Posted on 09/30/2006 1:57:29 AM PDT by 60Gunner
Everyone was talking about the Illinois ruling when I entered the ED staff break room before my shift.
The news story was clipped from our local paper and pinned to our bulletin board, with the title highlighted in yellow and the word "READ THIS" scrawled in bold red marker above the headline.
It was the topic of conversation for days, and dominated a full two hours of the ED consortium in which I participated.
Every ED in the country is going to be taking a hard look at their triage systems. It is always a good thing to take a step back and evaluate the effectiveness of the system. From my vantage as an ED nurse, I see the potential for one of two things to happen.
First, the good. EDs will reinforce the importance of treating chest pain as if it is cardiac-related until proven otherwise (which is already the standard at my ED). Triage RNs will in turn be more vigilant. Most already are; more will be forced to sharpen up.
Second, the bad. The pendulum of care will quickly swing to the other extreme: hypervigilance. While every case of chest pain should be regarded as cardiac until proven otherwise, pressure from hospital administrations and legal staff will force EDs to perform unnecessary and very expensive diagnostic tests on people whose complaints of chest pain are not cardiac-related, just to cover themselves. The practice is called defensive medicine, and it jacks up the price of healthcare. It slows the care process. It bogs down ED waiting rooms. Worst of all, it solves nothing while making the general population feel like something is being done.
The best solution for this is simply common sense. Triage nurses may vary in experience, but if a standard algorithm is followed, even relatively new nurses can be effective at triaging patients with chest pain. I don't know the standard at every ED; I can only speak for my own, which is very good at triaging chest pain. But then, my hospital just happens to be in the best city in which a person can have a heart attack.
Location has a significant influence on a healthcare system's focus. A rural area three-bed ED is less likely to be set up for gang-related violence or trauma than, say, UCLA. The Seattle area is THE place to have a heart attack. We know heart care.
That is not to say that there is any excuse for allowing someone to die of a heart attack in any ED waiting room, no matter where it may be. And as I said before, effective training can reduce the incidence of such awful events. But if you come in with chest pain that turns out to be from a pulled muscle and end up having a stress echocardiogram and/or a cardiac doppler performed "just to be on the safe side," you'll at least know why. And when you have to wait a little longer when someone else comes in with chest/shoulder pain, you'll at least know why.
I read that as Bob Dole's ED.
What is ED? Aren't we talking about emergency rooms?
emergency department.
I'll bet :)
correct!
What do heart attacks have to do with ED?
It's a shame he doesn't tell us what ruling he's referring to and a quick search of google news shows nothing
I knew there'd eventually be a thread where it'd be relevant to post this link!
http://www.chronic-illness.org/comic/name.html
;)
*sigh*. Okay, folks. Lesson learned. "ED" in this context stands for "Emergency Department". That's what I get for posting a thread after getting off shift.
Sorry about that.....zzzzzzzzzzzzzzzzzzzzz
We just wanted to give you a hard time.
You're a real stand-up guy. Besides, when was hte last time a death due to erectile dysfunction was in the news?
I have heard the warnings about the efficacy of the medicine, and to call a doctor if the effects last more than four hours. In fact, I know of an old geezer who was taken to the hospital after abusing Viagara.
So death by ED is not impossible. I think police call it "attack with a dead weapon."
But for cryin' out loud, guys! I'm talking about Emergency Departments here! I swear by all that is just and pure that this the last time I post right after finishing my shift... Y'all are merciless, I tell ya. Merciless.
The scoffers in the crowd will please note that I said finishing my shift rather than getting off.
Wouldn't want to add to the hoo-haw, would I?
You have the last word!
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