Millions of Americans visit
an emergency room each year. Millions more have seen
the hit TV show "ER." This has sparked an
almost insatiable interest in the fascinating, 24-hour-a-day,
non-stop world of emergency medicine.
Photo courtesy UAMS Campus
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A visit to the emergency room
can be a stressful, scary event. Why is it so scary?
First of all, there is the fear of not knowing what
is wrong with you. There is the fear of having to
visit an unfamiliar place filled with people you have
never met. Also, you may have to undergo tests that
you do not understand at a pace that discourages questions
and comprehension.
In this article, Dr. Carl Bianco
leads you through a complete behind-the-scenes tour
of a typical emergency room. You will learn about the
normal flow of traffic in an emergency room, the people
involved and the special techniques used to respond
to life-or-death situations. If you yourself find the
need to visit an emergency room, this article will make
it less stressful by revealing what will happen and
why things happen the way they do in an emergency department.
Emergency
Room Patients
Photo courtesy House.goOne of the most amazing
aspects of emergency medicine is the huge range
of conditions that arrive on a daily basis. No
other speciality in medicine sees the variety
of conditions that an emergency room physician
sees in a typical week. Some of the conditions
that bring people to the emergency room include: |
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Car accidents
， Sports injuries
， Broken bones and cuts from accidents and falls
， Burns
， Uncontrolled bleeding
， Heart attacks, chest pain
， Difficulty breathing, asthma attacks, pneumonia
， Strokes, loss of function and/or numbness in arms
or legs
， Loss of vision, hearing
， Unconsciousness
， Confusion, altered level of consciousness, fainting
， Suicidal or homicidal thoughts
， Overdoses
， Severe abdominal pain, persistent vomiting
， Food poisoning
， Blood when vomiting, coughing, urinating, or in
bowel movements
， Severe allergic reactions from insect bites, foods
or medications
， Complications from diseases, high fevers
Photo courtesy U.S. Navy, photo by Journalist 1st
Class Mark D. FaramMedical personnel place an injured
person into an ambulance outside the Pentagon, Arlington,
VA, Sept. 11, 2001.
Understanding the ER Maze
The classic emergency room scene involves an ambulance
screeching to a halt, a gurney hurtling through the
hallway and five people frantically working to save
a person's life with only seconds to spare. This does
happen and is not uncommon, but the majority of cases
seen in a typical emergency department aren't quite
this dramatic. Let's look at a typical case to see
how the normal flow of an emergency room works.
Imagine that it's 2 a.m., and you're dreaming about
whatever it is that you dream about. Suddenly you
wake up because your abdomen hurts -- a lot. This
seems like something out of the ordinary, so you call
your regular <"a href="becoming-a-doctor.htm">doctor.
He tells you to go to your local hospital's emergency
department: He is concerned about appendicitis because
your pain is located in the right, lower abdomen.
Triage
When you arrive at the Emergency Department, your
first stop is triage. This is the place where each
patient's condition is prioritized, typically by a
nurse, into three general categories. The categories
are:
， Immediately life threatening
， Urgent, but not immediately life threatening
， Less urgent
This categorization is necessary so that someone with
a life-threatening condition is not kept waiting because
they arrive a few minutes later than someone with
a more routine problem. The triage nurse records your
vital signs (temperature, pulse, respiratory rate
and blood pressure). She also gets a brief history
of your current medical complaints, past medical problems,
medications and allergies so that she can determine
the appropriate triage category. Here you find out
that your temperature is 101 degrees F.
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