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CASE REVIEW will be diffcult. As the ambulance begins to move, the driver notifes the dispatcher that they will be transporting one patient to the hospital she requested. The dispatcher acknowledges the message but reports the hospital is on diversion status, and the crew will need to select another. The driver requests a second hospital by name and is told that too is on diversion. The dispatcher fnally volunteers that almost all regional hospitals are on diversion, and only one some distance away is receiving ambulances. The driver passes that information to the paramedic, who then asks if that hospital will be OK with the patient. She nods, but then opens her eyes and becomes concerned. "What about my husband? He is going to our closest hospital and will not know where I am. And his phone is turned off—what are we going to do?" After some negotiation and conversation with the dispatcher, an arrangement is made to have a local police offcer go to the home and inform the husband that his wife is being transported to the farther hospital. That offcer will confrm delivery of the message to the dispatcher, and then the dispatcher back to the ambulance. Diversion has been a major issue before in Attack One's system, and the paramedic promises to let the EMS supervisor know about the issues related to this patient and communication to her husband at the end of his shift. The paramedic delivers a rapid notifcation to the appropriate receiving hospital. The emergency department staff asks if the patient can be masked on arrival and prepared for a signifcant wait. Because so many other hospitals are on diversion, the ambulance traffc has been heavy in the overnight hours. Hospital Course The ED is very busy on the patient's arrival. The ED staff performs an assessment, fnding her febrile at 104ºF. They conduct a rapid infuenza test, which is positive. Before the Attack One crew can complete its documentation, the patient has been to x-ray and found to have pneumonia. Her wheezing is treated with repeated nebulizer therapy. She will be admitted to the hospital. The patient actually deteriorates in the next day and needs treatment in Intensive Care. She remains hospitalized for 10 days, requiring the use of antiviral agents and antibiotics and support on a ventilator. She is released in fair condition and needs home therapy before she can completely recover. Case Discussion In January the CDC reported the You deserve the best. the best benets the greatest opportunities the strongest voice advocating on your behalf Support your career and your profession. Unite with your fellow EMS practitioners across our nation. Join NAEMT today. www.naemt.org | 1-800-346-2368 National Association of Emergency Medical Technicians For More Information Circle 19 on Reader Service Card 18 MARCH 2013 | EMSWORLD.com Serving our nation's EMS practitioners