ER's busy and a full triage

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As the cooler days approach we always see an increase in the triage waiting. With that waiting comes angry patients and frustrated triage nurses,..... and of course the ones working in the trenches inside aren't real happy either. Many times we get numerous family members coming in for the same ailment that is not an emergency, can be treated with otc's, or thru their primary physician. (Vomiting is not an emergency!) (adding co-morbitities to that might be but, simple vomiting is not)

It can be quite frustrating. Without educating the public we will always have issues such as this.

The Blue Suits that run facilities refuse to allow public teaching with this issue.

Many times these patients are ignorant about what to do. I would love to educate them. Instead they come to the ER, infect others and add to the system.

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Specializes in ER/Trauma.

Honestly, if there is something that surprises me about pharmacological interventions in the US it is this simple fact:

There are no real 'good drugs' sold over the counter for nausea/vomitting. Save for Dramamine.

Many countries have Phenergan 12.5 mg sold as OTC pills for nausea. I wish the US would follow suit.

cheers,

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i agree, seems like the er lobby is always full of people looking very ok to me, when the times i have taken the kids. i haven't had to visit er in a long time and hope it stays that way. but the public needs to utilize urgent cares more , but people won't because you have to pay up front an er will just bill you. people need to realize everything is not an emergency, betcha if they started mandating payments up front you would see an increase in "emergencies".

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oops meant to say decrease in emergencies.

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Specializes in LTC, Disease Management, smoking Cessati.
As the cooler days approach we always see an increase in the triage waiting. With that waiting comes angry patients and frustrated triage nurses,..... and of course the ones working in the trenches inside aren't real happy either. Many times we get numerous family members coming in for the same ailment that is not an emergency, can be treated with otc's, or thru their primary physician. (Vomiting is not an emergency!) (adding co-morbitities to that might be but, simple vomiting is not)

It can be quite frustrating. Without educating the public we will always have issues such as this.

The Blue Suits that run facilities refuse to allow public teaching with this issue.

Many times these patients are ignorant about what to do. I would love to educate them. Instead they come to the ER, infect others and add to the system.

I currently work telephone triage as a RN Health Coach for an insurance company... I am constantly amazed at how many calls I get for minor things that people think they need to run straight to emergency for. Fevers of 99F, "I vomited" how many times, "well once", they don't have a doctor, etc. We try to educate with home treatments for simple fevers, vomiting, diarrhea and all those things that are not emergent. Some people are surprised :eek: that they don't need to run right out in the middle of the night... Some do anyway.... and when you follow up they found it was "nothing major". Then there are those who need to go now, and won't....... but that's a story for another day. I'm all for educating everyone about the proper use of an ER. Some people however will never "get it" and continue to use it for everything. I know some people out there don't have insurance, but there are free clinics out there too.... I tell some that it is unwise to take your child with a mild fever and no other symptoms at that time and sit in a crowed ER and wait several hours while those who are "sicker" go first. Use some home treatment and call the child's doc.....

Ok I'm done now :specs:

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Specializes in Emergency.

these are the people you triage place in the lobby and make wait. After they wait they get seen in due course. When nothing is found wrong they are the same people who get called by our survey contractor days later and score us down as we did not answer their questions. Fortunately our management has realized that sometimes there is a certain group of people you are never going to please and you just have to move on. We just need to document repeat visits and the fact that they didnt follow up with their PCP or another doctor when we tell them to, so when the do call and c/o about us management pretty much writes them off as non-compliant whiners and moves on as well.

Rj

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Specializes in Emergency.
Honestly, if there is something that surprises me about pharmacological interventions in the US it is this simple fact:

There are no real 'good drugs' sold over the counter for nausea/vomitting. Save for Dramamine.

Many countries have Phenergan 12.5 mg sold as OTC pills for nausea. I wish the US would follow suit.

cheers,

Actually it probably works well, I know an ER doc that loved the stuff when it was available in IV form. It was her nausea drug of choice. She ordered it a lot, she was not to happy when it was no longer made in the US.

Rj

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Actually it probably works well, I know an ER doc that loved the stuff when it was available in IV form. It was her nausea drug of choice. She ordered it a lot, she was not to happy when it was no longer made.

Rj

Dramamine IV form would require someone to come into the ER. Vomiting is not an emergency.....unless you have co-morbitities and are dehydrated.

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Specializes in Spinal Cord injuries, Emergency+EMS.

ED misuse with primary care problems is a symptom of primary care availability issues whehter that'ds simply not enough appointments in hours or because of patient ignorance of the out of hours arrngements ... one again an area where 'evil' socialised medicine leads and others follow...

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i agree, seems like the er lobby is always full of people looking very ok to me, when the times i have taken the kids. i haven't had to visit er in a long time and hope it stays that way. but the public needs to utilize urgent cares more , but people won't because you have to pay up front an er will just bill you. people need to realize everything is not an emergency, betcha if they started mandating payments up front you would see an increase in "emergencies".

The problem with going to an Urgent Care or PMD is that many insurance companies will not pay--they feel if it was an emergency you should go to the ER or see your PCP--even if it is over 100 miles away. I worked at a camp and we used to send otitis medias, stomach flu, etc to a PMD office, trying not to burden our ER. But if the pt had a HMO, insurance companies refused to pay, saying they should be seen by PCP or ER only. So off to the ER they went!:banghead:

I agree--the FDA needs to loosen its grip on many medications such as Phenergan or Compazine as well as meds for minor issues such as pink eye. It bothers me to send a camper to the ER for pinkeye, esp. when I have to send 5 in one day!

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Specializes in ED.
Actually it probably works well, I know an ER doc that loved the stuff when it was available in IV form. It was her nausea drug of choice. She ordered it a lot, she was not to happy when it was no longer made in the US.

Rj

we still use phenergan IV.

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Specializes in Emergency Dept, ICU.

Let's not forget this either...

Death of Patient In Waiting Area Ruled Homocide

http://www.medlaw.com/healthlaw/HOSPITAL/6_1/death-of-patient-in-waiti.shtml

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