I completely agree Rowley, their rationale seems quite bizarre. Deciding
there is no need for hospital assessment is one thing, but if they're going
to decide hospital review is necessary then surely transport should be
provided, particularly in this sort of case, for all the reasons you've
outlined below.
Now may I ask two - perhaps silly - questions:
Rowley, what does HMO stand for? [There has been a concerted move towards an
HMO style of access to emergency care for over 10 years.]
And Tim, what does MSC stand for? [His VS are BP 130/80, RR 20, MSC x 4,
PERLA, BM 8.6 MMoL, PR 120]
AF
----- Original Message -----
From: "Rowley Cottingham" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, November 17, 2006 8:12 AM
Subject: Re: 48 y/o male 1st fit
> What was the cause of his seizure?
>
> The most likely reason he vomited blood was he had a fit. There is
> always a differential diagnosis, and with a tachycardia he may easily
> have had a GI bleed sufficient to drop his blood pressure so that the
> fit was as a result of a poor brain perfusion. A pulse rate of 120 AN
> HOUR after the fit is not usual. I acknowledge his blood pressure was
> now normal, but he has had an hour to compensate and I bet it was not
> performed standing.
>
> I find nothing to criticise in the crew's actions until bizarrely, they
> decide not to transport. Although I understand the rationale of making
> the ambulance clear for further calls in my view it is at the expense of
> this patient - the one they already have.
>
> Perhaps the most worrying feature is that nothing they did explained the
> fit, and the risk of subsequent fitting is high in this acute phase.
> Expecting a member of the public to protect the airway is quite
> unacceptable. I do not find they acted safely or in the patient's best
> interest.
>
> /Rowley./
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