Tuesday, September 25, 2007

It Begins (Addendum)


From the CDC and ACEP. Ring true guys? I could not readily find the definitions of "immediate", "emergent" etc... but given that about 15% of patients seen in the ED are eventually admitted that makes me think that to get in the "urgent" category can't be that difficult. Your tax dollars at work.

13 comments:

  1. Those are triage scores
    1=Immediate (full arrest in progress, etc)
    2=Emergent (Chest pain, stroke symptoms, severe respiratory distress, someone actively seizing)
    3=Urgent (Abdominal pain, chest pain yesterday, miscarriages, etc--anything probably needing more than 2 things like labs+CT scan that don't need to be rushed back immediately)
    4=Semiurgent (skin rashs, lacs, extremity injuries)
    5= Clinic stuff (cough, cold, earache, med refills, stich removal--things that will probably only need an exam and a prescription)

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  2. I've got an ingrown toenail!

    It has to be immediate! %)

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  3. I've had this cough for two weeks and I'm going out of town tomorrow and my doctor couldn't see me this afternoon and I'm really in a hurry this is ridiculous what kind of place are you running here?

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  4. When I was a resident, I actually heard a patient whose vagina was leaking green stuff after having a nasty infected penis shoved into it repeatedly say, regarding a GSW patient that we were coding, " I don't care if he is dying, I was here FIRST!" So I'm not sure what is urgent or emergent or just anoying.

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  5. This one wanted to be a "2" but was made a "5". You've had a rash for a month? I'll rush you right back, sir, right after Hell freezes over.

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  6. Cat,

    Was it shoved repeatedly?

    Or did she say it repeatedly?

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  7. thanks nurse k.
    we do have these categories in our ed but i, shame on me, do not look at the triage category but pick up each chart and look at the age, sex, chief complaint, and vital signs and make up my own mind.

    on this chart then 6% of patients need a nurse and doctor at the bedside upon arrival for possible acute intervention and 10% might be sick enough to need an intervention soon. the rest, yawn, see ya soon.

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  8. IMO, it should be narrowed to three categories:

    1: Stuff that will or very probably will get considerably worse without professional help sooner than the pt can get in to see their regular doc; broken bones, any leak that can't be patched with a band-aid, MI, etc.

    2: Stuff that a layman wouldn't necessarily be expected to know isn't a category 1; sprains, minor reactions to meds, etc.

    3: Criminally chargeable interference with emergency services needed by category 1 & 2 pts.

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  9. ANON

    THE PENIS WAS SHOVED REPEATEDLY, SHE DIDN'T SAY IT REPEATEDLY.

    CAT

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  10. i, shame on me, do not look at the triage category...

    Eh, not your job to worry about triage. That's our job. Triage is stressful, man. If you don't catch something, it's YOUR ASS, or if you bring someone back quickly who is BS, then you get yelled at too. Or if you have 1 open bed and 5 out of 20 people in the lobby (category #3 or whatever, you have to bring #2s back whether there's a bed or not) who you think should be in that bed, you get yelled at by whomever because the other 4 waited too long.

    You pretty much have a set of vitals and a couple of minutes to determine what you think a problem could be without benefit of an exam (we dont' do exams in triage) or diagnostic equipment of any sort.

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  11. I wouldn't trade places with the triage nurse or the unit secretary.

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  12. I wouldn't trade places with the triage nurse either given the system. there has to be a way to prioritize patients better!

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  13. Nurse K and erdoc85, today by your comments you have shown that you truly understand the value of your counterparts. Congratulations.

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