ER Doctor - What scares me more than Ebola

Tide1986

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Good article...sobering. Thanks for posting.

Today’s Ebola is tomorrow’s Spanish flu. We’ve had nearly a hundred years to get ready and the best we can come up with is plastic suits, double gloves, respirators, and masks. The battleground of this problem can’t be in the hospital. It is unwinnable in our emergency rooms.
 

Gr8hope

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Doctors have an obligation to care for their patients. I don't think this means they should do so at a significant risk to themselves or their families.
 
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TIDE-HSV

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Good read, DBF. I'm going to send it down to my retired ER doc friend in Miami and see what he thinks. Of course there are no real solutions once the virus gets "out in the wild." While I perfectly understand the doc's position on it, there's just no way that family members are going to be competent to protect themselves the way professionals can, which would facilitate a more rapid spread of the disease...
 

ValuJet

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I had the good fortune to be a patient in an ER Wednesday evening after a trip through O'Hare and all the delicious trappings that come with being in confined spaces with people travelling to the U.S. direct from West Africa.

Emergency Room waits can vary from a couple of hours to 12 hours or longer, depending on the other patients in the waiting room and how much closer to death they are than you. First thing I noticed outside was a sign that said "IF YOU THINK YOU HAVE EBOLA, DO NOT ENTER HERE." Once inside, I noticed about half the ER staff were wearing mouth masks and half were not. About half the people in the waiting room were wearing masks and half weren't. Mrs. VJ and I quickly decided we better join the mask wearers, especially considering there was a gentleman in a wheelchair, covered in blankets, who was praying to his Lord Jesus and violently vomiting. It was all very unsettling and very confusing in that there seemed to be no protocol among the ER staff.

Fortunately for me, all I needed was a couple of days of IV fluids and antibiotics to fight off a strep infection, dehydration and 102 temp.
 

ValuJet

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Normally speaking, throwing up in front of the admitting desk (or claiming chest pains) usually gets you back quickly. :D
I was wondering about that too. When he started throwing up constantly, the area around him cleared out quickly. A few minutes later one of the ER people came over and told him, loud enough for all of us to hear "Sir, you're next. We're getting you back as quickly as we can." When they finally put me back there I asked two of the nurses about the guy that was throwing up and they said they didn't know anything about it. How could they not know? I understand patient confidentiality but I felt bad for that guy because he needed help.
 

mikes12

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I was wondering about that too. When he started throwing up constantly, the area around him cleared out quickly. A few minutes later one of the ER people came over and told him, loud enough for all of us to hear "Sir, you're next. We're getting you back as quickly as we can." When they finally put me back there I asked two of the nurses about the guy that was throwing up and they said they didn't know anything about it. How could they not know? I understand patient confidentiality but I felt bad for that guy because he needed help.
No offense intended, but apparently you don't.

Anyway, they might not know about him. That patient may have another nurse assigned, and it's not uncommon for the nurses to not know what's going on with other patients, or what all is going on in the waiting area. (The triage nurse would be aware, but that person wouldn't be in the exam/trauma rooms.) Also, a vomiting patient wouldn't be all that unusual.
 

TIDE-HSV

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I was wondering about that too. When he started throwing up constantly, the area around him cleared out quickly. A few minutes later one of the ER people came over and told him, loud enough for all of us to hear "Sir, you're next. We're getting you back as quickly as we can." When they finally put me back there I asked two of the nurses about the guy that was throwing up and they said they didn't know anything about it. How could they not know? I understand patient confidentiality but I felt bad for that guy because he needed help.
I have to disagree a bit with Mike below. Under normal circumstances, I think they wouldn't know, but, these Ebola days, I bet word spread among staff like wildfire. A few years ago, I came down with gastroenteritis, probably viral, on New Year's Eve. I'm one of those people who has great difficulty throwing up, no matter how nauseated. I held off until about 5:00 AM and then I had to wake my wife and tell her she'd have to take me to the ER. When they wheeled me in, I was in front of the desk when I got that "here it comes" feeling. The receptionist was pretty sharp. She asked me if I needed a tray. I nodded, fearful of what would come out if I tried to say anything. I upchucked as soon as I got the tray in hand. They zipped me right on back. I improved rapidly and, talking to the ER doc, I made the comment "If I could have thrown up at home." Before I could complete it, he said "You wouldn't be down here, would you?" I laughed. When I was being wheeled out, the ER, which had a handful of people when I checked in, was packed, on New Year's Day. It was flu season and the nurses and other staff were going around passing out masks to those coughing. I guess those help, by stopping aerosol spread. Viruses can pass through them easily, however...
 
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ValuJet

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I don't know what the circumstances were; I only know what I saw. When I referred to "patient confidentiality" I was alluding to the fact that if the medical staff there did know, they were not going to tell me, but I asked any way. And I agree, Earle, considering his symptoms, I would think the staff knew of him as a risk and it was discussed.

They even asked me after I was admitted if I'd traveled overseas. I'm not a medical professional, but I assume based on one's vital signs and lab results that Ebola is something they are testing for. They drew enough blood that I looked like a heroine junkie by the time I came home Saturday.
 

TIDE-HSV

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I don't know what the circumstances were; I only know what I saw. When I referred to "patient confidentiality" I was alluding to the fact that if the medical staff there did know, they were not going to tell me, but I asked any way. And I agree, Earle, considering his symptoms, I would think the staff knew of him as a risk and it was discussed.

They even asked me after I was admitted if I'd traveled overseas. I'm not a medical professional, but I assume based on one's vital signs and lab results that Ebola is something they are testing for. They drew enough blood that I looked like a heroine junkie by the time I came home Saturday.
I don't know if they're routinely testing for Ebola or not. I do think they're testing for HIV routinely. I've had five heart catherizations over the last couple of years. I'm sure I've been tested for everything possible, other than Ebola. It never hurts to ask. Sometimes, they'll talk to you whether they're supposed to or not. One example - about ten years ago, I had my first heart catherization. (It was clear, as was the last one in April, after the second stent.) There was an elderly guy brought in while I was in recovery, heavy set, and he arrested before they could take him into the cath lab. They brought the paddles and shocked him several times. Each time, they would step back and calmly discuss the situation. Somehow, I had expected more scurrying around and sense of emergency. The workers around him had different scrubs from the cath lab workers, which I'd find out later were from the CICU unit. Since I was clamped to my bed with a monster "C" clamp in my groin for six hours, I'd made friends with my nurses. I commented that it didn't look like they were going to be able to do much for him. My nurse leaned over and in what was half whisper and half hiss said that he didn't belong over here (cath lab), that he was far too sick. I didn't know him, but it turned out that Liz did, since he'd lived close to her at one time. He owned a local, beloved, chain of pizza joints...
 

ValuJet

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Friday, they threatened me with a catheter if I couldn't "find" 650cc more in my bladder to empty into the container by midnight. I was ready to force Mrs. VJ to contribute some if I ran short. I whizzed 750cc into it and had that puppy on the counter, displayed like The Stanley Cup for all them to see. I love hospitals. :)
 

TIDE-HSV

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I literally laughed aloud.
I did too. I've been there, after the heart catherizations. You gotta do it on your own or you can't go home. Of course, that dye they use has to be radioactive, so they flush you out good with IVs. With the femoral catheter, you have to remain on your back until the next AM, so that means urinals. Just the sight of one sends me into "clamp down..." :)
 

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