September 22, 2013

Emergency & Trauma = ETD

When I first started this posting, I was terrified- first responder, first person to clerk the patients and manage them before referring them to respective department or discharge. What if we missed clues? What if we managed wrongly?

However by the time we came to the end of this posting, I can only say that I had a blast in ETD- most of my colleagues were final posters, those whom we’ve worked with before in previous postings which of course made things easier as we knew our capabilities and limits; the MOs were superb, not only were they our superiors, but they acted more like friends so it was easy to consult and communicate. The specialist was awesome, someone admirable and well-respected. The staffs were team-players- from SNs, to MAs to PPKs... well, I can’t say everything or everyone’s perfect but you get the overall picture.

Lately I’ve been reading comments, reviews and articles perhaps about how patients were treated in ETD and how ETD was being over-abused by patients.

Please note that this is just my two-cents, I may be right but I may be wrong as well. 

4 months isn’t a long time in ETD but at least we know what is considered ‘emergencies’. Initially I thought that this only happen in the district where I was working but upon discussion with friends from different places, I know that this happens elsewhere as well.

My night shifts in Green Zone after Eid were pretty much no-sleep shift; colleagues who were with me could pretty much testify how J I was. Saying that, I still couldn’t understand why people would go over the troubles to come at 3 or 4 a.m. in the morning when they noticed their child has a fever starting at 2 a.m. It would perhaps be more beneficial to give paracetamol to your child and let them sleep the fever off and go to clinic the next morning if fever still persists rather than waking them up and make them feel groggy freezing under the aircond at the waiting area.

I also still couldn’t fathom the idea of patients insisted on imaging even after assessment, they don’t need one; perhaps were more willing to be radiated by the x-ray radiation? If so, then be it. And if you think 166/92 is so high of a BP, then tell me how does 202/120 sounds to you?

Seeing varieties of cases, I can sometimes understand parents/grandparent’s worries if there’s no stock of medicine for their children/grandchildren at home. Sometimes being woken up at night due to intense pain, continuous retching, difficulties in breathing etc; or complaint that has been for weeks or years like whole body itchiness for one year, right knee pain for 6 months, back pain for 2 weeks etc- these are all the things that public considered as ‘emergencies’- they don’t read medicine so it’s fair enough.

But while public think it’s emergency enough to come to hospital at that particular time, we have procedure called ‘triage’. If clinically you look well enough and your vital signs are stable, then you’ll be triage as ‘green’- non-critical cases and even in green, there are priority cases to be seen first.

If you are sick enough to be triage as yellow (semi-critical) or red (critical), we would really appreciate it if you or family members could provide us with information enough for us to pinpoint the main issues and manage accordingly. It’s a little frustrating when people come and expect medical personnel to know exactly what’s wrong just by one look and on examination only. No, we need history too.

The point is, while you think your condition is serious enough to come to ETD, we will assess and re-assess your condition according to priority. What you may assume as emergency may not be emergency enough for us to attend there and then, and we will make way to those cases that are real emergencies.

So while we can understand your concern for your ‘medical emergencies’, please, PLEASE do understand that we are doing our best based on what we’ve learned to attend to critical, semi-critical and non-critical cases according to priorities.

If fast lane is what you’re looking for or VIP treatment, it’s perhaps the best to go to private sector where you don’t have to wait for hours and every basic investigation are done.
If MCs is what you’re looking for, know that if you’re well enough to wait for hours and then be discharged with stable vital signs and no fever, then know that you are well enough to work... we’ve had colleagues who’s temperature 39 or keep on purging and couldn’t afford the luxury of MCs because of pending works....

Similar topics- Jump to:
What Public Doesn't Know
In The News: 6-Hours Waiting Time

Hope this will at least give some overview of what's going on 'behind the scene'.
I guess the bottom line in the end lies on public education.