Lift-Assists, Refusals and Releases: Four Myths of No-Loads and Decisional Capacity Assessment

Four myths of no-loads & decisional capacity assessment A 9-1-1 call comes in for a 69-year-old female lift-assist. The patient’s daughter tells you that she found her mom on the floor that morning. According to your patient care report (PCR): “The patient appears in no distress and denies any complaints,” and you “assist the patient to her walker and her chair.” No past medical history, review of systems, or risk factors are recorded in the PCR, and no vital signs or physical exam are documented either. A release at scene is called into 9-1-1 dispatch, and the final call disposition in the computer-aided dispatch system lists your unit as “cancelled.” Several hours later, a second call comes into 9-1-1 from the same address, and this time another crew finds the patient in cardiac arrest. Although most lift-assists don’t typically end this badly, calls like this one are handled by 9-1-1 systems across the country each day. In many instances, there’s little documentation on the PCR—assuming one ever gets filled out in the first place. To put this case in better perspective, you can do a quick back-of-the-napkin calculation. If cardiac arrests represent approximately 1% of 9-1-1 call volume, and approximately half of these cases get worked, and 5–6% of them survive, then in a system with an annual call volume of 100,000, 25–30 patients will walk out of the hospital alive. Saving these 25 patients is, by the way, something that requires extraordinary ...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Patient Care Columns Source Type: news