ER visit -- part vent, should I complain? Long, as usual

In article ,
Jenn wrote:

In article rWkab.40989$n94.40634@fed1read04,
"Circe" wrote:

"Tina" wrote in message
om...
Does anyone else think it's exceptionally slow to wait three and a
half hours after a head injury with symptoms (sleeping, uneven gait,
pain moving around her head) in a child with a bleeding disorder to
get a catscan? I'm still angry (obviously), but I don't know how
angry to get, if I complain. That nurse definitely lied, I know that
for sure.

I agree with everyone that 3.5 hours seems like far too long to have to wait
to be seen after an incident like this, particularly if the child has a
known clotting disorder. OTOH, I have to say that my experience suggests
it's not at all uncommon and might even be normal.

When Julian cut his finger open with a pair of scissors on a Sunday, we too
him to the ER. It was very busy, and we eventually ended up going to an
urgent care center because the wait was 6+ hours. However, it was an hour
(and maybe 1.5 hours) before we were even triaged. And during that hour, we
met a couple with a son a little over than Solana who'd had a garden tool
fall on his head at a local home improvement warehouse. He had a significant
laceration on the top of his head and had been exhibiting other potential
symptoms of concussion/brain-bleed like Solana (sleepiness, nausea). They
had been there at 3 hours by the time we met them and they had still not
been seen by the doctor when we left, so they must have waited a good 4
hours before they were seen!

one of the reasons for this is that people take kids with cut fingers to
the ER -- it is this great surge of trivial problems that clog things up

part of the reason is that ERs are used as primary care by those without
insurance, and pediatricians who routinely worked with patients with
minor problems e.g. broken arms, cut fingers etc in the past, now don't
work after hours and send people to ERs and part of it is the judgment
of people who think it appropriate to use an ER for a trivial problem.

Where is it you think I'm supposed to go if I need stitches or have a
broken bone? My "regular" doctor doesn't take walk-ins, and if I call
I'm told to go to either urgent care or the ER -- and not all places
even have an urgent care or acute care center, it's either the ER or
nothing. The urgent care center is also not open 24-7, so it isn't
always an option. And $$ is sometimes an issue: at the urgent care
center, if you can't give them $$ when you get there, you don't get
seen. My co-pay for the urgent care center is now the same as my co-pay
for the emergency room (dumb!) but I know the ER will treat me whether I
have the $75 in my hand or not.

If possible, I make an appointment with our regular doctor; that's what
we did Tues. when my 17 yo had symptoms of an infection, and he got in
in about 5 hours. If they aren't open, I try urgent care -- but there
they do absolutely NO triage, and *I* have to guess whether it's more
important than the potential wait. I'm not a doctor or nurse, and I may
guess incorrectly. However, if there's a lot of blood, you can bet I'll
opt for the ER.

That said, the only time I've taken a child in for a head injury, she
was totally asymptomatic when we arrived, and there wasn't a mark on
her; the nurse at the triage desk started to take some of her clothes
off to get a better look (it was winter) and my baby started vomiting.
We got right in. (And she had a skull fracture and we stayed in the
hosp. for about 36 hours.)

I know I've had some real problems getting attention when I thought we
needed it; on one occassion, I think my brother damned near assaulted
someone -- it was the third time in 3 days he'd taken Dad in, they kept
saying he just had a stomach bug, and it was obvious to my brother that
it was worse; they finally looked more closely, and in less than an
hour he was in emergency surgery to have a VERY close to bursting
appendix removed (apparently not something they look for in an older
person, but in the two previous visits they hadn't even done a white
blood count!)



meh
--
Children won't care how much you know until they know how much you care

In article
,
dragonlady wrote:

In article ,
Jenn wrote:

In article rWkab.40989$n94.40634@fed1read04,
"Circe" wrote:

"Tina" wrote in message
om...
Does anyone else think it's exceptionally slow to wait three and a
half hours after a head injury with symptoms (sleeping, uneven gait,
pain moving around her head) in a child with a bleeding disorder to
get a catscan? I'm still angry (obviously), but I don't know how
angry to get, if I complain. That nurse definitely lied, I know that
for sure.

I agree with everyone that 3.5 hours seems like far too long to have to
wait
to be seen after an incident like this, particularly if the child has a
known clotting disorder. OTOH, I have to say that my experience suggests
it's not at all uncommon and might even be normal.

When Julian cut his finger open with a pair of scissors on a Sunday, we
too
him to the ER. It was very busy, and we eventually ended up going to an
urgent care center because the wait was 6+ hours. However, it was an hour
(and maybe 1.5 hours) before we were even triaged. And during that hour,
we
met a couple with a son a little over than Solana who'd had a garden tool
fall on his head at a local home improvement warehouse. He had a
significant
laceration on the top of his head and had been exhibiting other potential
symptoms of concussion/brain-bleed like Solana (sleepiness, nausea). They
had been there at 3 hours by the time we met them and they had still not
been seen by the doctor when we left, so they must have waited a good 4
hours before they were seen!

one of the reasons for this is that people take kids with cut fingers to
the ER -- it is this great surge of trivial problems that clog things up

part of the reason is that ERs are used as primary care by those without
insurance, and pediatricians who routinely worked with patients with
minor problems e.g. broken arms, cut fingers etc in the past, now don't
work after hours and send people to ERs and part of it is the judgment
of people who think it appropriate to use an ER for a trivial problem.

Where is it you think I'm supposed to go if I need stitches or have a
broken bone? My "regular" doctor doesn't take walk-ins, and if I call
I'm told to go to either urgent care or the ER -- and not all places
even have an urgent care or acute care center, it's either the ER or
nothing. The urgent care center is also not open 24-7, so it isn't
always an option. And $$ is sometimes an issue: at the urgent care
center, if you can't give them $$ when you get there, you don't get
seen. My co-pay for the urgent care center is now the same as my co-pay
for the emergency room (dumb!) but I know the ER will treat me whether I
have the $75 in my hand or not.

uh can you read? note that I indicated that one of the reasons for the
misuse of ERs is that regular doctors no longer do what they once did --
e.g. treat patients with minor problems like simple arm breaks and cut
fingers in their offices

and of course the motive of 'someone else pays and I don't have the $ in
hand' is both an example of your misuse of the system and the looney
way in which we arrange medical care services. the system is set up to
generate big bucks for stockholders andn ot to provide good care for
Americans -- which is why we have such expensive care which nevertheless
leaves out tens of millions

"Jenn" wrote in message
...
uh can you read? note that I indicated that one of the reasons for the
misuse of ERs is that regular doctors no longer do what they once did --
e.g. treat patients with minor problems like simple arm breaks and cut
fingers in their offices

If regular doctors no longer do it, how can it constitute "misuse" of the ER
to go there when you have one of these problems? It is only misuse if there
is a legitimate alternative. Otherwise, that's what it's for...
--
Be well, Barbara
(Julian [6], Aurora [4], and Vernon's [18mo] mom)
See us at http://photos.yahoo.com/guavaln

This week's special at the English Language Butcher Shop:
"No parking passed this sign" -- hotel parking lot sign

All opinions expressed in this post are well-reasoned and insightful.
Needless to say, they are not those of my Internet Service Provider, its
other subscribers or lackeys. Anyone who says otherwise is itchin' for a
fight. -- with apologies to Michael Feldman

In article ,
Jenn wrote:



and of course the motive of 'someone else pays and I don't have the $ in
hand' is both an example of your misuse of the system and the looney
way in which we arrange medical care services. the system is set up to
generate big bucks for stockholders andn ot to provide good care for
Americans -- which is why we have such expensive care which nevertheless
leaves out tens of millions

Actually, I said I had to pay the SAME whether I used urgent care or the
emergency room -- but that if I don't have $75 right now, I can still be
seen in the emergency room and pay later. If I go to the ER because i
don't have $75 and can't wait until I do (and these are for things that
can't wait, or I wouldn't be considering either) -- that is hardly my
misuse of the system. That is system stupidity and short sightedness.

I can remember when I was in my 20's and uninsured. I had just moved to
a new city, and had found a job but had to wait 6 months to qualify for
medical insurance. In my former city, I had been able to see a doctor
now and pay later -- however, when I started to feel seriously unwell,
and tried to find a doctor who would see me and let me pay as I could,
almost all of them told me if I was sick and uninsured (or didn't have
the $$ for a physical, which I didn't) I would have to go to the ER.
All of the clinics told me I could not be seen. I was lucky to finally
find a doctor in private practice who was willing to take me on as I
was. He treated me, and later DH and our first daughter, for the next
11 years, always willing to bill us if we didn't have the money up
front. And we always paid as quickly as we could.

But I developed one hell of an appreciation for why so many poor
families end up using ER as their first stop -- it is increasingly hard
to get medical care if you can't pay up front.

meh
--
Children won't care how much you know until they know how much you care

In article
,
dragonlady wrote:

In article ,
Jenn wrote:



and of course the motive of 'someone else pays and I don't have the $ in
hand' is both an example of your misuse of the system and the looney
way in which we arrange medical care services. the system is set up to
generate big bucks for stockholders andn ot to provide good care for
Americans -- which is why we have such expensive care which nevertheless
leaves out tens of millions

Actually, I said I had to pay the SAME whether I used urgent care or the
emergency room -- but that if I don't have $75 right now, I can still be
seen in the emergency room and pay later. If I go to the ER because i
don't have $75 and can't wait until I do (and these are for things that
can't wait, or I wouldn't be considering either) -- that is hardly my
misuse of the system. That is system stupidity and short sightedness.

I can remember when I was in my 20's and uninsured. I had just moved to
a new city, and had found a job but had to wait 6 months to qualify for
medical insurance. In my former city, I had been able to see a doctor
now and pay later -- however, when I started to feel seriously unwell,
and tried to find a doctor who would see me and let me pay as I could,
almost all of them told me if I was sick and uninsured (or didn't have
the $$ for a physical, which I didn't) I would have to go to the ER.
All of the clinics told me I could not be seen. I was lucky to finally
find a doctor in private practice who was willing to take me on as I
was. He treated me, and later DH and our first daughter, for the next
11 years, always willing to bill us if we didn't have the money up
front. And we always paid as quickly as we could.

But I developed one hell of an appreciation for why so many poor
families end up using ER as their first stop -- it is increasingly hard
to get medical care if you can't pay up front.

meh


yup the US has an insane, overpriced, inefficient and unjust system of
health care -- but like so many other things, we are heading away from
a system where all can prosper to one where a tiny group of families
will control most of the wealth and everyone else can live in penury --
in 50 years we will look a lot like South America

Jenn wrote:
one of the reasons for this is that people take kids with cut fingers to
the ER -- it is this great surge of trivial problems that clog things up

When we were in triage with my son who had a perforated bowel and
peritonitis (he has emergency surgery a few hours later) I saw a family
come in by ambulance with a kid who had fallen off a slide and broken his
arm. The mother said that she always calls an ambulance because those
kids get seen first.

Wendy

In article ,
Wendy Marsden wrote:

Jenn wrote:
one of the reasons for this is that people take kids with cut fingers to
the ER -- it is this great surge of trivial problems that clog things up

When we were in triage with my son who had a perforated bowel and
peritonitis (he has emergency surgery a few hours later) I saw a family
come in by ambulance with a kid who had fallen off a slide and broken his
arm. The mother said that she always calls an ambulance because those
kids get seen first.

Wendy

I've gone in by ambulance once, DH once, and, between my 3 kids, have
had 3 trips by ambulance. In each case, it was legitimately ambulance
business (in two cases, we were unable to get up or be moved without
paramedic help, in one the fire fighters called the ambulance, and I
don't even want to THINK about the other two -- but someone else called
for an ambulance both times.) And when my kids have gone in by
ambulance, they have been receiving treatment before I could get there
to fill out anything or sign anything, which was a Good Thing.

It's hard to know how quickly we would have been seen if we'd been able
to get in without the ambulance, since we've never used an ambulance
except for cases where it was necessary. But knowing how quickly we
each got seen, I can understand that mother's approach -- even as I
resent it.

meh
--
Children won't care how much you know until they know how much you care

"dragonlady" wrote in message
...
In article ,
Wendy Marsden wrote:
When we were in triage with my son who had a perforated bowel and
peritonitis (he has emergency surgery a few hours later) I saw a family
come in by ambulance with a kid who had fallen off a slide and broken
his
arm. The mother said that she always calls an ambulance because those
kids get seen first.

I've gone in by ambulance once, DH once, and, between my 3 kids, have
had 3 trips by ambulance. In each case, it was legitimately ambulance
business (in two cases, we were unable to get up or be moved without
paramedic help, in one the fire fighters called the ambulance, and I
don't even want to THINK about the other two -- but someone else called
for an ambulance both times.) And when my kids have gone in by
ambulance, they have been receiving treatment before I could get there
to fill out anything or sign anything, which was a Good Thing.

It's hard to know how quickly we would have been seen if we'd been able
to get in without the ambulance, since we've never used an ambulance
except for cases where it was necessary. But knowing how quickly we
each got seen, I can understand that mother's approach -- even as I
resent it.

Nods I've been to hospitals twice by ambulance--once after a backpacking
fall that broke my nose (I was evacuated from the mountain by helicopter and
then transferred to the ambulance to get to the hospital) and once this past
July. In July, I was cyanotic and had no pulse on arrival. I immediately got
the crisis room (which, thankfully, was not in use by another patient).

That said, it took so long for the ambulance to arrive and for them to get
me to the hospital (they kept trying to treat me with things like oxygen and
more of the nebulizer than I couldn't breathe instead of just putting me in
the damn ambulance and driving hell-bent-for-leather to the hospital) that
my husband thinks if the same sort of thing were to happen again, he'd just
toss me in the car and drive me to the hospital himself. But we both wonder
whether we'd be taken as seriously if we showed up in a private car as we
were when I came in the ambulance. It's a tough call, because the minutes
lost in waiting for the ambulance were the minutes it took me to go into
complete cardiac arrest, and had I been in cardiac arrest for even a few
minutes longer, I wouldn't be writing this post now (I'd be either
brain-damaged or dead).
--
Be well, Barbara
(Julian [6], Aurora [4], and Vernon's [18mo] mom)
See us at http://photos.yahoo.com/guavaln

This week's special at the English Language Butcher Shop:
"No parking passed this sign" -- hotel parking lot sign

All opinions expressed in this post are well-reasoned and insightful.
Needless to say, they are not those of my Internet Service Provider, its
other subscribers or lackeys. Anyone who says otherwise is itchin' for a
fight. -- with apologies to Michael Feldman

x-no-archive:yes
dragonlady wrote:

In article ,
Wendy Marsden wrote:

Jenn wrote:
one of the reasons for this is that people take kids with cut fingers to
the ER -- it is this great surge of trivial problems that clog things up

I've been to the ER twice this year - once because of vertigo very
early (6 a.m.) before I could get ahold of my doctor and once because
of what turned out to be shingles around 1 a.m. in the morning. Both
times I was afraid I was having a heart attack (I'm a little paranoid
about that) and dh drove me. I was seen in a timely manner, but in
both cases I don't think our local ER was too busy at that point in
time.

When dh WAS having a heart attack, he walked to the ER from a clinic
(he said he felt better standing up and refused to take a cab - I can
see where my kids get their hard-headedness from!!) The ER was FULL
up to the top (they were remodeling). People with broken limbs,
people throwing up etc. This was in Nassau Bahamas BTW. I grabbed a
person (I think a clerk) and said, "My husband is having a heart
attack", and he was on a stretcher before I could blink, and ahead of
anyone else in the waiting room. [They were a bit bemused when we told
them that the heart attack had actually started two days previously -
we had to sail the boat back to where we could get to medical care
because we were at an uninhabited cay when it happened.]

dd#3 was taken by her employer to the ER when she was kicked by a
horse (in the leg) at her working student job. I wasn't there so I'm
not sure if it was by ambulance or not. DS was taken to the hospital
by ambulance when he fell ice skating on the farm pond and was
unconscious for about 20 minutes - he was about 10. I wasn't there
then either and the ambulance was called by the friend whose farm it
was.

OTOH dd#1 didn't go to the doc at all when she fell under a horse and
was unconscious for a period. I watched her, and would have gone if
she'd had any symptoms other than aphasia.

I took my MIL to the ER when she couldn't swallow because she couldn't
use the base infirmary and I didn't have a local doc she could go to.
We had to wait a bit, but that was OK.

When we were in triage with my son who had a perforated bowel and
peritonitis (he has emergency surgery a few hours later) I saw a family
come in by ambulance with a kid who had fallen off a slide and broken his
arm. The mother said that she always calls an ambulance because those
kids get seen first.

I've gone in by ambulance once, DH once, and, between my 3 kids, have
had 3 trips by ambulance. In each case, it was legitimately ambulance
business (in two cases, we were unable to get up or be moved without
paramedic help, in one the fire fighters called the ambulance, and I
don't even want to THINK about the other two -- but someone else called
for an ambulance both times.) And when my kids have gone in by
ambulance, they have been receiving treatment before I could get there
to fill out anything or sign anything, which was a Good Thing.

OH - I forgot - I was T-boned in the driver's side of my car by a
young kid who ran a red light, and I broke 4 ribs (and totaled the
car). The paramedics extracted me from the car and took me to the ER
by ambulance. The driver didn't have a license (due to not having
shown up for a DWI hearing) and he also went to the ER - he tried to
run from the accident, but I gather that the bystanders prevented him.

DH fell off a stepladder (actually it fell out from under him), and he
landed on the ladder breaking the head of the humerus and his elbow.
He drove himself to the hospital after he realized that he couldn't
raise his arm. (I was in KY with dd#3 and ds was only about 14 and
couldn't drive.)

Prior to that, he was cutting downed wood with a chain saw and his
foot slipped into a Y in the tree and was caught and he fell over
sideways. This tore up his knee. He got dd#2 to drive him to the
hospital (I was in the county but with dd#3 at a band competition).
He refused crutches, and then had to send me back to get them when I
got home. I don't think it ever occurred to him to call an ambulance.

It's hard to know how quickly we would have been seen if we'd been able
to get in without the ambulance, since we've never used an ambulance
except for cases where it was necessary. But knowing how quickly we
each got seen, I can understand that mother's approach -- even as I
resent it.

Here the ambulances are run by the volunteer fire departments so I
wouldn't call one unless it was absolutely necessary, regardless of
how quickly I might be seen.

grandma Rosalie

In article ,
Rosalie B. wrote:



It's hard to know how quickly we would have been seen if we'd been able
to get in without the ambulance, since we've never used an ambulance
except for cases where it was necessary. But knowing how quickly we
each got seen, I can understand that mother's approach -- even as I
resent it.

Here the ambulances are run by the volunteer fire departments so I
wouldn't call one unless it was absolutely necessary, regardless of
how quickly I might be seen.

grandma Rosalie

That makes sense. Four of our ambulance journeys have been here in San
Jose -- very large city -- and one in a smaller midwest city, but big
enough for professional ambulance service.

The one in the midwest was almost funny -- we were literally across the
street from a hospital when DH fell, but we were unable to get him to
his feet or carry him out, so called an ambulance. The ambulance took
us to a hospital about five miles away! When I asked why, they
explained that the hospital we would have walked to had just taken in a
bunch of people from a multi-car accident, and it might be hours before
they'd see anyone with the relatively minor injury DH had. So, in the
long run, we were better off going by ambulance, anyway!
--
Children won't care how much you know until they know how much you care