The Case for ER Reform

Imagine that you're sitting at home when you suddenly develop a condition that you believe warrants the emergency medical attention you can only find at a Level 1 Trauma Center.  You call 911, and an ambulance arrives to provide acute, pre-hospital care while transporting you to the ER.  Upon arrival, however, you find an overcrowded facility, with patients lining the hallways and staff constantly running from one patient to the next.  Triaged to the waiting room, you sit for nearly two hours without being seen, wondering if you have been forgotten.  When your name is finally called, a nurse brings you back to the treatment area, where you wait once more, this time on an uncomfortable stretcher, as people rush by you...

This was the experience of a patient of mine from the other night.  She was sitting at home when she developed a nose bleed lasting approximately 30 seconds.  After applying a bit of tissue, the bleeding stopped and did not resume again.  After calling 911, an ambulance transported her to the emergency department.  No pertinent medical history, no medications.  Vital signs normal, no other complaints.  No signs of trauma, no active bleeding.   When the PA taking care of her asked if she lived in a dry building, she replied "yes, that's what they asked me the last time the ambulance brought me here."