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| No. 110 | 
Sep 22, 2006, 06:22 AM
 Re: Death after two-hour ER wait ruled homicide
Hi everyone, this is why it is advised if in doubt - call an ambulance - usually that puts you at the top of the triage list.
 | | Advertisement Sponsored Links | | | | No. 111 |
Sep 22, 2006, 07:00 AM
Re: Death after two-hour ER wait ruled homicide
Depends on the complaint, I have seen many an ambulance patient triaged to the lobby. Now mind you never a chest pain.
Rj Originally Posted by MAP1 Hi everyone, this is why it is advised if in doubt - call an ambulance - usually that puts you at the top of the triage list. | | No. 112 |
Sep 22, 2006, 08:12 AM
Re: Death in Illinois ER ruled a homicide Originally Posted by Angie O'Plasty, RN I feel that it was certainly a tragedy, but not a criminal act.
Sorry but although the triage nurse did not intend for someone to die it is negligent that a patient who had classic MI symptoms and was signed in to the emergency room was not seen by a doctor for 2 hours. I believe the standard of care is 90 minutes from door to cardiac cath. Standard of care was breeched. I'll make no excuses here.
| | No. 113 |
Sep 22, 2006, 08:52 AM
Re: Death after two-hour ER wait ruled homicide
As a Triage RN in the busiest ER in the state I can honestly say there are nights where there are simply no beds to be had. For that reason, more and more testing and treatment is started in Triage. It is ridiculous to be treating MIs in the lobby but what do you do when there is no where to go with a pt? In this specific case, there is much we don't know: was anything started in triage, was the triage RN attempting to get the pt back, was their ER full of other critical pts, was the pt reassessed during the 2 hrs? It sounds like the Triage RN screwed up but since we don't know all the facts it really is impossible to say for sure. I hope criminal charges aren't filed but kinda bet they will be. And you can bet the hospital won't stand behind her!
What we do know is that as ERs become more and more overwhelmed with true emergencies as well as the only access to health care many people have, we will face situations like this more frequently as Triage RNs. It sure makes our jobs more stressful and full of risks. Makes me think I need to do something else a lot of the time!  | | No. 114 |
Sep 22, 2006, 08:58 AM
Re: Death after two-hour ER wait ruled homicide Originally Posted by LilPeanut Wow. some of the comments here are downright hateful.
Illegals absolutely do have rights. Many of the people who post here, their parents, grandparents or greatgrandparents were probably illegals at one point.
People have the rights and protections of the US Constitution, even when they are not citizens. That's part of what sets us apart from other totalitarian and fascist regimes.
The US Constitution does not address the right to medical care. I understand the right to life, liberty, and the pursuit of happiness and the rights in the bill of rights. There is some point at which we have to say enough is enough. Had an illegal diabetic renal failure patient getting all his healthcare free including 3x/wk dialysis for the rest of his life. He pays nothing!!!  | | No. 115 |
Sep 22, 2006, 09:53 AM
Re: Death after two-hour ER wait ruled homicide
"Hi everyone, this is why it is advised if in doubt - call an ambulance - usually that puts you at the top of the triage list."
Being in the ER with a heart attack should put you at the top of the triage list. Period.
Some of my sickest patients walk through those front doors. If I don't treat them, it is my fault, not theirs. They shouldn't have to call an ambulance if they are in the ER waiting room.
| | No. 116 |
Sep 22, 2006, 10:09 AM
Re: Death after two-hour ER wait ruled homicide
I Have Been In Ob-gyn For Over 5yrs And Even I Know Those Symptom Merit An Ekg And Immediate Attention Of Some Degree. Many Times Panic Attacks Resemble Heart Attack But Cannot Assume, Must Be Ruled Out With Ekg And Labs Etc. Sorry For The Triage Nurse ,but........
| | No. 117 |
Sep 22, 2006, 10:16 AM
Re: Death after two-hour ER wait ruled homicide Originally Posted by alcml6473 New AHA/ACC guidelines call for only 10 minutes from entrance of ER to get a 12 lead EKG and have it reviewed by an experienced physician. They also call for right sided leads in patients with inferior STEMI to screen for ST elevation myocardial infarction then you have 30 minutes or less to give thrombolytic therapy (if not contraindicated), and within 90 minutes of arrival should have percutaneous coronary intervention like PTCA need to be done. This is truely a sad situation, my heart and prayers go out to the family.
I agree that my heart goes out to the family. But I also agree that there are many facts missing here. I would hate to stand in judgement of anyone without all of the facts.
Given the recommendations quoted above, I can say that I have worked in several ER's from the very small to the very large over the last 20+ years. All that I have worked in have always strived to attain these guidelines. But you must remember that in very small rural hospitals, it is almost impossible to obtain invasive interventions on these patients within that time frame. The EKG should most certainly be done immediately, and the thrombolytics are started ASAP when ordered. But beyond that, the patient must be transferred to a larger hospital and trust me when I say, that does not always happen in minutes.
You must find a cardiologist available and willing to accept, then you must have the hospital with the available space and staff to accept the patient. Then, of course, you have transport time, be it by ground or air. So as you can see, there are always variables to every case. Hence why I say, I will hold my judgement until all of the facts are released.
| | No. 118 |
Sep 22, 2006, 10:20 AM
Re: Death after two-hour ER wait ruled homicide Originally Posted by erdiane geez..........I work 12 hours tomorrow and I see by my schedule that I am the only "regular staff" person on. I will have to be charge. Do I take the triage assignment if no one else can? Do I take charge and take the "code room" assignment? Yuck. After reading about this, I don't know if I want to triage ever again. Triage is only OK if we are not busy. I actually LIKE triage if I can triage and place in bed, triage and place in bed, etc..... I HATE triage when the waits stack up and people are staring daggers at me in the waiting room (like that will help).
off the subject, we have recently been told that "diversion is out of the question". I suspect it is in relation to a news article that I recently read that states the average ER loses $1100 per hour for every hour on diversion.
I wonder how many nurses you could hire for $1100 per hour???????????
I have also worked in a few hospitals that have demanded "NO DIVERSION for ANY REASON". How absurd it that??????!!!!!!!!!!! As we all know, there are times when diversion is absolutely necessary for the safety of the patients. Needless to say, I never stayed with those hospitals very long. There were only a few, but when the hospital will place more emphasis on the money than the welfare and outcomes of the patients, I have no respect for them. I have seen many nurses and ER docs leave these facilities for the same reason.
| | No. 119 |
Sep 22, 2006, 10:23 AM
Re: Death after two-hour ER wait ruled homicide Originally Posted by hogan4736 I felt like this many times before going to nursing school in my late 20s...
I either:
did nothing, or...
WAITED until the next day...
If I had a dime for every pt, at 0200, who tells me he/she has an appt @ 0800, but "can't wait"
You described the problem...People who rush to the ED before trying things at home...
My son has had a fever for 6 days...I called at 1600 Tues afternoon (5th day of fever), and he got an appt at 0900 Wednesday...Notice I did not rush to the ED at 2100 (after his bedtime, why would I bring him in when it's not convenient for me, I mean, I'm only his parent)
And as far as giving "emergency services" to illegals...If they get the golden yellow "Federal Emergency Services" card (in AZ), they come to the ED for every stupid thing, (just like our own citizens)
stupid is as stupid does...
Oh my, is this "Toad" from County ???
Tony
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