Jo-Ann Boepple: About the ER

Published 4:06 pm Thursday, February 11, 2010

boeppleAfter having spent a morning attending a meeting addressing medical insurance in which a warning against using the hospital emergency room as a doctor’s office, I ended up spending the day in the St. Joseph Hospital Emergency Room in Tampa, Fla. This prompted me to think about emergency rooms and how they happened to be established.
The emergency department, sometimes called the emergency room, emergency ward, accident and emergency or casualty department is a hospital or primary care department that provides treatment to patients with a broad spectrum of illnesses and injuries requiring immediate attention.
It is often defined as the section of the health care facility for providing rapid treatment to victims of sudden illness or trauma. Another definition is an operating room reserved for emergency operations.
The term ER is generally used in the United States presumably because everything is done in one room, but with all of services and requirements for treatment available the emergency department contains many different specialty rooms. However all of my experiences in the ER, the treatment has taken place in one room. Now X-ray equipment is portable and is wheeled right into the room and there is no longer a need to go to the X-ray area.
Emergency rooms operate around the clock but find that the down time often occurs between 2 a.m. and 6 a.m. Most people seek the ER in the afternoon and evening hours. Many emergency rooms are exceedingly busy. A survey of New York area doctors in 2007 found that injuries and even deaths have been caused by excessive waits for hospital beds in the ER. An average wait time found was from two and a half hours to five hours. ERs often have more patients than it has beds.
The first trauma care center was opened in 1911 at the University of Louisville Hospital. In 1930 Arnold Griswold is credited with equipping police and fire vehicles with medical supplies and training officers to give medical care while en route to the hospital.
Within the emergency department are several different specialized areas. In the Triage area, patients are assessed by an RN or LPN who does an evaluation before they are transferred to a different department or a different area of the ER.
A hospital with an emergency department has a prominent sign reading “Emergency” or “Accident,” often in white text on a red background and an arrow to indicate where patients should proceed. This helps to direct patients in need of critical care to the correct location for service.
Emergency rooms or departments have seen an increasing amount of usage by those who lack medical insurance or have difficulty getting to see a doctor. Thus the term Emergency is no longer the designation of the medical emergency. At the insurance meeting it was stressed that the emergency room is for life-threatening afflictions and not routine medical care. In the emergency room I was in this past weekend, there seemed to be few life-threatening situations. Those who had life threatening situations were not waiting in the waiting room. Most of those cases came in ambulances and were treated before others.
Most true emergencies are cardiac arrest, heart attack, trauma, mental illness and asthma and chronic obstructive pulmonary disease and are usually referred to intensive care immediately.
I can recall that in my past trips to the ER were for stitches because my sons had a habit of getting lacerations from a variety of events; when my daughter who is asthmatic was having a severe attack and needed immediate attention, which always seemed to be in the middle of the night; or when my husband was dizzy and was having heart palpitations. or I was sent there from my doctor’s office for immediate tests and treatment.
Walk-in or Urgent Care clinics have been the new way to take the pressure off of the ER.  For routine services many are encouraged to use the services of the clinics for sore throats, minor infections, etc. if you can’t get to see your doctor.
When a life-threatening incident occurs, you will want the ER to be free of routine illnesses so that critical care can be given.
That’s all for this day.