What is happening in ER land? Things have changed in the last few years. Normal people don't seem to come to the ER anymore. Now when I say normal, I mean healthy people who are having some kind of problem like a broken leg or appendicitis or something like that. You know, people who are living a normal life and something happens to them that is an actual emergency. They seem to have found somewhere else to go. The demographics of the ER have changed. Here are examples of patients we get nowadays:
1) tragic tommies: quadriplegic on a vent with a colostomy, foley, portacath who has decreased LOC
2) nellie nursing home: elderly females who are demented who have developed decreased LOC
3) frannie fibromyalgia: middle aged females who have fibromyalgia, chronic fatigue, some kind of weird immune disorder, borderline personality who has decreased LOC (just kidding). Usually these people are there for some kind of pain somewhere in their pain riddled body.
4) hood rat richard: uses the ER as a clinic for STD, back pain, post MVA fender bender potential personal injury lawyer settlement bonanza.
In other words all of these people people (except hood rat richard who will probably warrant at the very least c spines) will usually get the 50,000 dollar ER work up special:
Lytes
CBC
troponin
UA (usually cathed)
CT
EKG
IV
meds
CXR
Where have all the normal people gone? Do they go to urgent care? Are they just not coming because they lost their job? Have they moved to Mexico? Are they in jail? Are they travelling the country warning of the end of humanity May 21, 2011? NORMAL PEOPLE WHERE ARE YOU????!!!!!
Normal ppl are afraid of bills to pay. They are tightening the belt and sucking it up until they are so sick the wife/husband drags them in with apologies for not having insurance. These are some of the sickest who walk in the front door, to save the money on the bambulance.
ReplyDeleteA lot of them go straight back. A lot of them end up in ICU.
haha...remember the Carl Reiner Frankenstein movie?...Abby Normal is the new name of all your patients.
ReplyDeleteooops I meant Mel Brooks..my bad.
ReplyDeleteIt's faster and easier for the normal folk to call their doc and go in the next day. Who wants to sit around with the dregs of humanity for hours on end and pay thousands for the experience.
ReplyDeleteA broken bone hurts but it won't kill you. I'd rather wait for my own doc than go to any ER.
They are the ones that go to their PCP or urgent care for their abdominal pain to r/o appy, either get send over for scans or have had them done, but not in a format we can read, have them repeated, always really do have appendicitis, and finally get to OR just before or right after shit gets real. There really is no reward for doing things the right way nowadays.
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