by John Kelly
On August 31, 2010, at around 2 PM, I became overheated while talking to a construction worker on Museum Road. I crossed the street, and requested that guards at the Museum give me some ice water. They gave me a few small plastic cups of ice water, and poured some over my head and neck, but shortly said that they had no more access to ice. After repeated additional requests did not get me any ice water, I consented to have them call 911.
I was overheated, because as a quadriplegic with a spinal cord injury (I drive a power wheelchair with a sip/puff tube), my body does not regulate its temperature. My body does not sweat according to its cooling needs. I have encountered this issue a number of times over my 25 years as a quadriplegic, and every single time, copious amounts of ice water has restored my body temperature to normal. I’ve never before been to the emergency room because of overheating.
My mistake in this case was thinking that Boston city EMTs arriving at the scene in the middle of a citywide heat advisory would make sure that I got all the ice water I needed.
Because I was so hot, I felt weak and had trouble speaking with any volume. So when the EMTs arrived at about 2:45 PM, I had already been rehearsing my request for assistance. When the first EMT came up, I said “Sir, I am very overheated, I need to drink ice water and get an ice pack on my neck. Could you please stay with me until my temperature returns to normal?” He ignored my urgent question, rather casually asking, “Why do you think you are warm?” I repeated my request for water, and began to get desperate. In my desperation, I could not understand why they would not give me ice water.
The EMTs also ignored my request to have my temperature taken, as that would’ve assisted me greatly in understanding my physical situation.
I continued to request icewater, more and more anxiously, but the EMTs would only say that they could transport me to the hospital.
I finally asked the second EMT, point blank, “are you refusing to give me water?” He replied “we’re not refusing to give you water, but we can take you to the hospital.” In hopes of getting some ice water, I agreed to go to the hospital with them.
On the ambulance, the first EMT (who stayed in the back of the ambulance with me) was sarcastic and cruel.. He ignored my requests for water. With great difficulty, I told him my name, address, and social security number, When he continued to ask me paperwork questions, I told him that it was too difficult to talk without water, but I could give that information at the hospital.
After one request for water, he answered harshly “we don’t have any water.”
He put an electronic thermometer into my ear without telling me what he was doing, and after a few attempts on both ears, said maliciously, “you’re not hot, you’re just warm.” But the machine didn’t work, and I saw him taking out and playing with the batteries.
He gave me only one ice pack under my neck, and gave me one more when I begged for one. (Emergency room staff put ice packs everywhere possible.)
When the EMTs arrived at BMC emergency room, they brought me in to the admitting area just outside the treatment area.. The EMTs continued to refuse to give me water. They said that “the doctor will decide when he sees you.”
Then I overheard the first EMT talking about me on the telephone. I heard him say “he kept asking for water but we didn’t give it to him, because he’d been sitting out in the sun without sunscreen.” I heard him say “I asked him why he thinks he’s hot and he looks at me like <indiscernible>.” Then later, “he’s got a little anger problem.” I also heard him say something about “not even wearing a hat.”
After about 10 minutes, the EMTs pushed the stretcher into the emergency treatment area, and transferred me into a bed. They did not ask me how best to do it, nor did they announce when they were doing it. They do not transfer my legs correctly, such that the lower legs hit the side of the bed and were still hanging off the bed. Without comment, one of them threw my legs up on the bed.
Because my blood pressure was increasing, I asked the first EMT if he could raise the back of my bed. He did this. I asked him “can you please remove my binder?” He ignored me. Then I tried again, still having had no water, “I have an abdominal binder on my belly, if you release it will help my blood pressure.” Then he responded “what binder?” I said it was around my belly. He undid it.
The EMTs did not tell me that they had made a diagnosis. As the MFA guard named Elizabeth told my helper Matt on the telephone at 3 PM, I was “extremely dehydrated.” I never said that I was dehydrated, and the EMTs never asked me if I could be dehydrated.
I was not dehydrated. I was overheated… (Unfortunately, the emergency room staff adopted the same erroneous diagnosis, and rushed to treat me for dehydration rather than overheating.)
I believe the first EMT was so hostile to me because I told him directly what I needed; then, when he would not help me, I lost my temper and shouted for water. The EMT became offended. Even though I felt sicker and sicker, I apologized, saying “I am sorry, but when I get overheated, I get cranky. ”
I have heard that EMTs are taught to listen to the patient, as the patient may well know both the problem and solution. These EMTs cruelly and I think vengefully refused to give me water, gave me minimal treatment for overheating, and continued to offer no assistance at the hospital during the time they were responsible for me. The first EMT condescended dramatically towards me, even as he was flirting ostentatiously with a female hospital staffer. (He called her “princess”).
I finally got my first sip of icewater at 3:35 PM (I requested the exact time from the nurse giving me the water), almost an hour after I came under the care of Boston EMS.
John Kelly lives in the East Fenway.
I am a certified emt in CT and have worked in the 911 sector for 5 years. First, I am not defending these emt’s, I may be able to provide some incite. In 5 years I have NEVER seen an ambulance carry potable ice. Supervisors carry it but not ambulances. There is simply no room for a cooler. You asked the EMT’s if they “could stay with you until your temp returns to normal”. How long will that take?! The area I work in in CT is busy, I can’t imagine how busy city’s like Boston and NEew York are. 911 personal can”t just wait around Sir, people are dying out there. Second, EMT’s are not doctors! EMT’s assess, treat and transport to the hospital. If I showed up to your call I would have provided you w/ ice packs and brought you to the ER. I would not giving you water. We are trained to “give nothing by mouth” (w/ a few exceptions, aspirin and nitroglycerin). Providing water for some patients may cause them to vomit. Vomiting could cause an airway obstruction which would just make things worse. I agree it sounds like their attitudes sound foul, but unfortunately so does yours.
Posted by mike | September 5, 2010, 1:35 pmThey followed protocol. Stop complaining. The EMTs offered you transportation to the closest appropriate hospital and provided you the only treatment they had en route.
Posted by Stop Complaining | September 5, 2010, 2:24 pmIf your body has trouble regulating your temperature its sounds you got yourself into this predicament. I know if I was susceptable to heat stroke and it was a “heat wave” I would not go out and park my wheelchair at a construction site to shoot the breeze. secondly, If you were so concerned about cooling off why wouldnt you wheel back to your residence and do so. Calling 911 for an ice pack and ice water doesnt sound prudent to me. I’m not sure if the ambulance carries this stuff. I’d argue you needed an icecream truck with a slushy and a snow cone for your neck, rather then an ambulance equipped with paramedics and life saving equipment. I cannot imagine being one of those emts working in the blistering heat non stop only to show up to an “emergency” with someone requesting an “ice water.” The city is busy enough, I see those ambulances running past my house constantly, now I cant help but wonder if they are on the way to your house to heat up your dinner. STOP abusing the system john other people may need life saving services. do us all a favor and stay out of the heat
PETER
Posted by BB CITIZEN | September 6, 2010, 12:29 pmThese responses, blaming the victim, are neither helpful or reasonable. Lots of other citizens get themselves into trouble in harsh weather, or accidents, etc., and we all assume that they can count on being helped by the tax-funded first responders whose sworn duty is to serve the public. But because this citizen has a physical disability, he should expect less? He should avoid any and all risky situations, so that he will never need to call upon the EMTs? That is not equality. Instead, we should hold our first responders accountable to provide appropriate care to all who need it.
Posted by Laura | September 6, 2010, 4:01 pmThis is outrageous! First of all, that something like this could ever happen. Secondly, that this behavior could be defended in any way! Instant ice packs are a staple in any household first aid kit; that an emergency medical vehicle would not stock these inexpensive lifesavers is preposterous! John, you have not reported on the outcome of this traumatic experience. If you had had a stroke, no one would be accusing you of being unreasonable. Let’s hope that it doesn’t come to that and that EMTs get proper training.
Posted by Hannah Jo. Karpilow | September 6, 2010, 7:16 pmit is incredibly disheartening that people are defending these incredibly patronizing EMTs. they were rude, condescending, and utterly disrespectful in so many way, but especially in terms of completely ignoring that someone disabled might now what’s going on with their own body.
if they don’t carry ice they could have respectfully explained that to John and tried to figure out another solution that wouldn’t have left him feeling anxious, uncomfortable, unheard and disrespected. how in the world can this be defended!!!!!!
to say that John should not have been out is outrageous and offensive. EMTs should be trained to respect that disabled people know their bodies well and know what they need.
Posted by staylor | September 6, 2010, 7:37 pmIt is regrettable that you feel you were treated inadequately and inconsiderately. Perhaps, had you understood the care providers’ motivation from withholding the administration of drinking water, you would be a bit less upset.
It sounds as if you know your body quite well. However, you should realize that EMS providers are required to follow rigid protocols that are based on standard pathophysiology, not specific irregular presentations. Although you felt able to self-diagnose based on prior occurrence of similar symptoms and then informed the EMTs of what had been an effective treatment in the past; the EMTs are unable to treat based on your anecdotal research. Your medical history is, of course, relevant and must be considered throughout evaluation and treatment. Despite that, it’s impossible to medically prove-in the field- that the symptoms you were experiencing at that time are attributable to the same cause as in past episodes. Therefore, the only responsible course of action is to treat you according to state and local protocol.
The EMTs did not provide you with water for a multitude of reasons- none of which are due to a lack of training. In fact, it would have been outside their scope of practice, in the state of Massachusetts, to allow you to orally consume any water while in their care. (As Mike has already so accurately articulated.)
Boston EMS is among the leading prehospital providers in the USA, and has an shining reputation among the healthcare community. This department routinely preforms mandatory inservice training with all employees as well as an initial six month long training academy comparable to that of the police and fire departments.
Having been so trained and educated, this ambulance crew was most likely aware that in severe cases of dehydration (almost always a condition that occurs simultaneously with being “overheated” aka hyperthermic) plain ice water can potentially harm a patient. In such cases, fluid restoration must include electrolyte replacement and monitoring. To give plain (hypotonic) drinking water to a severely dehydrated patient increases the risk of vomiting, and may lead to complications such as airway obstruction (as mike already mentioned), hyponatremia, hyokalemia, and alkalosis. Marathon runners don’t drink gatorade instead of water because it tastes better, they drink it because they don’t want to become ill.
The EMTs may have limited the amount of ice packs they provided you, as to not over cool you. Extreme cooling (especially in the facial area) can lead hypothermia and to vagus nerve stimulation-causing a reduction of heart rate, and eventually blood pressure.(I.e. the Diving Reflex) Possibly dehydrated (I am aware you are under the impression that dehydration is a completely separate illness from hyperthermia-but they actually are very closely related), you were already at risk for hypotension (low blood pressure.)
Laura, Hannah, and staylor make a good point: There is no justification for rudeness. Healthcare providers are taught to respect patients regardless of their disposition and to be sensitive to patients’ emotional states. It sounds though that you took a critical eye with the EMS crew as soon as they refused to comply with your request for water. Understand that healthcare providers are only human, and don’t possess infinite patience. It sounds as though the EMT became short with you after you refused to answer his questions and even resorted to shouting at him.
I am not debating that the EMTs’ social conduct was questionable. Talking on the telephone, flirting, and socializing while providing you care is unacceptable. Like staylor wrote, “they could have respectfully explained to John” why they didn’t provide you with water. It sounds like they made some unsuccessful attempts to do so-they informed you they had none, and that the doctor would determine if it were medically safe for you to have any. Would a more medically related explanation have put you at ease? Or had you already shouted and acted agitated and unreceptive to such an explanation?
It’s your responsibility to be your own advocate. If talking is difficult without water-then there’s no point in shouting then wasting more breath to apologize for doing so. Save your voice to explain how you would like to be transferred to the bed-which I’m certain you could have ascertained was imminent when they brought you to the room regardless of if they announced it.
The EMT most likely was attempting to gauge your mental status and assess the pertinent events leading up to your ailment, rather than ignore your statement, when he asked, ” Why do you think you are warm?”
Prehospital providers are trained to ask “paperwork” questions to conscious patients before arriving at the hospital. This allows for rapid and efficient triage once you reach the hospital and continuity of care after the EMS providers have left should the ER staff need to access the records of your prehospital treatment. In the event that a patient’s condition worsen while en route to the hospital, he or she may be unable to provide such information later on. Having access to the patient’s identity, social security number, birthdate, etc. is imperative to obtaining potentially lifesaving medical knowledge about that patient via medical records and contact with next of kin. The EMT wasn’t asking you these things just to send you a bill, he was asking you these questions because they are required in order to provide you with quality care.
BB CITIZEN aslo makes some notable arguments. Like I mentioned, it seems you know your body well. You’ve articulated yourself as an intelligent man. While you’re a quadriplegic it seems that you have the resources that allow you to care for yourself- and certainly have an active role in maintaining your health. (Demonstrated by this very post!) Its surprising then, that you were out on a hot day and so ill prepared for the weather. It’s especially confounding as you are already aware of how your body reacts to such conditions.
Both Mike and BB CITIZEN mention that calls for non emergencies put a strain on the 911 system. We should all be cognizant of our use for public resources, and the needs of our communities. It would be irresponsible for an ambulance to remain on scene with you until your “temperature returns to normal,” especially during “a city wide heat advisory.” The primary role of EMS is to safely and timely treat and transport you to the closest appropriate hospital and return to service without delay. While on scene, EMS may instead assess that you are competent and safe to refuse care, and document accordingly. EMS may even quickly assist you in obtaining the aid of other public safety resources via radio. It is most certainly not appropriate though, for an ambulance to be put out of service to sit with you until you feel better. They did the appropriate thing by transporting you to the hospital . It’s impossible to provide safe, definitive, care and monitoring on a city sidewalk-and a danger to your health to attempt to do so.
We all need to remember that city resources are limited and need to serve everyone.
How would you feel about someone calling the police for a noisy neighbor when there are people being held at gun point elsewhere in the same city? It’s the same thing when you call an ambulance for something you think you can self-treat, or more importantly- could have prevented. You’re holding up an ambulance while people with life threatening conditions are waiting longer to be treated because an ambulance now has to come from farther away.
I’m a bit puzzled as to why you agreed to go to the hospital, when it sounds like through out the entire ordeal you were convinced you knew exactly what was wrong with your body and exactly how to treat it. If you only agreed to go to the hospital “in the hopes of getting some ice water,” then why wouldn’t you opt to go to the nearest connivence store, water fountain, or faucet? It’s not a hospital’s responsibility to prepare drinks for everyone on a hot day, nor are you entitled to have beverages delivered to you by ambulance.
On the other hand, if you were agreeing to transport because you were also feeling ill-then you are by default accepting the help the EMS service and hospital are licensed to provide Accepting this aid includes allowing the EMS and hospital workers to assess you (which requires asking you questions) and determine your treatment according to their criteria-not yours. If you believe you know your body and your medical needs better than the EMTs and hospital staff then you don’t need their services. If you want to be treated for your own diagnosis and with your own interventions-then don’t ask for the help of trained professionals.
Ultimately, it’s saddening to read that you had such uncomfortable experience with the ambulance service. It sounds as if the EMTs could work on their communication skills but in no way was the medical treatment you received from them malicious or negligent. The EMTs did exactly what they are trained and licensed to do. I think mike put it best, “ti sounds like their attitudes sound foul, but unfortunately so does yours.”
Posted by Objectively anonymous s | September 8, 2010, 9:07 amIf you read the novel of a post before this one it seems like the way those guys treated you had nothing to do with your disability but more to do with your attitude.
It’s not fair to yell “DISCRIMINATION!” at public agencies when they probably would have treated any other patient who behaved the way you did the same way.
Ambulance workers and nurses probably don’t like being told that you know what’s going on and what you need better than they do. Just let them do their job, which they do for everyone of every color, kind, physical ability, and economic status.
Posted by trevor | September 8, 2010, 10:57 amLaura- Nobody here is saying that John doesn’t have a right to call for the ambulance because he’s disabled. The problem is that he says that he already knows he gets sick with extreme heat and he already knows how to make it better, so he should have brought water with him when he left the house since he knew it was going to be hot out. Obviously accidents still happen. Of course he has a right to the ambulance just like everybody else does, but he a has an obligation to take care of himself jut like everybody else does, and not to rely on tax payer money to do it for him.
The EMTs weren’t claiming that John doesn’t know his body because he’s disabled, they were acting according to code cause they have to. The long post before mine does a really good job of explaining this when they say that EMTs have to make decisions based on general training and not specific patients. They’re not doctors who see the same patients regularly. They see people once then never again, so they have to work with a standardized format-meaning they treated him EXACTLY like everybody else. Standard evulation, standard medical intervention-still not allowed to give water- has nothing to do with disability!
Hannah Jo.-
Are you a doctor ? Do you work on an ambulance? Do you work in finance? Calling ice packs “lifesaving” just because you stock them in your house is preposterous. Did you consider that they might not actually be inexpensive in large quantities? What about if you factor in shelf life? Maybe ice packs don’t hold up too well in vehicles that move around all day. Or maybe they don’t keep them because they’re full of dangerous chemicals. In the same long response before my first one they talked about how cold could actually do damage to somebody…and it sounds like that person did their homework.
There’s a difference between calling the ambulance for a stroke,heart attack, or accident and calling for something you think can by resolved by something that isn’t just found only on ambulances. Heart attacks and strokes need specific medicine that’s regulated, not something that comes out of every tap. John knew what was going on with his body, and he knew how to make it better, but had the ambulance come anyway…that’s the unreasonable part.
The ambulance staff could have been a lot nicer and had more patience, but they shouldn’t have to put up with rudeness just because someone is sick and stressed out or scared. John even says he was yelling, and it sounds like he kept asking for water even after the said they didn’t have it. Is it OK to go into a restaurant then repeatedly yell at the waiter for a meal the restaurant doesn’t even serve, just because you’re really hungry?
Posted by trevor | September 8, 2010, 11:50 amMr. Kelly- in all your whining about discrimination, you forgot to mention how the EMTs went out of their way to make arrangements to have your electric wheelchair transported to the hospital as well. And in the time they were dealing with you, two of your neighbors could have used the ambulance– one hit by a car, and one having an MI so while you were busy screaming at the EMTs, another ambulance had to come to take care of your neighbors. I’m sure they weren’t complaining when the ambulance showed up.
Posted by Frank | September 8, 2010, 12:26 pmSir,
These EMTs are not your maids. If you notice, it says “911 Emergency” on the side of the vehicle. You readily admit that your condition, was not an emergency. Let’s take a look at your self-admission.
“I believe the first EMT was so hostile to me because I told him directly what I needed; then, when he would not help me, I lost my temper and shouted for water.”
So you admit to losing your temper and shouting for something they cannot give you. You’re lucky I’m not the EMT who showed up, because I would have transported you to a pysch facility for anger management. You are obviously an unreasonable human being with pent up anger. Stop taking it out on everybody else. Get some therapy.
Posted by Jack | September 15, 2010, 2:42 pmYep, this sounds like another example of the increasing loss of compassion and civility within American society. Especially among the polictical class and health care industry.
We all read recently that hundreds of EMT’s in Mass. faked their certification exams, probably because govt. regulators took a cash payout.
I’ve been shocked by the routine callousness within the teaching hospital staff and clinicians in Boston.
Posted by Disabled | October 14, 2010, 3:25 pmI’m a paramedic in the Las Vegas valley and am planning to relocate to Boston next week. If the EMS protocols there are anything like they are here, oral hydration is not something that crew could have done. IV rehydration, sure. Oral? No. Here, some of us *do* carry water on board during the summer (the rate of patients suffering from heatstroke, heat exhaustion and dehydration increase dramatically from spring to summer), however, this water is to keep the crew orally hydrated, not patients. Had this gentleman been a patient of mine, he would have received an IV and a bolus of NS (we only carry normal saline in this system) and his core temp would have determined how many ice packs he would have received (which still wouldn’t be a tremendous amount as rapid cooling can turn into a problem, as has been mentioned above).
With that said, had this gentleman been a patient of mine, despite his anger, he still would have been met with professionalism. I’ve been a medic for 15 years now, and I can assure you, I have been cussed at, threatened, physically confronted (some people are just up for committing a felony, i guess), you name it, it has happened. But it is no excuse to return rudeness for rudeness. The mark of a professional is that she/he does not let their personal feelings get in the way. It seems like this crew may have personalized this mans’ anger, which is not professional at all.
Ultimately, I feel this way: He knew that he had an issue with temperature regulation but still went out to shoot the breeze during a heat wave. Most quads I know and have treated would have at the very least had their caretaker go with them and have a supply on hand of what they needed. In my eyes, because he knew the risk of going out all by his onesy, and not taking appropriate and prudent measures, he ultimately abused the 911 system in his area. To ask a crew of any system, let alone a busy system like Bostons’ to stand by why his temp regulates is silliness pure and simple. As has been mentioned before, in the time the crew was responding to you, several calls went out for actual 911 responses. While the crew was getting a primary assessment, asking him if he wanted to go to the ED for treatment, arranging to have his electric wheelchair tx’d to the facility – several calls went out for respiratory distress, chest pain, traumatic injury, et cetera. Being demanding of an EMS crew, demanding things that the crew cannot give because of protocol is also pure silliness. Throwing a fit over it is even more so. I understand the level of frustration a patient can feel over certain things, but it is not an excuse to lash out.
The fact is, sir, that you are angry because the crew could not possibly meet your demand according to protocol. Yes, the crew should have been consummately professional despite this, and for that, they too carry a small portion of their own blame but you shoulder the ultimate load of it. We have protocols to follow (they differ slightly from state to state as well) and ultimately, it *is* for the ED Dr. to decide after their assessment if you can orally hydrate or not. Also, dehydration and heatstroke/heat exhaustion often go hand in hand, which is why it becomes the primary Dx in such cases. 9 times out of 10 these patients are also in various states of dehydration. So no need to get your knickers in a knot over the Dr.’s discharge diagnosis. Perhaps next time you have to call on EMS, you’ll remember that allied healthcare workers of all sorts are bound by protocol, and that being a good patient means exhibiting extraordinary patience.
Sincerely,
A Las Vegas Paramedic
Posted by LVNVMedic | October 18, 2010, 6:42 pmPlain and simple. Another entitled person that wants the world to revolve around them. If you became “overheated” by simply talking to a construction worker in August, you have no business being in that position in the first place. Know your limitations and abide by them. Clearly since youve been a Quad for 25yrs you should know better. Prevention is best medicine, wear a hat and sunscreen, carry water on your scooter, go in the shade and cool off.
I wouldn’t have given you water or ice packs either, you could puke or pass out, thus making my job more difficult. If you are that in tune with your body and its “cooling needs” then stop being a retard and putting yourself in those positions.
Use your DTA card and stock up on water for the summer know fool.
Posted by you're an entitled dufus | February 3, 2011, 12:18 pmWow, where did all the assholes come from? I didn’t know EMTs were such shits that they’d deliberately do their best to be dicks to their patients. I would have just written it off as just a couple of losers but then a whole crowd of self-proclaimed paramedics come in and go “ENTITLED LOSER!!” when heat stroke is no laughing matter. It makes me think your job goes to your head and makes you unprofessional cretins as opposed to good profession life-savers.
You guys really should listen to the patient if he knows that he has a specific need – I understand, you guys don’t want to give out your precious water to some bum because he’s just some loser to sneer at and hate, but be human beings. That’s the MINIMUM requirement for your job, even if you and they can’t seem to understand it.
Posted by Nerem | February 18, 2011, 8:49 pmDear sir,
You state, “you’re quadriplegic with a spinal cord injury (I drive a power wheelchair with a sip/puff tube), my body does not regulate its temperature. My body does not sweat according to its cooling needs. I have encountered this issue a number of times over my 25 years as a quadriplegic, and every single time, copious amounts of ice water has restored my body temperature to normal.”
If this is the case and it there was heat advisory that day you should of known that you could easily become overheated, you should have taken responsibility for yourself and stayed home. As an EMT I would not have given you water due to I don’t know your history. There are a number of things that could have gone wrong even if I had water to give you. Ice packs and maybe and ALS intercept giving you IV fluids is best that could have been done. We assess, treat and transport. EMT’s and Paramedics as far as I know do not carry drinking water on board. For example if someone is in acute heat stoke that patient can be given IV fluids, ice packs towels soaked in saline to cool down the body. The IV fluids are as good as drinking water but works a hell of a lot faster. As for the rude behavior you speak of from the EMT’s that treated you, sometimes that is uncalled for and as an EMT I apologize on his behalf. Many EMT’s and Medics can become burnt out and not know it and therefore take it out on their patients. My advice, the next time there is heat wave, stay home. You know what’s best for you and you know what can cause you medical problems.
Posted by Hillary | February 22, 2011, 4:20 amYou are all idiots. Maybe if any of you had any experience you would understand why this happened. First off, ice water was his request and on ambulances we don’t carry that. I work in MA so I know this. Second off, yes, they could’ve given him ice packs, but, if he had just agreed to treatment the first time when they asked, then he would’ve been treated for heat exhuastion…not heat stroke (you don’t sweat when you have heat stroke). These EMT’s did everything they were supposed to. They asked him “Why do you think you’re hot?” because they aren’t mind readers and they need to understand why he is having the problem, so they can treat it appropriately. Before you decide to post comments that are outrageous and incorrect do your research. Boston EMS is one of the highest regarded EMS organizations in the country. They all go through a rigorous 6 month academy. To say they aren’t trained is plain dumb. For all you bystanders who thought it would be a good idea to chime in on an EMS issue without knowing what really goes on in a truck, shame on you. Have some respect for these people because one day you may need them.
“You guys really should listen to the patient if he knows that he has a specific need – I understand, you guys don’t want to give out your precious water to some bum because he’s just some loser to sneer at and hate, but be human beings. That’s the MINIMUM requirement for your job, even if you and they can’t seem to understand it.”
By the way, whoever wrote this is a complete idiot. If you actually knew what was carried on ambulances, you would understand drinking water isn’t one of them. Nice attempt to try to be the smart guy. Do some research before you add stupid comments like this one.
Posted by Chris | March 2, 2011, 4:16 amIt’s an ambulance, not an ice-cream truck. There is no water. The EMTs are not your waitresses. They cannot give you water, they cannot give you an IV (because a man feeling hot does not get an ALS truck), they cannot give you anything except a ride to the hospital. If you are sick, let them take you to a hospital. If you are not sick, go home and let them take care of someone else. In either case, stop feeling sorry for yourself. Be grateful that you were mostly likely the least-sick person they transported that day.
Posted by Kelly Clarkson | May 8, 2011, 2:16 amI have been in EMS since 1991. Working busy urban EMS in NJ since 1994 as both and EMT and Paramedic (2 tier system.) A normal 12 hour shift is between 10-15 calls my record is 26. Became registered nurse in 1999.
To the EMS crew :
There basically is no right answer to this. EMS personal are taught to NEVER give anything by mouth. I think this is totally unrealistic and probably was intended to keep the patient safe if sugery (general anesthesia) is needed or to prevent aggravating a surgical abdomen. It has been my experience though, that most people who actually require immediate surgery (within 12 hours or emergently) WILL NOT WANT TO TAKE ANYTHING BY MOUTH they are just too ill. It is pretty clear that this patient was suffering a heat emergency and not an acute appendicitis.
With that being said, if possible, I would have provided ice water to this patient. It is not unreasonable to have hung out for 10 minutes and tried to actively cool him and let him chill out a while. Arrangements had to be made for transport of the heavy motorized wheelchair, which likely meant either calling in a wheelchair van or pick-up truck with a ramp. Both would have taken probably at least 10 minutes to arrive, water could have been provided.
Because of this patient’s medical history and condition, he will likely be placed in the main ER (not to ER waiting room) and will be taking up a need ER bed for probably 4 hour minimum when the “emergency” could have been resolved relatively quickly.
There is also the consideration that potable water is often not carried on ambulances. This may be a surprise to the public. Realistically, ambulances should be issued a 5 gallon igloo type container that can be filled with water or Gatorade primarily for crew hydration and secondarily for FIRE/POLICE/Patient hydration. Especially in the middle of a heat wave. Anyone can easily become overheated on an accident scene or just wearing a dark blue uniform and standing in the sun. It is OK to use some common sense in EMS.
I do understand why the water wasn’t given and only transport was offered. I get this…and have been there. I also offer this advise with years of experience and also some common sense.
To the patient :
Have to agree with some of the replies regarding personal responsibility while being outside during a heat wave. You could probably be more cognoscente of this in the future, especially with previous episode of heat regulation emergencies.
I can never totally imagine what it is like to be a quad in that damn chair. It sucks. Most likely, you are probably continually spoken to and treated like you are stupid, infantile, or mentally challenged. People meeting you for the first time only see the chair and disability, not you. I HAVE DONE THIS TO DISABLED PATIENTS MYSELF. It is not intentional, and likely comes from the medical providers lack of care or knowledge of disabled. I can imagine the frustration of sitting in a wheelchair and having a medical professional ask a family member all the medical questions your are perfectly capable of answering because they assume you unable to. to.
It just plain sucks that you had this negative experience with EMS. You have every right to explore the outside and enjoy your life, but a little forethought would be better next time.
To the public:
This is an unfortunate call with only 1 side of the story. NONE of us were there. I am not undermining the complaints, but no one was injured and the patient did get to the hospital. The crew was not negligent in their duties at all.
EMS is a tough and thankless job. I ask all of you that have never done it to not judge. Your job at as a bank teller, carpenter, office person, or mechanic cannot compare. Medics and EMTs see real horror stories everyday. These might not be horrific accidents, but may be a 40 year old suffering a life-changing stroke…or countless other calls.
Given the heat, I am sure all parties involved had some short fuses. I think Mr. Kelly should write a letter to Boston EMS command staff and perhaps make himself available to meet with the crew or possibly be utilized as an “expert” in a disabilities awareness continuing ED class. This maybe extremely productive for everyone.
Posted by Streetskirt | May 10, 2011, 1:42 pmThis is a classic case of failure to be a responsible adult. Instead of complaining about the EMT’s who “refused” to give you ice water maybe you should face the facts. EMT’s and paramedics have protocols, which are concrete and definable medical laws that they have sworn to uphold and administer. Short of you becoming their medical director and changing their protocols, you are not ever going to get any kind of oral intake short of activated charcoal. In the event of the latter, they still have to call on the radio and get permission from a doctor beforehand.
Now, as s supposed grown adult with this unquestionable understanding of your own medical condition, you should have brought water. Heat wave, check. Pre-diagnosed medical condition making you susceptible to over heating check. Bottle of water no where to be found. Your personal inability to properly plan for the day a head of time does not constitute a need for EMS personnel to break their protocols, even with all of your self entitlement. If it was cold would you head out in a Hawaiian shirt, shorts, and flip flops? If you answer yes, then I suspect that the staff from your facility had no idea you had left the premise to begin with.
Had you been so completely disgusted with their quality of care, you should have signed the refusal and went down the street to any one of the world renowned hospitals located in Boston.
Stop blaming your own self inflicted “suffering” on others and man up like an adult. That EMS crew probably came from a real emergency to take care of someone who is thirsty and won’t buy a bottle of water for himself.
Posted by Fatz | September 15, 2011, 9:23 pm