Home Care , Lab Tests, X-rays, Doctors AT HOME
24 hours a day
hoMed emergency calls
When a doctor receives an emergency call:
He/she
tries to evaluate the degree of urgency of the event over the phone (e.g.
mild symptoms which have been present for a few days are not considered
urgent, whereas acute severe pain, acute dyspnoea, seizures, high fever
with rigors, change in the patient’s level of consciousness, acute disturbance
of the patient’s orientation in time and place, unusual perfuse sweating,
are some of the symptoms which could define a call as very urgent).
If
the call is not considered or described as urgent, a medical visit is
scheduled as soon as is feasible, but within the flow of the regular visits.
If it is a very urgent call, the medical team goes over as soon as possible
using the special visual and sound alarms to bypass any traffic.
Usually, when a medical team moves in this fashion, it covers even the
longest distance under heavy traffic conditions within less than half
an hour.
The doctor and the nurse(s) enter the patient’s home with the basic diagnostic
equipment (electron cardiographer, pulse oxymeter e.t.c.) and an initial
medical assessment is done.
If with the first assessment an acute life threatening condition is diagnosed
(pulmonary edema, seizures, coma) the nurses will go to the medical vehicle
and
immediately
bring in an oxygen bottle, a stand for drips and a mobile storage cupboard
which contains almost everything that will be necessary,
IV fluid bags, an electronic IV fluid administration pump, the suction/aspiration
equipment (if needed) and the medications which are necessary (there is
a full pharmacy within the medical vehicle).
Immediately
oxygen is administered and an intravenous line is inserted (an IV drip
is placed).
Arterial
blood is obtained and analyzed by the blood gas analyzer, which exists
within each medical vehicle. This way, the initial vital information concerning
oxygenation, carbon dioxide, possible acidosis or alkalosis, electrolytes,
hematocrit and blood sugar is immediately available.
Treatment
is immediately initiated. Doctor and nurse do not leave the patient’s
side before the clinical state is stabilized.
If
needed, one of the teams may carry blood samples to the lab for urgent
analyses (which cannot be done by the portable analyzer) or for developing
any radiograph films, which have been taken on site.
-The doctor is informed by phone regarding the test results and the radiographs.
Often he/she obtains the opinion of other hoMed doctors
over the phone or doctors of other specialties, if needed.
The patient is immediately admitted to a hospital of the patient’s choice, if:
- Myocardial ischemia or dangerous arrhythmia is diagnosed
- Blood gases are not improving despite any therapeutic steps taken or if mechanical ventilation will be needed in the next hours (intubation and mechanical respirator).
- Acute surgical condition is diagnosed (acute abdomen, pneumothorax, arterial embolisation of lower limbs).
- There is strong suspicion of a condition such as dissection of the aorta, thrombosis or embolism of the mesenteric vessels or pulmonary embolism.
The patient may be transferred to hospital only for a short time period if it is necessary to get:
Urgent
computer tomography (e.g. suspicion of subarachnoid hemorrhage, investigation
of a large lung consolidation or pleural fluid collection.).- Immediate MRI scanning with contrast (in case of a cerebrovasular accident)
- Immediate examination with abdominal ultrasound or cardiac triplex ultrasound.
- Also an evaluation by another doctor of an appropriate specialty when needed.
- If there are not findings which might mandate prompt surgical operation or admission to an ICU, the patient is transferred back home to continue his/her treatment at home.