This is verbatim the narrative of a call I recently reviewed for a client.
dispatched to a 51 yr old male with positive covid 19. On arrival pt was waiting outside. pt tested states that he had tested positive for covid 19 8 days ago and was in hospital. Pt states that he still is showing symptoms and would like to be reevaluated. Pt was explain that the hospital is not going to retest. Pt states that he is staying in his hotel room and has no more money and would like to go to noble so he has a place to stay. Pt was told that the hospital is not a free hotel. Pt was advised to find a way to pay for another week on hotel room. Pt was told to rest in his room while he can. Pt vitals not taken due to positive covid 19. Pt was told to call back if symptoms worsen. Pt was left in hotel room.
signature not obtained due to covid 19
I was so flabbergasted that I had to read this hot mess twice to believe that it was a real PCR.
It would be easier to list all that was done right in this report than all that was done wrong.
The total of things that were done right is zero. NOTHING that is documented here is within any protocol I’ve ever seen.
One of the first things I teach people when documenting patient refusals is to NEVER, EVER, under any circumstances suggest to the patient that you don’t think that he needs to go to the hospital.
Provider initiated refusals are a very good way to end an EMS career. Even if no one complains, if your employer has any sort of Quality Improvement or Quality Assurance program, whoever does the reviews is going to have their hair set on fire by this sort of thing.
Now, this call took place at the height of the Covid Panicdemic back a couple of months ago. The state released temporary special protocols for dealing with potential or actual exposure cases. There were some steps temporarily authorized that would not be allowed during normal times.
I won’t go into them, some of which I considered pretty unreasonable.
Suffice it to say that telling a patient that he wasn’t sick enough to go to the hospital, refusing to do an assessment, and abandoning the patient are not among them.
I completed the review, assigned a score to it, and sent it on to their medical director for her review. I also notified our operations manager as he may want to suggest to the agency manager responsible for EMS that this might, just might, be a reportable incident.
That’s a decision that the agency medical director and agency management make and fortunately, my company stays out of it.
Also fortunate is that this is the only egregious incident that I’ve come across in several hundred case reviews for several different agencies.