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EMTs on house calls can bring the patient’s story to the ED

Once a patient is in the exam room, they can appear very different than the person EMS responded to on the street

The people whose paths cross mine are what make this career so satisfying. Seeing where and how they live gives me a better understanding of who they are, and what they need from me. If I can help them without taking them to the emergency room, I do:

  • He’s 28, suffers from asthma, has no medical insurance, and calls 911 when he can’t breathe. We give him a breathing treatment; he feels better and signs off.
  • Her blood glucose drops to the twenties, and she becomes combative. Her husband can’t handle her so he calls us. Sometimes sugared OJ, sometimes D-50, but we get her right again. She’s nice as pie, and we go back in service.

If I take them in and without betraying too much of their privacy, I try to convey their means of existence in the narrative section of my report. There is always a chance that the medical team that I bring my patient to will benefit from the story behind the symptoms, and treat the patient accordingly.

  • They are in their 50s and living together as man and wife. They have different last names, but similar complaints. When one goes, the other usually decides to come along. They bring their suitcase full of meds, and tell me their problems.
  • She is obese and homeless, and lives on a folding chair that she folds up and hides between a couple of buildings nearby. Four hundred pounds, asthma, diabetes, heart problems, and kidney failure; She’s almost 50. We pick her up and take her in.
  • He’s 50 and lives in a deserted lot on one of the side streets. There used to be a building there, but it burned down decades ago. He drinks and pisses, drinks and pisses, drinks and passes out. Somebody calls us and we take him in.
  • He’s a retired merchant marine who lives in a high-rise, suffers from COPD, and panics easily. He calls when the anxiety level gets too high; we respond, and take care of him.
  • She had the baby at 29 weeks. He’s a year now, but still has occasional seizures. When his fever rises, we come and take care of him with Tylenol suppository and sometimes a transport.

A person presenting in a nice clean office, ready for an exam, already dressed in a gown with vital signs documented by somebody else appears far different from the real person; the one I find at the location I’ve been sent to. As EMT’s we have a unique perspective into the cause of what ails many of our patients. By looking a little more closely into the window of their world, we see the person behind the patient, and can tailor treatment accordingly.

Wherever they call home, we respond, give them the help they need or take them to it. We know their names, histories, birthdays, family and friends. Sometimes the calls are a bit much, but more often than not a familiar face and comfortable routine is just what the doctor ordered – for them, for us and for the people who will continue to treat them when our work is done, and we have moved on to the next person who needs us.

Captain Michael Morse (ret.), mmorsepfd@aol.com, is the bestselling author of Rescuing Providence, Rescue 1 Responding, City Life and Mr. Wilson Makes it Home. Michael has been active in EMS since 1991 and offers his views on a variety of EMS and firefighting topics, focusing mainly on the interaction between patient and provider as a well respected columnist and speaker. Captain Morse is a Johnson/Macoll fellow in literature from the Rhode Island Foundation.