Is earwax removal an emergency?

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What is an emergency? Is an overdue ear irrigation one? How about bedbug bites from a sleepover? A stiff neck from sleeping wrong? A child's fever, who got started on antibiotics prescribed by PCP this morning and went away after Tylenol given prior to arrival.

Do the people with these types of 'emergencies' actually have co-pays? And, what are health classes teaching in the schools these days?

Specializes in Urgent Care NP, Emergency Nursing, Camp Nursing.
Frankly, without all those non-emergent cases, we wouldn't employ nearly as many nurses as we do. Job security.

Oh, we'd all find work in urgent care/immediate care, public health, and other places that would actually get funding if our joke of a healthcare system worked properly

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Ear pain can be debilitating. The only time I was in an ER other than work I was brought in semi comatose post CPR. Obviously I don't like going but I seriously considered going with ear pain once. I would have if I hadn't found someone to drive me at 5 am to an urgent care clinic. Not everyone has my reticence though

I had a patient come in by ambulance for a bee sting at school 6 hours earlier. No one EMT, myself, PA, or Dr could even figure out where the child was stung. There were no red marks or swelling anywhere.

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I don't know about public aid, but I was always told that private insurance has the option to refuse to pay for an emergency room visit that wasn't a real emergency. I was told that "it's life or limb--anything else is not considered emergent and insurance wont' pay." I wonder if this is true, and if it is, why that wouldn't cut down trips to the ER that are not really emergencies?

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Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.
I think it's probably hard for the parents whose kids are away from home, too. I see a fair amount who have minor ailments and do take the step of calling home to see what to do about it...but I imagine it's diffitult to tell your child to wait it out/take ibuprofen, etc. when you can't see how they look or how much distress they are (or aren't) in.

Just a side note...

My daughter attended college on the opposite coast. She had health insurance through me and her father. There was no hospital within 2+ hrs that accepted her insurances.

She had to go to the ED twice (in 4 yrs) for non emergencies. I hated that.

I did a lot of telephone triage and treatment vi FaceTime.... 🤣

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I don't know about public aid, but I was always told that private insurance has the option to refuse to pay for an emergency room visit that wasn't a real emergency. I was told that "it's life or limb--anything else is not considered emergent and insurance wont' pay." I wonder if this is true, and if it is, why that wouldn't cut down trips to the ER that are not really emergencies?

It is a very complicated concept. It's one of those things that at first glance might seem to make sense, but with the convuluted way things are right now, it is not a very viable option - and ethically questionable for various reasons as well.

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Specializes in EM.
On 11/21/2017 at 10:29 AM, Emergent said:

What is an emergency? Is an overdue ear irrigation one? How about bedbug bites from a sleepover? A stiff neck from sleeping wrong? A child's fever, who got started on antibiotics prescribed by PCP this morning and went away after Tylenol given prior to arrival.

Do the people with these types of 'emergencies' actually have co-pays? And, what are health classes teaching in the schools these days?

Everyone of the items listed could be an emergency: 

overdue ear irrigation--mom assumed this was why child wasn't hearing so good when in reality the child had mastoiditis and was rushed to surgery

bedbug bites from a sleepover--Lyme's, cellulitis, early anaphylaxis...

stiff neck from sleeping wrong--turned out to be meningitis or SAH, or though not an emergency, torticollis

child's fever going down--bacteremia or sepsis right before hypothermia set in and child started on pressors

We as emergency staff are priveleged to provide unscheduled episodic care to any and all who think they need us. Simple cases often turn into something not so simple. Patients, parents, even providers do not enjoy our level of expertise. I am humbled that folks come to see me to ask what I think about whatever chief complaint is worrying them.

 

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
4 hours ago, MD married to RN said:

Everyone of the items listed could be an emergency: 

overdue ear irrigation--mom assumed this was why child wasn't hearing so good when in reality the child had mastoiditis and was rushed to surgery

bedbug bites from a sleepover--Lyme's, cellulitis, early anaphylaxis...

stiff neck from sleeping wrong--turned out to be meningitis or SAH, or though not an emergency, torticollis

child's fever going down--bacteremia or sepsis right before hypothermia set in and child started on pressors

We as emergency staff are priveleged to provide unscheduled episodic care to any and all who think they need us. Simple cases often turn into something not so simple. Patients, parents, even providers do not enjoy our level of expertise. I am humbled that folks come to see me to ask what I think about whatever chief complaint is worrying them.

 

I have learned over the years to take the patient's complaint as seriously as they do, to give it the same weight as they are. Takes out a lot of the hostility right off the bat. Not that I am going to rush them back to a room for something that could have been taken care of at a lower level of care, but I am not going to shame them for caring about themselves or their loved ones, either.

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