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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.
In this article, Dr. Carl Bianco leads you through a complete behind-the-scenes tour of a typical emergency room. You will learn about the normal flow of traffic in an emergency room, the people involved and the special techniques used to respond to life-or-death situations. If you yourself find the need to visit an emergency room, this article will make it less stressful by revealing what will happen and why things happen the way they do in an emergency.
One of the most amazing aspects of emergency medicine is the huge range of conditions that arrive on a daily basis. No other speciality in medicine sees the variety of conditions that an emergency room physician sees in a typical week. Some of the conditions that bring people to the emergency room include:
•Car accidents
•Sports injuries
•Broken bones and cuts from accidents and falls
•Burns
•Uncontrolled bleeding
•Heart attacks, chest pain
•Difficulty breathing, asthma attacks, pneumonia
•Strokes, loss of function and/or numbness in arms or legs
•Loss of vision, hearing
•Unconsciousness
•Confusion, altered level of consciousness, fainting
•Suicidal or homicidal thoughts
•Overdoses
•Severe abdominal pain, persistent vomiting
•Food poisoning
•Blood when vomiting, coughing, urinating, or in bowel movements
•Severe allergic reactions from insect bites, foods or medications
•Complications from diseases, high fevers
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.
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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