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Millions of Americans visit an emergency room each year. Millions more have seen the hit TV show "ER." This has sparked an almost insatiable interest in the fascinating, 24-hour-a-day, non-stop world of emergency medicine.A visit to the emergency room can be a stressful, scary event. Why is it so scary? First of all, there is the fear of not knowing what is wrong with you. There is the fear of having to visit an unfamiliar place filled with people you have never met. Also, you may have to undergo tests that you do not understand at a pace that discourages questions and comprehension.
Triage When you arrive at the Emergency Department, your first stop is triage. This is the place where each patient's condition is prioritized, typically by a nurse, into three general categories. The categories are: * Immediately life threatening * Urgent, but not immediately life threatening * Less urgent This categorization is necessary so that someone with a life-threatening condition is not kept waiting because they arrive a few minutes later than someone with a more routine problem. The triage nurse records your vital signs (temperature, pulse, respiratory rate and blood pressure). She also gets a brief history of your current medical complaints, past medical problems, medications and allergies so that she can determine the appropriate triage category. Here you find out that your temperature is 101 degrees F. Examination Room Now you are brought to the exam room. You promptly throw up in the bathroom, which may be more evidence of appendicitis. You are seen by an emergency-department nurse who obtains more detailed information about you. The nurse gets you settled into a patient gown so that you can be examined properly and perhaps obtains a urine specimen at this time. Some emergency departments have been subdivided into separate areas to better serve their patients. These separate areas can include a pediatric ER, a chest-pain ER, a fast track (for minor injuries and illnesses), trauma center (usually for severely injured patients) and an observation unit (for patients who do not require hospital admission but do require prolonged treatment or many diagnostic tests). Once the nurse has finished her tasks, the next visitor is an emergency-medicine physician. He gets a more detailed medical history about your present illness, past medical problems, family history, social history, and a complete review of all your body systems. He then formulates a list of possible causes of your symptoms. This list is called a differential diagnosis. The most likely diagnosis is then determined by the patient's symptoms and physical examination. If this is inadequate to determine the diagnosis, then diagnostic tests are required. The number "911" is the universal emergency number for everyone in the United States. In 2000, approximately 150 million calls were made to 911, according to the National Emergency Number Association (NENA). If you were born in the 1960s or later, 911 was ingrained in you during childhood, and those born prior to 1968 have been exposed enough to 911 that it has become second nature. Prior to 1968, there was no standard emergency number. So how did 911 become one of the most recognizable numbers in the United States? Choosing 911 as the universal emergency number was not an arbitrary selection, but it wasn't a difficult one either. In 1967, the Federal Communications Commission (FCC) met with AT&T to establish such an emergency number. They wanted a number that was short and easy to remember. More importantly, they needed a unique number, and since 911 had never been designated for an office code, area code or service code, that was the number they chose. In 1999, about 93 percent of the U.S. population was covered by 911 service. |