when to call 911?

  1. What would you do? I had an incident happen the other day & need some feedback please.

    A person has passed out completely, is twitching, (seizure?) and when awake is disoriented, & is adament about not going to hospital. Pale, cool clammy skin, BP is high according to persons baseline. Person when awake does not want ambulance. (this is not in a hospital).

    Person has normal health hx except for incident 24h prior when person passed out cold, (no seizure involved) was taken to ER, examined & released.

    So thirty minutes pass, with periodic episodes of so called seizures, I can't help but notice this person is obviously not getting better and needs medical attention, but surely I'm thinking the people attending her are thinking the same thing. (Case of too many cooks in the kitchen if you know what I mean).

    To end of story person was taken to hospital, 2 hours later.
    What is bothering me, is....shouldn't the people attending this person called earlier for an ambulance or taken person directly to ER themselves?

    Thanks all.....
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  2. 10 Comments

  3. by   cpgrn
    If an adult refuses treatment, you can't force them. If they are unconscious, it is implied consent.
  4. by   thatldo
    Then I had the correct line of thinking...that when person is unconscious thats when ER help should have been called. Way I was looking at situation was, even if person was awake when amublance arrived, the way the seizures were coming closer together, they could have transported person when person was unconscious.

    Thanks for replying..
  5. by   jemb
    Originally posted by thatldo
    Then I had the correct line of thinking...that when person is unconscious thats when ER help should have been called. Way I was looking at situation was, even if person was awake when amublance arrived, the way the seizures were coming closer together, they could have transported person when person was unconscious.

    Thanks for replying..
    No need to be sneaky about it. Calling for help when needed is appropriate. If the person is going in and out of consciousness, it is appropriate to call paramedics/ ambulance. If the situation improves and the person is walking, talking, and lucid when care arrives, he/she can always refuse the care. However, with paramedics and transportation right there, even if the person is conscious by then, it is more likely that he/she can be convinced that care is needed.

    When I taught CPR classes, I used to tell my students, "Even is someone insists that they are okay when you see that they are obviously showing signs of a heart attack, just go into the next room and dial 911. That way, you already have help on the way in case they person becomes unconsious or goes into cardiac arrest. If it is a false alarm, you'll have a story to share and laugh about later."

    I would say the same theory applies in the situation you described.
    Last edit by jemb on May 10, '03
  6. by   Good_Queen_Bess
    I don't wish to sound pedantic, but how do you know that this person is hypertensive?? Do you keep a BP monitor at home for those times when you need an emergency diagnosis? :chuckle

    I would call an ambulance unless the patient was cognitive and refused.
  7. by   thatldo
    The patient was a home health nurse & he always carries his medical supplies in his car which was available at time.
    Does this explain?

    And in answer, yes I have a BP monitor at my house, (FYI, this was not at my house but at a public event) for my husbands condition, surprise!
  8. by   cpgrn
    I teach cpr and we always teach that a conscious person has the right to refuse treatment. An unconscious person is a different story and that is where implied consent comes in. You can not force help on a conscious person without their consent.
  9. by   passing thru
    What's that old saying???

    "Don't let the inmates run the asylum!"
  10. by   robred
    Agreed that a conscious person has the right to refuse care, but only if they are aware, alet and oriented to person, place and time and to their particular situation. If they are not, one can question their ability to make a sound decision.
  11. by   neneRN
    Agree with robred; if the person was having seizures, are they really with it enough in a postictal state to make that decision?
  12. by   angelbear
    I agree with the thing about not being of sound mind enough to give consent. My hubby has athsma. One time he ate something that he had a bad reaction too. He was not breathing well at all but kept telling me not to call the ambulance and to leave him alone. I called the ambulance they gave him eppi. At the hospital MD said when people cannot breath right that they cant think right either and that I did the right thing. After hubby was better he said the same thing that he would not ever want to be left like that and he has no idea why he was refusing my help to the point of violence. MD said it is a common panic reaction. Hope that helps

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