Taxi vs. 911

Specialties Emergency

Published

Tonight, in our ER, a man came in with a gunshot wound to the arm via taxi and a three year old came in via ambulance (his parents called 911) because he put a dime in his nose.

Silly, I know.

Just thought I would share. :coollook:

Specializes in Emergency Room/corrections.
Best treatment for bug in the ear: use a syringe-full of alcohol. The bug will die and float to the surface and can be easily removed. Works much quicker than irrigation and doesn't cause any type of trauma.......

OR about 3 drops of 1% lidocaine. Same theory. It dies and floats up.

We had a guy call an ambulance because he had a small non-repairable lac on his toe.... and then there are always those who come in nearly dead in pulmonary edema via POV... they refuse to call and ambulance because their neigbors would know they went to the hospital. :rolleyes: :rolleyes:

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There was a study not too long ago (Journal of Trauma I think) that compared mortality in major trauma victims who arrived to the ED/Trauma Center via EMS vs Taxi. Those who arrived via EMS fared worse than those who arrived by Taxi. Seems the biggest contributor to mortality was time wasted on scene which EMS did a lot and Taxi drivers did very little. yes, injury severity was comparable in both groups.

I heard about that study at a trauma conference I went to recently. Pretty neat, eh? ;)

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I work in L&D at a local hospital, and one of my pet peeves is when pts use EMSA as a taxi service. Usually they've only had one contraction or two, water is intact, they insist that they didn't have anyone to drive them to the hospital but then 5 minutes later a car full of relatives pulls out and they exit like a carful of clowns!

What was really sad a few months ago is when I was at the delivery of someone like this. She arrived with a +UDS for marijuana and cocaine. She didn't seem to know (or care) that she was having a baby, and insisted on IV drugs over the epidural. That baby was so tiny due to drug use - she was a few days past due and she had a 4lb. 15oz baby. But I digress...

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What was really sad a few months ago is when I was at the delivery of someone like this. She arrived with a +UDS for marijuana and cocaine. She didn't seem to know (or care) that she was having a baby, and insisted on IV drugs over the epidural. That baby was so tiny due to drug use - she was a few days past due and she had a 4lb. 15oz baby. But I digress...

Poor kid, what kind of a life is he going to have? :crying2: :angryfire

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Last month we had a teenager with cockroach in his ear. Said it crawled in while he was sleeping.

Tried irrigating / suctioning it out but we weren't successful.

so what happened to it?? you just left it there?:uhoh21:

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a few weeks ago I saw a woman come in by taxi who had fallen on broken glass and ripped most of the flesh off her forearm :eek: :eek: . Poor thing was new to the area and didn't know that medic one is free.

Its so annoying though to see hear the whines of the frequent flyer who called 911 for a hangnail and is promptly triaged and sent out to the waiting room. "But I was brought in by an ambulance, and it has been hurting for a month now and the ambulance driver brought me in!!!" :rolleyes:

an ambulance ride is free? we've always had to pay when we rode in one. like that $600-something ride my mama took when she had to be driven an hour from the nearest hospital (which is 20 minutes away) cuz my little brother decided to be born 3 months early. then all those times i've had to ride no more than 45 minutes... grandma too. i'm in a rural area. perhaps there is looting afoot.... or, we need to stay out of the ER. :p

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Here in broward florida, I sometimes think better of calling 911 and going in ambulance my wife once had a bad pregnancy bleeding a lot and after 6 hours was allow inside the hospital. While in the ER wanted to go to the restroom the nurse said okay go. A little while later she fainted. Is good she told me to remain with her....Not to good experience..

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Specializes in Oncology/Haemetology/HIV.
There was a study not too long ago (Journal of Trauma I think) that compared mortality in major trauma victims who arrived to the ED/Trauma Center via EMS vs Taxi. Those who arrived via EMS fared worse than those who arrived by Taxi. Seems the biggest contributor to mortality was time wasted on scene which EMS did a lot and Taxi drivers did very little. yes, injury severity was comparable in both groups.

As a Southern living in Manhattan, I have yet to have had a taxi ride that didn't break a number of traffic laws, as well as a few laws of Physics and the speed of light.

So the speed factor probably helps in this case but do they have any records for the cases of shock/terror induced by the taxi ride or injuries from the ride itself?

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Specializes in ER, ICU, L&D, OR.

Cant even remember the last time I was in a taxi. Probably in Chicago, but that was 3 and 1/2 decades ago

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Last taxi ride for me was 4 years ago in SF. Met an old friend from high school who hailed the taxi, we got in and I saw the "Put On Your Seatbelt" sign, which I promptly did. My friend looked at me like I was crazy. I guess it is, I dunno . . not cool to wear seatbelts in the big city. I took it off. Peer pressure from high school maybe? :rolleyes: :chuckle

We don't have taxi service up here in the mountains. I do know I wouldn't call 911 . . dispatch is 70 miles away and they need street addresses and all that stuff. "Across from the feed store" doesn't cut it. I've taught my family to use the ambulance number . . . goes right into the ER. Everyone on the ambulance DOES NOT need a street address.

We had a family bring their grandma to the ER in a pickup . . she had been knocked over by a lamb. Had hip pain . . . . very caring family. About 20 members showed up to see her from toddlers to grownups.

steph

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EMS does not waste time at the scene!!!! It is called 'treatment and protocol' Oh I forget, they don't teach pt care in our 6 week medic class!!!! By the way, Paramedic school was 10 times harder that nursing school!!...

Did the article happen to mention that the guy who would have been properly packaged in our 'waste of time' on scene is now a paraplegic because someone threw him in the back of a taxi without proper c-spine protection. Or the fact that most Joe-public drivers instantly forget how to drive when they hear sirens and see lights! Or maybe the fact that our protocols are written by ED doctors!!(Our local protocols call for not-transport if we cannot have trauma patients to trauma centers within 10 or 15 minutes if they arrest).

There are many more things going on then the survival rates! If medics don't make a difference, why not just turn the whole thing back over to the funeral home directors who would 'scoop and run' with patients in the back of the heorifices, it would be much cheaper for all involved!

Why can't nurses and medics just love each other for the unique role that each plays in the EMS system. I hear more bickering between these to groups of professions than I care to report, I have been on both sides of the coin. Believe me, there are plenty of morans in both fields.

Christine EMT-P, BS-RN

There was a study not too long ago (Journal of Trauma I think) that compared mortality in major trauma victims who arrived to the ED/Trauma Center via EMS vs Taxi. Those who arrived via EMS fared worse than those who arrived by Taxi. Seems the biggest contributor to mortality was time wasted on scene which EMS did a lot and Taxi drivers did very little. yes, injury severity was comparable in both groups.
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It didn't sound to me like anyone was saying EMS is a bad thing. They were discussing studies that had been done. There is no doubt EMS provides a very valuable service to the community. Nobody disputes that.

There is a debate going on nationally whether scoop and scoot or stay and play is a better option. There are times when it's best to just grab and go than to stay and treat. Problem is in deciding when.

We just had a roundtable discussion with ED nurses, docs, and paramedics about protocols. Everyone agrees that it is a shame the paramedics don't have say in it. Even the docs agreed that some of the protocols were bad. The medics SHOULD have input, after all, they're the ones at the scene, not us. Hopefully, for our hospitals, at least this will change soon.

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