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It is interesting to learn a bit about how things work in the Emergency Room (ER). It can often save you some frustration and wasted time. Since Ron had his first stroke, we have spent our fair share of time there. The important thing to know about the ER is where your problem falls in the hierarchy of emergencies.
The thing is, often people can get mad and even fuss and scream, but there are protocols that decide who gets seen first in terms of the kind of patient. It is no accident that “emergency” is part of the title for Emergency Room.
When you arrive, be clear about your symptoms. Don’t equivocate. If you are wishy-washy about what your symptoms are, it could come back to bite you. Don’t downplay true symptoms. They listen to you. This is no the time to understate what is happening with you. You also don’t want to exaggerate them either.
Do you have chest pain or don’t you? Where does it go? How severe is it on a scale of 1-10? Are you short of breath? Think through your symptoms and be clear about them. As the doctor or nurse gets more specific with your loved one about symptoms, when they started, what they feel like, etc., they can understand more about what is going on with your body.
There are protocols for treatments. Sometimes arriving in an ambulance can move you up by a person or two.
When a person arrives in the ER in an ambulance, they are more likely to get into a room quicker. Of course, you won’t send someone to the ER in an ambulance who simply has a headache, but if they have a potentially serious diagnosis and you aren’t certain whether to take them or send them via ambulance, they will probably get treated a bit quicker if they arrive via ambulance.
People with diagnoses that need time-limited treatments will be treated first no matter how they arrive. This includes such things as heart attacks, stroke, head injury with potential for brain bleed, to name a few. Close behind these are people with respiratory distress, high fever/potential for septicemia and severe pain, especially abdominal pain. If it is accompanied by fever and/or vomiting/diarrhea or other signs of intestinal blockage, they will have you high on the list as well. Broken bones, small lacerations that will not require an admission, will be very low on the list. Things like broken hips or breaks that require surgery or severe lacerations that are complex and may require surgery will be higher on the priority list.
If there is something like a flu epidemic that is filling up hospitals, you will be on a lower priority list (if you have flu or even covid) unless you are having respiratory distress. While it is true that you as a family member may be distressed to see the discomfort/distress your family member is going through, you may find yourself in a situation where you have to spend a good while waiting in the ER before you are seen. Often, the nurses will triage you to be sure they know your symptoms and vital signs. They may even draw blood to clarify your situation so your waiting isn’t totally wasted. But they can’t do any CT scans, start IV’s, etc. until you are in one of the ER rooms. That’s when you are officially admitted as a patient.
Once you are either in a room or on a stretcher and are being seen in the ER, you are officially admitted. Now they can treat you.
Once you have a room in the ER, a doctor will see you as well as a nurse and you will be getting all the tests and procedures rather quickly. Blood is drawn, IV’s are started (if needed) and you get settled in your stretcher/bed rather quickly.
Then it is time to wait! That can go on for quite awhile. It all depends on what tests were done and how long it takes to get those results back. It will most likely take at least an hour, usually longer. So be sure you have something with you to enable you to wait patiently. It is part of the ER experience. Complaining, grousing, pacing…only make you miserable. Once the doctor has seen your loved one, go grab some coffee or food. It will help you feel more comfortable. Remember, if you are there with your loved one, you are there to be encouraging to them, not to complain. Make them comfortable. If there is a TV available, put it on a station they want to watch. Make sure they are comfortable.
After the test results are in, ask the questions you need to ask. Make use of the time while you wait to think through the possibilities so you can anticipate questions for if your loved one goes home? if they are admitted? if they have x diagnosis what happens next? Jot them down on either your phone or a piece of paper.
After, you have the results, you will know whether your loved one will be admitted and what kind of admission it will be. We have experienced both kinds. One kind of admission is where they need to observe the patient for awhile to know if he needs to have a full admission or go home. For Medicare patients, there is a 24 hour admission. In our hospital, it is in another part of the ER. It’s quieter than the ER and the rooms are private, but the beds are pretty similar.
There is also another kind of admission and that is a regular admission to a regular room. I guess you can break down regular admission to three types: a normal admission in a regular room, a step down unit that has all the patients EKG-monitored, an intensive care/coronary care bed.
We’ll talk a little more about admissions next week. I’m simply mentioning the three types of beds and two main types of admissions you might have. The majority of patients probably come through the ER except for Surgery patients who come in with planned surgery. When you are sick, most of the time, you will be admitted through the ER.
That’s my skim of the ER. I wrote on different aspects of the ER before. You can read about it here
Have you not known? Have you not heard?
The Lord is the everlasting God,
the Creator of the ends of the earth.
He does not faint or grow weary;
his understanding is unsearchable.
He gives power to the faint,
and to him who has no might he increases strength.
Even youths shall faint and be weary,
and young men shall fall exhausted;
but they who wait for the Lord shall renew their strength;
they shall mount up with wings like eagles;
they shall run and not be weary;
they shall walk and not faint.
Isaiah 40:28-31 ESV