Right or Wrong

EricJRN, MSN, RN · Jun 10, 2006

Sounds like that was a stressful day for a while! Your post brings up a really good point: It can be really hard to tell what's truly going on with a patient just based on a phone description, even if both people on the phone have medical training. As a nurse who is also active in EMS, I can tell you that we're never sure of what we're dealing with based on our dispatch information alone. If we're called to an abdominal pain, it might really be abdominal pain, or it could be a code. :) It must have been hard to be on the other end of the phone and listen to the staff's descriptions, trying to make sense of the whole thing.

Not sure what part of the US you're in, but remember that heat exposure doesn't just occur in places with 110 degree heat. Being cognitively impaired would no doubt place this patient at increased risk for heat emergencies, hypoglycemia, etc.

I'm wondering how disabled this patient is. Was there a possibility that the pt could have been stung and not felt it? While I admit that the combination of the respiratory noises and facial flushing is weird, it's hard to pin it 100% to any particular problem. If the pt had been experiencing a true anaphylaxis, it's likely that the pt would have continued to go downhill until he was given some epi or other meds.

Do you think that the staff was truly comfortable administering the EpiPen or that maybe they 'dropped it' rather than do something outside their comfort level. (Hate to even bring up that possibility, but the whole thing sounds kinda goofy.)

In the end, the pt did well, and you did the #1 thing that would help this particular pt: Instructing the staff to call 911. Assuming that you live in an area where advanced life support EMS is available, the medics would have been able to give other meds like Epi 1:1 and Benadryl if the situation had escalated.

In EMS I've learned one more important lesson: There are dozens of ways to handle any particular emergency. One way may not necessarily be more right or wrong than another, but there will always be those who like to sit back and play Monday morning quarterback with you.

Thanks for the interesting post.