to the hospital.

mrs.anteater's picture

mrs.anteater

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By the way, in NS you are supposed to let your provincial health insurance know when you are leaving the province (to go to another Canadian province) for more than two weeks. Otherwise you might not be covered. (Which means you might be paying the $672 for the ambulance in NS...)

lastpointe's picture

lastpointe

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I think an ambulance should only be used for situations that are life threatening of dangerous.

 

Obvious things like strokes and heart attacks where treatment cna be started.

Things like falls with possible back injuries

Massive injuries.

another might be a child with a very high fever.  over 41 that might result in seizures

 

Most things can be driven in.  Most broken bones while painful are not acute.

Most bad cuts are drivable.  Massive pain is drivable.

 

Unless you think the ambulance can initiate treatment than you are simply using them as a taxi.

 

In your daughters case, there was nothing the ambulance could do that you weren't doing.  Pain cannot be handled by them, they can't start morphine or things like that.

 

In the case of a back spasm, an ambulance is necessary because the person can't move their back.

 

Most accidents will use ambulances and you are responsible for the cost.  But that is often due to caution about possible back injury.

 

If you ever think back injury that is the one time, even a relatively normal looking person should be in an ambulance on a backboard 

GordW's picture

GordW

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If in doubt--call.  THe mere fact taht you think yuou need to is a sign for most people.

 

Another option is (if your province has one) call the Telehealth hot-iline and ask the nurse there.

Tiger Lily's picture

Tiger Lily

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If something seems to be an emergency I will treat it like an emergency.  I'm just an untrained person making the best decision that I can in the moment.

 

Having said that it seems to be much easier to make that call for an ambulance on someone else's behalf.  I have never done it for myself.

 

TL

trishcuit's picture

trishcuit

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 When I took Industrial First Aid ( heavy but very interesting course) several years ago, we had certain standards for 'rapid transit' criteria.  Heart attack,  and stroke symptoms being obvious. Another was a fracture that was compromising blood circulation to extremities, like a compound fracture.  Punture wounds to the head or face or abdomen, loss of conscousness, a fall from greater than 18 feet, and I can't remember what else.  One thing that was cool was (being THE attendant with level 3 training) was our ability to order transit by helicopter if you were working in the bush or remotely and a chopper would save more than 20 minutes of transit time.  Then strapping them to the spine board was a whole new exercise as the patient would have to ride at a 45% angle because of space constraints.   I remember my favorite part of the course was the oxygen tanks. We would occasionally  take a few puffs of pure oxygen and PING! we would be ready to learn some more!  

seeler's picture

seeler

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trish - you have industrial first aid.  Many of us don't.   Our knowledge of first aid is limited to the little booklet that came with the little first aid kit we have tucked away in the bathroom with bandaids and a bottle of antiseptic.    But we might find outselves in a position of having to decide - call or don't call.  

I was the young woman who got up in the night and fainted in the bathroom - came to - walked to the livingroom in a bit of a daze - curled up on the chesterfield thinking I would go back to sleep.   Thankfully, I didn't.  I broke out in a cold sweat.  I managed to call my husband.  He brought me some clothes.  I couldn't get dressed, even with help.  He called the ambulance.  (Yes, he could have wrapped me in a blanket and helped me to the car, and driven me over - leaving the kids alone).      It took the emergence room staff some time to diagnose me.  A tubal pregnancy (I didn't know I was pregnant) had ruptured and I had severe internal bleeding.

 

mrs.anteater's picture

mrs.anteater

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seeler,

I would suggest to everybody to do a first aid course on a regular basis- everybody can come across an emergency- your grandkids choke, a car accident, someone fainting at the grocery store. We should consider that as important as the need to vote- just being a good citizen.

jon71's picture

jon71

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seeler wrote:

Jon - I think that advice is only good in some cases.  I live ten minutes from the hospital.  No doubt, if the person is mobile or small enough that I can help him get into the car, I can reach the hospital faster than an ambulance could make the return trip.  However, the ambulance has trained medics and life saving equipment on board.  They can start treatment and stabilize the patient for transport easier than I can. 

So it is still a judgment call.  Will moving them cause more injury?  Do they require first aid (maybe the shock paddles to restart the heart) right away?

 

I know of a case where an elderly woman fell and broken her thigh bone and her friends helped her into a pick-up truck and drive 30 klms to the hospital.   I think of the pain and the possibility of further injury.  They thought they were doing the right thing and she agreed - it was not an emergency (not a life and death situation).  

 

Good points. I've always thought that if I could get myself or a loved one to the hospital I would and if not I'd call the ambulance but I guess there is more to consider.

DKS's picture

DKS

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lastpointe wrote:

I think an ambulance should only be used for situations that are life threatening of dangerous.

 

Obvious things like strokes and heart attacks where treatment cna be started.

Things like falls with possible back injuries

Massive injuries.

another might be a child with a very high fever.  over 41 that might result in seizures

 

Most things can be driven in.  Most broken bones while painful are not acute.

Most bad cuts are drivable.  Massive pain is drivable.

 

Unless you think the ambulance can initiate treatment than you are simply using them as a taxi.

 

In your daughters case, there was nothing the ambulance could do that you weren't doing.  Pain cannot be handled by them, they can't start morphine or things like that.

 

In the case of a back spasm, an ambulance is necessary because the person can't move their back.

 

Most accidents will use ambulances and you are responsible for the cost.  But that is often due to caution about possible back injury.

 

If you ever think back injury that is the one time, even a relatively normal looking person should be in an ambulance on a backboard 

 

Oh.... this is so wrong at so many levels. Never be afraid to call an ambulance. Ever. That is what we have ambulances for. The copayment should be the last of your worries. And if it' a car acident, your insurance pays it, anyway. Bad cuts are NOT driveable. Pain is NOT driveable (I've done it in the middle of the kidney stone attack that went off the scale as I was driving to the hospital).

DKS's picture

DKS

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One thing not to forget is to save the receipt. It's a medical expense and can become a tax credit.

Pinga's picture

Pinga

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 In each of the cases above, we are talking about people with others around...and we are talking about family / indepedent actions.

 

 

What are the norms re seniors residences?   

I remember a conversation a long time ago, where it was indicated that some seniors centres/homes were using ambulances instead of staff to transport non-emergency actions and causing heavy load.  I have no idea ifthis is real or not.  curious what people say.

 

What about schools?  

Teachers don't transport as far as i know.  Do kids wait for parents to arrive if say there is a broken arm or twisted foot, or...are they transported by taxi? ambulance?

 

For workplace -- we quit having a nurse when it became apparent it actually slowed down emergency response time and resulted in delays and incorrect actions.  We had a serious workplace accident which was delayed by callign the nurse and then, there are thoughts, that the nurse made the incorrect decision and compounded the dmage.  Not sure if true, and settlement was made.  In the case of a serious injury -- call the experts.

DKS's picture

DKS

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Pinga]</p> <p>&nbsp;In each of the cases above, we are talking about people with others around...and we are talking about family / indepedent actions.</p> <p>&nbsp;[quote wrote:
What are the norms re seniors residences?   

I remember a conversation a long time ago, where it was indicated that some seniors centres/homes were using ambulances instead of staff to transport non-emergency actions and causing heavy load.  I have no idea ifthis is real or not.  curious what people say.

 

In our city, all nursing/retirement homes call 911 for any fall, collapse or extended loss of consciousness. They are guided by the Purple Paper expressing patient's wishes re. end of life care) but it is not unusual for our emergency services to be attending our nursing homes, at all.

 

Quote:
What about schools?  

Teachers don't transport as far as i know.  Do kids wait for parents to arrive if say there is a broken arm or twisted foot, or...are they transported by taxi? ambulance?

 

Principal's decision using Board policy, but the norm here is to transport by ambulance.

 

Quote:
For workplace -- we quit having a nurse when it became apparent it actually slowed down emergency response time and resulted in delays and incorrect actions.  We had a serious workplace accident which was delayed by callign the nurse and then, there are thoughts, that the nurse made the incorrect decision and compounded the dmage.  Not sure if true, and settlement was made.  In the case of a serious injury -- call the experts.

 

Other than Bruce Power, who have their own unique needs (including a Contaminated Casualty facility at the Kincardine Hospital, just like any nuclear facility), our industries call 911.

somegalfromcan's picture

somegalfromcan

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Where I work I have had to deal with kids with broken bones 3 times - twice while we were away from our building. Everyone I work with has Standard First Aid and CPR certification. We create a splint and when the arm has been injured, we put a sling on and phone the parents. We meet up with them at our centre and make sure they have transportation to the hospital (when one parent had no car, we drove them there - otherwise the parent does the driving). None of these injuries were life and death fortunately. If the bones had been broken more badly, we would have called an ambulance and had one leader travel to the hospital with the child (either in the ambulance, or in one of our vehicles). We have the luxury of having a fleet of vehicles, which is nice.

trishcuit's picture

trishcuit

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somegalfrom, 

yes that is the key to the fracture; the severity.  

 

Seeler, I was just sharing my experience,  or putting in my two bits worth. As for the IFA  course EI paid for most of it.  I learned things I hope I never have to use. 

What a scary thing that must have been that you went through!  Glad your hubby made the judgement call to take you to the hospital.

 

Judgement calls are one of my least favorite things.  Don't think I could ever work triage.

revjohn's picture

revjohn

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Hi DKS,

 

DKS wrote:

Oh.... this is so wrong at so many levels. Never be afraid to call an ambulance. Ever. That is what we have ambulances for.

 

This is the heart of the matter isn't it?

 

If our fear of calling an ambulance results in significant suffering and possibly death for a loved one or neighbour the money saved cannot begin to soothe the damage to our conscience.

 

Grace and peace to you.

John

seeler's picture

seeler

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Thanks all for this lively and informative discussion.  I think it boils down to the fact that you call an ambulance when you think you need an ambulance (not just for convenience).  The expense (whether it comes out of your own pocket directly, or indirectly through taxes, shouldn't be a major factor in making a medical decision.  The person involved makes the best judgement call he or she can about whether to call.  

Dcn. Jae's picture

Dcn. Jae

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If you're wondering whether or not to call an ambulance --> call the ambulance.

Motheroffive's picture

Motheroffive

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It seems self-evident that we should call an ambulance when there is a question of whether or not we should (I hope that makes sense).

 

However, when one is of limited resources and those resources are always stretched to the limit, the cost is definitely a factor. Also, I've been told by a nurse in an emergency room that I was wasting their time when I brought my daughter in...that she just had a cold and that the emergency room was for "life and death" situations only. My daughter had been looking ill for quite a few days and I had already had her to the doctor's office where there didn't appear to be anything wrong. No doctor's office were open at this point in time.

 

I was pretty angry and told her the background in order to defend myself. Also, my response included a comment that I don't have the equipment or training to figure out what's going on when it was obvious my daughter was getting worse. No, they "checked" her over and sent us home. I was quite unsatisfied with this outcome and called the patient advocate the following day. While talking, she asked me how my daughter was and I said that she was no better. She encouraged me to take her back again...which I agreed to do even though I was worried about what would happen.

 

X-rays the next day showed that she had pneumonia affecting at least 1/3 of one lung.

 

I know that emergency rooms do more thorough checks now, even when they might not be convinced that there is an emergency however I think that there are many of us who are worried that we are making a mountain out of a molehill and will pay out of our wallets, too, when an ambulance is concerned. It's not as clear-cut when money is a factor.

qwerty's picture

qwerty

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 Call an ambulance ...

1. When you get your next hydro smart meter bill.

2. When that nagging cough finally gets too much to bear at 2 a.m. Saturday morning.

3. When your husband says, "I've got a pain in my chest and down my arm but I think I can still work the gear shift if you'll just steer.  We should be able to get to the hospital in no time".

4. When you call (from Toronto) your doctor in Cambridge about the tightness in your chest and he tells you to get to the hospital, he doesn't mean the hospital near your house in Cambridge.  Call an ambulance.

5. When you are sweating profusely and have a tremendous pain in your abdomen.

6. When your NGO is advised that CIDA officials have recommended approval of your CIDA application; in fact, that your NGO has met CIDA priorities so fully that it should receive a small increase to its proposed funding ... but Bev Oda is the minister in charge of CIDA

7. When you are bleeding profusely.

seeler's picture

seeler

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Very funny, Qwerty.  

 

Motheroffive - your story reminded me of something that happened some years ago, but I can imagine happening now as well.  My girlfriend lived out in the country - nearest doctor in the village, 15 miles away.  Several times she took her daughter to this doctor, only to be told it was 'the stomach flu', 'the cramps', or 'something she ate'.  All the while she watched her daughter losing weight and getting weaker and sicker.  She kept pushing, asking for a referal to a pediatrician.   Finally she got a call from the pediatrician in the city.  They had an appointment for her daughter in three months.   "You might as well cancel it," she told them.  "She'll be dead by then."    Suddenly they were able to see her daughter 'as soon as you can bring her in.'    Diagnosis:   severe dehydriation and malnutrition due to Crohns disease. 

 

Diagnosis is not a simple matter and to expect an untrained person to always know what is serious and what isn't doesn't make sense.   And sometimes mother's instincts, or knowledge of their children, are the best guides.

 

 

Pinga's picture

Pinga

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 hi, just got back from ER with my Dad.  He is fine; however, he probably should have gone at 3am last night..but can't drive in the dark.

 

I advised him next time, call me or a cab.  argh.

 

Anyhow, all is well, and they treated him (he had something in his eye...but due to other issues with his vision he thought it was worse.....nothing inappropriate; however, would have been better to go at 3am than to have stewed all night)

lastpointe's picture

lastpointe

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DKS , your response to me was wrong.  But I was referring to driving someone, not driving yourself.

 

Obviously if you are unable to drive due to pain, bleeding, cuts or losing consciousness then you call an ambulance.

 

but many times people call for one when there is a perfectly acceptable driver in the home.

 

Then ambulances are wasted.

 

Yes we have them to use but like any resource if they are abused they will be compromised.

 

It is one of the reasons that you pay for them now.  when they were free people called them for all sorts of unreasonable reasons.

 

I think what happened with Pingas dad is unfortunaltey very commmon.  In the night, unsure of what to do, not wanted to disturb folks, wait till morning........  Those sorts of things do require ambulances.

 

I was visiting my parents years ago, middle of the night, my mom came to wake me, my dad was having chest discomfort.  Wondered what to do.  Ask the nurse.......

I called an ambulance as chest pain and elderly folks don't mix and i wouldn't have risked the 15 minute drive with a possible heart attack on the way.

 

But very often, a family member is quite capable of driving a person.  Kidney stones?  Guess it depends on how intense the pain and if one can walk.  Not always but an ambulance will have no treatment available so if you can walk and sit. it is most likely easier and quicker to be driven by family

trishcuit's picture

trishcuit

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 A friend of mine is a single mom with a two year old daughter. They live by themselves and have no car, using the public transit and friends to get them where they need to go. One day she was feeling seriously wrong.  She talked to the nurse on the 24-hour nurses' hotline and was told to get herself to the hospital as her symptoms sounded like heart attack or stroke.  The ambulance came and took her to the hospital along with her daughter who would have been traumatized to be away from her mom for an extended period of time, especially waking up and not knowing where mommy is. (she was asleep on the sofa at the time.)

I picked herand her daughter up from the hospital a couple hours later.  She had been having panic attacks which can present themselves in a rather alarming manner to those who have not had them before.  Better safe than sorry and what else could she have done? Possible serious condition, no car, etc. Scary thing for her.  It was a judgement call that fortunately turned out to be non life threatening.

seeler's picture

seeler

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Besides the problem of expecting lay people to self-diagnose, there is another problem about charging a fee as a deterant.   How much is a deterant?   For a single working mom on minimum wage, $50 can play havoc with her grocery bill.   Another person might pay $250 without batting an eye.   And many people would have insurance to pay it.  

 

Motheroffive's picture

Motheroffive

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I would have no way of diagnosing a kidney stone in my house so it's sort of irrelevant as to whether or not they merit an ambulance. I've heard they're painful so if my spouse was in big pain, I probably wouldn't recognize it as a kidney stone and may very well call an ambulance should we ever be blessed with such an event.

DKS's picture

DKS

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lastpointe wrote:

DKS , your response to me was wrong.  But I was referring to driving someone, not driving yourself.

 

No, it wasn't wrong. The question wasn't clear and you didn't clarify.

 

Quote:
Then ambulances are wasted.

 

Yes we have them to use but like any resource if they are abused they will be compromised.

 

Sorry, that's nonsense. If, in your judgement, an ambulance is needed, it's needed. Thinking of an ambulance as a scarce commodity is absurd.  Ambulances are for sick people. That's why they exist.

 

Quote:
It is one of the reasons that you pay for them now.  when they were free people called them for all sorts of unreasonable reasons.

 

But that is not a reason to use them.

 

BTW, in Ontario, if you don't pay an ambulance bill, nothing really happens, I'm told.

 

Quote:
I called an ambulance as chest pain and elderly folks don't mix and i wouldn't have risked the 15 minute drive with a possible heart attack on the way.

 

That's dangerous. When you are talking to an ambulance dispatcher they can give you guidance as to how to position someone or what you can do to relieve symptoms. They can also tell you how far out the ambulance actually is.

 

Quote:
But very often, a family member is quite capable of driving a person.  Kidney stones?  Guess it depends on how intense the pain and if one can walk.  Not always but an ambulance will have no treatment available so if you can walk and sit. it is most likely easier and quicker to be driven by family

 

A paramedic equipped ambulance can start an IV and prevent complications before arrival at the ER.

DKS's picture

DKS

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Pinga wrote:

 hi, just got back from ER with my Dad.  He is fine; however, he probably should have gone at 3am last night..but can't drive in the dark.

 

I advised him next time, call me or a cab.  argh.

 

Anyhow, all is well, and they treated him (he had something in his eye...but due to other issues with his vision he thought it was worse.....nothing inappropriate; however, would have been better to go at 3am than to have stewed all night)

 

Good point. Same thing happend to my wife last week. She should have gone to the ER the night before. Instead, I had to call an ambulance in the morning. She admitted she made a bad decision.

DKS's picture

DKS

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Motheroffive wrote:

Also, I've been told by a nurse in an emergency room that I was wasting their time when I brought my daughter in...that she just had a cold and that the emergency room was for "life and death" situations only. My daughter had been looking ill for quite a few days and I had already had her to the doctor's office where there didn't appear to be anything wrong. No doctor's office were open at this point in time.

 

I was pretty angry and told her the background in order to defend myself. Also, my response included a comment that I don't have the equipment or training to figure out what's going on when it was obvious my daughter was getting worse. No, they "checked" her over and sent us home. I was quite unsatisfied with this outcome and called the patient advocate the following day. While talking, she asked me how my daughter was and I said that she was no better. She encouraged me to take her back again...which I agreed to do even though I was worried about what would happen.

 

X-rays the next day showed that she had pneumonia affecting at least 1/3 of one lung.

 

Always listen to Mom. And I'm glad you reported the nurse. I've never had that happen in our ER, and I've been there four ttimes in the last five days.

 

Quote:
I know that emergency rooms do more thorough checks now, even when they might not be convinced that there is an emergency however I think that there are many of us who are worried that we are making a mountain out of a molehill and will pay out of our wallets, too, when an ambulance is concerned. It's not as clear-cut when money is a factor.

 

Never be afraid of making a mountain out of a molehill where your child's health is concerned.

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DKS

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Motheroffive wrote:

I would have no way of diagnosing a kidney stone in my house so it's sort of irrelevant as to whether or not they merit an ambulance. I've heard they're painful so if my spouse was in big pain, I probably wouldn't recognize it as a kidney stone and may very well call an ambulance should we ever be blessed with such an event.

 

Once you have had a kidney stone, you know exactly what it is and you go "Oh, sh**".

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seeler

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Mr.Seeler and I have become quite expert on diagnosing his kidney stones and he decides when it's time for me to drive him to the hospital.  The first one was scary though - sudden onset, severe pain in lower abdomin.   But since he could walk, and we live 10 minutes from the hospital, I drove.  They move fast in the emergency room when someone comes in with that type of pain - he never made it to the waiting room - triage, then stretcher, etc.  

 

But yes - first time experience - you don't know what.   A person alone - or quite some distance from the hospital - I wouldn't blame them for calling an ambulance. 

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lastpointe

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DKS,

 

you obviously think I am against calling ambulances which i am not.

 

My point that i was attempting to make is that they are misused at times.

 

Talk to a few ER nurses to see the number who arrive with minor health issues and check out the corridors of emergency rooms that are lined with Ambulance crews that need to wait to off load patients.

 

It is a resource that can be misused and wasted and like all health care resources is finite.  Sure there are valid reasons for using one and I agree that cost should be a deterent, but wasting a resource should not be condoned

 

If you are in doubt about the patients condition then an ambulance should be the way to go.

and gee thanks for that condescending advice on how to treat a person with possible heart issues, in 32 years of being a nurse i wasn't quite sure

SG's picture

SG

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We live a half hour from the hospital. The First Response Team is quick to respond.

 

I would not abuse, but I am also not afraid to use.

 

I do not care if the bill was1 million dollars, if it saved the life of a loved one or a stranger, I would call. I also would not care whether they billed me personally. They would not get blood out of a turnip.

 

Ambulances get abused when somone uses them as a taxi. I do not think it is abuse when someone is generally so scared that they panic and call 911 when it was not all that serious.

 

I have a fair bit of training, and I would drive in most cuts and suspected broken bones (unless moving them would harm them) Most pain I would drive in. That said, any sudden onset severe pain for no known reason would likely get a 911 call. It could be embolism, heart attack, stroke, aneurysm, perforated ulcer ... and I cannot handle that. 

 

I would also call 911 if heart or lungs are involved (a bit of a pulse or breathing issue could turn into a need for epinephrine, paddles, oxygen, bagging, trach in a half an hour) and as I said,  if someone could not walk or if I thought moving them would harm them or if they could provide something they needed enroute that I could not- it may be pain meds (if needed asap) compression (I could not do while driving), paddles to IV to whatever.

 

Personally, any collapse or near collapse would likely get a 911 call. My mind tells me I cannot do what may need medically done in the half hour drive if it is a stroke, heart related, diabetes related...

 

You would not head out for a half hour drive if the car was on fire or had no air in the tires or when it might break down enroute. You also should not when the person in the car might die enroute because although you have a driver's license, you do not have medical training or the tools necesary to keep them alive.

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judyemd

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 In Ontario the person who takes the ambulance gets the bill.  It is charged by the hospital not the EMS service so the hospital only has the address of the patient not where the call originated.

Any patient also has the right to refuse transportation by ambulance by signing off on a form.  If they are unable to do that then the ambulance is pretty urgent for them anyways.

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somegirl

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Upthread Mrsanteater posted the fees for ambulance in NS.  A friend who is a NS resident and Canadian citizen got an ambulance from a car accident and was charged $672.  That's more than my rent.  If I were to call an ambulance I would have no way of knowing if I would be charged $134 or $672.  No wonder there is a problem here with people taking cabs to the hospital.  Especially since a cab ride to the children's hospital is free.

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Beloved

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Just read in  my local paper today that in my community the rate for an ambulance ride is $290 for basic pickup and $3.50 per kilometre.  Under my husband's work benefits we are covered for basic pickup.  There are many in my community who are not covered and would have to pay for this service out of their pockets.

 

If it helps or saves a life, $290 is worth it.

SG's picture

SG

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Ok, it is 41.2 kms to the hospital, According to those rates, it adds $144.20 to the bill. Uh, I know gas is high and wear and tear on the ol' ambulance... but sheesh $3.50 a kilometre. Toronto cab rates are what $1.75 or so a kilometre?

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waterfall

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Did you know that there is now a "new" CPR that is now accepted in Canada? It is now so easy and requires no mouth breathing.

 

Watch the video it may save a life! And have those you know watch it too.

 

See video

 

Also if someone is choking, attempt the Heimlich Maneuver if they cannot talk or make a sound. Wrap your arms around them while standing behind, clasp your hands together and thrust upwards. If the foreign object is not dislodged and they collapse from lack of oxygen, straddle them on the ground and thrust upwards with both hands clasped. It is different for children!

 

See video

 

Try to call an ambulance ASAP but while you're waiting it's good to know some essentials.

 

The ABC's 

 

Airway

Breathing

Circulation

In that order! Keeping the airway open and ensuring someone is breathing is the priority over anything.

 

Also keep the victim warm to prevent shock.

 

I would justify an ambulance for anything that is not normal. When you call 911 they will help you make the decision.

 

 

 

 

 

 

 

 

 

 

 

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