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re: RE: an ER in NBR - It appears the numbers are finally coming to light...

Posted on 6/13/16 at 3:49 pm to
Posted by LSU alum wannabe
Katy, TX
Member since Jan 2004
27036 posts
Posted on 6/13/16 at 3:49 pm to
quote:



I don't know much about free standing ERs. I think they seem pretty pointless imo. Just call it what it really is...a 24/7 urgent care.





Untrue. I've worked in all 3. Hospital ER, urgent care, and now two free standings.

ERs have to have CT scan, X-ray, and Ultrasound. Urgent Care needs none of these. Urgent Cares do not have to stabilize any more than an MD office does. They just call 911. Free standings must stabilize and calling 911 needs justification. As long as you can justify remotely that you were doing what's right for the patient. But they have full diagnostic capability. Then you ship if needed. Hospitals are quick to take the privately owned ER patients because they are 90% of the time insured.

quote:

By calling it an ER, it's easy for the public to misunderstand what it is really capable of treating. People see "ER" on a free standing ER and may assume it can handle anything and have some false sense of security if they live close to one.



There is something to this. Some is just learning curve and some is shady marketing. One place that I work wants EVERYTHING and we keep them too long. Heart attack? GTFO. Stroke GTFO. Ship them. Some folks have an absolute hard-on to give TPA. They will not have a face to face with a neurologist before administration. And we must keep that patient for the bolus (obviously) and the hour infusion afterward. They are too eager. A status change after TPA is begun indicates a bleed. We can't do dick about a bleed.

They have their purpose. You got a kidney stone? Want to sit in a lobby for 3 hours? Come see us. Possible appendicitis? Come see us. We aren't taking it out, but we will initiate treatment and get you to a surgeon.

You got shot? Call 911. A pit bull tried to eat your 4 year old head and face? Call 911.
Posted by lsunurse
Member since Dec 2005
129047 posts
Posted on 6/13/16 at 3:55 pm to
Thanks for clarifying the differences


If most people in NBR are M&M or uninsured.....how will a free standing ER help them?
Posted by Parallax
Member since Feb 2016
1451 posts
Posted on 6/13/16 at 4:06 pm to
Giving someone tPA and not immediately transferring them if you're not equipped to handle complications is unreal. Wow.

Free standing ERs are a money grab in Texas, not sure why one was proposed for North BR.
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