Older gentlemen, had fallen on his floor. Been down for several hours when a neighbor found him. Looked like a lift assist, minor bandaging and refusal.
Then there's vodka on the counter. Neighbor says he drinks 1/2 of a half gallon bottle of vodka each nite. So my partner, fire and police decide he's drunk and must go in. Call is made to med control and we get order to transport.
I was treating the patient. He didn't smell of alcohol. He had been down for 3-8 hours and his vodka bottle was a few feet away. I didn't see how he could be all that intoxicated. Granted he has a little trouble with the day of the week, but it didn't seem abnormal to me.
When we got to the hospital he was tested for alcohol and registered at 0.00. But most of the folks on the scene knew he was an alcoholic. Sure, probably about every other nite he is blotto, but not this nite.
I am fairly proud that I didn't jump to conclusions and assessed the patient without preconceptions. Not as proud I didn't stop my more senior partner from calling the hospital.
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If he is regularly intoxicated and now has no alcohol in his system, there should be some symptoms of withdrawal, unless the drinking to excess is new.
If you are taking him against his wishes, because of something like "unsure of day of week," which may be normal for him and is normal for me (I work all days, so Mondays, Fridays, and weekends are meaningless), you might want the police to sign as witnesses that they feel he is not competent to refuse transport. They probably won't. Now that you have the police telling you that the patient is not too incapacitated to refuse transport, talk to medical command again. What are the orders, now?
Get the medical command physician to state clearly that he wishes you to transport a person against their wishes, even though police on scene do not agree that the person lacks the capacity to make informed decisions. Not that this protects you from criminal conviction (I was just following orders), but at least the doctor should face some charges, too.
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