Silly reason for ER visit?

[DolceVita]

Question: Is it really silly for someone to go to the ER with a broken toe?

My sister went yesterday and she got the impression that the staff thought it was trivial (it was the forth toe). Admittedly she has NO tolerance for pain. Still, urgent care was closed.

Should she have waited until Monday and seen her own doc?

[Trishalishus, PhD, CNS]

... I'm a really clumsy person and apart from the broken toe, I've:

hurt my knee moving boxes ... hurt my back ... fell UP my stairs ... and sprained my little finger ... slipped over in the shower and bruised my ribs so badly I couldn't breathe in without pain ... had generalised abdo pain a few times which was quite severe ... slipped over in the shower again and bruised my shin so badly I couldn't walk properly ... The point is, most of my non medical friends/family would have gone to at least a GP, if not an ER for all of my above injuries because they are sensible. Me, not so much. But then I hate ERs!

Over what space of time have you committed all these felonies on your poor body?

Have you considered:

a) some kind of neuro problem associated with your ability to balance effectively? and/or

b) slowing down and planning ahead a little?

Best wishes

[DolceVita, ADN, BSN, RN]

To the person who asked me why my sister didn't talk to me:

She did. I am just a student nurse, and simply said I didn't think they could do much. I think the deal was she wanted some painkillers -- she asked me for some (I just had knee surgery) and I told her no way (I hate when people ask others for pain killers). So off she went to the ER.

She only waited about 30 minutes! Go figure.

[BabyLady, BSN, RN]

A UTI used to send me to the ER if urgent care isn't open...back in the days before peridium was available OTC.

The pain was always unrelenting...and it would hit me in the middle of the night...I would get the chills, shakes, I couldn't focus on anything but the pain.

[KneKno]

A dislocated great toe fracture Friday night, scheduled to work Sat, Sun and Mon nights sent me to the ER for the "time off" slip. I knew what it was, I knew what to do, but place of employment won't give a weeks medical leave without an MDs say-so!

[bamamamacat]

I've read all the responses, and while I agree in part, I have a somewhat different perspective. One should go to the ER with a broken toe if there is coldness/numbness/tingling present and/or if the toe has become blue/gray. Also, we as nurses have to always consider that the pt. may have undiagnosed diabetes and/or peripheral artery disease, which would indeed require emergency assessment. If the injured person does not have the related physical symptoms, and knows for certain there is no issue of diabetes or P.A.D. involved, then, yes, home care should suffice for the time being. But it's not as cut-and-dried as some of the responses have indicated. Is it ever?

[caroladybelle, BSN, RN]

I would have called my PCP, who would have had me describe the condition of the toe and would have directed me to see him in the AM. And as my insurance would not pay if the case was not an "emergency", I run it by my MD or call the ER for their guidance.

(Dad was military - and we were quite used to not using the ER or even the MD unnecessarily. Even as a layperson, I would not have gone to the ER, and would have waited until urgent care was open)

That said, while it may be okay for a layperson to report to ER, I can certainly understand the ER's frustation.

[Reddy,RN]

I've read all the responses, and while I agree in part, I have a somewhat different perspective. One should go to the ER with a broken toe if there is coldness/numbness/tingling present and/or if the toe has become blue/gray. Also, we as nurses have to always consider that the pt. may have undiagnosed diabetes and/or peripheral artery disease, which would indeed require emergency assessment. If the injured person does not have the related physical symptoms, and knows for certain there is no issue of diabetes or P.A.D. involved, then, yes, home care should suffice for the time being. But it's not as cut-and-dried as some of the responses have indicated. Is it ever?

True. I even remember a House episode where a perfectly healthy woman in Antarctica had an undiagnosed broken toe. It created fat emboli which traveled through her system and caused all sorts of symptoms. Not a likely scenario but a possibility. Letting someone know what to watch for doesn't have to happen in an ER but it does have to happen.

[NurseCard, ADN]

I've broken one of my fourth toes twice, and my big toe on my left foot once.... didn't seek medical attention any of those times. With the great toe, I debated several times whether or not I should see the doctor... it stayed swollen for quite a few days, stayed ruddy for a few days... but it seems pretty well fine now. (Wasn't very long ago that I broke it)

[RheatherN, ASN, RN, EMT-P]

most ppl may NOT know that there is nothing they can do for a broken toe. so she did what she thought she should do. whatever its over and done. but in the future she will know. they dont generally give pain pills for a broken toe, never seen it in fact, no matter the pain tolerance, and buddy tape.

no big deal, they have to treat, not that they should have treated her that way at all. srry to hear they were kinda rude!

-H-RN

[patrice meursault]

True. I even remember a House episode where a perfectly healthy woman in Antarctica had an undiagnosed broken toe. It created fat emboli which traveled through her system and caused all sorts of symptoms. Not a likely scenario but a possibility. Letting someone know what to watch for doesn't have to happen in an ER but it does have to happen.

WHATTTTTT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Please tell me you are a lay person. But do you really believe the stuff on House???????????????

Fatty emboli are usually created from a fracture of a long bone, not a toe.

And not to get up on a soapbox but the show House does nothing to portray nursing in any light. It is amazing that a group of doctors only have one patient to treat at a time. the next time you see a nurse on that show doing anything similiar to what we do in the real world, please let me know. That show is so far from reality it should be called a soap opera and shown during the daytime--in Mexico or Brazil!!!

[caroladybelle, BSN, RN]

True. I even remember a House episode where a perfectly healthy woman in Antarctica had an undiagnosed broken toe. It created fat emboli which traveled through her system and caused all sorts of symptoms. Not a likely scenario but a possibility. Letting someone know what to watch for doesn't have to happen in an ER but it does have to happen.

And I've read several fiction books where donating blood gave the donor AIDs, movies where MDs created monsters from dead body parts, and TV shows about an alien called Mork coming down from Ork, Na NOU, Na NOU.

"House" as a source of real life information?

[emmalou*]

Over what space of time have you committed all these felonies on your poor body?

Have you considered:

a) some kind of neuro problem associated with your ability to balance effectively? and/or

b) slowing down and planning ahead a little?

Best wishes

Eh??!!!

Well the felonies were committed over about, oh 15 years or so? I'm sure most people have had similar injuries/medical issues ....

No don't have any neuro problems.

Yes mum, maybe I do need to slow down and plan ahead.

Please understand, that being from a different culture (Aussie) that my style of writing might be different to yours and I was being tongue in cheek somewhat.