Paramedics made my father go to hospital

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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.

Yes because he has gone against medical advice. They advised going to hospital for a full check and rule out a heart attack and whilst he’s there if things do change he’s in the right place. They were letting you know that if his symptoms change at home and you ring again requesting them he won’t be a priority call as you refused to follow their advice

Just to clarify from people who think medical professionals can do no wrong: it is standard medical opinion that a sick old man will be better off sitting in a chair in a hospital for ten hours than at home in his own bed, is it?

Amazing how many people think that having medical training magically prevents any possibility of aggressive or coercive behaviour.

Harold Shipman couldn't possibly have murdered all those people, he was a doctor so all negative traits had bern surgically removed at university.

I can see both sides tbh

Their side
Patient has had an episode of AF, is now stable but of course is at risk for next few hours of stroke or heart attack. How can they reasonably say "stay home" when he is in a risky situ after the episode. Even if they DID send an ambulance again what if it didnt make it in time, and they were known to have left him earlier in the day.... litigation wise it is messy. Better to send him in.

Your side
He probably won't have a cardiac event, this happens frequently, he has become stable now and we don't need to take up a bed and resources in A&E. How about we just call you again if the situation changes.

~

Set in a wider context of how do we manage obligations re multiple call out possibilities to the same person with a fear or dislike of hospitals/stubborness etc - not saying your dad is like this but this is what the context they will be working within.

AF is tricky - it isnt serious until it really ducking is, so it is hard. Mum has just been diagnosed with it and it is a lot to learn

You don’t have to be an expert in anything just common sense
it certainly wasn’t beyond the realms of possibilities that he was having a heart attack
easy to criticise when you have the full facts
but this could of been every easily a different story

I really don’t understand why he didn’t just refuse to go

Well perhaps your Dad can pay to go private from now on, if the NHS is not good enough for your family and then the ambulance service can be used for people who actually need it and not for a taxi service or next time he could get off his ass and go to the reception and tell them he's leaving and to remove the cannula for him, it's not difficult.

No it's standard medical opinion that there are more than one thing in your chest/ upper abdo that can cause chest pain and have the potential to kill you, and with limited investigations, no access to previous investigations and no medical notes available in the pre hospital setting, we can not exclude those things. We can take a hunch that it is probably all related to the paroxysmal AF, which is already medicated for and currently resolved. But taking a hunch is when things DO go wrong.

This is why it was correct to advise hospital attendance and it is always correct to make patients aware that it is ultimately their choice but they have to take responsibility and sign for that risk, all off which happened with OP dad.

Why did you do it then?

So if this is the advice, that he is to attend hospital... and he did just that, what is the problem?

Hospital services are on their knees.

If your father didn't want to go to hospital then I think its actually you who wasted important resources. Thankfully your father was OK.... but many other people might not have been. Of course it shouldn't have taken so long for him to be seen but that's the unfortunate world we live in where hospital staff are absolutely run ragged.

I think its fair to say that if someone was unwell enough to call an ambulance but refused treatment, that they wouldn't be prioritised in the event they called again given the amount of calls to the services and the limited resources.

I wouldn't be angry and paramedics who have done their job, I'd be angry at the government for the sheer pressure on the system.

Yes, in addition they need to know that he understands, weighs and retains the decision he is making. They did a good job in my opinion. The complaint is the amount of time he waited at the hospital if you can’t stop yourself complaining.

This.

Total applause for am excellent situational analysis. I would suggest that those who don't wish to be dim notice how no medical knowledge was required to pull out these outcomes. Each one is a logical outcome based on events.

The OP rather seemed to have failed to consider these outcomes before rushing to judgement.

He should've signed the forms. I did this once with a broken hip. Turned the paramedics away as I was too scared of how much it would hurt for them to move me. They have to make you sign if they strongly recommend it but you refuse.

They can't force you but they will try and persuade if they think they need to. But once they offered the forms he should have signed and they wouldn't gone.

The paramedics that attended when both my mum and dad were ill were excellent. My dad had heart issues and was in and out of hospital but was sometimes not admitted and they particularly said to call them as many times as we/he liked and not to worry. That doesn't mean that I disbelieve the OP's account though.

Can you please provide the name of the private hospital that has an A&E with emergency cardiac care?

Just thought I'd highlight the tumbleweed here. But we all need to know how we can sign up to a private A&E service. Mainly because I know quite a few influencers who would be pretty gash at doing their TikToks,

He can always pay to go private. People are so quick to slag off the NHS. Sounds like they were doing their job.

The 'cardiac surgeon' is at fault here. A bit like GPs who instruct everyone to go to A&E if 'it gets worse'.

They should give the full picture that patients will not be admitted as a priority to some kind of vip suite, they'll be triaged and will wait hours like everyone else if there is nothing of concern on ecg and bloods .

Scenario 1 happened to one of our neighbours. The ambulance was less than a mile away after leaving the house. Thankfully that family weren't knobs and didn't blame the paramedics who had explained the risks.

Look at the worst case scenario. I had a situation not so long ago where 111 recommended an ambulance for DD, 2 minutes later the ambulance service called, there are none available can you make your own way to A&E? We drove straight there and there were no parking spaces so I had to drive around the car park 3 times until I found somewhere to park. It wasn’t so bad with a small child I could carry, not ideal but manageable, but probably not do-able with an elderly man having a heart attack. So he had to wait around a bit, he was in the best place in case of worst case scenario.

We are still awaiting details of the private A&E providers.

Glad your dad is ok OP. My mum had an episode of fast AF and was attending an oncology appointment at the hospital at the time. Her consultant didn't like the look of her so got the nurses to do some obs and she was admitted as she looked pale and her heart rate was high.

Her ECG didn't show any ischaemic changes but she had all the bloods done to check for cardiac enzymes which have to be done initially, then again in 6 hours as the rise in enzymes can increase over time but show as normal initially.

Her enzymes came back extremely high showing she'd had a severe type 2 myocardial infarction secondary to anaemia as her haemoglobin was so low due to her cancer. She didn't feel that unwell, just tired and some palpitations. My mum is now in irreversible heart failure and my point is that if she hadn't been in place where medical attention was given, she may well have died at home.

The paramedics made the right call, they are always going to take a cardiac patient into hospital- you have changed your story so many times about how the paramedics told you that a second ambulance wouldn't be sent. It sounds like their communication wasn't ideal but I also think you are twisting their words. If he needed one later on, they are saying that one may not be immediately available depending on demand on the service at the time and the number of higher priority calls. Some people call out ambulances multiple times a day and the ambulance service can't refuse to send one if the paramedics have already attended- each call will just be triaged on clinical priority.

I agree with others that say people are like you are why staff are leaving the nhs in droves.

First they "essentially made it sound like", then "insinuated", now they actually said it. So which one?

Sorry but when it comes to your heart, regardless of conditions, I think better safe than sorry is the best approach

Son in Law is a paramedic. I asked him about this scenario. He says it’s absolute nonsense, and at the very least OP has misunderstood what was actually said.

If you are awake, lucid and you are a competent adult who understands the risks, you have the right to refuse care - even if that’s not wise decision. If the paramedics advise that you should go to hospital and you refuse, it’s treated as informed refusal and they’ll ask you to sign a ‘refusal of medical assistance against medical advice’ form as evidence that they have advised you of the risks and you still declined.

In some cases where symptoms have passed and hospital attendance is a patient choice they will offer ‘safety net’ advice as to when to call again if symptoms reoccur.

You can refuse once, and if the symptoms happen again, you can call 999 again, and they will attend as a matter of priority. Paramedics have a duty of care and cannot ‘blacklist’ a patient for previously refusing care - which is essentially what OP is saying. If you refuse multiple times for the same issue, paramedics can suggest alternatives, such as contacting your GP, but they must still attend to assess your capacity to make that decision at that moment. If at any point they decide you lack the capacity to make an informed decision they will make a ‘best interests’ decision and overrule you.

Or self discharged from hospital as he knows his body so well, didn't need any intervention and sat in a plastic chair on his own for 10 hours,