When the phone rings in the middle of the night, you fear the worst, because good news usually waits till morning. It was thus with much trepidation that I picked up a call at 3.10am last Monday. It was a work colleague, who was experiencing some lower abdominal pain. From her narration, I thought it could be an acute appendicitis or an ectopic pregnancy, both surgical emergencies. Helpless as the distance had made the situation, all I could do was ask her to visit the nearest emergency room (ER). When I spoke to her 3 hours later she was well, but bitter, because she had received no treatment at the hospital. She recounted that after her vital signs were checked and found to be all normal, she was asked to go home and report later at the Out-patient department (OPD) for management; they didn\u2019t consider her presentation an emergency.<\/p>\n
Well, it turns out her abdominal pain was not a life-threatening condition. Far from it. But she was livid nonetheless. She couldn\u2019t understand why what she considered an emergency was pushed to the bottom of the OPD queue. Her question, and I\u2019m sure the question of millions others, is: who determines what an emergency is? The answer is simple; the case does. Not the patient, not the medic.<\/p>\n
A medical emergency is the sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in: placing the patient\u2019s health in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.<\/p>\n
According to the American College of Emergency Physicians, the following are warning signs of a medical emergency:<\/p>\n
Patients who come into the ER are systematically assessed and sorted into various levels of urgency. This process is known as triaging. This scientific assessment ensures that those who need immediate attention receive it and those who can be seen at a later time wait. This structure is designed mainly to ensure the best outcomes for patients. It is also designed to ensure efficient expenditure of resources, both human and material, at the ER, and in our resource-deprived setting this is critical.<\/p>\n
Patients should understand that in the ER, the business of first come, first served does not exist; the ER runs only on a needs-assessment basis; the one closest to death or permanent damage will be seen first and the stable ones will be seen later. The ER deals in equity, not equality, because no two cases are equal in severity.<\/p>\n
The triaging system is by all intents and purposes an effective one. It sanitizes the traffic flow in the ER and enhances service delivery. So why do some patients leave dissatisfied?<\/p>\n
The problem is communication and information flow. If the patient is left in the dark, there will be dissatisfaction. This was the cause of my colleague\u2019s vituperation. Even though ER staff do not typically have the time to sit the patient down for a long discussion, they must ensure that the patient and\/or family is aware and understand why they have to do one thing or other, or wait as it may be. If you have to let a patient scheduled for the suturing of a minor, non-bleeding laceration wait so you attend to someone who has just come in with severe chest pain, let the person understand same. \u201cI\u2019m coming\u201d and \u201cPlease wait\u201d will not suffice. Patients are more sympathetic to the situation if they understand what is going on.<\/p>\n
A show of concern for non-emergent cases is also comforting. Take a new mother who comes to the ER at 2am with the complaint that her 3 week old is stretching too much. Obviously, her anxiety emanates from a lack of knowledge on the issue. She does not know it is just colic (gas, more or less). This is definitely not an emergency, but a show of concern and some reassurance- not asking her to go and come back later to see the paediatrician- will go a long way to assuage her worry and probably save her another trip- an unnecessary trip- to the hospital.<\/p>\n
In conclusion, it must be noted that emergency preparedness is advised for everyone, irrespective of the strength or otherwise of your healthcare system. Ultimately, your health is your responsibility. Adopt a strategy that best fits your circumstances. The National Institute of Health of the US suggests the following, which can be adapted for your peculiar setting:<\/p>\n
The ER can be a very scary place, even if you are not ill. The fear of the patient and his family is not only mollified by the expert treatment given, but also the kind words offered. To make the ER experience a less stressful one, medics and patients must keep the lines of communication always open.<\/p>\n
Always remember that if the weather or the wait time determines your \u201cneed\u201d to come to the ER\u2026 It\u2019s not an emergency.<\/p>\n
And oh, waiting is good. It means you are not going to die. The one you should be sorry for is the one who is rushed in and gets treated first.<\/p>\n
–<\/p>\n
By: K.T. Nimako (MB ChB)<\/p>\n
Dr. Kojo Nimako is a private medical practitioner with an interest in public health and Citi FM\u2019s Chief Medical Correspondent. He is also the Executive Director of Helping Hand Medical Outreach, an NGO focused on health education.<\/p>\n
E-mail: kojotwumnimako@gmail.com<\/p>\n
Twitter: @KTNimako<\/p>\n","protected":false},"excerpt":{"rendered":"
When the phone rings in the middle of the night, you fear the worst, because good news usually waits till morning. It was thus with much trepidation that I picked up a call at 3.10am last Monday. It was a work colleague, who was experiencing some lower abdominal pain. From her narration, I thought it […]<\/p>\n","protected":false},"author":27,"featured_media":125752,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[2],"tags":[8,15,38],"yoast_head":"\n