To The E.R. Is Human……
Actually the “E.R.” (Emergency Room) has been supplanted by the “E.D.” (Emergency Department), signifying more than one room, but never enough to hold the swarms of patients therein. I’m told that one fellow, on seeing the crowded waiting room at his local E.D., went home, put on his old Army fatigues, downloaded a badge from the internet, and returned, whereupon 80% of the people left. The badge said “U.S. Border Patrol”. (Warning: this site is not politically correct. If that’s a problem I refer you to the Times {NY or LA – same thing} or CNN).
But seriously, why the problem and what to do about it?
Millions of folks have no “medical home” or choose not to use it. Some try and can’t get an appointment; some won’t take time off work. But a great deal of the overcrowding is the result of misjudgment. The law doesn’t permit ED’s to send anyone away without an assessment. It is usual to see people with bleeding injuries, chest pain, breathing trouble etc. wait for hours while minor illnesses clog up the pipeline. ED doctors must practice defensive medicine, which means hours of labs, scans, x-rays and whatnot and that’s after the 4-6 hour wait just to get past the front desk.
Because a third to a half of ED patients are children, let me suggest some common-sense guidelines for parents. First, when to call 911: head or neck injuries with altered consciousness; seizures; poisoning; choking – in short, life-or-limb-threatening situations.
Other than the above, there are few reasons to rush (People always “rush” to the ED, especially on TV) there. Call your pediatrician if in doubt. If he or she still uses an answering service (I dumped mine ten years ago) be assertive and call back if help is slow in coming.
Please refer to my articles on fever and diarrhea/vomiting. These and injuries make up most reasons for ED visits. Fever by itself is never an emergency. Earaches can be controlled with painkillers, olive oil and a heating pad (your grandma knew that). Sore throats can wait. Asthma and croup could get out of hand, but recurrent asthmatics should have tools at home to deal with attacks. Suspect appendicitis? Call first; you have time. Dehydrated child? Call first. If the doctor is concerned, your child might be admitted directly to the ward, be treated and discharged almost as quickly as an ED visit. Did your child just discover he can’t really fly? Suspected broken legs, arms or ribs can represent true emergencies, but a good urgent care can treat most of these, with lower co-pays and less waiting.
Spending a night in the ED can be emotionally stressful for you and your children, and in flu season downright risky.
Still want to visit your ED? Bring “War and Peace”, food bars, and a pillow.