To believe or not to believe, that is the question…

The biggest lies in Emergency Medical Services:

  1. I don’t have any medical history
  2. I don’t take any medications
  3. Your “so called” end of shift time

How many times have you heard these lies?  Like me, you’ve probably heard them every shift.  You ask a patient if they have any medical history and the answer is always “no.”  Yet, they have a gallon size zip-lock bag of medications that they HAVE to take with them to the hospital.  But how can that be, people aren’t really that dumb, are they?

Well, part of the problem is in our wording.  We have all been taught the same medical jargon, so for us it seems completely normal to ask “what’s your history?”  The problem is, most people don’t communicate this way.  Let me give you an example.  If I said, “I need you to hand me an 18g, 1L of LR, and some 4×4’s”, you would know what I’m talking about, right?  This isn’t common knowledge though.  These are terms that we all use in the medical field, but the “outside world” has no clue what I’m talking about.  So as simple as it may seem, there is a huge difference in asking your patient what their “medical history” is, versus “do you have any medical problems?”  Sadly enough, they still may answer this with a “no”, when they actually do. In this case, it’s best to do a thorough assessment and patient history.

Now this segues into my next point which is, most people believe that they no longer have a medical problem if they are currently taking medications for it.  We all know that taking blood pressure medications isn’t making you not have hypertension, it is merely lowering your blood pressure for a certain amount of time.  But yet again, most people don’t see it this way.  How many times have you heard a patient say they don’t have any medical problems, but when you question them on their Lisinopril and Hydrochlorothiazide prescriptions, their response is “yeah, I take those so I don’t have high blood pressure?”  You have to realize that this is just the way some people think and it’s just something with which you are going to have to work. This is the exact reason I ask MULTIPLE times what medications someone is taking, because on more than one occasion, I have found out a medical history that was initially denied.

This goes beyond a patient’s medical history though.  Allergies are a major factor that need to be taken into consideration on each and every call.  While it’s not common, people can be allergic to some of the medications we give, but have them free-flowing in their bloodstream.  An example of this is Epinephrine.  Yes, that’s right I said Epi.  But how can that be?  Every living human being has epinephrine in their system.  Without it, they would be in cardiac arrest.  So how in the world can you be allergic to it??? Well, the suspension fluid that Epi is sold in is derived from egg whites; therefore, if a patient has an allergy to eggs they could be allergic to the synthetic Epi we carry on our trucks.  But this is just one example of this.  By no means am I saying that you need to be aware of EVERY in and out of EVERY medication we carry, but you do need to know if a patient has a documented allergy. This information could be VERY valuable to the receiving hospital upon your arrival.  In our example before, with the patient being allergic to Epi, say they go into anaphylactic shock for some “unknown” reason.  Even if you do not know about the whole egg debacle, by passing the information of the patient’s allergy to the receiving facility, maybe the on-duty pharmacist would catch this and know to administer Benadryl.  See why this is so important, even if there allergy seems to have NOTHING to do with our treatments?

Finally, let’s talk about other communication topics to which you need to be aware.  By no means am I saying just assume every patient is incompetent, but you do need to “lower the bar” in your head a bit.  You need to find a happy medium between what you believe to be “common sense” and complete incompetence.  This is one of those things that just comes with time.  The average person is unaware of anything to do with the medical field.  I would say that 90% of the population has COMPLETELY checked out of their own medical health and relies on the healthcare system to do what’s best for them.  Some of these patient’s would literally jump off of a bridge if a doctor told them to do so.  I’m not saying that to say anything bad about doctors or any other healthcare provider, I’m just saying that’s the common mentality in the US.  It is nothing out of the ordinary for a patient to be taking a medication and have literally no clue why they are taking it.  This is the sad unfortunate truth these days, but there’s nothing you can do to fix it.  It is our job to take care of these patients to the best of our abilities and to explain to them what and why we are doing what we are.  Hopefully with time this mentality will improve.  On the flip side to this, we also have patients who have a “Google Doctorate” and believe that because someone on the internet/radio/TV said something, that it must be so.  These false truths are just as much part of the problem.  The only true way to fix these problems are to continually educate the masses and try to correct any fatal flaws that we see in the field.  With time, hopefully we as a people can learn to become more educated and wise.