Death after two-hour ER wait ruled homicide - page 9
Death after two-hour ER wait ruled homicide "WAUKEGAN, Illinois (AP) -- A coroner's jury has declared the death of a heart attack victim who spent almost two hours in a hospital waiting room to be... Read More
Sep 21, '06Quote from clee1I am so with you and could add another 1000 lame excuses for misuse of the ED....but EMTALA says we turn no one away. If we had the ability to tell the obvious they're not an emergency problem and sent people away to take responsibility for themselves, our chest pains wouldn't have to sit for 2 minutes!! God forbid anyone takes care of themselves these days..run to the ED!!!!!!This is going to happen more and more in the coming years.... until the ptb and the medical establishment get the guts to say "No, Mr./Mrs. Whinybutt. Your sinus infection is NOT an emergency - call your PCP in the morning. Oh, you don't have a PCP? Find one.... in the morning. Good bye."
Also, the rash of Un/under-insured people using the ER as a PCP HAS to stop - like right now!
It is unconscionable that people with emergent conditions like MI, SOB, or even a serious lac requiring sutures have to wait for hours for treatment because our ER's are crammed full of the slightly sick, chronically lame, or the insufferably lazy. Oops! I almost forgot: the severe LBP x 3 months that HAS to have some IV narcs RIGHT NOW!
Gimme a break.
Sep 21, '06Quote from ERTRAVELERABSOLUTELY RIGHT!!!!!!!!!The criminal issures here are all the sore throats and belly aches that take up precious time and rooms in the ER because that's where their FREE access card covers them 100% coverage. People who come in and demand we give them Tylenol because they can't "afford" to buy it, but they can afford that $5.00 pack of cigarettes in their pockets
Sep 21, '06Quote from rjflynmy question is where was the ekg on this patient. the national standard of care is that a patient having an mi have one within 15 mins of arrival. hence at my facility even when full up and overflowing we have one done on every patient presenting with chest pain in the triage area if need be. i would find it extremely hard to believe that this patients ekg did not have changes consistent with mi or at the very least abnormal to the point of she would not of waited in triage long enough to move some bs pt out in to the hall.
so yes something criminal did take place. as to what i will not say as i dont know that hospital system or their protocols.
with out all the informatin ie the chart specifically its hard to know what the triage nurse was presented with or saw. but since a jury determined a gross deviation from standards i would bet something pretty glaring occurred.
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.
Sep 22, '06Quote from lizzI don't know all the circumstances of your story but an ear infection can be quite painful. Also primary md offices are overloaded as well. I agree ED is for emergencies but if you can't get treatment for an ear infection what are you going to do? I had a cyst on my back, became huge size of a tennis ball, hurt so much and was draining but needed to be cut out, cultured and stitched up. I went to PMD, got my hmo referal to the dermatologist, took week see dermatologist only to be scheduled it for removal in THREE WEEKS after that!!!!!!!! I almost started crying infront of the receptionist when she told me. I couldn't sleep on my back, stained bunch sheets and clothes despite continually putting on bandages to my back. Had to WORK like that. But I did it b/c that's how I thought it should go. NO it should not take that long. We only have one dermatologist in our entire area. Now I'm working in the ER and I'm like wow should've just came here probably fixed faster. So some cases have to come just based on the failure of other systems ex other pmd and specialty offices. And what about Ortho coverage for ED. Been a big joke, ortho refusing to do it. It is such a mess. Now I'm sure people just come to Ed without considering pmd and that should not be but the way the health system is right now sometimes you do have to go to the ED to take care of things. Now, those people then should definitely wait for less emergent cases. We have a huge issue b/c some mds like to cram in minor cases to increase number meanwhile more critical maybe not cp but definitely more critical are waiting longer. So our management wants to implement if there are more critical waiting then minor emergenices to select 1/2 the minor section for the fast track cases and then the other for those acute make it a subacute to get them in. Now some mds don't like this then there's staff issues. But that is what should be done but with staff and equipment dynamics mixed with overload pts it's just so difficult.Last semester our teacher really hammered on this point during our ER lecture ... that people need to go to doctor's offices, urgent care, etc. instead for minor ailments.
Nevertheless, while I'm doing my ER rotation ... there's one of our nursing students bringing her kid into the ER for a minor ear infection. I was stunned ... did she listen to the lecture at all?
She's a nursing student ... and she should know better. It just goes to show how bad it is. People will continue to abuse the ER as long as you let them.
Sep 22, '06Quote from mysticalwaters1First, I saw the kid ... and he was fine. He wasn't crying in pain or anything like that. Second, there are at least three urgent care facilities she could have gone to. I've personally been to them and you can get seen right away, especially if you show up first thing in the morning.I don't know all the circumstances of your story but an ear infection can be quite painful. Also primary md offices are overloaded as well. I agree ED is for emergencies but if you can't get treatment for an ear infection what are you going to do?
I can assure you that she didn't need to take her kid to the ER.
:typingLast edit by Sheri257 on Sep 22, '06
Sep 22, '06Quote from ERTRAVELERThey also seem to have plenty of money for booze as well ...The criminal issures here are all the sore throats and belly aches that take up precious time and rooms in the ER because that's where their FREE access card covers them 100% coverage. People who come in and demand we give them Tylenol because they can't "afford" to buy it, but they can afford that $5.00 pack of cigarettes in their pockets
Sep 22, '06Hi everyone, this is why it is advised if in doubt - call an ambulance - usually that puts you at the top of the triage list.
Sep 22, '06Depends on the complaint, I have seen many an ambulance patient triaged to the lobby. Now mind you never a chest pain.
Quote from MAP1Hi everyone, this is why it is advised if in doubt - call an ambulance - usually that puts you at the top of the triage list.
Sep 22, '06Quote from Angie O'Plasty, RNSorry 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.I feel that it was certainly a tragedy, but not a criminal act.
Sep 22, '06As 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!
Sep 22, '06Quote from LilPeanutThe 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!!!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.
Sep 22, '06"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.
Sep 22, '06I 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........