Reducing misuse of Emergency Departments!

Specialties Emergency

Published

After reading much of the posts about ED Nursing, my first suggestion would be for people to stop inserting objects where they do not belong!.On a more serious note, i just read an article in the paper about a study completed which showed that 41% of parents undermedicate their children for fevers. the study examined Emergency room visits, and it determined that those visits could have been avoided had the children been dosed appropriately. What are your suggestions to reduce unecessary visits to the ER?

Come to think of it...I used to eat a lot of play-dough as a kid. It was pretty good. Salty. I ate a hotdog once made entirely out of playdough. :rolleyes: But anyway, do you guys get the people who fake faint? It's always females. They always look so pretty and graceful, taking care not to hurt themselves as they fall into someone's arms.. And our stupid ER doctors always admit them to telemetry too, for syncope. I can't stand it! :angryfire

I learned a good way to assess if the syncope is fake or real (of course the more dramatic the faint the less likely it is to be real) Hold their hand up in the air over their face---amazingly the fake faints alway seem to miss their faces. No matter how hard they try to let the hand land on the forehead, they just can't do it.

I love the diagnosis, near syncopal episode---how many times have ya'll heard that one? :rolleyes:

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Specializes in ER, ICU, L&D, OR.

thats older than me

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Yes, love the "near syncope", or the syncope that fails the 'dropped arm test', the seizure patients that can open one eye to make sure that you are getting a preview of their academy award winning performance, the drug addicts that can sit calmly laughing and talking with their family while chowing down on a bag of chips and washing it down with a Coke but writhe in pain whenever a nurse is present, the parents that run in with their children wrapped in blankets demanding to be triaged right away because Little Johnny's fever is very high almost 100.5, the parents that say "I think she swallowed a penny" and what is the child playing with when you enter the room, a nickel, the people who OD on Tylenol to show their significant other how stressed they are over the break up, a liver transplant will be a lot less stressful, the parents that bring their children in and then will not allow you to do anything to the child not even examine them because it is too upsetting to the child, the mother who brings in her child with the 1 cm abrasion by ambulance and then has the nerve to tell the triage nurse "I came in by ambulance that means I get to go back first" sorry honey, CP trumps non-existent skin tear by a million miles, and my favorite taking an ambulance to the hospital each month for you guessed it, menstrual cramps. I really feel education is the key, but also some form of punishment for abuse of the system.

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I saw someone come in by ambulance for an itching foot once.

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I saw someone come in by ambulance for an itching foot once.

OMG! LFT's stat!

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

"Near syncope". Is that in the same book of diagnosis as "almost pregnant"?

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Is there some internal mechanism in some people that just doesn't work? You know, the one that says, am I going to die if I don't get this itching foot or shaving cut or slight poop problem or 99.9 degree fever taken care of right now?

If we can find that bit of common sense amongst those who don't panic and teach it to those who seem to be lacking it, we'd no longer have to wrangle bedpans to pay the bills.

I swear some people come to the ER because they are bored and we are forever an entertaining bunch, or they are hungry and hospital food is not to be missed. I don't mean the drug seekers, either. We'll never fix that problem. The night of the first "Survivor" finale there was no one in the ER. We were happy to have the local PD bring in a beligerent drunk guy just to have something to do. I think that night is when I discovered how much I love Amazon.com and surfing in general.

Of course, at the same time, our mission is to teach people who have crushing chest pain for 3 days that that is bad and yes, we love active infarcts here in our ER!

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During the flu outbreak in December, our Infection Control Nurse put a sign on the ER door for folks who thought they had the flu not to enter! Nice gesture, but I told her to move it to the visitors entrance.

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My absolute biggest pet peeve is the parent that rushes their child into the ER because they have just discovered that the child has a fever...when questioned when the last dose of Tylenol/Motrin was given..the response...."well I didn't give hime anything I rushed him right here so you could see how high it was"!!! Hello....can we say febrile seizure people! Pediatricians really need to educate these people a little bit more. :angryfire

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Specializes in Emergency Room.

http://www.acep.org/library/pdf/medfront.pdf

just thought it was interesting..........not exactly what you want. I'll keep looking

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Specializes in ER, ICU, L&D, OR.

I liked the one the other night where a 6 foot 4 inch male came by ambulance after dropping the toilet seat on his external genitalia . I never asked him how he accomplished that.

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