Nobody hear has the actual chart, or was actually there so lets not forget that.
I'm sure this had something to do with the medics being burnt-out, tired, and looking for a reason not to do their jobs. Unfortunately I have seen it way too many times. They don't want to be in EMS anymore but have nothing else to fall back on so they stay on the job.
This can happen to anyone. This could have easily been a triage nurse dismissing the patient's complaints and having him die in a waiting room or a doc dismissing his complaints and discharging him home.
You're absolutely right...this could have been something an EP him/herself discharged without a second thought. The problem is we will never know whether it was the lack of training from the EMS crew, or if it was just a very, very unfortunate presentation that anyone would have missed. Until doctors are manning ambulances, we should assume that EMS personnel do not have the proper education to refuse transport and should not have the right to refuse.This can happen to anyone. This could have easily been a triage nurse dismissing the patient's complaints and having him die in a waiting room or a doc dismissing his complaints and discharging him home.
As a former paramedic, we had treat and release protocols in place where I worked. Many places also have these, although it doesn't appear DC EMS has these in place yet.As a former EMT, I have to respectfully disagree with you, and point out a major difference between the examples you give and the medics in this case. The nurse and the doctor in your examples made the wrong decision, but made a decision within their scope of training and practice (eg a doctor is trained to discharge patients, a triage nurse is trained to triage patients).
Medics do not have antacids within their scope of practice, so this decision was not just the wrong decision, it was beyond their scope and therefore they shouldn't have been making a decision like this at all. The outcome is not the issue here, it is the thought process that led up to it that makes this intolerable.
As a former paramedic, we had treat and release protocols in place where I worked. Many places also have these, although it doesn't appear DC EMS has these in place yet.
EMS varies significantly from state to state and even within states. Although not acceptable where you worked, the diagnosis of conditions and appropriate treatment of conditions outside of protocol was allowed and even facilitated by utilization of non-standard protocols. For instance, we didn't have a specific nausea and vomiting protocol, but our protocol for metoclopramide and droperidol drug usage allowed us to use it for nausea and vomiting without consulting with a physician.
As far as we know, the patient may have signed an AMA form.
A wrong decision was made. My point was that it could have happened to anyone of us, and we shouldn't be so hard on these guys without knowing all the facts. For all we know, the patient could have refused to go to the hospital despite the family wanting him to go.