Walk me through your ER

Rhi007 · Sep 22, 2013

Level one trauma centre so we get everything from cat 5 paper cut on the finger to patients being flown in by helicopter with fatal crush injuries, MIs, Stroke.

CodeteamB · Sep 22, 2013

We are the smallest ER in size in my city but we see the most patients. We are not the trauma center but due to our location many of the assaults, stabbings and gsws end up walking through our door (don't want to call an ambulance). Thankfully these are relatively rare in my city anyway, but I've seen my share.

We also see a large number of walk-in clinic type visits. Although it is not terribly difficult to find a GP in my city if you are motivated, many people prefer to use the ER. We also have many temporary residents in our province in general and our city in particular (oil $ gas).

Although my city has a children's hospital 30% of our patients are pediatrics. Again, if they call an ambulance little buddy is not coming to us, but if mom chucks him in the back of the car we are likely to be on the receiving end. We get a lot of very sick peds walk ins. We are also the Rapid response team for the inpatient peds unit in our hospital.

Because of walk-ins we are responsible for transporting patients to the big medical centre in a nicer part of town. Thankfully our children's hospital sends a transport team, but traumas, cath lab, neuro etc. get shipped out post stabilization and the nurse rides along in the ambulance to monitor drips and the patient and to provide an extra set of hands for ACLS if the patient crumps.

I love my ER. It is true we see all that belly pain and UTIs etc. Sometimes I think it would be cool to work in a trauma centre, but I wouldn't want to move away from my hospital in the 'hood! Plus, a doctor who I work with (and works at both hospitals) once told me "you think it would be exciting over there, but it's all oncology" (they are also the cancer centre).

NurseOnAMotorcycle, ASN, RN · Sep 22, 2013

Helped deliver a baby in the E.R. parking lot last night. Also had some stroke pts, MI, and bad GI bleed. At the same time had a dislocated shoulder pt, detox pts, drug seekers, and intoxicated college kids who should have stayed home and slept it off.

Editorial Team / Moderator · Sep 22, 2013

Two trauma bays in a plywood building. Dirt. Flies. Trauma. MASCALs. IEDs and GSWs and shrapnel. An OR with two tables about 10 feet away. What's not to love?

Anna Flaxis, BSN, RN · Sep 22, 2013

My old ED: Level 2 Trauma Center serving a multi county region, everything from stubbed toe to MVC, etc. Not many GSWs, in fact I saw maybe two in the 2.5 years I was there, and one was accidental while cleaning the weapon. Our traumas were more of the industrial accident, MVC, tree falling on house, suicide attempt by jumping from height types. We don't have much urban violence here.

My new ED is a small community hospital. We get bypassed for traumas but they do come in by POV through the lobby sometimes. We had one yesterday, in fact. Otherwise, we get the same types of complaints as my last work place, like suspected fractures, lacerations, abdominal pain, chest pain, wanting a hot meal, etc.

ChristineN, BSN, RN · Sep 23, 2013

Small inner city ER, not a trauma center. We get a lot of walk in's with abd pain, resp issues, etc. A lot of urgent care stuff. However many of our Level 3's and 4's tend to have complex histories due to my hospital being the only transplant center in town and a major oncology center. Also get a lot of walk in peds.

Belle2013 · Sep 23, 2013

Level 1 trauma center. We get everything from medication refills to sore throats to abdominal pain to GSWs. We have a lot of traumas come in like MVCs 40+ mph, GSWs, stabbings, boating accidents, and assaults. On a typical day in medical you'll see chest pains with maybe an active stemi, usually at least one stroke pt a day being flown in,lots of abdominal pain, vag bleeding in preg, SOB, and SI/HIs. Of course random things in between but that's the typical pt flow we see daily.

**NickiLaughs, ADN, BSN, RN** · Sep 23, 2013

Level 1 trauma 66 beds. Peds ER is separate. Traumas flown in, overdoses, Gsw, rodeo accidents, bad drunk driving accidents (we start getting nervous at 2 AM when the bars close). The drunk guy who comes in every day for chest pain trying to get Dilaudid. We are also usually boarding between 5 to 10 5150s since we are short on mental health beds in our county. And frequently board our ICU patients around 12 hours. :)

forget_me_not · Sep 26, 2013

Small rural critical access ER. 5 rooms, 8 beds. 1 "trauma bay". We see everything and are mainly a stabilize and ship 'em kind of place. The closest level 1 traumas are an hour away by ground.

OlivetheRN, ADN, BSN, RN · Sep 26, 2013

Community hospital with several level one trauma centers within less than an hour by ground. We currently have 26 rooms since we just finished phase one of an expansion and moved into the new part Tuesday, and lost 8 rooms or so, but in January we'll be up to 58 rooms once the old part is renovated. We see pretty much everything but will stabilize and ship some things that aren't flown directly from the scene.

Guests · Nov 10, 2013

I started at a tiny, rural critical access ER - two rooms, 4 beds.. plus two hall beds. Mostly clinic stuff along with appy's, choly's, pancreatitis, etc. We got our share of SIRS/sepsis and the occasional trauma - either fairly minor or over-the-top who couldn't be transported from the scene.

The little joint was a great experience at learning to be self-reliant.

Now I work at a university trauma center and we truly see it all from the mundane to the massive trauma getting 6 units of blood in the first 15 minutes on our way straight to the OR, ECMO running in the ED, strokes, crazy folks... codes are fairly common. It's a kick in the pants, to be sure...

We have a great mix of nurses from all kinds of backgrounds - docs of various types and experience around all the time - dedicated RT and clinical pharmacy - and a pretty cohesive team.