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The Ride to stay High
How drug addicts manipulate EMS, hospitals for their fix
Published Saturday, June 13, 2009
IRONTON — The call is made.
“Lawrence County 9-1-1, what is your emergency?”
“I need an ambulance right away.”
“Ok, what is your condition sir?”
“I’m having severe chest pains. They’re really bad.”
“Chest pains, does it hurt anywhere else?”
“I’m not sure, please hurry.”
“EMS will soon be dispatched, can I confirm your address as . . .”
Those three numbers are dialed hundreds of times a year to the county’s downtown Ironton dispatch center. Someone feels extreme chest, abdominal or joint pain and contacts 9-1-1 for immediate medical help. EMS units are en route and hospital emergency rooms have been notified. Identifying the nature of the call should be relatively easy.
Heart attack, maybe; pulmonary embolism, a chance; a viral infection, could be.
Actually all of those diagnoses, along with angina, acute heartburn, aortic dissection, panic attacks and pleurisy, can be ruled out. A person could recite the entire medical dictionary and still not pinpoint the reason for the call.
Here’s why.
What the caller, and only the caller, knows is that his chest is not throbbing in pain. Actually, his chest is fine. What he has done is just reserve his personal medical limousine for transport to the head of the line at the area emergency room — an emergency room that may unknowingly feed his current prescription drug addiction.
The caller also knows that Lawrence County taxpayers are going to pick up the dime for the entire trip. Not a single cent is coming out of his pocket. He does not have insurance and has no intention of paying for the trip.
The only thing the caller is sure of is the chances of him “scoring” depends on acting skills, choosing the right hospital and if the doctor he is assigned to is willing to buy his story.
EMS cannot come soon enough for this prescription drug addict.
Calls like this are not fiction or random acts. Actually, abuse of the area ambulance companies, including Lawrence County-funded Southeast Ohio Emergency Medical Services, are becoming an ever-growing nuisance.
So much so, statistics indicate that nearly 50 percent of calls that come into SEOEMS’ Ironton station are not true emergencies.
Many are emergency calls for ailments such as ingrown toenails, colds and assistance getting out of bed in the morning.
But another chunk of the non-emergency calls SEOEMS responds to comes from an underground society of prescription drug addicts who know how to beat the system and Lawrence County taxpayers out of hundreds of thousands of dollars annually.
Here is their story.
‘It is what it is’
“I need to do what I need to do.”
Meet Rachel.
Rachel is a prescription drug addict who considers herself an expert on “beating the system” to score. She admits being part of a conglomerate that uses area ambulance services and hospitals as a means to obtain prescription drugs. Asked why she goes that route, Rachel does not hesitate to answer.
“Because more often than not, it works.”
Rachel is addicted to a variety of highly addictive painkillers with OxyContin and Lortab as her drugs of choice. She has been an addict for more than 10 years.
The 31-year-old Ironton resident admits the shame that used to come with looking in the mirror and realizing that her world does not revolve around her estranged children or family, but around getting high.
“It just turned out that way. I can’t really put a finger how it came to be, but it is what it is, as they say.”
Under the condition that her real name not be printed, “Rachel” agreed to sit down with The Tribune and give a detailed account of her life as a prescription drug addict and how the “ambulance trick” she participates in operates. All other details of Rachel are factual.
“I used to be pretty hot,” Rachel said when describing her teens and early 20s in central Ohio. “I wasn’t ‘little miss sunshine’ but I knew how to get what I wanted. I don’t think I’ve ever bought a drink in a bar in my life.”
At five-foot, eight-inches, Rachel claims her looks and “bubbly personality” allowed her to enjoy many of the fringe benefits life can offer.
Even after the birth of her third child, Rachel says she was able to secure an older “sugar daddy” who gave her money to buy the things she needed not only for her kids, but for her herself as well.
“He probably spent $75,000 on me during the time we were together. Most of the money I had left over went to buying clothes, a car and eventually drugs.”
Fast forward to 2009 and Rachel’s current existence is a life of deceit and drugs.
Years of substance abuse have taken their toll on her physical appearance. Looking 10 years older than her age, Rachel is now rail-thin with unmanaged hair and dark, sunken eye sockets.
Now a mother of four children with three different fathers, Rachel lives a gypsy lifestyle sleeping in a variety of Ironton and Lawrence County homes weekly.
Asked where her children are, Rachel says they needed “to spend some time with their nana and papa while I sort some things out.”
She later confessed her kids have been with their grandparents on a regular basis for more than two years. Rachel has no means to support them.
“I haven’t held a real job in probably five years.”
The afternoon she agrees to the interview, Rachel is staying with friends in a bungalow-style house on Ironton’s south side. The house has seen better days with siding warped and shingles missing. The porch contains piles of damp clothes infected with fleas.
“Ignore the mess” Rachel says while entering the house.
The interior is no better.
Two men, probably in their late 20s or early 30s, lie on couches that butt up in the corner of the living room. Resting upon the spool-shaped coffee table in the center are some knickknacks, a remote control, candles and about a half-dozen hypodermic needles.
“Don’t worry about those, you’re here for the ambulance story,” she snaps.
After a walk through a kitchen with a sizeable stack of dirty dishes, Rachel exits a back door to a picnic table on a mildew-laden brick patio.
“So where do we start?” Rachel asks.
She is asked to start from the beginning and where using EMS came into the picture.
‘They have to take us’
The Lawrence County underground prescription drug market is a very secretive and closed society. Those who distribute or use drugs range from high-school dropouts on the verge of skid row to businessmen and women who guard their addictions closer than their own Social Security number.
It is also very lucrative if you distribute and very expensive if you use.
Market prices on the streets of Ironton for the popular opiate-based drug OxyContin are $1 a milligram. With most OxyContin pills available in its 80 milligram form, users unable to secure any type of legal prescription can be forced to shell out up to $160 for just two pills.
Much of the OxyContin distributed illegally in the county comes from financially-strapped doctors with loose prescription pens or the drug routes from the south, mostly out of Florida.
Those unable to get prescriptions written or who are low on cash have little options for their fix. That is where the county’s high theft rate comes into play.
“When you have no money, people do some interesting things,” Rachel said. “You have to become very creative to find cash streams because dealers don’t take checks, money orders or credit cards. None of us have health insurance either.”
One scheme Rachel said friends of hers did in order to raise cash were fencing stolen items at area rummage and yard sales around Ironton.
“They would go out and look for things that could bring some value and steal them. Small things, like iPod’s, video game systems, leather jackets, you name it. Once they got enough items that could bring in a nice penny, they would try to sell them privately or hold weekend rummage sales.”
Rachel said the rummage and yard sales ended due to the chance the victim also might be the buyer.
“Everybody in Ironton knows everybody. It was way too dangerous and risky, plus it took a lot of work. There had to be an easier way.”
And they found it.
According to Rachel, following the advice of a friend who dealt with medical laws and policies, they figured out that publicly-funded ambulance services, like SEOEMS, were required to respond to a patient’s call regardless of the circumstances. Plus, most EMS calls get preferred treatment at area emergency rooms, meaning less waiting in triage.
“They have to take us. It’s a free ride to the front of the line.”
They also figured out what conditions to call their “emergencies” under in order to have the greatest potential in snagging the prescriptions drugs they needed. After discussions with an area medical associate, the conditions they would use were finalized to chest and joint pain.
Following some internal role-playing they were ready. The first call was going to be chest pain.
“It worked like clockwork. The call was made, EMS came, he told the medics his choice of hospital and he was admitted within minutes while we waited in the parking lot,” Rachel said. “An hour and half later, he was walking out with Lortab.”
Rachel said they learned ahead of time current hospital procedures for conditions like chest pain.
“When you are admitted to an emergency room with chest pains, most doctors are going to want to administer nitroglycerin right away. By putting up a strong stance and saying you need something stronger, your wish might be granted.”
And what if things do go as planned?
“You get the heck out of there. We had a rule that if you felt it wasn’t your day, demand the AMA (Against Medical Advice) release document, sign it and walk out the door. There is always another day and a variety of hospitals to choose from.”
All four Ashland, Ky., and Huntington, W.Va., hospitals were contacted and asked about this problem.
Only Cabell Huntington Hospital returned calls to The Tribune, to say they would look into what procedures the hospital has if they suspect a prescription drug addict might be abusing their emergency room.
The choice of hospitals and the guidelines publicly-funded ambulance services operates under makes Rachel’s ride to stay high an inviting opportunity. An opportunity officials from SEOEMS say is at a level of abuse.
‘Musical hospitals’
Richard Chandler is an experienced paramedic. He is the type of EMS medic that earns high praise from those across the medical spectrum. A 19-year SEOEMS employee, Chandler has seen nearly every type of medical emergency. He currently serves as SEOEMS Ironton Station Chief.
Sadly, he has also seen the abuse grow since joining the ambulance service in 1990.
Chandler confirmed the “ambulance trick” scheme is alive and well in Lawrence County.
“It happens all the time,” Chandler said. “It continues to be a growing problem. As the economy gets worse, it has become more prevalent.”
Chandler said the addicts have also become more brazen in their attempts.
He gave an example of a recent call where SEOEMS responded to a patient complaining of severe abdominal pains and asked to be transported to King’s Daughters Medical Center for treatment.
However, EMS staffers were shocked to find out minutes after dropping the patient off at the hospital’s emergency room, the patient was in a car sitting at a red light next to the same ambulance that had just delivered him.
But, as Chandler said, this setback wasn’t going to deter this alleged addict.
Just a few hours after calling 9-1-1 and asking to be taken to King’s Daughters Medical Center, the same individual called 9-1-1 again on the same abdominal pain complaint.
This time though, when asked by SEOEMS medics what hospital he would prefer, the patient told them Our Lady of Bellefonte Hospital.
And in both cases, SEOEMS was required to respond to the call and in both cases never got a single dime of payment out of it.
“The abuse of EMS services is becoming a terrible burden on the taxpayer,” Chandler said. “We have people who have called us three or four times and each time they request to go to a different hospital. We sometimes can see a pattern, but that takes a long time to figure it out.”
Statistics provided by SEOEMS show that in a 20-year period, emergency runs made by the ambulance service in Lawrence County increased more than 120 percent despite a drop in county population and age median.
SEOEMS now averages more than 550 runs a month compared to 250 in the early 1990s.
With all the non-life-threatening and bogus runs now burdening SEOEMS, Chandler conservatively estimates those call-outs cost taxpayers more than $100,000 annually.
Before last month, SEOEMS was subsidized by Lawrence County taxpayers for 42 percent of their operations in exchange for lower ambulance rates than the county’s private EMS services
In May, Lawrence County Commissioners altered the county subsidy for SEOEMS to 15 percent by enacting a rate increase for both advanced life and basic life runs along with increases in treat-no-transport runs, where medical assistance is needed without a trip to the hospital.
Chandler points to most of the issue as the way society has changed in calling for injuries.
“You have patients now who call EMS to get picked out of a chair or to get lifted out of bed,” Chandler explained. “What you’ve done is taken the ambulance away from someone who truly needs an ambulance.”
SEOEMS Executive Director Eric Kuhn shares Chandler frustrations.
“These people have turned EMS services into a game of musical hospitals,” Kuhn said. “It’s a pretty common tactic.”
He said that while all ambulance services are victimized time and again, SEOEMS is especially vulnerable due to its inability to refuse an emergency call — something private ambulance services have the opportunity to do.
Kuhn, who joined SEOEMS in 1980 and was appointed its executive director in 1997, said areas like Lawrence County should be averaging a daily run rate of only one emergency for every 10,000 in population.
With 60,000 residents, the county should be averaging approximately 180 true emergency runs a month, not the 550 runs SEOEMS currently is saddled with.
“The non-emergency calls are costing a significant amount of money,” Kuhn said. “There needs to be increased education on the proper uses of 9-1-1.”
As for the prescription drug addicts who use SEOEMS as their own private taxi, Kuhn knows there is not much his service can do right now and any type of solution requires identifying a pattern and a little bit of luck.
But do not tell that to Ed Hughes. He has looked prescription drug addicts right in the face and has walked away with positive results.
‘A powerful high’
“No one seeks to become addicted to prescription drugs,” explained Ed Hughes, executive director of The Counseling Center, Inc. when asked about why powerful prescriptions are chosen over other narcotics.
Hughes, whose operations are in Portsmouth, has seen up close what prescription drug abuse has done to southeastern Ohio.
“We are in an epidemic here. The potency of these prescription pain killers is different than it has been in the past.”
Hughes said the abundant supply of highly addictive, opiate-based drugs like Percodan, Vicodin, Demerol and the king of the hill OxyContin have resulted in a huge spike of young people finding themselves addicted.
He alleged doctors have been way too aggressive in prescribing drugs like OxyContin due to “incentives” pharmaceutical sales representatives have available in prescribing the powerful pain killer.
But even not getting a prescription doesn’t mean a fix isn’t going to happen.
Hughes cited a recent area trend where Fentanyl patches are being scraped down to draw out the drug for illegal use. Fentanyl is a powerful drug used to treat post-operative and chronic pain. It is 81 times more potent than morphine.
In Scioto County alone, the number of accidental deaths caused by opiate-based drugs has increased 429 percent.
Statewide, overdoses passed automobile accidents as the leading cause of accidental death in the state of Ohio for the first time in 2008.
“What addicts are dealing with is a high that is so powerful, people are addicted from the beginning,” Hughes said.
And that is what Rachel deals with every single day — being addicted from the beginning.
“I’m not proud of it, and I do believe I will get clean. But for now I’m living one day at a time and if today is the day for me to turn it around, then so be it. But if it isn’t, then I’m going to live my life the way I want to.”
As for additional ambulance attempts to score, Rachel said she was not sure when that would happen saying she was “set” for a while.
“We are actually scoring through a new channel and it’s become a little easier for us to get what we need. But the ambulance trick will never go away.”
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Comments
Posted by bornandraisedironton (anonymous) on June 14, 2009 at 12:51 a.m. (Suggest removal)
Excellent article ! Now what can be done about the abuse? Taxpayers are paying for this - -
Posted by MasterChef (anonymous) on June 14, 2009 at 7:21 a.m. (Suggest removal)
Congrats, Jim Sullivan! This is one of the best articles I've seen in years. When I started reading I thought of at least 6-7 "Rachael's" this could be.
This story could very well lead to another...the rising crime rates that lead to increased law enforcement, jail expenses and E.R. expenses borne by the city, villages and county.
Posted by nottellin (anonymous) on June 14, 2009 at 8:16 a.m. (Suggest removal)
I have a neighbor, who, until she could get a doctor to give her a scam diagnosis of "Fibromyalgia", would go to KDMC e.r. one night, then Bellefonte one night, the Cabell, then St. Mary's... All e.r. visits, all to get shots of pain meds.
She has medicaid, and, for whatever reason, each hospital e.r. neglected to realize that this b***h was coming to them every week, at least once a week, for the same "problem".
The people in this story are the worst kind, because they are taking up ambulance time that could be needed by someone who REALLY needs an ambulance.
This is a very good article and one that could be written for any area with several hospitals in close proximity. Excellent writing.
Posted by NancyB (anonymous) on June 14, 2009 at 9:36 a.m. (Suggest removal)
Get help for Painkiller & Heroin Addictions
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Posted by Dad (anonymous) on June 14, 2009 at 10:17 a.m. (Suggest removal)
I am not sure about the Suboxine. I think you are just trading one drug for another. It did not work for my son. I think the best option is to get away, get in a long term program and stop altogether. Plus we could not afford the Suboxine, it was just too expensive.
Posted by Nurse2010 (anonymous) on June 14, 2009 at 10:22 a.m. (Suggest removal)
Excellent article Jim Sullivan...Kudos to you. This is something we see too often and Nancy B kudos to you for giving the information to maybe help an individual climb out of the substance abuse pit.
Posted by hustlinhillbilly (anonymous) on June 14, 2009 at 11:07 a.m. (Suggest removal)
Outstanding article.
Posted by no1 (anonymous) on June 14, 2009 at 12:09 p.m. (Suggest removal)
This is why the people who really need pain medication can not get it and they have to suffer because of someone else has to have a fix to make it throught the day. It makes me sick to see elderly people go in pain because their doctor is afraid that they are going to get busted if they write a script. I am in health care and I see it every day with my paitents. I have watched them cry from the pain while the person that is abusing it is able to get pain medication. I have taken them to the ER when they could not take it anymore. One was ready to blow his head off because he could not take the pain anymore. I do not care one bit about those who abuse the drugs maybe they will overdose and that will be one less to transport.
Posted by armymomchris (anonymous) on June 14, 2009 at 1:32 p.m. (Suggest removal)
This is the reason that people with legitimate needs for certain medications are looked at strangely by doctors and nurses, and are asked a million questions that make one feel like a criminal.
Posted by cashmere (anonymous) on June 14, 2009 at 2:24 p.m. (Suggest removal)
thought provoking article! good journalism!
Posted by duoneber (anonymous) on June 15, 2009 at 2:36 a.m. (Suggest removal)
This is a wonderful article! Congrats Ironton Tribune on attempting to educate the citizens of a major abuse system. This occurs everywhere, in every state, in every county, in every city, at every hospital. I truely hope your article does some good. Since the medical professionals can't figure out how to 'derail' this abuse problem, hopefully someone in the reader world can render a solution!
As for "Rachel"- you and your kind are a major problem, but not as smart as you think you are. Don't think that the medical professionals who treat you and your kind are being 'misled' or 'lied to'. They know your story as well as the hospital staff does. Behaviors of the addicts are repetitive and easily recognizable. Your medical professionals are not ignorant and can spot out a 'liar' immediately- this ranges from EMS to the hospital staff. And yes, the EMS may 'have to transport them' but they don't have to 'treat them (meaning pain medications- which they want)' or their addictions. Please, believe your local (tri-state that is) EMS agencies are smarter than those who attempt to 'bluff them'. As for the hospitals in the area, they too have 'caught on' to this abuse- rumor has it, they are no longer writing scripts for 'narcotics'- it's Motrin all the way!
This "Rachel" chick has educated the readers of this article. You now see what a problem it is that your 911 EMS system is SEVERLY abused. It is up to you, citizens of the USA to contact your representatives to formulate a plan to change this problem nationwide. Lawrence Co isn't going to change it- it's going to take a NATIONWIDE attempt to change it. PLEASE, save you and your's money- CONTACT YOUR STATE OFFICIALS FOR A CHANGE!!!!
Finally, if these drug addicts want to 'attempt to fool the EMS', then why not give them what they want anyways? That way, between the EMS and the hospital, they can be heavily medicated like they wish, and OD and then--- problem solved! OD= Death; Problem solved!!! No more burden on familes, taxpayers or those who 'HAVE' to treat them! Should only take a few years!!!
Posted by duoneber (anonymous) on June 15, 2009 at 2:46 a.m. (Suggest removal)
One last thing, Suboxine is not a treatment. It is no different than going to the methadone treatment center.
These folks have to either get off the drugs completely or die. It's as serious as that. Methadone and Suboxine just prolong the addiction.
GROW UP ADDICTS AND GET REAL HELP- INPATIENT ALL THE WAY!!!
Posted by nursetam01 (anonymous) on June 15, 2009 at 5:09 a.m. (Suggest removal)
Precisely why I cannot handle working in an emergency room!!!!!!!They can spot drug seekers a mile away...But they give them what they want anyway - just to get rid of them. What do you do as a physician? If you don't give them what they want they will threaten to report you, they will tie up a bed for hours in the ER and make everyone's life there a living hell. If you give them what they want they will leave quietly and make room for someone else to get the much needed medical attention that they deserve. It is a lose - lose situation for everyone involved.
Posted by michaelOH (anonymous) on June 15, 2009 at 9:22 a.m. (Suggest removal)
duonebar is right on the mark.
As a former Respiratory Therapist we could easily tell who did and who did not do something as small as light up a cigarette soon after we were done.
Then the Hospital where I worked developed a "Psychiatric Unit" and man, we learned fast to tell who the liars were.
My girlfriend was a Nurses Aide on that floor and they would bring in a urine sample from home or from a friend after getting to go home temporarily, and all the Nurse had to do was see if the cup was warm, if not, the Nurse would demand demand a new one.
One stunt a man pulled was when he got pulled over for a DUI was to tell an Officer he was on his way for treatment in the "Detox" center. It worked. He got a free ride, no ticket, and signed his self out the very next day.
Things like that is why the Public in general hates anyone on food stamps and such, and I really can't say that I can blame them, because I used to feel that way myself.
Posted by michaelOH (anonymous) on June 15, 2009 at 11:01 a.m. (Suggest removal)
Hi Neo, wb & how are ya?
Posted by pantherpride (anonymous) on June 15, 2009 at 11:11 a.m. (Suggest removal)
Bravo, Tribune! THANK YOU for shining the light of truth on abuse of publicly-funded EMS systems, and for showing Lawrence County taxpayers where a lot of their sales tax money goes (when it isn't going to the Sheriff's office).
A correction in the article:
The ststement "SEOEMS now averages more than 550 runs a month compared to 250 in the early 1990s" should be changed. Those numbers reflect only what the Ironton station handles. For a more correct countywide set of numbers, you need to add South Point, Chesapeake, Rome, Aid and (part of) Oak Hill's call volume.
Please understand that 550 calls a month at a station with 2 trucks is an ungodly number of runs. I am certain that the sheer volume of calls at Ironton combined with the high levels of abuse burns out a lot of EMTs and Paramedics. This turnover of employees is very detrimental to any company or government agency, but especially so to an emergency service organization where, when someone's life is truly on the line, the best patient care is normally provided by seasoned, experienced caregivers. SEOEMS needs to keep those people, especially at a place like the Ironton station.
Secondly, a comment. Mr. Kuhn speaks of a need to educate the public about the proper use of 9-1-1. He is in a position to do this, but SEOEMS has never taken the first step to decrease or eliminate the abuse of their services. Kuhn has been Executive Director since 1997. How long does it take to get a public education campaign together and make some inroads to decreasing system abuses? If this was such a huge concern, why was there 12 years of doing absolutely nothing under your watch? The EMS Fairy isn't going to wave a magic wand and make all the "Rachels" go away.
Once again, kudos to the Tribune for an excellent and well researched article. If your newspaper participates in any awards program for editorial excellence, you should submit this article for consideration.
Posted by OhioanAtHeart (anonymous) on June 15, 2009 at 12:05 p.m. (Suggest removal)
I agree that alot of these addicts are thieves, trouble makers, liars and down right scum. But... How do they stop?
I have a relative that was sentenced to 18m and was addicted to crack, he came out of jail addicted to pain pills. No crack but he wasn't "healed" either. He traded one addiction for another.. And the so-called therapists knew it. Here is the kicker.. No job, no insurance, no medicaid, no money.. How is one to pay for In Patient help? Unless they want the help they can sign themselves out of almost any institution and until they kill someone or try to kill themselves you cant get the committed.
I wish I knew the answer.. The pain, hard feelings and damage that has been done to his family and friends is irreversable. The addict knows this but cant stop. When he is not "high" or "needing a fix" he would give you the shirt off of his back.. When he is in need, he would steel it back...
As for the medical field: Hospitals, doctors and nurses should stand up and put their foot down and quit accomodating these people.. Good Grief, quit passing the buck and telling people it isnt your problem, you are one of the reasons the problem goes on...
Posted by mommyof4 (anonymous) on June 15, 2009 at 12:50 p.m. (Suggest removal)
I think this was a very educational and eye opening article. It actually went hands on and I think that was awsome. This seems to be a bigger prob than people thought. Its sad how so many people have turned to drugs and dont value thier life enough to enjoy it and live it right but to walk around like a zombie. Im sure if enough people pitched ideas something could at least slow this down. I know its impossible to stop it completly but I know some states have some pretty rough laws on this stuff now and maybe Ohio should think about adopting some....Indiana will take you to court and issue bench warrents and so on till its payed off maybe that may help but I think a big starter would be to pinpoint the regulars and warn the hospitals..I know its hard but like the EMT said they got called to the same residense 2 times ..thats a regular let the hospitals know...create a list or a drop a hint to the nurse or doc. I have heard Cabell is cracking down on these people but there are so many doctors and hospitals that pass drugs out for the stupidest stuff.
Posted by armymomchris (anonymous) on June 15, 2009 at 3:35 p.m. (Suggest removal)
Perhaps give them the meds they "need", but make the dosage more like an overdosage. And be done with it.
Posted by duoneber (anonymous) on June 15, 2009 at 3:44 p.m. (Suggest removal)
Panther pride is 100% correct- I agree with you and many others that Eric Kuhn has been the director for so many years and let this problem slip by. However, the surrounding EMS agencies are no different. The EMTs and Paramedics have their hands tied with these chronic system abusers. The laws are not written to protect them- people sue daily for ignorant reasons and this is no exception. It is up to the federal government and state governments to formulate a plan to fix this problem. As for now though, the EMTs don't want law suits so of course they will have to continue to transport these people. However, the treatment the patient receives doesn't aid in their addiction- the EMTs don't give out medications for pain that they are looking for. Also, just because an EMT 'treats a patient that will get them in the back faster' doesn't mean anything- i've seen nurses pull out the IVs in the patients and send them out to triage. This needs to happen more often.
As for a list of patients- i would assume it's a mental list that they already have prepared and use. The EMTs are being abused yes, but keeping their ambulances tied up on nonsense, but the people who suffer the most are the ones waiting on an ambulance coming from another area because the EMS crews can't say 'no'. It's a sad situation with no real hope for an answer. The best the public can do is CONTACT YOUR STATE REPS and alert them of the problem. Encourage them to take it to the federal government. That's our only option for help.
So... the next time you call 911 and your ambulance isn't there in a split second, don't take it out on the arriving crew members- you now know what 99% of the delays are caused by. That and people not moving over for ambulances--- TURN DOWN YOUR RADIO, PAY ATTENTION, GET OFF YOUR CELL PHONE AND PULL TO THE RIGHT AND STOP!!!!!
Posted by piece_of_mind (anonymous) on June 15, 2009 at 4:08 p.m. (Suggest removal)
drug seekers are not the only one's who abuse the ambulance service or the emergency room. this is an ongoing problem with people of all walks of life.
people have become so lazy and spoiled that they no longer make a doctor's appt when they get sick. they have symptoms for less than 24 hours and call 911 for the ambulance and go to the er for treatment. it's ridiculous!
so, let me help here... please read, remember and tell your family and friends the following:
911 is for emergencies only- this includes persons who may be having a heart attack or a stroke, a person who has low blood sugar and can't eat or drink or a person with high blood sugar that is unconscious, a person who is having severe difficulties with their breathing, a person who has a seizure that lasts longer than normal or is the first one they've had, a person involved in a traumatic accident and has a threat to life or limb loss, a person who is bleeding severely and you can't get it to stop on your own, or any person who is found unconscious and you can't wake them up.
most other complaints like fever, weakness, nausea, vomiting, diahrrea, stomachache, migraine headache, back pain, limb or joint pain, or 'i just don't feel good', medication refills, i'm drunk and need to sober up, your family members catheter fell out, your doctor called with test results that aren't life threatenting and suggest you go to the hospital, a broken bone, or any illness or injury that is not life threatening. unfortunately, these listed calls are 95% of the run volume for ambulances.
what ever happened to calling your family or friends to take you to the doctor when you are ill if you can't drive there yourself. what ever happened to calling your doctor and discussing your problem before you call 911 and go to the er. what ever happened to taking over the counter medications for a 'cold or flu'.
whatever happened to society to make them think they are allowed to do such things to medical professionals is disturbing. if you are ill or injured and aren't dieing- don't call 911. there are actually people out there who will have a crisis and will be dieing and need the immediate help of the emts and paramedics but they will suffer in the end because i guarantee you that someone you know is calling 911 for a 'cold for 5 days'.
also, take care of your family and friends. if they are no longer able to take care of themselves by themselves, assist them. put them into a group home or nursing home or allow them to call you when they need help- help like assistance out of the floor when they fall if they aren't injured, assistance with moving them from one location to another, etc etc. don't tie up an ambulance due to laziness- someone will die when you continue to do this.
Posted by MasterChef (anonymous) on June 15, 2009 at 8:25 p.m. (Suggest removal)
WOW! SOMEbody's shorts are in a wad today! First, you should NEVER take medical advice from an EMT. They think they are doctors.They're not even close.
Could part of the problem be that you're paid by the hour and not "the run". Sounds like you have too comfy a stationhouse to get back to, when you're not chatting up the nurses.
And "what ever happened to calling your doctor and discussing your problem before you call 911 and go to the er."? Are you nuts???? I know of NO doctor who takes phone calls. All you'll hear is, "the earliest I can get you in to see the doctor is Friday at 4p.m. (4 days away). If your problem persists, call 911 and go to the hospital."
The hospitals and the ambulances will always continue to be exploited. Its called "job security" here in Lawrence County, piece_of_mind.
Posted by pantherpride (anonymous) on June 15, 2009 at 11:33 p.m. (Suggest removal)
MasterChef,
You do make some goods points about "calling your Doctor". Physicians have distanced themselves from almost all day-to-day contact with any patient. If you wanna talk to the doc, you gotta make an appointment -- ususlly weeks or months down the road -- then get all your questions and concerns handled in your alloted 15 minutes of exam room time. The doctor's office assembly line is in motion, and the next three paying customers are waiting just outside the door.
I beg to differ, though, when you seem to feel like flagrant abuse of the system should be tolerated as "job security". The system we have is broken. It is over stressed, under funded, and was designed and staffed for that one emergency run a day per 10,000 population, a 1970s statistic that has never been updated.
We need to learn how to Just Say No to non-emergency transports and courtesy services, or we need to belly up to the table and pay the taxes necessary to operate a "have it all, do it all" publicly funded emergency medical service. You can't be everything to everybody while operating under the funding allocations, staffing levels and vehicle placement of a restricted, emergency-only ambulance service.
On your comment about EMT pay, I think most people at SEOEMS would love to be paid by the call, because 24 on/48 off hour staffing is the cheapest way to operate a paid ambulance service. 24/48 staffing is now only recommended for slower operations, because of the liability in driving and medical judgment for crews taking their 10th or 12th call of the day at 5:00 am after having been on duty for 21 hours. Many busy services have extra crews during peak hours, or operate on eight or 12 hour shifts. But not SEOEMS. They can't afford the luxury of an alternative staffing plan. So they burn employees out, often losing our best and brightest in the process, and never deal with the laundry list of problems that created the mess in the first place.
There are a number of EMS services in this country and internationally that have effectively reduced non-emergency calls through a positive and agressive PR campaign. Administrators stepped up to the plate at these other agencies and dealt with chronic system abusers, including the home health agencies and free-standing urgent care centers, who often view taxpayer-funded EMS as a free taxicab or an extra set of hands to do heavy lifting, keeping down liability and worker's comp expenses for private businesses.
The system is a mess and it needs to be fixed. I'm sure EMS people would settle for a little less "job security", as you call it, in return for a manageable call volume and being available to help those who truly need it.
Posted by MasterChef (anonymous) on June 16, 2009 at 9:06 a.m. (Suggest removal)
Pantherpride, first let me say my comment about "job security" was just a mild attempt at a little humor after writing the previous paragraphs.
I agree the system is broken. I feel we need some out-of-the-box thinking. Maybe after triage the SEOEMS personnel should inform the "patient" that their "problem" is NOT an emergency and offer to call family/friend/neighbor to take them to ? (I'll get to the "?" shortly). As a last resort, the SEOEMS EMT can offer the patient a transportation voucher good ONLY for a ride to the hospital or clinic.
Did I say clinic? That's where the "?" comes in. We NEED a walk-in clinic open from 7 p.m.-3 a.m. (the time of most "fever/sniffles/cough" E.R. visits).
This isn't a total fix but its a start.
Posted by Doctor_Rocktor (anonymous) on July 29, 2009 at 9:32 a.m. (Suggest removal)
The patently absurd, and truly wasteful and tragic scenarios of EMS and ER capacities being exploited by people desperate to obtain relatively small quantities of a class of relatively physiologically benign molecules which enable adults to experience a sense of physical/mental well being is emblematic of the convoluted value system of a culture that places physicians squarely in the middle of a insoluble conundrum where they, too (along with the human beings ostensibly being protected and served), are obliged to participate in the ritual trivialization, demonization, persecution, and dehumanization of adults who might choose peaceful psychotropic endeavors.
Our society’s (all too often considered as ineluctable and beyond reasonable debate) stuctures and strictures - where the State and the (profit-driven and litigation phobic) Insurance/Theraputic State imprisons both physicians and patients within such an inhumane system of mandatory paternalistic supervision of people’s minds as well as their bodies from cradle to grave - is the overlying tragedy out of which these imbroglios arise.
Simplistic declarations surrounding the freely made choices of human beings (such as “abuse”, “self-misuse”) are, sadly, wielded with great hostility against the patient. The legal and corporate systems under which physicians are routinely confined and indentured, and the patently absurd war against human nature whose moral crusade masquerades under a medical mask should themselves be examined at their cores, and their tragic futilities be faced by lawmakers, physicians, and laypersons alike.
Let it be understood that such tragically absurd events and waste of critical resources arise out of our society’s choice to presume that adults who would seek relief from their physical/mental sufferings via psychotropic pharmacology alone are to be presumed to be mentally incompetent, to be demonized, ostracized, and subjected to endless (itself quite profitable) supervision by corporately controlled, exploited, and law/policy-shackled physicians who (somewhat understandably) evolve into hatred of those that the system allegedly serves - as opposed to questioning the very premise under which drug controls place the physician in service to their patients, beyond physiological technology, and into the dubious and clearly ineffective secondary and tertiary realms of priest and policeman. We all reap the bitter fruit of such folly, with far too little questioning of the veracity of its core premises in the first place.
This cult of drug-avoidance (the driving forces of which revolve around the material wealth of insurance/institutions/physicians at least as much as around the best interests of the patients) has been historically shown to be futile (as a war without end waged upon basic and age-old human nature). How can such paternalism on the part of the rulers lead to anything but infantilism on the part of the ruled?
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