When is a situation considered an Emergency? - page 2
:D Hi, I am not a nurse yet, so I would like to ask ya'll a question. This post is a little long, so just try to bare with me. What makes a situation an Emergency??? I will explain myself: ... Read More
Jan 30, '07That's too bad that happened. But, like other people on this thread said, it's the way most ER's are now day's. I remember the days that such pt's used to go back right a way, but now ER's are swamped with colds, back pain, STD and pregnency test on top of true emergencies. If you've been in ER a while you can pick a ks out of the crowd. But , you can also pick out the true chest pain, appy etc... The triage RN has to be the one to control the never ending flood gates of people. Everyone there feels they are in an emergency situation. Trieage is just what is says : Deciding what pt's go back first, who waits. Some times it's a no win situation for everyone involved. ER's could be more efficiant if they wern't used as doctors offices. I work in an inner city ER, there is never a distinction between insurance and non insurance pt's. If they need treated they need treated.
Jan 31, '07Pain is a subjective symptom not anything I have ever seen anyone actually die from(even tho many people think they are). Have you ever read an obituary where the patient died from pain?
Jan 31, '07I understand why he would be upset, especially in so much pain. People in pain do not react rationally. I work in an ED that is almost always full to the gills and somehow I always end up being the one to go out and explain why someone can't come back and lie down or get treated right now. It's useless to try and explain that while others are being treated for more life threatening conditions others will have to wait in the waiting room.
Sometimes people seem to think that we're just trying to be vindictive and make them suffer. We don't want you to be in pain anymore than you would like to be in pain. Unfortulately when every bed is full, each nurse has 5-6 patients and the doctors have yet to see 12 patients that are in the rooms and beds in the hallways helping you is just not possible at the moment. I assure you that I have never seen anyone taken straight back because they said they were in to much pain to wait any longer. There is just nothing we can do to make it go any faster. Everyone will be seen it's just a matter of when we have the resources available.
Jan 31, '07I agree with the above posters. Look at it this way- you now know what the "kidney stone dance" looks like, and will probably never forget it.
Jan 31, '07Quote from Baptized_By_FireMy husband's had kidney stones in the past (before we met) and he thought he had another one when we went to the ER. It turned out his colon had ruptured. The DH is just unlucky!I agree with the above posters. Look at it this way- you now know what the "kidney stone dance" looks like, and will probably never forget it.
Jan 31, '07Quote from tazzirna year or two ago my mil suffered a cat bite, which segued into cat bite cellulitis. i took her to the er at midnight because she couldn't take the pain anymore. waited in the wr for about an hour, waited in the back for about an hour and a half.......and she complained the whole time. after trying to soothe and explain and cajole, i'd had enough. i stood up beside her gurney and yelled "do you think you are the only one who is miserable here??? these people are not here at 2 in the morning because they have nothing better to do!!!"
not another peep...........
oh, i don't know......sometimes it sure does seem like that is why they come in......
Jan 31, '07Quote from burn outNo, I have not ever heard of anyone dying of pain. But he didn't know it was just pain. He didn't know what was going on. He was scared that something was seriously going wrong in side of him. Isn't excrutiating pain sometimes an indicator that something serious is going on????Pain is a subjective symptom not anything I have ever seen anyone actually die from(even tho many people think they are). Have you ever read an obituary where the patient died from pain?
Thanks everyone for responding. I totally understand that other emergencies have to take precedence over others. It is just the way it works. There was just nothing I could tell him, and seeing him like that, I guess I just got upset about it also.
Thanks again for taking the time to respond.
Jan 31, '07Actually, yes , you can die from pain. Pain causes the body to loose blood to non vital organs, to shunt blood to the place of pain. Pain also causes stress to the body, can have an MI etc. Not to say that ks pain is that kind of pain, but, ks's are worth getting back to ER asap if possible. Ever see a ks pt come in pale , diaphoretic , low bp. It happens. If they can't get back they are most certainly a pt that is worth keeping an eye on and evaluating as much as possible in triage. Ks can cause pylo, that can lead to sepsis.
Feb 1, '07I have never been working in the ED or ER before....
But I know ER nurses always pay great attention to patients who have airway problems...think about it...patient die very quickly without oxygen.
In the case of your husband, he showed the ER nurse that his airway had no problem...and he was walking around...
I hope this will help you understand better how the ER/ED nurses function in the ER/ED. I felt sorry for what you had gone through...it must have been a very scary experience.
Feb 1, '07Quote from lauralassieActually, yes , you can die from pain. Pain causes the body to loose blood to non vital organs, to shunt blood to the place of pain. Pain also causes stress to the body, can have an MI etc. Not to say that ks pain is that kind of pain, but, ks's are worth getting back to ER asap if possible. Ever see a ks pt come in pale , diaphoretic , low bp. It happens. If they can't get back they are most certainly a pt that is worth keeping an eye on and evaluating as much as possible in triage. Ks can cause pylo, that can lead to sepsis.
This still does not make the pt emergent. A death from pain R/T a stone would not happen in one evening. And if a pt in pain was diaphoretic with low BP, he would have been brought back, I guarantee it. Most stone pts do not come in with low BP, however. And there is no indication the OP's husband wasn't being eyeballed by the triage nurse while in the WR.
Feb 1, '07Where I work I am sometimes still fortunate enough to be able to bring kidney stone pains right back to a room. Although once in the room there is little I can do to speed the physician eval up. But more there are been many times I have had to tell a kidney stone pt that they have to wait. I really have sympathy, but as already stated, we get swamped, have no beds, ambulances coming in up the wazzoo. Sometimes people are misled by the lobby being empty, but that is not always an indicator of the rooms in back. I understnad one of the main issues here is the way the staff communicated that to the OP and her husband. I can't excuse or defend them, I was not there, and I do think there are nice ways of explaining the situation. However, I also understand two things 1. sometimes no matter how good an explanation, and how nice/appropriately it was stated people in distress do not hear the same message that was said--understandably. 2. The big picture is the important issue, and it is the triage nurses job to keep track of that. Knowing the big picture some nurses can be blunt, or appear to loose sympathy in explaining to the 30th pt of the morning that although the pt feels thier emergecny is most urgent someone else is having even more of an emergency and there are no beds.
Feb 1, '07Quote from lauralassieI have never started a dopamine drip for someone with pain the only symptom, or coded someone because they were in pain only. Pain is a symptom not a disease process. Please explain to me the physiological process that pain shunts blood to "non vital organs." Yes the ks is painful and they can be very sick and have low blood pressures etc.Actually, yes , you can die from pain. Pain causes the body to loose blood to non vital organs, to shunt blood to the place of pain. Pain also causes stress to the body, can have an MI etc. Not to say that ks pain is that kind of pain, but, ks's are worth getting back to ER asap if possible. Ever see a ks pt come in pale , diaphoretic , low bp. It happens. If they can't get back they are most certainly a pt that is worth keeping an eye on and evaluating as much as possible in triage. Ks can cause pylo, that can lead to sepsis.
but the OP and her husband did not even stay at one hospital long enough to be triaged.
Feb 1, '07Hey guys...remember, the patient did not have a dx yet...so sudden onset of pain like that, even if very typcial of a kidney stone...still needs to be Dx'd before we can rule out life threatening or loss of organ/limb...while this was occuring no one really knew what was going on...talk about fear factor!
Naaaa pain won't kill you, but pain indicates a probelm that might (unless you stroke/MI out from the high blood pressure pain causes!) be life threatening. We don't just get pain when there isn't a probelm...so we have to go through the motions of rule out and what not to find the solution.
But I agree full heartedly...you can't tell what pain is indicating by a persons account because it is so varied from person to person. One person may feel sharp shooting pressure chest pain 10/10 for heartburn or a gall stone and not an MI...but the little old lady in the corner just feeling "uncomfortable" in the chest with no other pain than perhaps "well....4/10 sweety, I have felt this before but it scares me"...could indeed be having an MI!
Or headaches..dont' you love these! Could be a migraine, could be meningitis, could be stroke! Even at a 10/10 pain level...these three can't be Dx'd without testing...and all of these dependant on situation can be life threatening (yes even the migraine untill we find out why it is occuring...I had a pt with a migraine that was severely DKA and almost died because it was triaged as a migraine, and in a triage room with the story the pt gave..that is what it was..female in her 20's with Hx of migraines pre menses..but this one was what she said as "different"...okay can't triage any other way besides migraine and can wait over more emergent cases).
So basically pain doesn't kill ya (for the most part), but till you know what and why it is there...woooooo hooooooo it is a bumpy scary ride!