Would you go to the ER for this?

Antikigirl, ASN, RN · Dec 5, 2006

I would have chosen to go to an urgent care frankly if one was open. If not I may have tried benadryl in case it was an insect bite, tylenol for the fever, and wait it out only if my respirations were good. If I had any trouble with my resps or throat...ER.

I have had this happen, and it wound up being a spider bite. I was able to wait it out till the urgent clinic was open and didn't suffer any ill effects thankfully! But you never know, some people can be highly sensitive needing more help immediately.

Hnebun · Dec 5, 2006

In answer to your original question: would you go to the ER for this? In one word, NO. An ER visit is costly whether you have insurance or not....a PCP or urgent care clinic HAS to be a lot cheaper, and our local free clinic always has a provider/triage nurse on call. Even if yours doesn't, a lot of ER's and hospitals have in-house triage you can call and ask.

I think people need to realize that emergency room visits are for "life threatening" not "more convenient to my schedule" visits. Hence the name, EMERGENCY-if I called 911 about a boil, they would laugh in my face!

lauralassie · Dec 5, 2006

if someone had a huge boil on thier arm with a growing red ring around it, nausea, and dizziness, as well as a fever.....would it be a good idea to go to the er? my friend had this, she's ok now, has gotten medical treatment and antibiotics. is this what you all would consider something that needs to be seen in an er or in an urgent care setting?

hard to say, as i tell patients at discharge, if you feel something isn't right,feel free to come back (like with abd. pain, head injury ,peds etc. not a tooth ach). i think it has to be up to the individual. that,s why i don't take nurse calls, can't dx. or make a jugement call on the phone most times. there's a difference between a real illness and fear surrounding that illness, even if it seems silly to us. on the other hand there are those people who come in for things i wouldn't even go to the dr. for. we had a lady wait 6 hours because she drank a coke that was expired 1 day. but then when we gave the dc instructions ... (that should of said get a life you fool!)....of course she wanted vicodin for the tremendous headach she suffered while waiting and dealing with the stress of expired coke. my, what a surprise , wanted a narcotic. but since she was allergic to toradol, motrin, ultram , she got tylenol. ha!!!!(this is me doing the , you didn't get a narcotic, you fool! discharge dance)

Roseyposey · Dec 5, 2006

I definitely would not go to the ER for a boil. This would be something well handled in an urgent care clinic. I have to say, as I work in an urgent care clinic, you can get excellent care in one. There is a myth that the doctors in these clinics are somehow "substandard." The clinic I work in have great doctors, some have trained at very well-known hospitals. I have seen them bend over backwards to work out payment plans with people, and several times the doctors have waived their fees to people who can't pay. The samples the drug reps drop off also go to people who don't have insurance and can't afford prescriptions. There are several patients who use us as their PCP as there is a huge shortage of providers in my state....ok....stepping off my soapbox now...carry on.

SOREFEETEMPTYSTOMACH · Dec 6, 2006

As A Former Er Nurse Of 30 Years, Your Friend Would Have Been Seen By A Doc And Advised Hot Compresses And Possibly Betadine Wet To Dry Compresses. If Necessary Antibiotics. Who Knows Without Seeing The Lesion Firsthand.

Most Er's In Metropolitan Areas Have A Tiered Fee Schedule Based On The Acuity Of The Patient And The Time The Physician Spends With A Patient.

lauralassie · Dec 6, 2006

I find it interesting that you were able to call this a boil without seeing it. First , you've just made a DX. Then you recomeded TX. We've seen many cases of MRSA in our ER. Some can be treated in an urgent care setting some can not. We are lucky enough to have a fast track in our ER. The triage RN decides where the pt is most approprite for. I had two the other day that needed admitted. Both patient were first time MRSA'ers. They thought it was a boil, attempted several over the counter TX's etc.. because they couldn't afford a DR visit and by - the- way had an appoitment at the clinic but it takes 2 weeks to get in. So they waited. One was close to developing osteo. One of those pt's could have perhaps been a little more particular about his personal care, but the other was a teen of a single mother who works and a fast food place and who's son, most likley got the MRSA from the sporting eqipment he uses a school. On the cheif complaint, it said. "Boil on R calf" He was admitted under surg. care ,on vanco IV.

This is in ref to Jkcmom : quote

shiloh11 · Dec 6, 2006

Having worked in both ER and in Outpatient Infusion/Procedures, I would have to agree with Lauralassie. Ideally the patient would be seen by their PMD but often times they cant get in. Our hospital has a fast track in the ED as well so that the triage nurse can determine the most appropriate place for the patient to be seen. It seems like more often than not now days (patients with the symptoms described) wind up on IV antibiotics. This patient was febrile as well. Most of the docs in our ED in this case would do a culture and sensitivity and start antibiotics. Many times they are admitted for IV antibiotics and Infectious Disease consult. Pending the results of the C & S, the patient may be looking at long term IV antibiotics in the Outpatient Infusion Center.

This is just one scenario and it really is difficult to say without actually seeing the patient, looking at her history and doing an assessment. It is entirely possible given the history of abscess, spreading redness, fever, dizziness, and nausea, that the patient is becoming septic. Regardless, there is no way to tell what is going on without SOMEONE (PMD, Urgent Care, ED) seeing the patient asap.

DaFreak71 · Dec 6, 2006

No offense, but spoken like someone who feels they are entitled to receive health care (for non-life-threatening situations) at no cost.
Health insurance or not, isn't the goal to get the best appropriate care at the lowest out-of-pocket cost? Without insurance, an office visit will probably run me less than $200 ... an ER visit will be a minimum of $500 to $1000.
I cannot imagine expecting services to be provided (in a non-life-threatening situation) for free -- I expect to have to pay appropriately for services, whether that's in the form of insurance premiums or directly out of my pocket.

No cost? I'm paying upwards of double the cost that an insured person would pay for the exact same service. And yes, I and millions others are paying for services received in monthly installments for the next year or so to come. Many people don't have an extra few hundred dollars in their pockets in order to pay for an office visit. This was my situation when I visited the ER for a non-life threatening condition.

jojotoo, RN · Dec 6, 2006

No cost? I'm paying upwards of double the cost that an insured person would pay for the exact same service. And yes, I and millions others are paying for services received in monthly installments for the next year or so to come. Many people don't have an extra few hundred dollars in their pockets in order to pay for an office visit. This was my situation when I visited the ER for a non-life threatening condition.

Double the cost of what an insured patient pays? I don't thinks so. That insured patient has probably been paying PREMIUMS for months, if not years. And when the insured patient seeks medical care for that boil, he will most likely at least call his PMD first and attempt to avoid an ER visit.

So when someone goes to the ER because they cannot afford to go to Urgent Care, just remember that it is the patient that has insurance that is subsidizing the un/ underinsureds health care.

Ruby Vee, BSN · Dec 6, 2006

many insurers not are steering their insured away from emergency rooms and toward urgent care clinics. my own health insurer, for example. when i had 10/10 pain from my lower back, down my right leg to my foot that was unrelieved with the percocet left over from my root canal, i wanted to go to the er. i just wanted some relief from the pain. i couldn't stand still, sit, or lie in a comfortable postition, and so i paced. actually, i hobbled because my leg hurt so much to move. when i sat down, finally, felt something "give" in my back and then went numb in the affected leg, i did go to the er. after dilaudid (thank you to whomever invented the stuff!) and a series of spinal films, i was diagnosed with sciatica. the insurance company refused to pay for the visit, sending me an "educational letter" about using urgent care clinics for things that don't actually threaten life or limb.

fortunately, the er pursued the insurance company and they did eventually pay -- sometime while i was in the hospital following spinal surgery and complications.

SharonH, RN · Dec 6, 2006

had someone come in by ambulance for a paper cut. I couldn't even find it, she had to point it out to me. Can we say therapeutic wait time.

That's amazing since I've called EMS for people with chest pain and dizziness, weakness and numbness and I've watched EMTs attempt to diagnose on the spot and try to talk clients out of being transported, etc. I can't believe they transported for a paper cut.

jojotoo, RN · Dec 6, 2006

That's amazing since I've called EMS for people with chest pain and dizziness, weakness and numbness and I've watched EMTs attempt to diagnose on the spot and try to talk clients out of being transported, etc. I can't believe they transported for a paper cut.

In Los Angeles, Fire and Rescue are required to transport everyone. They have no discretion at all in this matter. Only if the patient declines transport are they not brought in.