1. EMS Case Study Presentation March 27, 2013

2.  Period of Review for Study: January 15, 2008 thru May 22, 2011 Total number of calls reviewed - 54

3. Nature Code of Calls: Falls – 42 Trouble Breathing – 1 Sick Person – 2 Medical Alarm – 2 Bleeding – 1 Unknown Medical Problem – 4 Check The Welfare – 1 Traffic Accident - 1

4. Incident Disposition: Patient non-transports – 50 Patient transports to hospital - 4

5. Patient Background:  70 Year Old Male (2008)  Highly Educated Professional  Is A Paraplegic As A Result Of A Fall  Uses A Condom Catheter  Spouse Based Out-Of-State

6. Patient Issues:  Patient Alone Most Of The Time  Alcohol May Be A Contributing Factor  Failing/Declining Mobility  Driver License Revoked Due To DUI  Increasing Health Issues  Nasty And Mean Towards Responders

7. Situation Found On “Fall” Runs: Not all of the runs coded as a “Fall” were actually attributed to a “Fall.” Many of these runs included moving the patient from his van to bed, or moving him from his chair to the toilet and back. On numerous occasions, the medics cleaned up the aftermath of explosive diarrhea on the patient and in his residence. Medics also assisted the patient with his condom catheter and other medical and comfort needs.

8. Agency Referral : On June 23, 2010 the Clermont County Adult Protective Services agency was notified and a caseworker was assigned to the case. Following the referral, a care provider visited and assisted the patient on a limited basis.

9. EMS Case Study Review: There has been no contact with the patient since May 22, 2011. It’s unknown if the patient still resides at the same address or if he passed away.

10. Questions Raised: Are legal issues involved regarding care? Are there psychological issues that may impact the patient’s ability to care for himself? Are there underlying alcohol issues? Should the patient be in a care facility and who makes that decision? Can the hospital provide assistance if they are aware of the problem?

11. Potential Referral Agencies:  Adult Protective Services?  Mobile Crisis Team?  Prosecutors Office?  Clermont Senior Services?  Clermont Counseling-Mental Health