Time in the ER

So today was my first real experience in the ER. We have a new initiative at St. Fozzie's called "Physician First" and basically, patients receive immediate triage care and they're quickly discharged, kept for additional tests and observation, or whisked off to emergency surgery. It's dramatically affecting the ER patient flow, but that's boring administrative speak. I'll get to the good stuff.

I hate to be clichee, but it DID remind me of some scenes from when "E.R." was on television. I was in the ER for two hours and saw a few interesting cases. The first case was an ectopic pregnancy, which obviously required emergency surgery. They soon wheeled that poor girl off to the OR. She was doubled-over in agonizing pain and I felt for her.

The second case was an older woman with some sort of GI bleed...and she had uncontrollable vomiting and diarrhea. You know how you get that "flight or fight" feeling when scary things happen? I totally got the fight or flight feeling with this one! I felt like I needed to either fix her problems (hello, not possible) or run away very quickly! I opted for stepping out of the room. She was also taken into emergency surgery and was in critical condition.

The third case came in when I was talking to a few of the new ER docs (their first day at St. Fozzie's) in the hallway. A few of the nurses flew by and I overheard one of them yell, "AMI, 3 minutes!!" Acute Myocardial Infarction. Severe heart attack, three minutes away via ambulance. Sure enough, the wailing sirens soon filled our ears. The scene was one of organized chaos, where the clinical staff start the lines, cut the clothing, start oxygen, and within seconds, the attending doc was diagnosing the severity of the situation. A few minutes later when they definitively diagnosed an AMI, the patient was rushed up to the Cath Lab.

To my untrained and unfamiliar eye, the ER seems like an ant hill. It seems like people are scurrying around but really, they all have explicit tasks in the patient's overall care. As scary as those moments were, it was truly an adventure for me. And since I work on the south side of Chicago, it *is* similar to the setting for the "E.R." show. I wonder if Dr. Carter is on staff?