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.

Exactly!
"Didn't need to be there and should have been seen urgently" is a hilarious argument to make.

What private insurer wants ill people ?

Don't be ridiculous OP.

I smell a compo sad face in the paper.

Their professional opinion was that everything was fine, but “better safe than sorry"

So they were not really 100% sure otherwise they would not have insisted. And if they do get it wrong where would the blame lie?

At what point does anyone absolutely know AF is not seconds away from a heart attack? My guess is no-one..

I've made a note to see if it pops up in my APILN feed 😀

Why the hell do you presume you are better qualified to decide if someone with a serious heart condition needs hospital treatment than a trained paramedic? If you decide to reject medical advice, it is completely reasonable that they ask you to confirm that you are rejecting their advice. Would you blame the paramedics if your father stayed at home and died during the night?

I wouldn't put in a complaint as such. I would write and state what happened and what your father's history is, that he has had AF for a long time and knows how to deal with it. I suggest that you word your letter as showing up a training need rather than that the paramedics over-reacted.
When did your father last see a cardiologist? Has he had the AV node ablation? As said by someone else here that can help a lot. Two friends of mine have had it successfully. My husband though has had AF all his life and now has a pacemaker/defibrillator.
I hope that the hospital refers him back to the cardiologist for review.
Good luck!

Please update

Jesus wept, they cannot win can they? They did the right thing and he should get it checked.. I would hope that anyone doing their job approaches or with an abundance of caution. And yes, you do need to sign a waiver if you go against medical advice. All of this is normal and you are being difficult with people just genuinely trying to do their job in good faith.

I work in A&E. Welcome to my world. We genuinely can’t do the right thing for some people. The waits can be horrendous but it is never the staff causing the long waits I promise you.

No doubt it will change again when she complains.

Edit - sorry didn't mean to quote you! Was just generally replying in the thread I agree with your comment!!

You have to put a measure of "pressure", you have to make sure it's a fully informed decision/refusal. Otherwise in addition to the risk to the patient you leave yourself open to serious complaint/job loss. "Well they just said it was my Dad's choice and he looked ok to them, he didn't realise he could die and it was only a blood test that they couldn't do that would show he was ok, now he's dead and it's all their fault..."

Generally it would be something like "your observations and ECG look normal to me now which is a good sign, but what you've told me about the long/unusual episode of chest pain/palpitations etc is concerning and could be a sign of a heart attack, it's only by having a blood test and further monitoring under the Drs that we would know. We haven't done these tests, they're only done in hospital. If this is a heart attack the delay by not going now could be fatal, symptoms can suddenly worsen and it can occur that we won't arrive in time for you, and even if it does the delay in care will have a significant affect on your outcome, including death. If you're refusing to come to hospital then you need to acknowledge this risk and that you are refusing our advise to come to hospital now with us where we would hand you over to the continued care of the hospital team..."

Obviously having one ambulance out won't mean one is refused if you call back. Indeed you'd be encouraged to call back if your symptoms returned/worsened (part of keeping me safe as well as the patient). It's only when people refuse several ambulances/become a regular that decisions are on occasion made about refusing to send one - it has to be lot of time wasting like calls for this to occur.

Who mentioned insurance?

YABVU.

Your Mum has a protocol to follow if your Dad has a prolonged episode of AF that is not responding to treatment. She followed that protocol and called 999. The paramedics probably have a protocol too, which they followed. It’s not their fault he’s waited so long to be seen.

Also, when the cardiac surgeon said to call 999, he won’t have meant “call 999 and see what happens”. He’ll have meant “call 999 so you can be taken to hospital for assessment and treatment”.

But OP, since you’re clearly a cardiology expert, next time why not just sort it all out yourself?

He knows how to deal with it but they still called an ambulance. If they are so sure they why bother?

Oh op once you ring for an ambulance they have procedures that they have to follow they don't just make it up as they go along. In the absence of chest pain or breathlessness I'm surprised he didn't wait it out as you said 'He has had plenty of AF episodes and knows exactly what they’re like, he’s very experienced in them now'

They did bloods and an ecg which must've been fine hence he's still waiting for someone to review as he clearly isn't urgent or unstable.

Awful for anyone to live with a chronic medical problem but don't blame nhs staff for doing their job.

The fact that there is an event on in your town that often gets out of hand changes things massively!

They werent threatening him, they were warning him that there was a good chance that if he called again later there wouldnt be an ambulance available. Thats not bullying, thats the truth! We have a similar yearly event in my town, usually ok but sometimes does get a but lairy, and it is not a good night to get ill. A&E gets over run and ambulances are few and far between (made worse by the queues).

I understand that you are worried but his consultant said he should do this, he has done it. What is happening now is nothing to do with the Paramedics, not their fault at all.

Whilst the state of the NHS times and waiting experience there is awful… I do think you are being completely unreasonable here.

YOU (or your mother) called the ambulance despite knowing the episode had passed. Why did you allow it to still come if everything was fine and normal now? Was it ‘better safe than sorry’ for you? So it’s okay for you but when medical professionals request it then it’s not normal?

The paramedics were not trying to get more people to hospital earlier that’s absolutely obsurd to think. Putting people there unnecessarily doesn’t make it that they will have less to do later that day.

not sure why your father is there on his own also why didn’t someone go with him?

This is why paramedics and similar should wear body cams. To save them from people’s embellishments of what actuLky happens

As you were convinced he as not having a heart attack, why didn’t you tell the paramedics that you will take their advice and go to A&E - but go yourself.

ambulances are not taxi’s - next time if concerned go yourself.

ECGs are actually indicated for loads of random seeming symptoms! And Paramedic and EMTs are trained to read them.
Including AF which is very common.

What training need exactly do they need??...

They don't ime, if they were so insistent then they must have been worried. It's standard practice to ask to sign a refusal of treatment form, it covers them if anything subsequently happens.

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.

@wecangoupupup on the face of it I don't think that's so terribly unreasonable; but of course a lot depends on tone and delivery.
If he refuses their "just in case" medical advice and then "just in case" happens, well he/you can't complain if a subsequent call on the same day is given a lower priority.
And if they are thinking that they might be busy later today (as you suggest) then all the more reason to play the "just in case" card, don't you think?

You have to understand (and should respect) that their priority is to keep people safe, whereas you are thinking about his comfort and mental well-being as well. I do think you should have insisted on a bed in A&E (or wherever he ended up) however - leaving an elderly man to sleep on a plastic chair is pretty bad imo.

My experience of the ambulance service has been the reverse actually - which is arguably worse. My elderly and very frail mother has a condition that causes intermittent bleeding; the care home has called for an ambulance 3 times in the last fortnight. On the third time the call handler (NOT a medical professional) told them not to call for an ambulance but to manage the bleed themselves!