What is a hospital's definition of an emergency?

[fuzzykitten99]

Yesterday we made a trip down to the emergency room because my son had tripped and hit his head on the corner of the wooden chest we have in the living room. It bled quite a bit, but with pressure, we got it to stop just as the ambulance arrived. Because we were able to get it to stop enough, they said they think it would be best if we took him the hospital ourselves, because the loud ambulance and strange people would just scare him more, because he is so little (17 months).

Anyway, we get to the hospital, and we see all these people in the waiting room. One infant next to us (through me talking to the mother) had a 104 temp...in a baby under a year, that can be lethal. She had him in nothing but a diarper and onsie, and he was still boiling hot. She had been sitting there for 2 hours before we got there. While waiting our turn, a lady came in with what looked like a broken ankle, with 2 people carrying her. They asked when they could get in, and the nurse said about 4 hours. They used the phone and called one of the urgent care clinics, and they told her they would be able to see her immediately. I wish I would have thought of that instead of sitting there forever, with my husband trying to keep our son from touching the cut. I had a hard time keeping the gauze on him because I would struggle and it would start bleeding again. After 2 hours of sitting in the waiting room, I went up to the nurse as nicely as I could and told her that my son NEEDED to be seen sooner because he keeps bumping the cut, and it keeps bleeding, and I am sure they don't want blood to get onto anyone else or the chairs or anything. It wasn't bleeding that bad, but it was enough to get all over me while trying to hold the gauze on my crying, hungry son. They wouldn't let us feed him for fear of concussion, and the possibility of having to sedate him. I know the side effects of sedation, and I didn't want him to go through that. Plus that would add 4-5 hours to the whole thing. So he's hungry, tired (it was well past his naptime), bleeding and hurting, and there's nothing we can really do to help him. I finally got upset enough that my husband went and got some milk and cookies for him. He wolfed those down in about 2 minutes.

They finally called us in, and numbed his cut up, which took an hour in itself. They had to wrap him in a blanket and strap him down. He was so mad and upset, I was praying that this would not scar him emotionally. I have never heard him scream and cry like that-I had to choke back tears to keep talking to him to help at least calm him. My husband wasn't in the room while he was being stitched up because he is too squeamish, and couldn't handle hearing Nathan cry like that. He must have worn himself out, and must have been so tired, he actually fell asleep about 2 minutes before the Dr. was done. He got 8 stitches, and has to go in on friday to get checked out, and make sure there is no infection, that it is healing well, etc. The stitches will dissolve on their own.

We got to the hospital at about 11 am, and didn't get home until after 5. I know that sometimes they get busy, but c'mon. One guy came in with his thumb half cut off, and they made him sit down and wait too.

What is THEIR definition of an emergency?

 

[no1tovote4]

Yesterday we made a trip down to the emergency room because my son had tripped and hit his head on the corner of the wooden chest we have in the living room. It bled quite a bit, but with pressure, we got it to stop just as the ambulance arrived. Because we were able to get it to stop enough, they said they think it would be best if we took him the hospital ourselves, because the loud ambulance and strange people would just scare him more, because he is so little (17 months).

Anyway, we get to the hospital, and we see all these people in the waiting room. One infant next to us (through me talking to the mother) had a 104 temp...in a baby under a year, that can be lethal. She had him in nothing but a diarper and onsie, and he was still boiling hot. She had been sitting there for 2 hours before we got there. While waiting our turn, a lady came in with what looked like a broken ankle, with 2 people carrying her. They asked when they could get in, and the nurse said about 4 hours. They used the phone and called one of the urgent care clinics, and they told her they would be able to see her immediately. I wish I would have thought of that instead of sitting there forever, with my husband trying to keep our son from touching the cut. I had a hard time keeping the gauze on him because I would struggle and it would start bleeding again. After 2 hours of sitting in the waiting room, I went up to the nurse as nicely as I could and told her that my son NEEDED to be seen sooner because he keeps bumping the cut, and it keeps bleeding, and I am sure they don't want blood to get onto anyone else or the chairs or anything. It wasn't bleeding that bad, but it was enough to get all over me while trying to hold the gauze on my crying, hungry son. They wouldn't let us feed him for fear of concussion, and the possibility of having to sedate him. I know the side effects of sedation, and I didn't want him to go through that. Plus that would add 4-5 hours to the whole thing. So he's hungry, tired (it was well past his naptime), bleeding and hurting, and there's nothing we can really do to help him. I finally got upset enough that my husband went and got some milk and cookies for him. He wolfed those down in about 2 minutes.

They finally called us in, and numbed his cut up, which took an hour in itself. They had to wrap him in a blanket and strap him down. He was so mad and upset, I was praying that this would not scar him emotionally. I have never heard him scream and cry like that-I had to choke back tears to keep talking to him to help at least calm him. My husband wasn't in the room while he was being stitched up because he is too squeamish, and couldn't handle hearing Nathan cry like that. He must have worn himself out, and must have been so tired, he actually fell asleep about 2 minutes before the Dr. was done. He got 8 stitches, and has to go in on friday to get checked out, and make sure there is no infection, that it is healing well, etc. The stitches will dissolve on their own.

We got to the hospital at about 11 am, and didn't get home until after 5. I know that sometimes they get busy, but c'mon. One guy came in with his thumb half cut off, and they made him sit down and wait too.

What is THEIR definition of an emergency?

Triage is a crappy job that nobody appreciates. Since your son was unlikely to die they had to take people that were likely to die first. There was likely an emergency of epic proportions going on in the background that nobody in the waiting room knew anything about.

I can't believe when they brought their son in with a 104 temp they didn't at least give her some alcohol pads with which to bring the temp down. (Rub it on the skin evaporation helps to keep the temp down.)

It sounds like this particular hospital was short on Doctors as the young person with the high temp would normally be seen rather quickly.

 

[dilloduck]

Yesterday we made a trip down to the emergency room because my son had tripped and hit his head on the corner of the wooden chest we have in the living room. It bled quite a bit, but with pressure, we got it to stop just as the ambulance arrived. Because we were able to get it to stop enough, they said they think it would be best if we took him the hospital ourselves, because the loud ambulance and strange people would just scare him more, because he is so little (17 months).

Anyway, we get to the hospital, and we see all these people in the waiting room. One infant next to us (through me talking to the mother) had a 104 temp...in a baby under a year, that can be lethal. She had him in nothing but a diarper and onsie, and he was still boiling hot. She had been sitting there for 2 hours before we got there. While waiting our turn, a lady came in with what looked like a broken ankle, with 2 people carrying her. They asked when they could get in, and the nurse said about 4 hours. They used the phone and called one of the urgent care clinics, and they told her they would be able to see her immediately. I wish I would have thought of that instead of sitting there forever, with my husband trying to keep our son from touching the cut. I had a hard time keeping the gauze on him because I would struggle and it would start bleeding again. After 2 hours of sitting in the waiting room, I went up to the nurse as nicely as I could and told her that my son NEEDED to be seen sooner because he keeps bumping the cut, and it keeps bleeding, and I am sure they don't want blood to get onto anyone else or the chairs or anything. It wasn't bleeding that bad, but it was enough to get all over me while trying to hold the gauze on my crying, hungry son. They wouldn't let us feed him for fear of concussion, and the possibility of having to sedate him. I know the side effects of sedation, and I didn't want him to go through that. Plus that would add 4-5 hours to the whole thing. So he's hungry, tired (it was well past his naptime), bleeding and hurting, and there's nothing we can really do to help him. I finally got upset enough that my husband went and got some milk and cookies for him. He wolfed those down in about 2 minutes.

They finally called us in, and numbed his cut up, which took an hour in itself. They had to wrap him in a blanket and strap him down. He was so mad and upset, I was praying that this would not scar him emotionally. I have never heard him scream and cry like that-I had to choke back tears to keep talking to him to help at least calm him. My husband wasn't in the room while he was being stitched up because he is too squeamish, and couldn't handle hearing Nathan cry like that. He must have worn himself out, and must have been so tired, he actually fell asleep about 2 minutes before the Dr. was done. He got 8 stitches, and has to go in on friday to get checked out, and make sure there is no infection, that it is healing well, etc. The stitches will dissolve on their own.

We got to the hospital at about 11 am, and didn't get home until after 5. I know that sometimes they get busy, but c'mon. One guy came in with his thumb half cut off, and they made him sit down and wait too.

What is THEIR definition of an emergency?

I used to work full time at one-----now just part time.

Emergency means life or death situations---everything else is handled through an assessmenst process called triage, which is basically prioritizing the need for treament and working within the parameters of which Drs. are available. Unfortunately too many people use the ER as if it were a Dr.s' office and go there to treat everything,anytime . Makes it tough on the staff but 99.9% of the time they get it right

 

[fuzzykitten99]

Triage is a crappy job that nobody appreciates. Since your son was unlikely to die they had to take people that were likely to die first. There was likely an emergency of epic proportions going on in the background that nobody in the waiting room knew anything about.

I can't believe when they brought their son in with a 104 temp they didn't at least give her some alcohol pads with which to bring the temp down. (Rub it on the skin evaporation helps to keep the temp down.)

It sounds like this particular hospital was short on Doctors as the young person with the high temp would normally be seen rather quickly.

but this is a level 4 trauma center. They have more than enough doctors, especially in the winter.

 

[dilloduck]

but this is a level 4 trauma center. They have more than enough doctors, especially in the winter.

If the child lived they did their job. That is the perspective they are coming from.

 

[no1tovote4]

but this is a level 4 trauma center. They have more than enough doctors, especially in the winter.

In this case they were clearly occupied. The hospital would not make you sit there if they were available for care. Like any other business they want their employees working...

Unfortunately while uncomfortable your child was unlikely to die and therefore was low on the triage pole.

 

[krisy]

We have a hospital down the street that is slower than molasses. The Cincinnati Children's Hspital here though is pretty good. When my 4 year old daughter was a baby,she got brochialitus(sp?) at 3 months. Her pulse ox was down to 80 something when we got there,but the nurse didn't know that. Because her instincts were good,she saw our daughter right away and got her on oxygen. Last summer my son got in the bathtub and a couple of minutes layter was screaming for me. I ran in and there was blood pouring down his leg. My daughter had left a little tiny teapot in the tub and he was goofing off and fell on it. He had to get stitches in his rear. Even though it wasn't life threatening,they saw him fast then too.

On the other hand,I remember a couple of times when my son was a baby and had serious diarrhea and fever and we were sent to the E.R. and sat for hours. I remember a teenage boy came in that had been siphoning gasoline by mouth,and swallowed some. Being an upset mom,Iwas pissed off that they saw someone that stupid over my kid,even though I knew they had too.As hard as it was,I figured there was probably something more serious than what our problem was. I feel your pain though. Sitting in the E.R. with a sick kid is no fun at all!!!

 

[speederdoc]

If the child lived they did their job. That is the perspective they are coming from.

Bingo. You win.

If you are upset you have to wait a while to be seen in the ER for a cut...ask yourself this....when could your personal physician see you? Tomorrow? Maybe. More likely next week. Then ask yourself if you really are more important than the other 20 people who are waiting to see me. And then realize that if you were really that important, then your personal physician would come to see you himself.

The ER is busy because we are the place people can go for any medical problem, 24 hours a day, 7 days a week including holidays, whether they can afford to pay (or intend to pay) or not, and be seen the same day, without appointment. And to those who think we need to hire more doctors or nurses to see people quicker, well, the hospital isn't interested in getting you seen all that quickly. Just quickly enough that no adverse effects occur from the wait is good enough. Since we are forced by federal law to see everybody regardless of ability to pay, the ER isn't really a big moneymaker for the hospital. So they don't want to encourage people to go there by making it too pleasant.

The wait isn't all the ER's fault anyway, it's the hospital that often gets us backed up. Nursing shortage = less wards open = fuller wards = decreased bed availability = holding admissions in the ER = less rooms to see new patients = longer waiting time for you.

I start a shift at 10 PM, and sometimes begin seeing patients that checked in at 2 or 3 PM. The angry guy at the doorway, arms crossed, making a point to look at his watch and say "I'VE BEEN HERE FOUR HOURS!!!!!". Sorry sir, I just got here myself, and I'm going to see the lady who has been waiting 6 hours first. Basically, all potentially life-threatening conditions have to be evaluated before we can get to the cuts and sprains.


Oh, and a fever of 104 in a one year old is not likely to be lethal. Uncomfortable, yes. Lethal, not likely at all. This is the only country in the world I bet where everybody rushes their kid to the ER for a freaking fever.

 

[Mr. P]

.....

What is THEIR definition of an emergency?

Don't worry about that, wait till ya get the BILL!

 

[speederdoc]

Oh, and the Minor ER, or Urgent Care Facility, is an excellent choice for appropriate simple things like fractures, cuts, fevers, coughs, and the like. In and out time is usually 1.5 to 2 hours, and often much shorter.

 

[Mr. P]

After flying into ERs many, many times..I have to say that, The very sick do get attention right now. The ill just have to wait. As Doc said, many use an ER like a docs' office visit..That doesn't help the wait a bit.

 

[Trinity]

I can relate, I remember when I lived in Cincinnati and had to go to the ER, they was usually a long wait, however they also brought in the ambulance riders past the waiting room so I had an idea of what was going on to cause the wait.

Thankfully I now live in a rural area, and when ever I have had to take my children to the ER, (which isn't often because we have such a wonderful Doctor who will meet me at his office on his day off to see me or my children.) The longest I have ever been in our ER was 2 hours. That was when my 8 year old who at the time was 3, had cut his upper lip and needed stitches (his doctor sent us there after seeing him first) but they were great they had taken us back and put my poor son in a papoose where he was strapped so he couldn't move, he's screaming and crying it was very heart wrenching and then they stitched up his lip. we were out of there in 2 hours tops!

and yes my son remebers that. The part he tells me about is how he said he had to go potty which he did, but they had already started stitching him up so we couldn't let him up and he ended up having an accident. he is still upset about that wanting to know why didn't we let him go potty?

 

[CivilLiberty]

What is THEIR definition of an emergency?

A friend of a friend of mine dies in the waiting area of the emergency room of Kaiser Permenente here in LA of a gunshot wound.

The problem is, he walked in. If you're Ambulatory you wait like everyone else. It's called triage. Here, the guy did not make much of his wound, and the triage nurse made a very bad call on it. (It was just a .22 in the stomach).


I had a emergency once that nearly killed me - I waited in the waiting area for 5 hours at Cedars before being look at. Why? In the emergency room was an accident with a couple critical cases that were keeping the doctors tied up.

In an emergency room, everyone waits their turn, unless it's life threatening. While you're child's cut was no doubt traumatic, it was not life threatening. Urgent care centers are a better place to go for things like that.



Andy

 

[Mr. P]

Kaiser Permenente

Nuff said.

 

[speederdoc]

A friend of a friend of mine dies in the waiting area of the emergency room of Kaiser Permenente here in LA of a gunshot wound.

The problem is, he walked in. If you're Ambulatory you wait like everyone else. It's called triage. Here, the guy did not make much of his wound, and the triage nurse made a very bad call on it. (It was just a .22 in the stomach).


I had a emergency once that nearly killed me - I waited in the waiting area for 5 hours at Cedars before being look at. Why? In the emergency room was an accident with a couple critical cases that were keeping the doctors tied up.

In an emergency room, everyone waits their turn, unless it's life threatening. While you're child's cut was no doubt traumatic, it was not life threatening. Urgent care centers are a better place to go for things like that.



Andy

Wow. Penetrating abdominal trauma. It doesn't get much more emergent than that. That's pretty classic....they look pretty good with stable vital signs, then they can crump in a hurry.

That was a good post. As you said, it only takes one critical patient to make the place very busy indeed. It's worth mentioning that just because you come in an ambulance, you are not necessarily going to the front of the line. If you are not sicker than some of the walk-ins, we'll take you off the stretcher and give you a seat in the waiting room (or a stretcher in the hall, if needed). :spank3:

Also in some rural ERs, the ER doc is responsible for certain emergencies in the hospital as well, especially at night. So if a patient has an emergency in the ICU, you have to leave all the patients in the ER and run upstairs to work on someone else. That is a very bad and dangerous system, btw.

 

[Joz]

I, too, have sat many hours in a ER waiting room. With kids, with mom, with dad, with husband. But I will tell you this, when your child is grasping for every breath he takes, you will be very grateful that they took him instead of the fever, the cut, or the bump on the head.

 

[Trinity]

so basically the bottom line is evalute your child after an injury, I know it's hard but try to look at it objectivly. For instance when my oldest knocked out his 2 front teeth at football, my first instinct was to take him to DR., Dentist something. He was screaming and I was in mom mode, however I had to switch from mom mode and look at the situation, He's not bleeding, there are no cuts, or bruises around his mouth, only 2 broken teeth, looked at the teeth they did not appear to have any nerve exposed, did a test had him drink some ice cold gatorade. no pain, so I decided it could wait till morning. However I was still intending on taking him home, until he started crying because he did not want to miss football practice. clearly if it is a life threatening situation go to ER immediatly but if it's not I would recommend urgent care or preferably your own doctor.

and remember head wounds always bleed alot, even small cuts.


If you don't feel that you could evalute your child go take a first aid class, they are not very expensive and you will learn alot, most hospitals offer them.

 

[Shattered]

Butterfly stiches work like a charm until you can get in to see your normal doctor, or go to Urgent Care. They're cheap, too.

 

[speederdoc]

Well, you need to take your child with a bad cut or other injury somewhere, because the longer you wait, the more likely we are to suspect foul play. Yes, some kids are abused, and we are bound by law and morals to report it if we suspect it. And it happens in all families, rich and poor, black and white and brown.

I have occasionally had to arrange for CPS evaluation, or for the police to take a parent and child to the Childrens Assessment Center to be further evaluated for the possibility of abuse. So you should be aware that when we are evaluating your child's injury, we are evaluating your dynamic with him and the validity of the causitive events as reported.

And generally, cuts should be sutured within six hours, depending on the location and degree of wound contamination. But if you go to any ER/urgent care facility right after work, expect to wait. That's when it gets busiest.

 

[Joz]

... and I was in mom mode, however I had to switch from mom mode and look at the situation....

This says ALOT right here. I have a friend who's a cardiac nurse and she 'freaks' when one of her kids gets hurt. We lose some of our rationality when it comes to our kids. They're hurt, we can't fix it....HELP THEM NOW!