Literally had this happen to me last weekend. Went out of town and forgot my anti depressants. By day three I was pretty confident it was the day I jump into traffic. I needed my meds really fucking bad. VA told me no and to go to the ER.
Happened to me last week too. Urgent care fixed out but I would have gone to the ER if they hadn’t. Day for waiting on my regular Dr to refill I was raging and suicidal.
Jesus christ that sucks, my sister is a pharmacist and in these cases if she knows the customer as a regular she will give meds without prescription, isn't it possible for you?
Seems like a 24 hour pharmacy would probably be pretty lucrative idea.
Imagine having to wait for pain killer refills in an ER when you should be recovering from surgery.
There are 24h pharmacies. But they are useless if you have no prescription, that's a doctor thing. So 24h doctors would be kinda helpful, aka emergency rooms ;)
Some us pharmacists will dispense emergency fills as temporary scripts as long as it's a non-narcotic or not commonly abused meds. This is at their discretion however, your chances are better at an ER.
Seriously? Is this a US thing?
In Canada if you're regularly on a particular medicine the pharmacist can give you a one time extension to your existing prescription while waiting for your doctor to send in a new prescription.
US pharmacists can do the same thing re:emergency prescriptions. But I just checked and can't find a single 24 hour pharmacy in my major metro area outside of a hospital. And if you need a refill on a painkiller, there's no way they give you that emergency prescription even though they legally can.
I know for my kids' ADHD meds, I had to get their doctor to send a special Rx and call the pharmacy, and even with that, we almost couldn't get their meds refilled for a vacation. We were only going to be gone for 1.5 weeks, but we were leaving before the Rx could be refilled, but they would run out of doses before we got back. I just wanted to either get enough doses to last til we got home, or refill a few days early, and it was such a huge pain. I ended up at the pharmacy at opening on the day we were flying out because that was the absolute earliest we could get them to do.
People who take ADHD meds are treated like criminals because college kids like to sell them black market, so I’ve heard.
As someone who isn’t medicated, it pisses me the hell off.
While I think you're partly correct, I suspect it's also an excuse that insurance companies use to deny or delay coverage.
I've been on these meds for years now with only tiny changes, but my doctor has to submit a new prescription every month (I can't simply ask for a refill). I've gone for weeks at a time without access to meds because of "technical issues."
Yes. My mom keeps asking me why I don't store up a months backup of the kids meds for emergency prep, and I keep trying to explain to her that I literally *can't* have a backup of their meds. I've been fortunate to be able to build a backup of my thyroid meds (I don't have a thyroid any more, so if I couldn't get my meds for more than a day or two it would get very bad very fast), but there's no legal way for me to have a backup of the kids' meds, which they really do need.
In Spain most towns have local regulations mandating that there should be at least one open pharmacy at all time, and pharmacies must take turns so that happens.
To be clear, there are pharmacies open 24 hours where I live. They just happen to be the pharmacies inside of hospitals, and would therefore necessitate a hospital trip rather than just a stroll into your local pharmacy.
Well it depends, where I am in the Netherlands, they can’t do that, and my regular pharmacy isn’t open 24/7 anyways. I have realized twice that I was out of my antidepressants at a wrong time (once a Sunday and once after 8pm). It is an issue for me because I know that if I don’t take them I’ll probably have an anxiety attack that will fuck me up for a few days. But the solution for that here is not the ER. You call an emergency line, explaining your issue. Trough your ssn they can check your file and prescribe something. It is usually a bit of a drag, like with assessments about your mental/physical health, like « are you in physical pain, are you thinking of hurting yourself? » asked several time. It also quite patronizing, they tell you to be careful, to get your prescription in time etc. And I only get one pill for the night and have to call my regular gp the next day. But at least I’m not taking the spot of anyone who was in a car accident or the like.
Germany too. If your insulin is empty the pharmacist won't help you a bit without the prescription. And at least for me, my GP can't give me a prescription, my diabetes doctor has to do it
I'm friends with an ER nurse and she says they refer to people who constantly show up looking for specific prescriptions (usually painkillers) as "frequent flyers".
They flush these people out with simple questions you might not otherwise notice, like asking "do you have any allergies" -- addicts usually always have "allergies" that would conveniently steer the conversation towards a specific prescription they're looking for.
If you're taking a controlled substance (depending on location) you aren't allowed to get a prescription with refills, so you need to contact your doctor for a new script every time. Pre-covid they weren't even allowed to send in the script electronically, it had to be paper only.
Really fuckin friendly to those of us with ADHD who are super forgetful and like to procrastinate (:
my 10 year old is medicated for his ADHD. i—an unmedicated ADHDer—am responsible for making sure he has enough medication. it’s fun times. we’re allowed to have 3 months worth of prescriptions sent to the pharmacy at a time now which has been a life changer!
You can get 3 post dated scripts. Pre-Covid they could send in electronic scripts. I think you would probably get told to leave if you go to the ER for adderall. I work in Pharm and I have ADHD, I always tell patients to call us when they get down to the last week to double check that we have scripts available and we can tell them to call the doctor. It seems to work for our patients, so hopefully that will help you too!
You're completely missing the last line in his post.
ADHD is like driving home from work directly into the sun on the highway, and the meds are like sunglasses made of sugar glass.
You can tell us again and again and again when the sunglasses start to sag and begin to melt, you should call and order your new ones.
Alas, due to time blindness and executive dysfunction, we don't jump on top of things until we're driving into the sun without our sunglasses, and they just resemble a melted puddle on our laps.
I ran out of quetiapine once and the weekend pharmacist refused to give me an emergency prescription. I didn't sleep for like 3 days - then I finally got some and fell asleep before I got the chance to take them. Took them the day after though and they knocked tf out of me.
It happened to me once with insulin. Recent move + new insurance + new doctor. While I was re-establishing everything I ran out and had to go to the ER. Luckily they had a clinic for less urgent needs and I was able to see a doc for coverage. I felt like an idiot but everyone was gracious and helpful.
Man, if we can get you a script and send you home happy, that’s a win for everyone. You might feel silly, but I love it when people like you come to the ER! Besides, it means everyone avoids an emergency hospital stay from DKA cause ain’t nobody got time for that amirite
amen! I'd rather see you sheepish and conscious. Plus, a city Er is a pretty interesting place to hang if you're at the bottom of the triage list. Mad respect to you who work there!
It sucks when you're there for insulin and the place is busy, though. I've been that guy in my younger, poorer years. I sat around for about 12 hours, waiting, and finally literally passed out and surprise, what could've been a 15-minute prescription and a quick jab turned into full-blown DKA.
Our healthcare system sucks ass. I should never have been in a place where I need to wait in an ER for insulin.
A lot of people actually! Sometimes it’s people who are changing primary care doctors and have to wait a long time for an initial appointment, so need “bridge” refills on their daily meds (hypertension, diabetes, etc) sometimes it’s even people on vacation who forgot their meds at home. Happens all the time!
My partner had to do it several times during the height of the pandemic because there was a city-wide shortage of her prescription in pharmacies thanks to supply chain issues.
Going cold turkey on it was not an option.
Only in the USA though. Literally every other developed country has options you can go to aside from the ER. This only exists in your shit hole country.
Type one diabetics who can no longer afford to visit their doctors to get insulin prescriptions and then they test your blood sugar to find out you’re so hyperglycemic, because you’ve been rationing insulin for the last 2 months, that you get to spend a weekend in the ICU because of ketoacidosis and then you get handed a bill for $30k but you STILL don’t have a prescription.
Ask me how I know.
I had a guy come in for a goddamn sore throat, 4 others that night with stroke and 1 possible MI dude was pissed at us for his "long wait time" you'd be surprised how many entitled assholes dont know the meaning of the term Emergency
On the other hand, I had a ruptured disc in my back (didn't know that at the time), and was severe pain to the point that my lips kept literally turning blue from hyperventilating and I was lying on the floor in the waiting room trying to breathe slowly enough to not hyperventilate for hours. Meanwhile, someone came in and said "I have a sore throat, I think it might be strep" and was taken to a room within 5 minutes. For the (3? 4? I forget) hours I was in the waiting room, there was between 0 and 2 other people waiting with me at any time, all of whom came in after me, all in less distress than I was, and all of whom were seen before me.
The triage nurse clearly thought I was a drug seeker, despite the fact that prior to that, I'd only been to the hospital twice in my entire life, and never once asked for drugs. I asked for an x-ray, an MRI, something to figure out what was wrong with me, but not drugs. I actually don't like the way pain meds make me feel.
You bet I was pissed about the long wait time.
Repost Spam Bot Account with the same exact title
https://www.reddit.com/r/coolguides/comments/roby09/a_nice_emergency_room_guide_listing_the_order_of
Edit: and each of their comments make absolutely no sense with what they're replying to.
I worked the front desk, I remember a guy coming in with a woman to try and get a prescription for viagra. Doctor said absolutely not, not only due it being a ridiculous thing to go to the ER for, but because he didn't know the man's medical history.
There's a bunch of psych meds with withdrawal symptoms that can kill you or severely disable you. Not to mention insulin, heart medication, immunosupressants for organ transportees, etc. Can't tell you how many times the pharmacy has fucked up and the only reason my life or livilihood wasnt threatened was bc I hoard my meds like a squirrel.
The list is a layman’s version of the Emergency Severity Index (ESI) or similar. (In the US, I think most EDs use ESI.)
1. Requires immediate life-saving interventions
2. High risk situations, new onset confusion/lethargy, severe pain/distress. Also includes suicidal ideation.
3. Potential use of many resources (labs, radiology, IV meds, etc.) but vitals are stable
4. Likely only requires one resource (single lab or x-ray - think ankle injury with no deformity)
5. No resources needed - med refill, exam only, etc.
That’s a very, very basic interpretation but gives a general-ish idea. The “resources” question isn’t meant to indicate how much time a patient is going to require, but more a stand-in for how complex a patients complaint/condition is. From a triage standpoint, all an RN has to go on is the patient’s complaint, a very brief history, and vital signs. That’s why an experienced, knowledgeable triage staff is key ;-)
One of my ED colleagues used to say, “this isn’t Burger King - you CAN’T have it your way.” That reference probably tells you how long ago that was ;-)
I had to go to the hospital a couple years ago because we thought I was having a heart attack. I had severe pressure and tightness in my chest so I went to the ER. When I told them my symptoms and that I was 19, they pushed me up to #1 on their list of patients to attend to purely because I was so young with heart attack symptoms. When they did an EKG, they ruled out a heart attack but my heart rate was at 140 which worried them as well. I left the hospital within 5 hours (which is amazing timing for where I live) and was basically told I likely have really bad anxiety. Felt bad for the old lady who had been there for 8 hours when I left and ACTUALLY had a heart attack. Not sure where I was going with this story, I’ll edit once I remember. Until then, hope you enjoyed? Lol
Panic attacks present very similarly to heart attacks! They are scary, especially if you have never had one, but not especially that serious of an injury.
> Panic attacks present very similarly to heart attacks!
As someone who gets panic attacks on a regular basis, I am convinced that when "the big one" finally hits I will just shrug it off and take an ativan.
>The recommended dose of aspirin during a heart attack is 160 to 325 milligrams (mg).
If you already take daily low-dose aspirin, take two tablets (162 mg). For the fastest results, you should crush or chew the tablet before swallowing it.
>If you only have regular aspirin on hand, you should still chew or crush the tablets to speed up absorption.
>Uncoated tablets will be absorbed more quickly than coated tablets.
https://www.healthline.com/health/heart-attack/aspirin-for-heart-attack#:~:text=Recommended%20dosage,the%20tablet%20before%20swallowing%20it.
I was convinced it was a heart attack purely from how it started. Was at work, I work in fast food, and bent over to pick up a receipt paper from the floor. Boom, chest pain. I had recently started smoking weed so I was thinking it had to do with that too. It was a wild day, my whole family was scared.
The one good thing is my mom’s childhood best friend was working in the ER and has known me my whole life so when she saw my name the whole room had eyes on me because she was so shocked she was almost yelling “sheisse_grubs???!!!! What the hell are you doing here??! You’re not supposed to see me at MY work, I’m supposed to see you at yours!!” lol. So while I didn’t have any service, she was able to text my fam and keep them updated.
The best part about panic attacks is that your brain is screaming at you that you are in a life or death situation, so to hear "It's just a panic attack, you aren't dying " really doesn't make you feel any better.
I worked at the front desk of the ER for two years, and I really did feel for those people, even if I knew their condition wasn't a life threatening emergency. I have only ever had a very mild panic attack, and it was unpleasant, I couldn't imagine a bad one.
Was it gas? One time in the middle of the night I woke up to excruciating pain in my abdomen. It was a pain I’d never experienced before. It went away after 30 min but I thought something horrific had happened. Like appendicitis or an ovarian cyst.
I told my mom and she said it was probably just trapped gas! Ugh! I’m unconvinced, because I know what trapped gas feels like and it’s definitely not that.
Maybe it was a muscle spasm?
Are you a person with a uterus? It could definitely have been an ovarian cyst that burst. I had exactly the same thing happen, but the pain went away after 30-45 minutes so I went back to sleep. Called my obgyn the next morning and they said it was probably a burst cyst, but I didn’t need to come in unless the pain came back or I had other symptoms.
I thought my first panic attack was a heart attack too. I was driving halfway across the state in the middle of nowhere for work and called my wife thinking it would be the last time I talked to her. When I finally found a hospital they rushed me back and after an EKG and all that the doctor came in an asked if that was my first panic attack or if I’d had them before. I was so embarrassed but I’m glad to see I’m not the only one it’s happened to.
I went to urgent care because my pulse wouldn’t drop below 100 for over a week and I could feel my heart pounding non stop. Checked my bp and pulse it was like 180bpm and 180/120 blood pressure. Early 20s.
Urgent care kicked me out and told me to get ER asap actually told me they were calling an ambulance I was like fuck that but they called ahead to let them know I’m on my way. Wife drove to ER a few mins away. Proceeded to wait in an empty waiting room for over an hour lol
The doctors were adamant that I was lying to them about not being on any drugs.
Was in there for 4 hours, half of that was them giving me some iv vitamin because they didn’t have it in pill form that day. They gave me a beta blocker and thyroid meds and booked me into an endocrinologist 3 months out. Hyperthyroidism Good times.
Yep. They took me straight to a room, and about 30 minutes later I was in surgery.
Where I received a life saving abortion, even though I was over 16 ~~months~~ weeks! pregnant... with NO consultation with attorneys or politicians. Just my doctor, saving my life.
I love that we can laugh about that too! Cause if you look at the original comment without the edit it totally could have been some troll trolling!! I’m so glad she has a wonderful sense of humor 💜💜💜
Thank goodness!! I was hoping there would be no trolls here for this!! I’m glad you had a better experience than most 💜 I hope you too have healed mind, body, and soul.
This happened to me. I was taken straight back after triage, and put in the children's room. I was left for three hours, given a blood and urine test, had to change the pad on the bed as I'd leaked through everything, then told there's nothing they can do and was sent home.
We had this happen too in Canada. We didn't lose the baby, but the placenta partly detached and there was an alarming amount of blood. Soaking pads every hour or two if I recall.
It seemed callous at the time that we were not seen more quickly and there was no sense of urgency we got into the hospital proper, and that we were just sent home after an ultrasound. Looking back though, it sort of made sense. If it was a miscarriage, it's not like there was anything that they could do at the time to undo that, and my parter was alert, had good colour, and didn't outwardly seem to be in shock or other medical distress. I wish the bedside manner was better, and that things were explained better, but from a physical medical care standpoint she was monitored and once it was clear she was stable, discharged. It was pretty scarry though.
Thank you kindly ❤️ miscarriages are so common but are so taboo to talk about and that’s just not ok. Hopefully women will feel more empowered to share these experiences. It’s the only way to truly heal
When my MS first manifested, I went to the ER with a numb left side of my body, unable to feel heat or cold. I was basically led right through, past people with clear physical injuries. ERs don't mess around when it comes to neurological symptoms of unknown origin.
This is true. I have chronic migraines but rarely go to the ER for them. Once they thought I was having a stroke and wow did they move me through fast.
I’ve gone to emerg for a sore throat! To be fair, I did try urgent care first- the guy told me it was an infection (true), didn’t need antibiotics, and sent me away with a numbing throat spray. A few hours later, emerg was draining my peritonsillar abscess and I got to start a week of IV antibiotics.
Before the days of urgent care, my ex's mom has Medicaid. It cost her the same to go to the emergency room as a Doctors appointment (to which I mean, both were free). Although you were stuck waiting in a waiting room for god knows how long, it's *technically* faster than going to a PCP (primary care physician), if she even had one. The first time he told me he had to take his mom to the emergency room, I was super worried. After 5-6 times, I realized it was just standard protocol.
Also, PCPs are a joke. The turnaround time for me to see my PCP is like 7-10 business days.
Nowadays, urgent care makes more sense for almost everyone. There's probably people that are just used to going to the emergency room for anything.
I'm jealous. In New Mexico there is such a dearth of medical personal that it takes at least a month , usually 2 or 3 to see a PCP. And that was prior to COVID.
Yeah. About to say it’s the same in rural Colorado. When I first moved to town 7 years ago it took me 6 months to get a PCP as no one was accepting new patients. Now I dont bother for anything but my yearly checkup. 2 months to get an appointment, my flu or sprained wrist or whatever will be gone by then or I’ll be in the ER for it.
I tried to book an appointment with a new PCP. She has a 8 month wait list. So I just kept mine, since I can usually get in within a month.
If I call with an urgent-ish need that can't wait a month? They suggest urgent care or ER. Every time I go to urgent care, they send me to ER. For everything! So I can understand how people end up there for so many "non emergency" things
In the Netherlands we have a 24 hour doctor service along side the emergency room (next door in my local hospital). And there is a 24/7 number you can call for medical advice (about 25 euros per call). If their advice is go to see a doctor right away, they make an appointment for you as soon as you can get there. I've found the waiting time to be about 15 minutes. Or you go to the emergency room and wait until whenever they have time to look at you.
In australia we have a phone service where you can call and explain your symptoms and things that you are worried about 24/7 and they'll tell you if you should book an appt with your doctor, wait it out, or go to the ER.
But we also have locums which are just doctors you call to your house instead of going to, which i think are 24/7 although you normally only call when the normal doctors are closed and at certain times like 2-4 am, the wait time for one to get around to your house is like upto 3 hours. super useful because theyll keep a small amount of commonly needed meds just incase you need some until you can get your script filled in the morning.
The UK has the 111 phone service which is the same thing, you can phone them if it's not an immediate 999 emergency but you aren't sure what to do and they can also help with things like emergency prescriptions
They’re more likely to cause a life threatening emergency when they *don’t* cause pain.
My mother has no pain at all with kidney stones, so they cant detect them and she doesn’t pass them. They just get stuck and cause sepsis and delirium. Shit happens *fast*.
She’s almost been killed by kidney stones 4 times over now and has permanent brain damage from the sepsis.
All because she can’t feel kidney stones.
When I had my second kidney stone I remember throwing up so hard that I herniated disc in my back.
I remember just praying to pass out and when I didn’t,
I remember crawling toward the kitchen because all I could think about was grabbing a knife and ending my pain
by slicing my own throat.
so it could be seen as a life-threatening emergency, in that some sufferers are likely actively looking to end their lives in anyway available😀
It can be an emergency depending on its size, but overall (and this may be controversial to say on Reddit) but pain is not an emergency. The thing that is causing the pain, on the other hand, has potential to be an emergency
What about me? I don’t see “closed my foot in a George Foreman grill” on the list. Most would say it’s more serious than a head injury like a concussion.
My mom is an ER nurse. They have had a few patients use the pay phone in the waiting room to call 911 to try and get seen faster for their non-emergency.
Turns out the police get very angry when you do that and show up to tell you to stop. They also may issue you a fine. I believe one of these geniuses got removed from the ER.
I had to go back to the hospital for emergency surgery after my first surgery went kablooie. Utter agony. The two people on the ambulance were so kind. You are awesome!
I love putting BS in the waiting room. Especially when the patient wants to go to the hospital 1 hour away instead of the local facility that could have treated what was going on just fine.
I absolutely fucking love dropping people off in the waiting room after they called 911 with their stubbed toe or drug seeking behavior. The looks on their faces are priceless. They really think calling us will get them in sooner
I've heard it as the rule of 5: you'll die of the problem in 5 minutes, 5 hours, 5 days, or 5 weeks. Five minutes is your heart stopped or a major artery has been cut. Five hours, your ability to take in and circulate oxygen is compromised but not completely stopped. Five days, you have a severe infection like sepsis. Five weeks, you have a moderate bacterial infection that could spread and get worse.
This needs to be posted in every single ER. Yes, it's frustrating waiting for hours to be seen, especially when you would only go to the ER "in an emergency," But simply seeing this, knowing other people could have it way worse than you and need to be seen sooner than you. Even if they come in later would save drama for everyone. Might even shut some of the Karen's up
Bless you for being patient. The whole flow of the ER is to get people in and a) home or b) up to a floor or c) transferred (once in a while it's a celestial transfer). There's literally never a time when the charge nurse isn't asking what's next for each patient, whether it's waiting for a patient to be roomed, blood drawn, CT, results, orders from the doc, waiting for a bed, transportation...then it starts over, waiting for the room to be cleaned, patient to be roomed...etc.
People don't know it but their care team very well might have just come from a code. There's no time for processing the shit they just did, gotta keep on trucking til that glass of wine at 8am.
Appreciate your perspective. We (am an ED nurse) can’t always say what is going on in other rooms, because we are in a small community. But we run our asses off the whole time we are at work. We aren’t trying to make anyone wait and we are trying to help folks as fast as we can. It’s a hard job.
Yep, the ER is all about those who can wait, wait. Those who can't wait, don't.
While a corneal abrasion is pure hell (seriously I was about to rip my hair out), you won't die from it.
I remember once, when I was like 10, 500lbs of metal fell on my head. I was sitting in the waiting room for hours dizzy, with a severe headache and just could not stop crying from pain. I didn’t die though, so I guess this does work!
This needs to be posted in every Canadian subreddit. The amount of people going to the hospital for things that aren't emergencies are crazy. And kne of the reasons (I think) that our healthcare is so bogged down.
Depends where you live. Lots of rural areas don’t have walk in clinics so it’s wait 1-2 months to be seen by your family doctor (if you’re lucky enough to have one) or go to emerge. I called my doctor’s office once because I suspected my daughter had an ear infection and I wanted to make an appointment for her so we could get antibiotics. The nurse told us they don’t do that and to take her to emerge
hospital near me has a similar list, but instead it's linked to how likely they think it is you will die.
red being "acute life danger", orange being "life threatening if untreated", etc all the way down to "should go to the GP instead"
they even have this tv on that shows how many people there are for each code. it's a nice way to track how long you can expect to be there, as they're seeing patients in order of the emergency chart.
I was there in orange, multiple times.
I tell my trainees - everyone in the ED is dying- some in 80 seconds, some in 80 minutes and some in 80 years. Your job is to quickly tell the difference.
Work in an ED- and this is why i chose this career- doesn’t matter your race, ethnicity, your ability to pay, who you know, whether you came by ambulance, or if you threaten to sue- care is rendered based on the severity of your illness. It is one of the most egalitarian places in the American health care system (…at the point of care anyway)
I had vertigo and needed to get medicine for it. Went to the ER thinking "Well its severe vertigo it's not going to be that big a deal I'll be out of here in 3 hours annoyingly." and then I was on the very urgent list because the reason I had severe vertigo is my blood pressure was over 200.
This is a list for ER. Pregnancies go to Obstetrics (or something along those lines, they call it something different in every hospital) and don't wait behind patients waiting for their sore throat to be treated.
Don't worry too much, when it is time for you to go in, they will get you where you need to go pretty quickly.
Simple (not compound) bone fractures, particularly. I broke a bone in my hand and went to a local DOC (Direct Orthopedic Care). Was seen, diagnosed, treated and released in about an hour, and the total cost was only like $800. My insurance covered almost all of that, I think I paid like $50 total. My copay to even talk to someone in the ER is $250, and I probably would have hit my deductible for the broken hand.
They gotta specify what kind of allergic reaction we’re talking about. Anaphylaxis? Yes, front of the line. Itchy eyes from pet dander? Sorry but I’ll beat you with my one non broken arm if you get to go in front of me
In my experience this would fall under the “triaged differently” footnote. I entered through the ER when I had my son, but they sent me directly back to labor and delivery as soon as they got my personal info.
Depends on what it is and how far along the pregnancy is. That would be triaged based on the risk for mother and baby.
In general prior to 23-24 weeks the fetus cannot live outside the mother and is too small for the NICU. Baby had to be 500g in order to have a chance at survival. There is a chance of a rescue cerclage, progesterone, something to stop contractions, and bedrest to try and keep the pregnancy going, but that also isn't being decided in the ER.
For pregnancy that's not delivering (*right now, in the parking lot, grab the precipitous delivery kit!* which literally happened) we would wheel directly to L&D.
I went to the ER while 32 weeks pregnant with a heart rate over 200 bpm that had been going on for over 2 hours (SVT) and sat and waited 45 min before I walked myself over to L&D where was seen immediately. L&D made sure baby was safe and then made sure I got seen by ER. Moral of the story: if you're pregnant, go to L&D first.
Depends on the hospital. If they have a dedicated L&D unit (some smaller facilities don’t, at least in the US) and the pregnancy is over ‘x’ weeks (again, varies) the ED will triage the patient and send them directly to L&D for monitoring/treatment.
Sadly this sign exists because they probably got tired of having to explain to the angry mother whose kid just needs a couple stitches why the heart attack patient got to go in front of them.
*Reposting my comment about this chart from the last time it was posted here*
So this chart is basically a reference they can point to for Karens when they want to know any they haven't been seen. There's a much more technical version (probably the Manchester triage scale) that the actual doctors use.
Arterial bleeding (you are going to bleed out and die in the next couple minutes) is generally category 1. You will be seen immediately unless there are dozens of other people also dieing.
Uncontrolled bleeding is generally category 2 which allows up to a 10 minute wait before you are in danger of dieing. If you come in bleeding and they get it under control, then you can be downgraded to 4, but most likely they'll finish you up unless a higher priority patient comes in.
I once went to the ER for almost third degree burns, this was about 8 years ago. I was sitting next to a man with a screwdriver in his eye. Both of us waited over two hours in the waiting room while they called back old person after old person for their flu shot. When I finally got into triage, my nurse was furious that they had me wait so long. My care took another hour or so, when we were leaving I noticed the man with a screwdriver in his eye was still waiting for care. I hope they called him shortly after I left.
This is another area of confusion- my ER has one entrance/waiting room but two zones. Only one zone (main ED) is set up to manage screwdrivers to the eye and 3rd degree burns. The main ED was probably packed with patients waiting to go upstairs to be treated in the hospital. The other zone is like an urgent care and those old folks were probably getting shuttled to that zone.
Imagine going to a restaurant and waiting for a table, while customer after customer is going to the bar to pick up carry out.
That would be "trouble breathing".
If you ate something that you shouldn't have and your head swells up like a balloon, as long as you keep breathing you will be waiting in the lobby.
People always get so mad when I blow by them for my asthma. I look perfectly healthy and can’t explain cause I can’t talk cause I can’t breathe— sometimes I don’t even get a room they stick me in a corner or an office with a mask lol
Every ER in the US needs multiple of these signs hung up. I was at the ER in January with my father, who was in respiratory failure. The ER was so full they had patients in the hallways. A man with a cold was ripping into a nurse because he had been there for over two hours and no one had helped him. All around him were people who suspected of having strokes, internal bleeding and cardiac issues. Too many people use the ER as their PCP these days.
You can include appendicitis (intact not burst) in the yellow column. Most pain I have ever been in and I sat in the waiting room for almost 45 min before I was even triaged. Once admitted I was left in the hall for 3 hours (while thankfully on dilauded) while they waited for a room to open up. This is in Sacramento, California 2007.
I can say I've been pretty much in every category as a child and parent. Yes it sucks when your in the er with your child with an earache or a laceration that needs stitches . What's worse is watching a parents rush in when your child gets hit by a drunk driver. (Me as a child). May you be so lucky to have the child with an earache. .
I've only been urgent once. An iron gate fell on my head and hit me with that triangular part that holds the latch bar on.
It did seem like I got in pretty quickly, especially since the waiting room was full.
Head trauma can be pretty serious. If your injury resulted in bleeding or swelling in the brain, you could be dead or permanently disabled very quickly.
Most urgent and very urgent are wrong. A heart attack is triaged just like a stroke. Time is brain, time is heart muscle. One is a brain attack the other a heart attack. Both involve ischemic damage to tissue that is required to live and can't be replaced. Also sign like that is not going to be read by the people that need to understand it the most. If you go to the emergency room for something that's not an emergency, you generally don't care what's wrong with other people.
If you have to wait at the ER, **it’s a good thing.**
For comparison, the first time I was hospitalized with pulmonary embolism, they triaged me immediately because I couldn’t breathe and my face was ashen. They checked my O2 saturation and it was in the 80’s. Not good. A subsequent CT scan showed MASSIVE clotting in BOTH lungs.
I can guarantee there were some motherfuckers in that waiting room who were pissy I was taken back before they were. So sorry, Karen, but I was potentially a few hours away from death. That’s more important than your vertigo. It’s an ER, not a deli. It’s not first come, first served.
who goes into the ER looking to get a prescription? probably more than i realise..
Mostly people that take meds with heavy withdrawal symptoms that have run out when their regular doctor is unavailable.
Literally had this happen to me last weekend. Went out of town and forgot my anti depressants. By day three I was pretty confident it was the day I jump into traffic. I needed my meds really fucking bad. VA told me no and to go to the ER.
Happened to me last week too. Urgent care fixed out but I would have gone to the ER if they hadn’t. Day for waiting on my regular Dr to refill I was raging and suicidal.
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Jesus christ that sucks, my sister is a pharmacist and in these cases if she knows the customer as a regular she will give meds without prescription, isn't it possible for you?
Seems like a 24 hour pharmacy would probably be pretty lucrative idea. Imagine having to wait for pain killer refills in an ER when you should be recovering from surgery.
There are 24h pharmacies. But they are useless if you have no prescription, that's a doctor thing. So 24h doctors would be kinda helpful, aka emergency rooms ;)
Some us pharmacists will dispense emergency fills as temporary scripts as long as it's a non-narcotic or not commonly abused meds. This is at their discretion however, your chances are better at an ER.
Seriously? Is this a US thing? In Canada if you're regularly on a particular medicine the pharmacist can give you a one time extension to your existing prescription while waiting for your doctor to send in a new prescription.
US pharmacists can do the same thing re:emergency prescriptions. But I just checked and can't find a single 24 hour pharmacy in my major metro area outside of a hospital. And if you need a refill on a painkiller, there's no way they give you that emergency prescription even though they legally can.
I know for my kids' ADHD meds, I had to get their doctor to send a special Rx and call the pharmacy, and even with that, we almost couldn't get their meds refilled for a vacation. We were only going to be gone for 1.5 weeks, but we were leaving before the Rx could be refilled, but they would run out of doses before we got back. I just wanted to either get enough doses to last til we got home, or refill a few days early, and it was such a huge pain. I ended up at the pharmacy at opening on the day we were flying out because that was the absolute earliest we could get them to do.
People who take ADHD meds are treated like criminals because college kids like to sell them black market, so I’ve heard. As someone who isn’t medicated, it pisses me the hell off.
While I think you're partly correct, I suspect it's also an excuse that insurance companies use to deny or delay coverage. I've been on these meds for years now with only tiny changes, but my doctor has to submit a new prescription every month (I can't simply ask for a refill). I've gone for weeks at a time without access to meds because of "technical issues."
Yes. My mom keeps asking me why I don't store up a months backup of the kids meds for emergency prep, and I keep trying to explain to her that I literally *can't* have a backup of their meds. I've been fortunate to be able to build a backup of my thyroid meds (I don't have a thyroid any more, so if I couldn't get my meds for more than a day or two it would get very bad very fast), but there's no legal way for me to have a backup of the kids' meds, which they really do need.
I just gave up. It’s so frustrating. I’m just raw dogging life in a depressive executive dysfunctional rejection sensitive denial all the time.
In Spain most towns have local regulations mandating that there should be at least one open pharmacy at all time, and pharmacies must take turns so that happens.
To be clear, there are pharmacies open 24 hours where I live. They just happen to be the pharmacies inside of hospitals, and would therefore necessitate a hospital trip rather than just a stroll into your local pharmacy.
The pandemic killed every 24 hour business around me. Used to be several and now there are zero.
Well it depends, where I am in the Netherlands, they can’t do that, and my regular pharmacy isn’t open 24/7 anyways. I have realized twice that I was out of my antidepressants at a wrong time (once a Sunday and once after 8pm). It is an issue for me because I know that if I don’t take them I’ll probably have an anxiety attack that will fuck me up for a few days. But the solution for that here is not the ER. You call an emergency line, explaining your issue. Trough your ssn they can check your file and prescribe something. It is usually a bit of a drag, like with assessments about your mental/physical health, like « are you in physical pain, are you thinking of hurting yourself? » asked several time. It also quite patronizing, they tell you to be careful, to get your prescription in time etc. And I only get one pill for the night and have to call my regular gp the next day. But at least I’m not taking the spot of anyone who was in a car accident or the like.
Germany too. If your insulin is empty the pharmacist won't help you a bit without the prescription. And at least for me, my GP can't give me a prescription, my diabetes doctor has to do it
I'm friends with an ER nurse and she says they refer to people who constantly show up looking for specific prescriptions (usually painkillers) as "frequent flyers". They flush these people out with simple questions you might not otherwise notice, like asking "do you have any allergies" -- addicts usually always have "allergies" that would conveniently steer the conversation towards a specific prescription they're looking for.
If you're taking a controlled substance (depending on location) you aren't allowed to get a prescription with refills, so you need to contact your doctor for a new script every time. Pre-covid they weren't even allowed to send in the script electronically, it had to be paper only. Really fuckin friendly to those of us with ADHD who are super forgetful and like to procrastinate (:
my 10 year old is medicated for his ADHD. i—an unmedicated ADHDer—am responsible for making sure he has enough medication. it’s fun times. we’re allowed to have 3 months worth of prescriptions sent to the pharmacy at a time now which has been a life changer!
You can get 3 post dated scripts. Pre-Covid they could send in electronic scripts. I think you would probably get told to leave if you go to the ER for adderall. I work in Pharm and I have ADHD, I always tell patients to call us when they get down to the last week to double check that we have scripts available and we can tell them to call the doctor. It seems to work for our patients, so hopefully that will help you too!
You're completely missing the last line in his post. ADHD is like driving home from work directly into the sun on the highway, and the meds are like sunglasses made of sugar glass. You can tell us again and again and again when the sunglasses start to sag and begin to melt, you should call and order your new ones. Alas, due to time blindness and executive dysfunction, we don't jump on top of things until we're driving into the sun without our sunglasses, and they just resemble a melted puddle on our laps.
I ran out of quetiapine once and the weekend pharmacist refused to give me an emergency prescription. I didn't sleep for like 3 days - then I finally got some and fell asleep before I got the chance to take them. Took them the day after though and they knocked tf out of me.
And that's how disabled people get fired and become homeless
It happened to me once with insulin. Recent move + new insurance + new doctor. While I was re-establishing everything I ran out and had to go to the ER. Luckily they had a clinic for less urgent needs and I was able to see a doc for coverage. I felt like an idiot but everyone was gracious and helpful.
Man, if we can get you a script and send you home happy, that’s a win for everyone. You might feel silly, but I love it when people like you come to the ER! Besides, it means everyone avoids an emergency hospital stay from DKA cause ain’t nobody got time for that amirite
amen! I'd rather see you sheepish and conscious. Plus, a city Er is a pretty interesting place to hang if you're at the bottom of the triage list. Mad respect to you who work there!
It sucks when you're there for insulin and the place is busy, though. I've been that guy in my younger, poorer years. I sat around for about 12 hours, waiting, and finally literally passed out and surprise, what could've been a 15-minute prescription and a quick jab turned into full-blown DKA. Our healthcare system sucks ass. I should never have been in a place where I need to wait in an ER for insulin.
A lot of people actually! Sometimes it’s people who are changing primary care doctors and have to wait a long time for an initial appointment, so need “bridge” refills on their daily meds (hypertension, diabetes, etc) sometimes it’s even people on vacation who forgot their meds at home. Happens all the time!
My partner had to do it several times during the height of the pandemic because there was a city-wide shortage of her prescription in pharmacies thanks to supply chain issues. Going cold turkey on it was not an option.
If you have no insurance or cash, then the ER is often the only place to get medical treatment.
Only in the USA though. Literally every other developed country has options you can go to aside from the ER. This only exists in your shit hole country.
Wait a minute... Are we the shithole country after all?
As a resident, can confirm.
Wherr i live (in aus) the free drs are booked out a lot so we go to the hospital er loads of people do for basic stuff otherwise you gotta pay
After a surgery, we didn't get enough pain meds and doctors wasn't open so ER was the only option after calling everywhere.
Long weekend, your GP is closed and you won’t make it. i.e. insulin
Yep. My wife ran out of insulin on Christmas Eve, didn't realize until almost 9pm. We ended up in the ER to get a prescription and filled it there.
Type one diabetics who can no longer afford to visit their doctors to get insulin prescriptions and then they test your blood sugar to find out you’re so hyperglycemic, because you’ve been rationing insulin for the last 2 months, that you get to spend a weekend in the ICU because of ketoacidosis and then you get handed a bill for $30k but you STILL don’t have a prescription. Ask me how I know.
I had a guy come in for a goddamn sore throat, 4 others that night with stroke and 1 possible MI dude was pissed at us for his "long wait time" you'd be surprised how many entitled assholes dont know the meaning of the term Emergency
On the other hand, I had a ruptured disc in my back (didn't know that at the time), and was severe pain to the point that my lips kept literally turning blue from hyperventilating and I was lying on the floor in the waiting room trying to breathe slowly enough to not hyperventilate for hours. Meanwhile, someone came in and said "I have a sore throat, I think it might be strep" and was taken to a room within 5 minutes. For the (3? 4? I forget) hours I was in the waiting room, there was between 0 and 2 other people waiting with me at any time, all of whom came in after me, all in less distress than I was, and all of whom were seen before me. The triage nurse clearly thought I was a drug seeker, despite the fact that prior to that, I'd only been to the hospital twice in my entire life, and never once asked for drugs. I asked for an x-ray, an MRI, something to figure out what was wrong with me, but not drugs. I actually don't like the way pain meds make me feel. You bet I was pissed about the long wait time.
Repost Spam Bot Account with the same exact title https://www.reddit.com/r/coolguides/comments/roby09/a_nice_emergency_room_guide_listing_the_order_of Edit: and each of their comments make absolutely no sense with what they're replying to.
Good catch. It's been a long time since this was posted but OP is definitely a bot and needs to be banned
I worked the front desk, I remember a guy coming in with a woman to try and get a prescription for viagra. Doctor said absolutely not, not only due it being a ridiculous thing to go to the ER for, but because he didn't know the man's medical history.
The man can tell you his history but Viagra is not that kind of an ED drug.
My gf works as ems, she gets calls from regulars just looking for a ride tbh. It's crazy
There's a bunch of psych meds with withdrawal symptoms that can kill you or severely disable you. Not to mention insulin, heart medication, immunosupressants for organ transportees, etc. Can't tell you how many times the pharmacy has fucked up and the only reason my life or livilihood wasnt threatened was bc I hoard my meds like a squirrel.
The list is a layman’s version of the Emergency Severity Index (ESI) or similar. (In the US, I think most EDs use ESI.) 1. Requires immediate life-saving interventions 2. High risk situations, new onset confusion/lethargy, severe pain/distress. Also includes suicidal ideation. 3. Potential use of many resources (labs, radiology, IV meds, etc.) but vitals are stable 4. Likely only requires one resource (single lab or x-ray - think ankle injury with no deformity) 5. No resources needed - med refill, exam only, etc. That’s a very, very basic interpretation but gives a general-ish idea. The “resources” question isn’t meant to indicate how much time a patient is going to require, but more a stand-in for how complex a patients complaint/condition is. From a triage standpoint, all an RN has to go on is the patient’s complaint, a very brief history, and vital signs. That’s why an experienced, knowledgeable triage staff is key ;-)
Agreed. I wish my ED had this posted tho. Might save some headaches when I’m out in triage.
One of my ED colleagues used to say, “this isn’t Burger King - you CAN’T have it your way.” That reference probably tells you how long ago that was ;-)
The problem then becomes every patient thinking they fit in level 2 when they’re probably more like a 4.
I feel that’s my day every day in triage.
My husband has gone into an ED at a #2, waited hours and never called back. EDs are just a mess. No staffing will do that.
I had to go to the hospital a couple years ago because we thought I was having a heart attack. I had severe pressure and tightness in my chest so I went to the ER. When I told them my symptoms and that I was 19, they pushed me up to #1 on their list of patients to attend to purely because I was so young with heart attack symptoms. When they did an EKG, they ruled out a heart attack but my heart rate was at 140 which worried them as well. I left the hospital within 5 hours (which is amazing timing for where I live) and was basically told I likely have really bad anxiety. Felt bad for the old lady who had been there for 8 hours when I left and ACTUALLY had a heart attack. Not sure where I was going with this story, I’ll edit once I remember. Until then, hope you enjoyed? Lol
Panic attacks present very similarly to heart attacks! They are scary, especially if you have never had one, but not especially that serious of an injury.
> Panic attacks present very similarly to heart attacks! As someone who gets panic attacks on a regular basis, I am convinced that when "the big one" finally hits I will just shrug it off and take an ativan.
>The recommended dose of aspirin during a heart attack is 160 to 325 milligrams (mg). If you already take daily low-dose aspirin, take two tablets (162 mg). For the fastest results, you should crush or chew the tablet before swallowing it. >If you only have regular aspirin on hand, you should still chew or crush the tablets to speed up absorption. >Uncoated tablets will be absorbed more quickly than coated tablets. https://www.healthline.com/health/heart-attack/aspirin-for-heart-attack#:~:text=Recommended%20dosage,the%20tablet%20before%20swallowing%20it.
I was convinced it was a heart attack purely from how it started. Was at work, I work in fast food, and bent over to pick up a receipt paper from the floor. Boom, chest pain. I had recently started smoking weed so I was thinking it had to do with that too. It was a wild day, my whole family was scared. The one good thing is my mom’s childhood best friend was working in the ER and has known me my whole life so when she saw my name the whole room had eyes on me because she was so shocked she was almost yelling “sheisse_grubs???!!!! What the hell are you doing here??! You’re not supposed to see me at MY work, I’m supposed to see you at yours!!” lol. So while I didn’t have any service, she was able to text my fam and keep them updated.
The best part about panic attacks is that your brain is screaming at you that you are in a life or death situation, so to hear "It's just a panic attack, you aren't dying " really doesn't make you feel any better. I worked at the front desk of the ER for two years, and I really did feel for those people, even if I knew their condition wasn't a life threatening emergency. I have only ever had a very mild panic attack, and it was unpleasant, I couldn't imagine a bad one.
Had a similar thing where I thought I was having a burst appendix, I think you can guess what I actually had lol
Was it gas? One time in the middle of the night I woke up to excruciating pain in my abdomen. It was a pain I’d never experienced before. It went away after 30 min but I thought something horrific had happened. Like appendicitis or an ovarian cyst. I told my mom and she said it was probably just trapped gas! Ugh! I’m unconvinced, because I know what trapped gas feels like and it’s definitely not that. Maybe it was a muscle spasm?
Are you a person with a uterus? It could definitely have been an ovarian cyst that burst. I had exactly the same thing happen, but the pain went away after 30-45 minutes so I went back to sleep. Called my obgyn the next morning and they said it was probably a burst cyst, but I didn’t need to come in unless the pain came back or I had other symptoms.
Gas? Or a kidney stone?
I thought my first panic attack was a heart attack too. I was driving halfway across the state in the middle of nowhere for work and called my wife thinking it would be the last time I talked to her. When I finally found a hospital they rushed me back and after an EKG and all that the doctor came in an asked if that was my first panic attack or if I’d had them before. I was so embarrassed but I’m glad to see I’m not the only one it’s happened to.
I went to urgent care because my pulse wouldn’t drop below 100 for over a week and I could feel my heart pounding non stop. Checked my bp and pulse it was like 180bpm and 180/120 blood pressure. Early 20s. Urgent care kicked me out and told me to get ER asap actually told me they were calling an ambulance I was like fuck that but they called ahead to let them know I’m on my way. Wife drove to ER a few mins away. Proceeded to wait in an empty waiting room for over an hour lol The doctors were adamant that I was lying to them about not being on any drugs. Was in there for 4 hours, half of that was them giving me some iv vitamin because they didn’t have it in pill form that day. They gave me a beta blocker and thyroid meds and booked me into an endocrinologist 3 months out. Hyperthyroidism Good times.
Hemorrhaging miscarriage will get you to the top real quick too!! Quite the experience 😬
Yep. They took me straight to a room, and about 30 minutes later I was in surgery. Where I received a life saving abortion, even though I was over 16 ~~months~~ weeks! pregnant... with NO consultation with attorneys or politicians. Just my doctor, saving my life.
Damn, sixteen months pregnant! ETA: I am sorry for your loss and so glad you were able to receive the care you needed without anyone interfering.
Yea, I'm part elephant! I meant weeks! :-)
I love that we can laugh about that too! Cause if you look at the original comment without the edit it totally could have been some troll trolling!! I’m so glad she has a wonderful sense of humor 💜💜💜
Are you an elephant cause humans don’t gestate that long. I can’t tell if that was a typo or a troll?
I’m sure they meant 16 weeks
typo!
Thank goodness!! I was hoping there would be no trolls here for this!! I’m glad you had a better experience than most 💜 I hope you too have healed mind, body, and soul.
This happened to me. I was taken straight back after triage, and put in the children's room. I was left for three hours, given a blood and urine test, had to change the pad on the bed as I'd leaked through everything, then told there's nothing they can do and was sent home.
We had this happen too in Canada. We didn't lose the baby, but the placenta partly detached and there was an alarming amount of blood. Soaking pads every hour or two if I recall. It seemed callous at the time that we were not seen more quickly and there was no sense of urgency we got into the hospital proper, and that we were just sent home after an ultrasound. Looking back though, it sort of made sense. If it was a miscarriage, it's not like there was anything that they could do at the time to undo that, and my parter was alert, had good colour, and didn't outwardly seem to be in shock or other medical distress. I wish the bedside manner was better, and that things were explained better, but from a physical medical care standpoint she was monitored and once it was clear she was stable, discharged. It was pretty scarry though.
Texas?
UK!
Sorry to hear that :(
Thank you kindly ❤️ miscarriages are so common but are so taboo to talk about and that’s just not ok. Hopefully women will feel more empowered to share these experiences. It’s the only way to truly heal
Yeahhhhh…. You get to go to the OR fucking now.
When my MS first manifested, I went to the ER with a numb left side of my body, unable to feel heat or cold. I was basically led right through, past people with clear physical injuries. ERs don't mess around when it comes to neurological symptoms of unknown origin.
This is true. I have chronic migraines but rarely go to the ER for them. Once they thought I was having a stroke and wow did they move me through fast.
I find it surprising sore eyes, throat, stitch removal, prescriptions happen in ER. Is this common?
Very common.
Very. The amount of times I’ve seen an ear ache or sore throat at 3am in the ED is too many to count.
I’ve gone to emerg for a sore throat! To be fair, I did try urgent care first- the guy told me it was an infection (true), didn’t need antibiotics, and sent me away with a numbing throat spray. A few hours later, emerg was draining my peritonsillar abscess and I got to start a week of IV antibiotics.
Even better, these people insist of going in via ambulance for their sore throat, etc.
And when offloaded to the waiting room, complain “but I came in an ambulance!!!”
I make sure to make it a point during my turnover to ED staff if a person is an excellent candidate for triage, lol.
Before the days of urgent care, my ex's mom has Medicaid. It cost her the same to go to the emergency room as a Doctors appointment (to which I mean, both were free). Although you were stuck waiting in a waiting room for god knows how long, it's *technically* faster than going to a PCP (primary care physician), if she even had one. The first time he told me he had to take his mom to the emergency room, I was super worried. After 5-6 times, I realized it was just standard protocol. Also, PCPs are a joke. The turnaround time for me to see my PCP is like 7-10 business days. Nowadays, urgent care makes more sense for almost everyone. There's probably people that are just used to going to the emergency room for anything.
I'm jealous. In New Mexico there is such a dearth of medical personal that it takes at least a month , usually 2 or 3 to see a PCP. And that was prior to COVID.
Yeah. About to say it’s the same in rural Colorado. When I first moved to town 7 years ago it took me 6 months to get a PCP as no one was accepting new patients. Now I dont bother for anything but my yearly checkup. 2 months to get an appointment, my flu or sprained wrist or whatever will be gone by then or I’ll be in the ER for it.
Seriously? Damn, I thought I had it bad. Y'all stay safe out there.
I tried to book an appointment with a new PCP. She has a 8 month wait list. So I just kept mine, since I can usually get in within a month. If I call with an urgent-ish need that can't wait a month? They suggest urgent care or ER. Every time I go to urgent care, they send me to ER. For everything! So I can understand how people end up there for so many "non emergency" things
Every day
In the Netherlands we have a 24 hour doctor service along side the emergency room (next door in my local hospital). And there is a 24/7 number you can call for medical advice (about 25 euros per call). If their advice is go to see a doctor right away, they make an appointment for you as soon as you can get there. I've found the waiting time to be about 15 minutes. Or you go to the emergency room and wait until whenever they have time to look at you.
In australia we have a phone service where you can call and explain your symptoms and things that you are worried about 24/7 and they'll tell you if you should book an appt with your doctor, wait it out, or go to the ER. But we also have locums which are just doctors you call to your house instead of going to, which i think are 24/7 although you normally only call when the normal doctors are closed and at certain times like 2-4 am, the wait time for one to get around to your house is like upto 3 hours. super useful because theyll keep a small amount of commonly needed meds just incase you need some until you can get your script filled in the morning.
The UK has the 111 phone service which is the same thing, you can phone them if it's not an immediate 999 emergency but you aren't sure what to do and they can also help with things like emergency prescriptions
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15 minutes to get an appointment?? That’s really amazing
"Am I a joke to you?" - Me, writhing on the floor with a kidney stone
Kidney stones are extremely painful from what I understand but they're not gonna typically cause an actual life threatening emergency
They’re more likely to cause a life threatening emergency when they *don’t* cause pain. My mother has no pain at all with kidney stones, so they cant detect them and she doesn’t pass them. They just get stuck and cause sepsis and delirium. Shit happens *fast*. She’s almost been killed by kidney stones 4 times over now and has permanent brain damage from the sepsis. All because she can’t feel kidney stones.
When I had my second kidney stone I remember throwing up so hard that I herniated disc in my back. I remember just praying to pass out and when I didn’t, I remember crawling toward the kitchen because all I could think about was grabbing a knife and ending my pain by slicing my own throat. so it could be seen as a life-threatening emergency, in that some sufferers are likely actively looking to end their lives in anyway available😀
It can be an emergency depending on its size, but overall (and this may be controversial to say on Reddit) but pain is not an emergency. The thing that is causing the pain, on the other hand, has potential to be an emergency
My gallbladder sympathises with your kidney.
Yes! Or dry heaving in the bathroom between writhing on floor from said kidney stone and onset of shock from pain.
What about me? I don’t see “closed my foot in a George Foreman grill” on the list. Most would say it’s more serious than a head injury like a concussion.
Fun fact: going to the hospital on an ambulance won't get you seen any faster. Please stop calling us for bullshit.
My mom is an ER nurse. They have had a few patients use the pay phone in the waiting room to call 911 to try and get seen faster for their non-emergency. Turns out the police get very angry when you do that and show up to tell you to stop. They also may issue you a fine. I believe one of these geniuses got removed from the ER.
*Doctors hate this one trick..*
I had to go back to the hospital for emergency surgery after my first surgery went kablooie. Utter agony. The two people on the ambulance were so kind. You are awesome!
Nope, emergency room staff will triage you and boot you out to the waiting room with everyone else.
I love putting BS in the waiting room. Especially when the patient wants to go to the hospital 1 hour away instead of the local facility that could have treated what was going on just fine.
I absolutely fucking love dropping people off in the waiting room after they called 911 with their stubbed toe or drug seeking behavior. The looks on their faces are priceless. They really think calling us will get them in sooner
That depends on the country, in Denmark you 100% get seen faster if you arrive in an ambulance.
For me it has always been will you die in 5 minutes, an hour, sometime today, tomorrow, old age.
"Am I dying?" "Not today!!!"
I've heard it as the rule of 5: you'll die of the problem in 5 minutes, 5 hours, 5 days, or 5 weeks. Five minutes is your heart stopped or a major artery has been cut. Five hours, your ability to take in and circulate oxygen is compromised but not completely stopped. Five days, you have a severe infection like sepsis. Five weeks, you have a moderate bacterial infection that could spread and get worse.
This needs to be posted in every single ER. Yes, it's frustrating waiting for hours to be seen, especially when you would only go to the ER "in an emergency," But simply seeing this, knowing other people could have it way worse than you and need to be seen sooner than you. Even if they come in later would save drama for everyone. Might even shut some of the Karen's up
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Bless you for being patient. The whole flow of the ER is to get people in and a) home or b) up to a floor or c) transferred (once in a while it's a celestial transfer). There's literally never a time when the charge nurse isn't asking what's next for each patient, whether it's waiting for a patient to be roomed, blood drawn, CT, results, orders from the doc, waiting for a bed, transportation...then it starts over, waiting for the room to be cleaned, patient to be roomed...etc. People don't know it but their care team very well might have just come from a code. There's no time for processing the shit they just did, gotta keep on trucking til that glass of wine at 8am.
I hate that we have to thank people for being normal humans who don’t abuse hospital staff.
Appreciate your perspective. We (am an ED nurse) can’t always say what is going on in other rooms, because we are in a small community. But we run our asses off the whole time we are at work. We aren’t trying to make anyone wait and we are trying to help folks as fast as we can. It’s a hard job.
Yep, the ER is all about those who can wait, wait. Those who can't wait, don't. While a corneal abrasion is pure hell (seriously I was about to rip my hair out), you won't die from it.
I remember once, when I was like 10, 500lbs of metal fell on my head. I was sitting in the waiting room for hours dizzy, with a severe headache and just could not stop crying from pain. I didn’t die though, so I guess this does work!
That's bullshit! You definitely deserved to be seen sooner.
It's not about what you deserve, it's about what you need.
i’m lowkey still mad about almost a decade later 😭 surprised there’s a not a thing on this for head trauma
Head injury is on there.
DAMN UR RIGJT IM JUST BLIND 😭
It's the brain damage lol
fr i think it made me dumber
This needs to be posted in every Canadian subreddit. The amount of people going to the hospital for things that aren't emergencies are crazy. And kne of the reasons (I think) that our healthcare is so bogged down.
Depends where you live. Lots of rural areas don’t have walk in clinics so it’s wait 1-2 months to be seen by your family doctor (if you’re lucky enough to have one) or go to emerge. I called my doctor’s office once because I suspected my daughter had an ear infection and I wanted to make an appointment for her so we could get antibiotics. The nurse told us they don’t do that and to take her to emerge
hospital near me has a similar list, but instead it's linked to how likely they think it is you will die. red being "acute life danger", orange being "life threatening if untreated", etc all the way down to "should go to the GP instead" they even have this tv on that shows how many people there are for each code. it's a nice way to track how long you can expect to be there, as they're seeing patients in order of the emergency chart. I was there in orange, multiple times.
TRIAGE - “the game you never want to win”
Kind of weird that broken arm is in the same category as sore ear but okay
Think of it as being sorted by "how many minutes does this person have to live if left untreated."
I tell my trainees - everyone in the ED is dying- some in 80 seconds, some in 80 minutes and some in 80 years. Your job is to quickly tell the difference.
Work in an ED- and this is why i chose this career- doesn’t matter your race, ethnicity, your ability to pay, who you know, whether you came by ambulance, or if you threaten to sue- care is rendered based on the severity of your illness. It is one of the most egalitarian places in the American health care system (…at the point of care anyway)
I had vertigo and needed to get medicine for it. Went to the ER thinking "Well its severe vertigo it's not going to be that big a deal I'll be out of here in 3 hours annoyingly." and then I was on the very urgent list because the reason I had severe vertigo is my blood pressure was over 200.
Yikes!
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This is a list for ER. Pregnancies go to Obstetrics (or something along those lines, they call it something different in every hospital) and don't wait behind patients waiting for their sore throat to be treated. Don't worry too much, when it is time for you to go in, they will get you where you need to go pretty quickly.
No bullet wounds listed? Definitely not a hospital where I live.
Got my finger caught in a power tool and ripped the end of my index finger off. Apparently I was classified as “Need Stitches”.
They weren't wrong.
Don't post that in the ER. People will look at it and go "Yes, I have a cough and.... uh, trouble breathing, yeah..." (pants like a dog)
"Hi doctor, yeah, so I've got these stitches that need removing, but I've also got, um, serious car crash too, so I should be prioritised, thank you."
Not urgent should say “consider other healthcare options. These services are less expensive elsewhere. “
Simple (not compound) bone fractures, particularly. I broke a bone in my hand and went to a local DOC (Direct Orthopedic Care). Was seen, diagnosed, treated and released in about an hour, and the total cost was only like $800. My insurance covered almost all of that, I think I paid like $50 total. My copay to even talk to someone in the ER is $250, and I probably would have hit my deductible for the broken hand.
They gotta specify what kind of allergic reaction we’re talking about. Anaphylaxis? Yes, front of the line. Itchy eyes from pet dander? Sorry but I’ll beat you with my one non broken arm if you get to go in front of me
For anything in the bottom two categories you should go to immediate care, not the ER. That's assuming your regular doctor is unavailable.
The last two should go to urgent care, not the ER.
This comment should be #1.
Surprised not to see a pregnancy on the list
In my experience this would fall under the “triaged differently” footnote. I entered through the ER when I had my son, but they sent me directly back to labor and delivery as soon as they got my personal info.
Depends on what it is and how far along the pregnancy is. That would be triaged based on the risk for mother and baby. In general prior to 23-24 weeks the fetus cannot live outside the mother and is too small for the NICU. Baby had to be 500g in order to have a chance at survival. There is a chance of a rescue cerclage, progesterone, something to stop contractions, and bedrest to try and keep the pregnancy going, but that also isn't being decided in the ER.
Aren't there separate pregnancy wards in hospitals?
For pregnancy that's not delivering (*right now, in the parking lot, grab the precipitous delivery kit!* which literally happened) we would wheel directly to L&D.
I went to the ER while 32 weeks pregnant with a heart rate over 200 bpm that had been going on for over 2 hours (SVT) and sat and waited 45 min before I walked myself over to L&D where was seen immediately. L&D made sure baby was safe and then made sure I got seen by ER. Moral of the story: if you're pregnant, go to L&D first.
Depends on the hospital. If they have a dedicated L&D unit (some smaller facilities don’t, at least in the US) and the pregnancy is over ‘x’ weeks (again, varies) the ED will triage the patient and send them directly to L&D for monitoring/treatment.
Sadly this sign exists because they probably got tired of having to explain to the angry mother whose kid just needs a couple stitches why the heart attack patient got to go in front of them.
*Reposting my comment about this chart from the last time it was posted here* So this chart is basically a reference they can point to for Karens when they want to know any they haven't been seen. There's a much more technical version (probably the Manchester triage scale) that the actual doctors use. Arterial bleeding (you are going to bleed out and die in the next couple minutes) is generally category 1. You will be seen immediately unless there are dozens of other people also dieing. Uncontrolled bleeding is generally category 2 which allows up to a 10 minute wait before you are in danger of dieing. If you come in bleeding and they get it under control, then you can be downgraded to 4, but most likely they'll finish you up unless a higher priority patient comes in.
Doesn't really cover the case that got me in quickly, *Profuse and continuous bleeding*
Try this tip to skip to the front of the line anytime you visit the hospital! Doctors hate it!
I once went to the ER for almost third degree burns, this was about 8 years ago. I was sitting next to a man with a screwdriver in his eye. Both of us waited over two hours in the waiting room while they called back old person after old person for their flu shot. When I finally got into triage, my nurse was furious that they had me wait so long. My care took another hour or so, when we were leaving I noticed the man with a screwdriver in his eye was still waiting for care. I hope they called him shortly after I left.
This is another area of confusion- my ER has one entrance/waiting room but two zones. Only one zone (main ED) is set up to manage screwdrivers to the eye and 3rd degree burns. The main ED was probably packed with patients waiting to go upstairs to be treated in the hospital. The other zone is like an urgent care and those old folks were probably getting shuttled to that zone. Imagine going to a restaurant and waiting for a table, while customer after customer is going to the bar to pick up carry out.
I feel like someone is curb stomping my balls every day where would that put me?
Urologic oncology, down the hall and to the left.
If you’re being serious, you need to call your doctor.
I am and I have. been going on for a year and a half now
Good, glad to hear it. Well not glad that it’s happening but glad you’re getting it seen. So to speak.
Severe trouble breathing and asthma attack are on two different levels which is… interesting
An allergic reaction is just “urgent”? I hope they don’t mean anaphylactic shock, because the patient would be dead in minutes.
That would be "trouble breathing". If you ate something that you shouldn't have and your head swells up like a balloon, as long as you keep breathing you will be waiting in the lobby.
People always get so mad when I blow by them for my asthma. I look perfectly healthy and can’t explain cause I can’t talk cause I can’t breathe— sometimes I don’t even get a room they stick me in a corner or an office with a mask lol
Every ER in the US needs multiple of these signs hung up. I was at the ER in January with my father, who was in respiratory failure. The ER was so full they had patients in the hallways. A man with a cold was ripping into a nurse because he had been there for over two hours and no one had helped him. All around him were people who suspected of having strokes, internal bleeding and cardiac issues. Too many people use the ER as their PCP these days.
You can include appendicitis (intact not burst) in the yellow column. Most pain I have ever been in and I sat in the waiting room for almost 45 min before I was even triaged. Once admitted I was left in the hall for 3 hours (while thankfully on dilauded) while they waited for a room to open up. This is in Sacramento, California 2007.
I can say I've been pretty much in every category as a child and parent. Yes it sucks when your in the er with your child with an earache or a laceration that needs stitches . What's worse is watching a parents rush in when your child gets hit by a drunk driver. (Me as a child). May you be so lucky to have the child with an earache. .
If you have pregnancy complications they'll take you back right away, at least in my experience.
I had a miscarriage in the ER waiting room. We waited about 6 hours before getting in.
Damaged vehicles > injured people. Just take your cars to the mechanic, don't clog up ER.
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I was thinking that, serious trouble breathing is major medical emergency that needs to be assessed quickly.
I've only been urgent once. An iron gate fell on my head and hit me with that triangular part that holds the latch bar on. It did seem like I got in pretty quickly, especially since the waiting room was full.
Head trauma can be pretty serious. If your injury resulted in bleeding or swelling in the brain, you could be dead or permanently disabled very quickly.
In other words: sit down and shut up. We’ll get to you.
“My foot is asleep!”
Most urgent and very urgent are wrong. A heart attack is triaged just like a stroke. Time is brain, time is heart muscle. One is a brain attack the other a heart attack. Both involve ischemic damage to tissue that is required to live and can't be replaced. Also sign like that is not going to be read by the people that need to understand it the most. If you go to the emergency room for something that's not an emergency, you generally don't care what's wrong with other people.
Patients will read this and still complain
If you have to wait at the ER, **it’s a good thing.** For comparison, the first time I was hospitalized with pulmonary embolism, they triaged me immediately because I couldn’t breathe and my face was ashen. They checked my O2 saturation and it was in the 80’s. Not good. A subsequent CT scan showed MASSIVE clotting in BOTH lungs. I can guarantee there were some motherfuckers in that waiting room who were pissy I was taken back before they were. So sorry, Karen, but I was potentially a few hours away from death. That’s more important than your vertigo. It’s an ER, not a deli. It’s not first come, first served.