Understanding the ER Maze

The classic emergency room scene involves an ambulance screeching to a halt, a gurney hurtling through the hallway and five people frantically working to save a person's life with only seconds to spare. This does happen and is not uncommon, but the majority of cases seen in a typical emergency department aren't quite this dramatic. Let's look at a typical case to see how the normal flow of an emergency room works.

Imagine that it's 2 a.m., and you're dreaming about whatever it is that you dream about. Suddenly you wake up because your abdomen hurts -- a lot. This seems like something out of the ordinary, so you call your regular doctor. He tells you to go to your local hospital's emergency department: He is concerned about appendicitis because your pain is located in the right, lower abdomen.

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.

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