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Started By
Message
My EEEE ARE story. Asking for the MDs and ER RNs thoughts.
Posted on 10/13/22 at 6:29 pm
Posted on 10/13/22 at 6:29 pm
Been long enough, Last year had a female patient with a terrible outcome. Walked in and dropped dead. Early 40's so it wasn't supposed to happen. Very unexpected.
This is a freestanding ER. The code begins in the ER lobby. Loaded into a stretcher. Taken to the back got her back once very briefly. I decide to call 911 as this woman needs more than we offer. They arrive 911 takes her. Doc agrees get her out.
I was treated as though I violated all rules of ER nursing. You swear I asked for her insurance and put her in a car with family to go elsewhere.
Any of you involved in something like this? Patient presents probably somewhere they should not. (should have called 911... the night before) We do our best but get her the hell out for the best chance of survival. Called to the carpet. To this day I do not understand it.
Discuss? Please...
Names and details will be changed to protect the innocent.
This is a freestanding ER. The code begins in the ER lobby. Loaded into a stretcher. Taken to the back got her back once very briefly. I decide to call 911 as this woman needs more than we offer. They arrive 911 takes her. Doc agrees get her out.
I was treated as though I violated all rules of ER nursing. You swear I asked for her insurance and put her in a car with family to go elsewhere.
Any of you involved in something like this? Patient presents probably somewhere they should not. (should have called 911... the night before) We do our best but get her the hell out for the best chance of survival. Called to the carpet. To this day I do not understand it.
Discuss? Please...
Names and details will be changed to protect the innocent.
23
Posted on 10/13/22 at 6:32 pm to LSU alum wannabe
quote:
I was treated as though I violated all rules of ER nursing. You swear I asked for her insurance and put her in a car with family to go elsewhere.
By who?
Posted on 10/13/22 at 6:32 pm to LSU alum wannabe
quote:by whom?
I was treated as though I violated all rules of ER nursing
Posted on 10/13/22 at 6:32 pm to LSU alum wannabe
As long as you took her to the back and did an appropriate triage, assessment, and any applicable treatment was done until ems arrived I think you are good.
Posted on 10/13/22 at 6:32 pm to LSU alum wannabe
You have to stabilize before transfer according to Emtala
Posted on 10/13/22 at 6:34 pm to GEAUXT
quote:
By who?
All levels of management.
Posted on 10/13/22 at 6:34 pm to LSU alum wannabe
Seems like everything was done right
Posted on 10/13/22 at 6:36 pm to GVT
quote:
You have to stabilize before transfer according to Emtala
What is "stabilization"?
Meaning what if the only stabilization is definitive treatment? A cardiac catheterization or a trauma center.
Remember we are a freestanding. There is no upstairs.
Posted on 10/13/22 at 6:37 pm to LSU alum wannabe
I love how you wrote “eeeeee arrrre” out.
It conveys so much.
Medicine is one of those fields where everyone is judged by the bad outcome. Everybody’s ticket is getting punched someday.
It conveys so much.
Medicine is one of those fields where everyone is judged by the bad outcome. Everybody’s ticket is getting punched someday.
This post was edited on 10/13/22 at 6:40 pm
Posted on 10/13/22 at 6:38 pm to GVT
quote:
You have to stabilize before transfer according to Emtala
EMTALA also states:
Provide an appropriate transfer of an unstabilized individual to another medical facility if:
° The individual (or person acting on his or her behalf) after being informed of the risks and the hospital’s obligations requests a transfer,
°A physician has signed the certification that the benefits of the transfer of the patient to another facility outweigh the risks
Posted on 10/13/22 at 6:39 pm to LSU alum wannabe
quote:
All levels of management.
Was the physician reprimanded? Just by your story I don't see anything wrong. You triaged, did ACLS, and got her moved to a higher level facility. That sounds pretty good to me, unless there are other details.
Posted on 10/13/22 at 6:40 pm to Koach K
quote:
I love how you wrote “eeeeee arrrre” out.
It conveys so much.
A poor attempt to keep this away from a google search. Probably an utter waste of time.
Posted on 10/13/22 at 6:40 pm to LSU alum wannabe
quote:
This is a freestanding ER.
This story is why I don’t really get the concept of these.
Posted on 10/13/22 at 6:41 pm to LSU alum wannabe
Does she have a stable airway and VS? If so, then a transfer to another facility for services is appropriate.
Posted on 10/13/22 at 6:41 pm to LSU alum wannabe
I’m not saying you did anything wrong but how do you know that your ER couldn’t handle her care or wherever you were sending her had what she needed?
It seems like there wasn’t even time to consider a diagnosis.
And it also just seems strange that an ER would call 911. I could definitely understand if you were an urgent care, surgery center, or doctor’s office.
It seems like there wasn’t even time to consider a diagnosis.
And it also just seems strange that an ER would call 911. I could definitely understand if you were an urgent care, surgery center, or doctor’s office.
Posted on 10/13/22 at 6:43 pm to LSU alum wannabe
quote:
A poor attempt to keep this away from a google search. Probably an utter waste of time.
Then goes on to just write ER in the same sentence (not to mention clarifying the type of facility) and has his city in his bio
Posted on 10/13/22 at 6:43 pm to GEAUXT
quote:
Was the physician reprimanded? J
Yes.
We were all told don't do that...
To which we said we wouldn't. Until the same nightmare scenario unfolds.
Posted on 10/13/22 at 6:44 pm to WaWaWeeWa
Also, shouldn't a freestanding ER be affiliated with a medical center, in which case you could just call the transfer center to arrange the most appropriate transfer?
Posted on 10/13/22 at 6:44 pm to GreenRockTiger
quote:
A physician has signed the certification that the benefits of the transfer of the patient to another facility outweigh the risks
This is why I could see that management is upset. If you don’t even know a diagnosis, the patient is unstable, no pulse, etc. how do you know the best thing for them is to get in an ambulance?
I think we need to know more details of the story.
Posted on 10/13/22 at 6:46 pm to GVT
quote:
Also, shouldn't a freestanding ER be affiliated with a medical center,
Yea it sounds like he works at a glorified urgent care and that may be the problem here. The patient just sees “emergency room” and probably expects that they have everything she needs.
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