I have an friend who went to the ER in the hospital where I work. She had a terrible headache and a BP of 206/110. Labs where drawn. A CTA cardiac was done, EKG, etc...I saw her today and asked her how she was doing? She still has high BP, she still has headaches, she looked very uncomfortable. I said didn't you get a script for a BP med? "No, the tests were all normal and the ER doctor was uncomfortable starting me on a BP med because I don't have a PCP and I made an appointment with a doctor and can't get in until the 20th".
Is this because in case the BP med caused an allergic or adverse reaction she wouldn't have an available doc?
Or do you think she should have gotten a script for her BP and told to check her BP daily until she gets an appt and if there is any further trouble before the doctors appt to come back to the ER?
I am basically appalled that she went to the ER for significant hypertension and was not treated for it. She was told her headaches were causing the hypertension. I think it's the other way around and besides no matter what, hypertension like that needs to be treated. The only thing they gave her in the ER was a pain med for the headache. :uhoh21:
This happens alot in the small town that I live in, there are so many patients that the doctors are overwhelmed with the amount, I always tell patients to make sure that when they make an appointment to tell the sceretary that they have been seen in the ER. Also on our discharge instructions, we can write extra, and we always write something to the effect establish primary care physician within 2 weeks etc... Amazingly how mentioning a trip to the ER will get into the dr. quicker. And our dr. here are really excellent.
Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.
Has she tried asking the medical assistant to have a nurse return her call when available? I've done this before and sometimes a nurse can advocate to get her a quicker appointment or call if there is a cancellation.
At the office I work at, triage nurses will not take calls from patients that have not ever been seen in our office. It is unfair to ask a nurse to assess a patient that we have no records on, no history, and has not previously seen any of our MDs, especially over the phone. If the nurse did speak to the patient, none of our MDs would assist her with questions, etc on an unestablished patient for liability reasons. So the nurse is in a no-win situation. Unfortunately, the office looks at it as 'this is not our patient yet,' until their first appointment with the Dr. It is different of course, for an established patient.
I have an friend who went to the ER in the hospital where I work. She had a terrible headache and a BP of 206/110. Labs where drawn. A CTA cardiac was done, EKG, etc...I saw her today and asked her how she was doing? She still has high BP, she still has headaches, she looked very uncomfortable. I said didn't you get a script for a BP med? "No, the tests were all normal and the ER doctor was uncomfortable starting me on a BP med because I don't have a PCP and I made an appointment with a doctor and can't get in until the 20th".
Is this because in case the BP med caused an allergic or adverse reaction she wouldn't have an available doc?
Or do you think she should have gotten a script for her BP and told to check her BP daily until she gets an appt and if there is any further trouble before the doctors appt to come back to the ER?
I am basically appalled that she went to the ER for significant hypertension and was not treated for it. She was told her headaches were causing the hypertension. I think it's the other way around and besides no matter what, hypertension like that needs to be treated. The only thing they gave her in the ER was a pain med for the headache. :uhoh21:
Ok that was her initial b/p, did it stay that way. Any number of things can influence that.
Most MDs will not initiate on a one time occurrence of elevated b/p, and its not uncommon for head aches and stress to cause the b/p to be elevated.
sounds like she was worked up appropiately
You made an appointment for your friend, thats very nice of you.
Last night in our ER we had a mom that brought in her son, 7, due to tooth pain. no abcess of course we aren't dentists and have none on staff. upset she asked for the records of the visit. I got a release, copied off the papers, explained since she is being seen in the ER the paperwork is minimal. Her reply " as long as a lawyer can decifer it" Dr didn't want to give narcotics to a 7 yr old.
People really don't know what emergency is for, the expectation that they are resposible for their own health and we the ER should be able to fix all that ails in a matter of hours is ridculous. We are constantly inandated with threats of law suits, complaints about wait time and rude behavior. Or course these people want us to make them the our focus.
As for our family and friends we are a little more upset when things aren't "done Right" the problem is that we are passing along bad information if we fail to look at the big picture.
Specializes in Flight, ER, Transport, ICU/Critical Care.
Not.
No question.
No doubts.
I have NEVER seen an ER MD start a patient on BP meds (yep, they do refills on "established" patients in rare occasions.) I can say without any question that any patient in hypertensive crisis/urgency IS treated for primary BP problems. The r/o in these cases is clear. Your friend was certainly "ruled out". I like tom wonder -
* Did her BP remain that way? I'm certain that it did not. The care and diagnosis was most reasonable. And she got the "blue plate special" with the work up.
For the Record --- I cannot remember d/c'ing any patient that I treated for primary hypertensive problems. These patients are ADMITTED.
Bless you in your efforts in helping your friend. Skip the malpractice talk - THAT would get my BP up at any time.
Not. Skip the malpractice talk - THAT would get my BP up at any time.
Ok friends.....please do not respond without reading the thread. I have already said this is just a question....my friend nor anyone else has no intention of prosecuting anyone....and finally, I have posted that I totally (now) understand the situation and why she wasn't started on any BP meds and agree with what everyone has said. I thank everyone for the education.
Freshman RN
75 Posts
This happens alot in the small town that I live in, there are so many patients that the doctors are overwhelmed with the amount, I always tell patients to make sure that when they make an appointment to tell the sceretary that they have been seen in the ER. Also on our discharge instructions, we can write extra, and we always write something to the effect establish primary care physician within 2 weeks etc... Amazingly how mentioning a trip to the ER will get into the dr. quicker. And our dr. here are really excellent.