Emergency Rooms Are Beginning to Enter the 21st Century
The American health care system generates considerable resentment at the emergency room level. Waiting times are customarily 3 to 6 hours or more. The medical staffs are overtaxed. Anger simmers from the waiting rooms, to the back lounges, where physicians and nurses seek temporary shelter from the tensions.
Much discussion has taken place regarding the factors that create such a dismal delivery of health care services. Now some hospitals are beginning to respond to the economic threat offered by urgent care centers. These competitors have boldly assumed a larger amount of the dollars in the emergency services marketplace.
Some of the new methodologies for coping with the constant stream of patients include systems management ideas borrowed from the business world. Now it is more common for a triage nurse to greet patients as they enter the ER. They quickly assess the urgency of treatment with form questions and an exam. The next level of care is with a triage physician who will order the preliminary lab tests and x-rays. The focus is on obtaining an initial diagnosis. This may later be changed, but the speed at which the patient is attended to can be one-third the length of time.
New approaches to testing step up the evaluation phase to lightening speed. Certain lab tests, for cardiac dysfunction, asthma or kidney problems, can be ordered within 15 minutes of the gateway nurse or physician’s initial look-over.
In really able hospitals, which have adopted the new express procedures, patients requiring hospitalization can be placed in a bed and find themselves wheeled to a room in less than half the customary time. The fastest ERs usually strive to accomplish their assessments, and possibly treatment, within 90 minutes to 2 hours at the maximum.
The urgent care centers still remain the better options for minor injuries such as sprains or cuts requiring stitches. For multiple-system injuries and more complex matters, the ER will still be your targeted destination.
Hospitals have been forced to change their ways. Within the next few years, we will look back on current practices and evaluate many as primitive. The day will come when triage determination by physicians and nurses will be routine. Heart attack patients will be catheterized within an hour and a half of walking through the doors. Timely treatment will be the norm. And each patient’s experience will be vastly speeded up and improved.
Concussions Now Are Taken Seriously
Concussions are only now being recognized as carrying the potential for serious injury. Much of this has been fostered by the extensive media coverage of long-term consequences to former football players in the NFL. The concern has also worked to benefit the medical needs of injured children.
Even mild concussions require prompt attention. Any complaints of stomach distress or of light annoying the eyes are red flags. Untreated, concussions can soon lead to headaches, dizziness, memory problems and behavioral issues.
With greater public awareness of the warning signs, more kids are getting immediate medical attention. New studies involving brain chemistry and blood flow have furthered the national interest in concussions. It is now known that traumatic brain injury causes the chemical N-acetylaspartate to lower in brain cells. Experts are now designing better protective equipment to identify those at risk of brain damage after an impact.
