Story URL: http://news.medill.northwestern.edu/chicago/news.aspx?id=214662
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ERs: The first and last resort

by Kristin Callahan
Jan 31, 2013


Rush ER 2

Kristin Callahan/MEDILL

At Rush University Medical Center, the average number of patient visits is up substantially from six months ago. 
 

An early and vigorous flu season is drawing people out of their beds and into emergency rooms; but that may not be the place for them to go.

Although emergency departments are frequently overloaded, there are various aspects that contribute to the problem, including what season it is.

At Rush University Medical Center, the average number of patient visits six months ago was between 168-170. Presently, the average visits are between 190-200, according to Frederick Serafin, Assistant Unit Director.

“Right now ERs have become overcrowded and, in some cases, it has been necessary for hospitals to institute a bypass protocol – prohibiting them from taking anymore patients,” said Danny Chun, spokesperson for the Illinois Hospital Association.

This is one way to manage the influx because emergency departments are required to treat everyone who comes in their doors. While many are aware of this system, people often are not familiar with the system the ERs are operating under.

They triage, or categorize, people based on severity of the illness. People with life threatening injuries will be seen immediately, while those with lower acuity levels will have to wait until resources become open.

There is no first come, first serve basis.

In addition to the flu season, overcrowding of ERs results from people not knowing the difference between “emergency” and “urgency.” This, however, varies depending on one’s definition.

According to Serafin, an emergency does not have to be a life threatening situation such as a car accident, gunshot or stabbing. It also includes medical situations where a patient is going into a coma or experiencing heart failure. On the other side of the coin, people classified as non-urgent are those who come in with your sprains and strains and an assortment of viruses.

“That actually clogs the system up because you have to cycle these patients through the system as opposed to seeing true emergencies,” said Serafin.

In 2009, there were 136 million emergency patients reported in the United States, according to the Centers for Disease Control and Prevention. The leading reason for emergency department visits was stomach pain, cramps and spasms totaling 9,597. The second leading cause was fever, followed by chest pain.

Do these people belong in an emergency room? A lot if it depends on your viewpoint.

Ryan Stanton, spokesperson for American College of Emergency Physicians, who also is an emergency medicine physician in Lexington, Ky., sees overcrowding as a symptom of larger problems within the health care system.

“A lot of the things we see wouldn’t be emergencies if there was quality access to care around the clock,” Stanton said. “We take care of the situation because there is not a broad primary care system.”

Doctor’s offices are not open 24 hours, and not many doctors can see you in a moment’s notice.

“What people don’t understand is that people don’t have anywhere else to go; refusing them is not the way,” Stanton said.

Emergency departments seem to be the safety net of medicine. While 100 percent of people have access to care at any moment, ERs are there to catch everything and make sure nobody falls through.