Paramedics made my father go to hospital

I’m a paramedic. Obviously I wasn’t on your father’s call, however, I can already strongly state you’re BU. A few observations:

• An ECG machine is a marvellous thing. It tells us if you’re in a funny heart rhythm or if there’s a complete blockage in one of the arteries supplying blood to your heart. It does not necessarily tell us if you’re having a partial occlusion of one of these vessels. The only way to rule that out (an impending BIG heart attack) is to have bloods done in hospital, specifically ones that look for troponins; which are released from the damaged heart muscle.
• Fast AF (which is likely what caused the “AF attack”), is a peri-arrest rhythm. Aka one of the rhythms your heart goes into just before it goes “nah love, I’ve had enough, I’m giving up”. Cardiac arrest beckons. Your father may well/is highly likely to have been in this rhythm and luckily it self resolved. Normal AF does not have “attacks”.
• If the crew had not advised further investigations into any damage from this episode and he’d died in the night, they’d risk being struck off. Let alone the devastation you would feel at losing a family member.

Are we sure this just isn’t due to the “inconvenience” it’s now caused you? You’re delayed being seen in ED because there are people in there who are sicker. Doesn’t mean he doesn’t need seeing though.

I’m appalled that you feel that the paramedics doing their job is reason for complaint. As a manager of ambulance crews, I can assure you that every complaint takes hours upon hours of meetings, paperwork and time spent on them. If we weren’t having to do these things, we’d be booked on alongside crews going to 999 calls. Not to mention the stress on the crew when they have probably already seen horrific things in this block of shifts. I really hope you have a long hard think about what the outcome could have been if they’d left him at home. As perhaps they’d be writing coroner’s statements then.

There’s no way you ‘wouldn’t get an ambulance later’ but I’m guessing that they wouldn’t be too impressed having to come back to you if you declined their suggestion to go in to hospital when they attended the first time, understandably! If he really didn’t want to go in then maybe he should have just signed the paperwork to say he was happy to take the risk. And next time definitely cancel the ambulance if the episode has finished and he would decline A&E.

i don’t really think it’s right to call an ambulance, not cancel it at the point it’s not needed, then refuse the treatment they offer, what a waste of resources.

Its also perfectly ok to self discharge, they’ll want you to sign more paperwork there but I’m sure they’d find someone to take the cannula out if you said that you were leaving.

Calling an ambulance in this instance was the right thing to do. Although having waited for such a long time it may have been much quicker for you (or someone) to drive him to the hospital. Once the episode subsided you were going to call to cancel but the ambulance had arrived, they did all the usual checks and it appeared from the ECG that there was nothing indicating an immediate admission was necessary. However an ECG only shows what happening at that moment, not what may have happened earlier when you called. To find that out, blood tests need to be undertaken at hospital. They would have advised your father to go to hospital. IF he chooses not to, that's absolutely his decision and he would need to sign paperwork to confirm that he was acting against the advice of the paramedics and he fully understood the potential consequences. This is applicable for anyone who refuses to attend hospital against paramedics advice. It sounds as if they were busy - given the time it took for someone to arrive, they will have stated that absolutely another ambulance would be sent BUT it very likely would take some time if there was no-one immediately available. Under those circumstances they obviously felt it was more appropriate and safer for you dad to be in a hospital environment where they could rule out an earlier heart attack and also be readily available should your dad take a turn for the worse. Hearts are unpredictable and he could very easily have had a major heart attack and consequently a cardiac arrest. Their advice was based on their knowledge and experience. What would be the objective of a complaint??? Would you rather they do not take someone who has an unstable heart condition to hospital? And if that person has a cardiac arrest and dies? Your dad is fine by the sounds of it - making a complaint would be detrimental to the NHS and the paramedics involved, would serve no positive purpose because the position will remain exactly the same - if you have an unstable heart condition and call an ambulance the advice will always be - you need to be seen in hospital. Please don't underestimate their knowledge and experience, it's far more than most people realise. They will have carried out CPR on far to many people and they were only wanting the best for your dad.

We’re going through a situation different to yours but in a way similar. My partners mum is in sheltered accommodation and in October fell over but couldn’t get up because she can only use one arm. She wasn’t hurt in any way but the carer called an ambulance and she went to hospital where she was checked over and found to be ok. However it took us over 5 months to get her out of hospital because social services got involved and kept refusing to send her home, saying she was a falls risk. His mum has now spent 5 months in various care facilities whilst she is supposedly being assessed but has been left in bed 90% of the time in a nappy making her virtually immobile and has put in lots of weight so it’s harder for her to move. She has very little medically wrong with her despite having a stroke many years ago. We dread her going into hospital again because the medical people just refuse to listen to us, the people that know her best. Therefore I’d agree with the OP, the patient knows their own body best in times like that.

This- why call an ambulance if you don't want to go to hospital, the ambulance could be needed somewhere else.
All the paramedics l have encountered have been lovely, a lot nicer than some of the hospital staff. Don't blame them.

The issue here I think is that the paramedics implied that in the event of subsequently needing an ambulance he wouldn’t get one.I think saying this precipitates a lot of extra stress and worry for the patient and his family. I think that signing a disclaimer is fine but then to add that doing so would result in an ambulance not being available if needed later is not.

The exact point of the thread.

How is your Dad now? I hope he’s OK. I totally understand your concerns as I have AFib myself.
The issue here I think is that the paramedics implied that in the event of subsequently needing an ambulance he wouldn’t get one.I think saying this precipitates a lot of extra stress and worry for the patient and his family. I think that signing a disclaimer is fine but then to add that doing so would result in an ambulance not being available if needed later is not.
There are a few pieces of information missing here though. Did the paramedics do an ECG? They should have, and if your Dad was in normal sinus rhythm and his AFib symptoms had responded to additional beta blockers and breathing exercises then he would have been extremely unlikely to have had a heart attack! Does your Dad have an ECG machine? Then ditto. (If your Dad doesn’t;t have an ECG machine, could I suggest he gets a Kardia mobile? My cardiologist urged me to get one and it is immeasurably helpful and easy to use. It is hugely reassuring in monitoring AFib episodes and their reversion to normal.
The other question in my mind is when the paramedics said an ambulance would not be available if your Dad subsequently needed one, then what timeframe were they referring to? If say he needed an ambulance some days later (hopefully not!) and for a different reason, would their comment still apply? They would have needed to qualify their comment with further information such as “we won’t be able to come back out again within the next hour or two” or something like that. Paramedics use guidance called the JRCALC and the thing to do in such circumstances is to ask whether their recommendations comply with the JRCALC. (I know this through my professional experience).
Having gone to the hospital, yes, your Dad could have self-discharged at any point - but that’s a very difficult thing to do for most people, because as I know from experience, once you are there you feel compelled to stay within the system, and also there will have been the niggling thought that maybe “the paramedics knew something that they weren’t saying so better to get checked out”. I imagine your Dad had bloods taken to check his troponin level to make absolutely sure he hadn’t had a heart attack, even if his sinus rhythm was normal - that’s a routine process for people who are known to have had an episode of arrhythmia whether AFib or something else.
I think that the important thing here, instead of levying a complaint initially, is to ask for a more detailed explanation around the paramedics’ judgement that your Dad should go to hospital even after having been informed of his AFib and self-management regimen. That way, everyone can learn from the experience.
I’m sorry to hear your Dad had to sit on a hard plastic chair for 10 hours - unfortunately that’s the state of acute care in the NHS at the moment. However, it does sound like there wasn’t serious concern about your Dad when he will have been triaged on arrival at the hospital (otherwise he would have been put in resus), which again supports the suggestion that he simply had a longer than usual AFib episode that should be reported to his cardiologist.

Sorry for the long post - but I write from personal experience both from a personal and a professional perspective.

Take care.

How ill informed?

The OP literally said calling an ambulance was in the plan... Tiddlywink was merely repeating.

I thought you had, you sounded so ill-informed!

Of course you're unreasonable. You could have rung and cancelled the ambulance but instead allowed it to still come and the form he was told he'd have to sign is the same one the hospital would get him to sign if he, or anyone, decided to leave before being seen or waiting for results.
You know how busy the ambulance service is so if you decide you no longer need one please cancel it!

No idea. Haven't seen it myself.

But what else was in the consultants plan?

Try opening your mind a little. If you’re a paramedic with an AF patient, he or she is not dying on my watch.

I totally agree. I had a similar problem with 111 - long story, but the summary was that I had an optical migraine - never had one before and didn’t know what it was so phoned 111 who were helpful, but after 25 minutes it passed and I was still on the phone to them and I just wanted to go to bed. It was late evening, I’m a carer for my husband, and I have a dog, and no family to help and they wanted me to go to A & E. So it’s not that easy. 30 minutes later they finally let me go, but I had a confirm I wouldn’t hold them responsible if anything happened overnight. I saw my doctor next day and he diagnosed it and said A&E would have been no help, I needed to see an optician to get it confirmed and checked. Had I gone I’d have walked in, quite wEll, and guess I’d have sat there all night!

so I have full sympathy with your dad. I wonder how this over cautious attitude impacts on A&E?

They called the ambulance because it's in the consultant's plan.

Why call an ambulance if it wasn’t needed???

People like you.... how charming

It is really infuriating. However, I think the paramedics are damned if they do and damned if they don’t. They just have to stick to procedures. Likewise, if he is not critical, the hospital have to stick to priorities. It is unfortunate that it all worked out like this as I’m sure your dad would rather be recovering from this episode at home. But I guess, the nhs is trying its best. Hopefully he’ll be home soon and the AF will be treated again soon. Such a pain though.

And what else was in the consultants plan?

So you’ve got great faith in the consultant?

You chose to phone an ambulance. You chose not to cancel the ambulance, You chose not to sign the form, he chose not to leave the hospital. But now you are putting a complaint in. Absolutely pathetic. They gave you the opportunity to sign a form and made it quite clear that it was on your head if he didn't. The reason they do these things is because people like you would be the first complain if he dropped dead and if they then said he said he felt all right he wanted to stay home, you would rightly reply we're not a medical professionals how are we supposed to know? it's not the paramedics, the doctors or the nurses faults that there's massive delays. People like you make my blood boil.

And that’s because you’re obtuse!

They called the ambulance because it's in the consultant's plan.

I’m so confused why call an ambulance if you don’t want medical treatment? Bizarre behaviour!

If your father doesn’t want medical treatment don’t call an ambulance and let someone who does want and need treatment!

It would have been better to cancel the ambulance if you had waited a long time and in the meantime the episode had subsided. I did this recently and was asked verbally if I took responsibility which I agreed to. The next day I called an ambulance with no issue.

I was taken to hospital by ambulance on the advice of paramedics within the last 6 months. It was almost certainly a false alarm - I felt so, and a friend a rang who's a GP felt so, but they wanted to be on the safe side. It all kicked off at about 12am, and I got home the next day at about 2pm, after having spent most of the intervening time on a trolley in an electric lit hallway, with only 3 5-minute consultations to clear me.

My response to this?

Grateful to live in a country that was able and willing to check me out, and efficient enough to prioritise other patients on realising I wasn't an urgent case.

(Also knackered! 😂)