[pickledpepperRN]

Some Hospitals Call 911 to Save Their Patients

Should a hospital be able to handle a medical emergency?

The answer may seem self-evident. But patients at some hospitals may find the staff resorting to what someone might do at home in a crisis: call 911 for an ambulance.
That happened recently in Texas, where a 44-year-old man named Steve Spivey developed breathing problems after spine surgery. No physician was working there when the staff first recognized he was in trouble. They phoned 911, and he was taken to a nearby full-service hospital, where he was pronounced dead a short time later. …

…Beyond any changes Medicare might make, some states are also contemplating new rules. Texas, for example, is considering requiring any hospital in a county with 100,000 or more residents to have a doctor on the premises around the clock and to have certain emergency medical equipment on hand. Indiana and Kansas are also contemplating similar changes…

http://www.nytimes.com/2007/04/02/bu...=1&oref=slogin

http://www.wilmingtonstar.com/apps/p.../1002/business

[caroladybelle]

And now we see what happens when doctors run hospitals.

[pickledpepperRN]

I think the doctors hire consultants to "help" them run a hospital.

I remember excellent hospitals run by nursing nuns.

I don't understand how doctors don't think a doctor has to be available?!?!

[Hopefull2009]

My grandmother almost died on a weekend following heart surgery (two days before she was looking at going home, had been doing amazingly well, and she was only 66 at the time)...fluid suddenly built up and compressed around her lungs, and they called the Pluminary Doctor who took 90 MINUTES to get to the hospital...I was there alone with her, and I was FREAKING out, screaming at anyone to call and see what was taking so long....no Doctor on call should be that far away from the hospital."

You know what they said, "Well, he's the only pulminary on call and he'll get here when he can."

By the time he got there she was close to a code and they had to vent her, and 3 MONTHS later, she went home, died a couple of years later...they never gave a good explanation of what happened..but I sometimes wonder if her problem had been addressed immediately if she would still be with us.

[Sweetooth EMT-P, RN]

Well I am a paramedic and beleive it or not in the state I work in it is legal for ANY facility to dial 911 for an emergency transfer, even a hospital. They are suppose to only use this method if they have tried area private ambulace companies first, but like I said it is perfectly legal and an ambulace has to respond.

Swtooth

[LilPeanut]

My ER has used 911 in emergency situations. I worked at a children's hospital and one night we were short a doc and a few nurses, had two critically ill patients come in, 3 level 2 traumas and 3 c-spines, all within about a 30 minute span of time. Then a post partum mom visiting her child in the NICU started to hemmorage. She was an adult, so we called 911 to get one of the buses to take her stat to the adult hospital 1 mile away (of course we made sure she was stable for transport first). We didn't have the staff or equipment to deal with a problem like that, at that point.

[Captain Tripps]

It's pretty common to run calls from hospital to hospital because the shipping hospital cannot handle the patient. For the most part it is peds that we transport to a ped specialist hospital, i.e a NICU unit.

My favorite calls are when a patient gets tired of waiting and wanders out to the lobby to call 911 from the pay phone. Pay phones for the most part don't have names attached to them, just addresses, so the EOC doesn't know it's a hospital. The transcripts go something like this...

EOC: 308 copy an emergency 123 Anywhere St, priority 2 abdominal pain time out 2308.
308: copy 123 anywhere st, you do realize this is St. Johns?
EOC: copy 308, I just realized that too, disregard, we'll call St. Johns and let them know they have an unhappy patient.



Peace,
Tripps

[Jokerhill]

I know this is about MD's but it does not stop there. We got a call last night to go to another local hospital for a high risk delivery. They wanted us to do the baby recovery and stabilization strait from delivery in their OR. They said they just did not have the staff for the baby and the Mom was too unstable for transport. We finally agreed to go over and wait for the baby during delivery and after the initial recovery by their NICU staff. And then we would take over and transfer the baby out to our NICU. I don't know the final cost but I bet it is a bit more than what it would have been to have staff come in at double their pay. But there is not a nursing shortage, we just cant get enough of them to work here.

[queenjean]

As to calling 911--well, I used to feel like I needed that sometimes. The patient wasn't in full arrest or even on the brink, so we didn't need to call a code. The hospital didn't have a physician in house at night except in the ER, but they can't leave except for codes, you can't get ahold of the doc right away, you know your patient is having problems that maybe require more than you are capable of giving--what do you do?

Our hospital has followed the lead of many other hospitals in developing a rapid response team. So now, if say my patient suddenly develops signs of a PE, I can call the rapid response team and have a pharmacist, lab tech, ICU nurse, ER nurse, respiratory therapist and the nursing supervisor show up in the patient's room within 60 seconds. We have standing orders that we can implement in a rapid response call, including CTs, Xrays, lab draws, O2, and certain medications. I don't have to wait to have the pt's physician call me back to get orders to do anything, and I have some more experienced people in the room to help me care for my patient. It has helped enormously, and the number of codes called in our facility has actually decreased fairly dramatically since we started the rapid response team. It is a wonderful resource, especially for us night shift staff.

I wonder if hospitals who have to call 911 for emergencies would benefit from having such a team in place.

[Elvish]

We too have a Rapid Response Team and we love it. We have a dedicated one for Peds and one for neonates (fortunately not used much). The RRT has done a lot in reducing code blues. I realize smaller hospitals (we are 700 beds) may not have quite the luxury of so many dedicated RRTs, but it does make a difference.