ED Advice. What is going to happen during my ED visit? PART I

You have a complaint, something that is bothering you, it may be life- threatening like a heart attack or something benign like an ingrown toenail. I want to to give you some advice for surviving your ED visit literally and figuratively.

Expect to wait, wait, wait and wait more!!!

This is not Burger King, you will not "have it you way". You can be nice. You can curse and scream, definitely not recommended, you will wait longer. You can throw yourself on the floor, this does not always work either. Decreasing ED wait time is a priority at most ED's but there are multiple factors that prevent this from happening. Here are some of the reasons that you are going to wait:

ED overcrowding is at an all time high. The ED is the only place in medicine that you must accept all comers. Unlike private offices, where a doctor can refuse a visit because you have no insurance, the provider doesn't like you or your scheduling your 22nd appointment in 1 month for abdominal pain that your doctor has no answer for. The ED is required to see you. This prevents sick people from mistakenly being sent away(EMTALA) but it also allows many to abuse the system. So when your 40 year uncle with a beer belly, that eats bacon for breakfast, lunch and dinner shows up with his heart attack, he has to wait to be "triaged" or assessed because Tonya the vicodin pain seeking drug addict is complaining of her perpetual back pain despite a negative MRI. Thomas the homeless guy from the shelter six blocks away, wants a place sleep, but complains of chest pain and an elephant sitting on his chest। Finally Sandra the 90 year old demented lady feels like talking about her 30 year old hand pain from rheumatoid arthritis and mentions by the way she fell down the stairs 3 weeks ago and hit her head। Hence we have the triage system.

Your chief complaint is recorded, the "vital signs" blood pressure, heart rate, temperature, oxygen saturation, are taken and then you are categorized। It is done a million different ways, but basically your placed in 1 of three categories। Emergent, semi-emergent and non-emergent। At well organized departments, triage will happen right away but at others that are disorganized or just simply overwhelmed by sheer numbers, the wait to be triaged can be up to 60 minutes. Now the real wait begins. You may wait in a room, in a hallway, in a chair inside the department, or in the dreaded waiting room that can range from urine stained seats to plasma TV's and cappuchino machines. If your fortunate enough to have your faculties during your visit, my advice come prepared. Many of you prepare to go to a baseball game. You bring a jacket, a hidden sandwich if your cheap, paper towels, whatever. Bring some of your favorite stuff with you, ie food, water, harry potter, xxl, psp, nintendo DS, because as I said before, waiting is common, you will need distraction. The average wait 2-12 hours,yeah 2- 12 hours. Most ED are trying to decrease their wait time to 30 minutes. Return for my next blog ED visit part II and I will let you why "this is impossible." and more about your emergency room journey.