As long as a patient who arrives in emergencies is seen by the doctor and investigated is often the subject of discussion between patients. Doctors point out that the system does not work on the “first, first served” principle and explains why.
Patient assessment takes place according to the Emergency Code set Photo: Archive/Shutterstock
When patients are in a medical emergency (or at least they consider) and are addressed to Emergency staff, they would like to be steady, to be consulted, medical investigated and to receive a diagnosis and, possibly, treatment. It does not happen every time according to expectations, and this gives birth to dissatisfaction and, quite often, complaints, especially in the online environment.
The priority in emergencies, however, explains doctors, does not work according to the principle “first coming, first served”. There are clear rules, there are codes that are allocated to each case, and according to these codes, but also the number of patients who are presented at a given time in the emergency service, the wait can be extended even good hours.
Most of the patients who present themselves in UPU – and this is valid for all such services in the country – does not really represent a medical emergency.
The meaning of the codes in the emergency
“A man who has a change in health in the last 24 hours, or in the last week, did not go to the family doctor, comes to the urgency. It is clear that it will be evaluated, except that he will have to know that the triage, so the first contact with the doctor, is the moment when it is established what his priority is. Because it is clear that every man believes that his need is a priority. But from the other side, that is, from us, of the medical staff, things are different. Because if we serve the patient
In order not to happen, in the triage every patient who presents a code. The cases of red code are the most serious and impose the immediate intervention, at the opposite pole being the cases of white code, which are not actually emergencies. Even for these patients the system instead consumes resources.
“The patient with red, that is, with vital functions immediately endangered, does not stand in the triage. It comes by ambulance or comes with its own car, is taken by the medical staff and immediately taken to the room where it intervenes immediately for life saving. The next color is yellow, a color that the patient is received by an emergency, but not very large as the red code. That is, it has stable vital functions, but which can deteriorate at some point and endanger its life. And this patient must go to the area where it will be permanently monitored in terms of vital functions. And the others, with green, with blue, are emergencies that can wait for tens of minutes or hours, depending on the number of patients of the same type. If there are five people in a row, clearly the patient will be seen quickly. If there are 50, it is clear that it will wait longer. The white color is the patient who is non-urgent. And that one will be sent home. But it is clear that this is happening theoretically, because we have never sent a patient home from triage without being seen, without being investigated, without being consulted ”explained Dr. Geormaneanu.
The importance of the medical file
What patients should know is that doctors help them a lot in faster diagnosis if those who are addressed in UPU are presented on the place and the medical file. This is because, although there is many years of electronic file, today the patient’s medical history is not available at a click away, as life savior would like.
“If he has the medical file, it will be very simple to see what diseases he has, what medicines he takes, or what treatment he has recommended, what analysis he did, to say yesterday, yesterday, and to realize faster what to unbalance. While if he comes to the emergency and we know nothing about him, it is for the first time I see this patient, it is clear that I will take him from head to tail. And the man, not being specialized, does not know how much to tell me. There are also patients, for example cardiac patients, cardiovascular, who have an a history of heart attack, have realized, realize what happens to them and have a file with consultations, with analyzes. People know how to tell us very well what’s with them, but they don’t visit us very often, so to speak, because they take care, they go to periodic checks ”, the doctor explained.
Equally organized are the pregnant women with the task supervised by the gynecologist, Dr. Geormaneanu says. “There are also genetic diseases or rare diseases, where patients know about them, I know what treatments are allowed to do, what they are not allowed to do, and also have medical documents”adds Dr. Geormaneanu. The responsible patients know their complications, they also know what regime to follow and control their disease much better.
“I said – I do not think so!”
A special category of patients is those who force things, loading the expenses unjustified. The doctor exposes the case of an elderly taken from the center of the municipality by ambulance and transported to UPU.
“At the reception, there are two assistants who evaluate patients at first sight, place them on a chair where there is a monitor and evaluate vital functions: frequency of breathing, blood pressure, oxygen saturation. An ambulance patient comes from the Great Square, ie from the city center. The man also had two bags at him. The nurse says – lady, doctor, is taken from the market. Patient with chest pain. I did an electrocardiogram, I monitored it, the normal tension. This is the appearance of the electrocardiogram. I brought him to you. And now, when I entered the door, the man said that nothing hurts -. And the Lord tells the assistant on the ambulance:
Another category is the chronic consumers of various substances, for which the good people call 112, the ambulance takes them, transports them to the hospital, they recover after the treatment and often simply run from UPU. “I had a person who came five, six times in the emergency, with the ambulance, in a state of unconsciousness. As I open my eyes, after an infusion, two, they leave without signing. I also draw a pack of swearing. They leave and over an hour. There is no solution for these people. The teacher was walking with the chair through the hospital yard, he said that it is his right. Dr. Geormaneanu exposed another situation.
Patients who present themselves in urgent benefit from the necessary investigations and free treatment, regardless of the category they belong to – insured or uninsured. Things change from the moment it is established that the state of health no longer represents emergency, for the medical services that they benefit later, they need to pay the payment note, if they are not insured patients, or the expenses are settled by CJAS, if they are included in the package of services that benefit from the state system.
