Paramedics made my father go to hospital

[wecangoupupup]

My father has atrial fibrillation. He has had this for years.

He has been told multiple times what to do in the case of an episode of AF. Today, he had one while I was visiting. It took a long time to pass, so in line with his consultant’s plan my mother called 999, after the usual medications had been given at home.

In the time it took for the paramedics to arrive, the attack passed and when they did arrive, it had been nearly an hour since it had ended.

They still made him go to hospital as they “couldn’t rule out a heart attack”, despite my father insisting that he knows his body, knows what an AF episode feels like and knows when it has passed. All he wanted was to go to bed and sleep off the effects of the beta blockers he had taken.

They still essentially made him go to hospital, saying that they would make him sign forms if he didn’t which showed he had refused medical advice. I was present and the paramedics essentially made it sound as though he would be at the back of the queue if it returned and he needed an ambulance again.

Fast forward 10 hours and he’s still in hospital, no doctors available to read his ECG or his blood test results, and he’s been sleeping in a hard plastic chair. AIBU to think this is ridiculous? Paramedics really shouldn’t be encouraging patients to attend hospital when it’s not necessary.

DH is in permanent AF, is supposedly on the urgent list for a second ablation (been waiting 11 months so far) and is prone to syncope episodes. Last time i had to call an ambulance, his heart rate was 160-180 bpm and he was sweaty/clammy. They were amazing with him, and suggested he went in for bloods which would take around 6 hours. The reality was that he was there for nearly 14 hours, by which time he'd absolutely had enough and discharged himself "against" medical advice. He had an appointment with the Cardiologist days later, who told us never to bother with A & E unless absolutely no choice as the reality is sitting in a noisy germ laden environment for 24 hours on a plastic chair if you hit the jackpot of getting one.

I thought they had to do 2 blood tests several hours apart to determine if a heart attack has occurred?
You first posted at 3 minutes to 6 this evening, said your DF had been waiting in hospital for 10 hours, the ambulance came an hour after his attack had ceased. So that means your DM must have phoned 999 well before 7am as he was waiting an hour for it to arrive, and would presumably been in AF for some time hoping his meds would control it. Isn’t that an early time to be visiting? I’m a bit confused as to why you wouldn’t be insisting that your DF goes to get checked out seeing as his usual meds didn’t seem to be working and he’d been in significant pain.

What, telling somebody that unless they go to hospital unnecessarily, an ambulance won't be sent for him next time he needs one? That sounds like disgusting bullying to me.

The medical advice was to go to the hospital. If he signed the forms stating he wasn't following medical advice, why should they send an ambulance if he later had a heart attack, for someone who clearly knew the risks and went against medical advice?

Sounds like your father/you wanted to go against the paramedics medical advice, but have the safety net of an ambulance if he was wrong. It's not bullying, it's setting out the options and the risks of going against medical advice.

I had sympathy for your situation until you said you had complained - those poor paramedics. The health service (as we all know) is massively under-resourced and involves long waits. Your father should have signed the waiver and not gone to hospital if he felt sure it wasn't needed. Of course the paramedics thought he needed to go, from an objective perspective they were likely correct, but still absolutely your father's prerogative not to comply.

You complained!!

As if.

Probably the same kind of person who would sue if he had a heart attack later that day.

No please, why is the NHS in such a shit place.

Poor paramedics couldn't win either way really, could they? If they left your dad to struggle at home and he dies - it's on them.

Take him to hospital and his daughters mad its taking too long - it's on them.

Yes

gosh its not the worse thing in the world - stop complaining - no its not perfect but unfortunately the public want lower taxes so we are stuck with what weve got

we are still one of the most fortunate countries for health services

i am aghast you are complaining - would you rather he didnt come back? just be glad hes ok ffs

My point exactly!

"If they left your dad to struggle at home and he dies - it's on them."

Not if he's signed a waiver.

Yes

where else precisely has he got to be?

OP words fail me. What you have done is truly terrible.

I had a similar episode with my DH. He has AF and had an associated angina attack. I called paramedics because it was quite a bad one. Their equipment indicated that he hadn’t had a heart attack so they stood down after making sure his heart rate had come down and he had recovered.

Unrelated, my mum died a few weeks ago - she was 95 and had AF and vascular dementia. Had had a couple of mini strokes and her consultant had issued a DNR because she would have had no quality of life if revived from a vascular event. On the morning she died I found her in bed and called 999. The operator insisted that I perform CPR even though it was clear she was dead and I told him several times she was DNR. I broke a rib during the procedure and it’s something I will never forget. My estimation of the 999 service is not the same as it was due to this.

Well they can’t keep sending ambulances as a priority to people who then refuse to go with them?

Also if he’s fine now of course he is triaged as low priority for the doctors to see and assess him.

Do you realise how ridiculous that sounds?
‘Dear NHS, I am writing to complain that following an AF episode today that didn’t seem to respond to my usual medication, and resulting in a call to 999, the paramedics forced me against my will to get into an ambulance and told me that if I didn’t go then went on to have a subsequent heart attack no further ambulances would be sent. I was forced to sit in hospital for 10 hours just to be told I had not had a heart attack. This is unacceptable treatment. I should have been left at home to my own devices and taken my chance that it wasn’t a heart attack”

Well next time don’t call an ambulance and then save the paramedics the time and effort of taking your dad to hospital. Save the nurses checking his ops. Save the doctors checking the results and making sure your dad is safe to come home. Save the NHS the money, the staff, and bed for someone who does want to be checked to see if they are okay 🙄

I can’t believe you’re complaining that health professionals are caring enough about your dad to check he is okay and safe to return home.

Dont be stupid - they are giving him the picture - of course they deescalate it if hes already had attention

you are contrDicting yourself OP - you said he cam manage it - but thats not what his cardiac consultant thought - so take the advice of the paramedics you called

This, if you’re waiting in ED, there are people way worse than you.
last trip to ED with 2 yo thought would be usual frequent flyer, in IV antibiotics and fluids and home once stable.. the frightening sudden rush around him and number of staff then blue lighted the 20 miles from one hospital to another for specialist care was terrifying, then felt grateful and simultaneously shit for all the times had moaned about all the times had waited hours to be seen…

I've done the job for 20 years and never heard anyone tell a patient that.
We might tell them that if they need to call again, that with long ambulance delays there may not be one immediately available due to demand and hospital delays, but that is not co-ercian, that is the truth, and informed decision making and informed consent requires accurate honest infomation, even if it isn't what you want to hear.

Well but how are dispatchers supposed to know that you aren’t going to waste every ones time and ignore professional advice again?

Your father could have signed the form. Why would a highly qualified professional risk their career by allowing him stay home without any official documentation that he refused treatment.

I can understand your frustration. However, before you put in a complaint, I would recommend watching Ambulance on bbc. I’ve been binge watching old series and they are under a lot of pressure. If you do complain, the individual paramedic may then go through suspension procedures and anxiety when really this comes down to a lack of resources and funding. They are all trying their best, and after watching the documentary, in a lot of cases as Ambulance is there to take the patient to hospital.

Hope your dad gets the help needed.

You are wrong op. By 'transient' i believe you mean a paroxysmal AF attack, which is what I have. Which caused me to have a heart attack. Which meant I had a 8 hrs wait in A&E whilst they did the sequential troponin blood tests.

And i may 'only' have transient/paroxysmal AF but I have an elevated risk of stroke, heart failure and MI.
I believe you dont fully understand your fathers condition or it's treatment and risks.
We are so, so lucky to have the NHS even if the medics don't have the time to dance attendance on us personally.

That's what OP said they said.
People are questioning, but we can only go by what OP said.

There is a clear protocol if a patient does not wish to take the advice to be taken to hospital. This should have been followed by the paramedics and the OP's choice respected.
If the paramedics did indeed say that dad would be low priority if he did not take the advice if he needed to call again anytime that is unacceptable.
As I said upthread, the visit was not a waste of the paramedics' time as they were able to do an ecg which is the first line test when a heart attack might reasonably be suspected. If that looks OK, not everyone needs to go to the next stage of a blood test in hospital, although it is recommended.

My advice to the OP would be to let things lie. It will not help your dad for there to be a fuss. Your dad had a right to refuse advice with no detriment to future callouts and he also should follow the consultant's advice again next time. I do not think there should be a complaint about the long wait at the hospital ... that is partly due to lack of resources, but also to the fact that the relevant blood tests take 2 hours to show a result and then a second test is needed which also takes 2 hours .... the important thing is to show whether the levels are rising so 2 tests (each with a result time wait of 2 hours) are needed. This inevitably means a long wait of 4 hours at the very least. Often they do not tell you this, which is unfortunate. I only found this out after a few visits!
I hope you can put all this behind you now.

That is OP interpretation of what she thinks she heard.
I think it's BS, along with her implication that paramedics don't know what AF is!