# How would paramedics/EMTs React To This?



## evolution_rex (Mar 26, 2016)

So, here is the scene:

The main character delivered a pizza to the house of a shapeshifter in the form of a human. It grabs him and tries to push him into the abandoned house he lives in, but he escapes. He gets in his car and speeds away and sees the creature go on all fours and chase him. He then goes back to his workplace in panic, trying to tell everybody what happened. He is having a panic attack and passes out. He wakes up just as the paramedics arrive.

In the story, it is a necessity that he doesn't go to the hospital. How would the paramedics in this scene react to him waking up before they get to them, and how would they determine that he doesn't need to be hospitalized? What would their dialogue look like? I've never written paramedics before and don't have much knowledge about how they work.

EDIT: Sorry, I put this thread in the wrong section. If someone could move it to the Research section that would be great.


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## Geo (Mar 26, 2016)

Hello, I worked as a voluntary life guard (this was more than 15 years ago, so things may have changed a lot). 

Here an extract of what we were told to do if the victim of a fall, accidental drowning, or seizure recovered before the paramedics arrived on the scene:

"...If the victim recovers before medical personnel arrive, he/she should seek medical advice as soon as possible. Any loss of consciousness after a head injury, even if only for a short time, requires immediate evaluation by a health-care professional..."

"...If the victim recovers as medical personnel arrive on the scene, they must evaluate the victim. If the victim's vital signs are stable, and there is no evidence of injuries, the victim may be release under his/her own recognizance after signing the corresponding release forms (this refers to our own release forms, those from the life guard's unit) and if the paramedics agreed that the danger has passed..."


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## evolution_rex (Mar 26, 2016)

Thank you, that is very helpful! How do they check their vital signs? What kind of things would they do?


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## Geo (Mar 26, 2016)

Vital signs are:

Blood pressure, temperature, pupil reactivity, balance... they check airways, in case of drowning they check for water in the lungs (with the stethoscope), pulse.

There was a lot about asking the victim for his/her name, the date, who was with them, if they have drink or do drugs, what happened, ask witnesses what they saw, sometimes they ask us about what happened, things like that, and at the same time that one person was asking these questions, the other one (they always came in two, sometimes three) was checking pulse, blood pressure, palpating for injuries (if the victim was unconscious they opened airways and checked for breathing, but that's not your case), hearth rate, temperature, etc.

Probably you can get a good idea of what to write from an old episode of ER or Nurse Jackie (any TV series that shows ER work, I guess), because I can't really remember what the paramedics asked and did... it was looooong ago. 

Sorry...


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## ascanius (Mar 28, 2016)

Me coming across this patient.  First think I am going to look at is the location.  Mostly for my saftey but also to help understand what happened. then.Without even touching or talking to the patient I want to develop a general impression and see if there are any red flags, sitting(possible respiratory distress). prone, supine, heavy/abnormal breathing, agitated, clumsy movements like drunk(doesn't mean they are drunk but can be a sign of something else).  So without touching the patient I have developed a general impression along with the information given by dispatch I start to modify or adjust what I am going to do.  How I see the patient and the situation is going to influence what we do next.  Unless there is a clear life threat to the patient we can proceed calmly (getting anxious and rushing is never a good idea).  Most often one of us will talk to the patient and or bystanders while the other takes vitals. First up for vitals are ABC, Airway; mouth, nose and throat, any obstructions, anything out of the ordinary.  Then breathing; normal, shallow, huffing, wheezing, fast, slow, patterns such as, gasping, kussmaul, cheyne stokes etc, respiratory rate.  Cardiac; blood pressure, heart rate, pulse, capillary refill, pallor of the skin, sweating, any bleeding.  Once I have established that the basic functioning for life is stable, especially breathing and cardiac I can move on.  If at any point I find a problem I treat the problem (how this is done is dependent on a lot of factors)  

Now I have established the patient is in no immediate danger I can move on to a more detailed secondary exam depending on need.  In this case if the patient tells me or my partner that he was being chased by a werewolf and had a panic attack my evaluation is going to change.  I am going to suspect drug use, criminal activity(mugging, assault etc) and possible trauma.  So still doing vitals I would start with PERRL= pupils equal round react to light, then move on to look for any trauma DCAP-BTLS (deformities, contusions, abrasions, penetrations, burns, tenderness, lacerations, swelling) on the head, neck, chest, abdomen etc, I'm going to also be on the look for signs of drug use.  Anything of I notice I am going to note down and or treat.

All this while my partner is asking questions, Identifying questions, SAMPLE, signs and symptoms, allergies, medications(drug use), pertinent medical history, last oral intake, events leading up to the injury illness.  A quick Glascow coma score can be taken and in this case I would put a nice score of 15.  The thing is, if he is telling us that he was chased by a werewolf it can confuse things because this could be a psychological patient in need of care, or a person who is on drugs.  Now if there is no evidence of trauma, the patient is calm, acting normally, not aggressive, healthy, answer questions in a calm organized articulate fashion there is little to do.  I would say we would start asking questions to him and bystanders about what happened and what they saw.  I would also alert the police immediately once he mentions being chased, be it by Bigfoot or a dog(most probable).  A lot of the questions can be asked on the way to the ambulance but there is no hurry.  I would also tell the patient that he should go to the hospital and visit with a doctor.  I cannot force him to go if he does not want to.  The exact questions, other than the standards, are hard to say I can change from call to call.  Mostly I ask the questions that are relevant to getting a better picture of who the patient is and what the problem is.  Its hard to tell you exactly because there are so many factors but the above are the basics.


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## Heliotrope (Mar 28, 2016)

Yep. I'm with search and rescue and can verify pretty much everything stated above.


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