Waiting at an ER, who should get seen first?ER's are getting more crowded everyday. Do you think people should be seen in the order of first come first served or by acuity of illness (let's say nothing immediately life threatening)? Before answering, consider the following scenarios:
1) you smashed your finger and in a severe amount of pain, yet the young girl who came 1 hour after you (and looking pretty comfortable) with "shortness of breath" gets seen first because "shortness of breath" has a higher acuity than "finger pain"
2) you have gastroenteritis, and running to the bathroom every 5 min to throw up, but the homeless guy walks in wanting a warm bed for a few hours tells the triage nurse he has "chest pain" and gets into a room before you do
There was a study done involving a survey of patients already waiting in the ER for may hours to be seen. The result of the study was that 60% believed ER should be first come first served. Most people are saying by "acuity of illness" but it appears to be a different story when you are the one feeling ill and waiting forever.
I purposely left out details because there's no way for the triage nurse to know whether someone's complaint of "chest pain" is real or truly dangerous without further studies or tests. In the meantime, someone with gastroenteritis...if they were THAT dehydrated to the point of death, they would surely be altered, moving them up the line. However, just plain nausea/vomiting isn't immediately life threatening.
-Fluffy
First in everyone of them.
-Maria
The first situation sounds about right. In the second situation, they could both be equally dangerous. The man could be having a heart attack, although you haven't described enough symptoms to warrant that, and you could be severely dehydrated. I would take you first. I think that in most cases, it should be first come, first served, unless there is a situation where waiting could cause the patient to get worse.
-sadloner07
Of course, I am ready to stand the pain for people who needs the doctors more than I. As long as I could, I will take the pain so that people who might be in more danger than me will get taken care of.
A girl who has shortness of breath might be having some inflammation in her lungs which could of course cut off her air supply
The homeless guy is another story. I am no mind read so.... who knows, maybe he is in pain.
People should see a doctor when they are most in danger... not most in pain.
-CHEPIBE72
Well the system is screwed as of now. Did you see the news about the woman dying in the ER?
Makes you wonder who the hell is in charge of hospitals! You figure that if things are these bad they should hire more trained people. Maybe it is time for the government to help with hospitals (Not doctors, most of them are filthy rich).
In any case, more important cases goes first. That is why I try to evaluate hospitals near my work and residence. So I go to the good ones where you get attended more decently than the ones that get crowded with people.
The idea of first come first served is ludicrous though. It is against medical, professional, and human ethics. Lets switch the tables around. If you were a homeless man, would it be more important the smashed thumb of a kid or your life? Would it matter if you are homeless? If you had shortness of breath and possibly be dead in a few minutes due to the illness rather than what you see, would you be letting the kid with a smashed thumb go ahead? Without air, you will be dead in a couple of minutes compared to the thumb smashed. Even if you take into account gangrene, it will take more times for you to die than the others if they happen to have a serious illness.
But as I said, it all comes down to the quality of the people in the ER and the hospital. You go to the ER in the slums and you will die just like the woman who waited for hours on end even when she dropped into the floor and layed there dying for hours.
I think we need to address our medical issues and help our people in need.
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