There is a free standing ER that is located in a nearby suburb which is connected with our hospital. A free standing ER is an ER that has no hospital at the location. Any patients admitted are transferred to our hospital or another hospital. These free standing ERs operate the same as any other ER. They can do anything a normal ER can do.
I was thinking about the whole Joan Rivers thing and the news that she probably died of airway compromise related to vocal cord spasm. I don't know anything about how something like this is dealt with. I mean I don't know if you can do a cric or what. Its obvious that an outpatient clinic isn't prepared for something like this.
Got me to thinking about free standing how vulnerable free standing ERs are. Yes they have qualified highly trained ER doctors who can manage just about anything. I wonder if there have been cases across the country where something has come in that can't be handled or a delay in transfer has caused a death?
I remember one time when a young girl came into our ER. She was about 6 years old. She was in anaphylactic shock. It was very difficult to intubate her. Fortunately there was a pediatrician who was in the special care nursery and helped with it. What would they have done if he hadn't been there?
I guess thats the chance you take with outpatient settings.
5 comments:
I guess the other side of the Free standing ER scenario is the increase in the level of care. Large urban ED's are few and far between for parents or ems providers. My opinion is it is far better to get a patient to a higher level of care in an ED and transfer emergently via critical care ground or rotor wing to a specialty hospital. Yes I do work in a free standing and have worked in the urban setting as well.
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Free standing ER is 15 minute emergent ambu ride from it's affiliated hospital. High risk preggers woman walks in having complications. The affiliated hospital admitting docs screw around and the pt and unborn baby die at free standing ER.
It was a long sad story of something that should have NEVER happened.
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Doctors in Training Step 1 2014
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