How an Emergency Room Works
The emergency room (ER) is one active and complicated part of an active and complicated emergency response system. Most of the information the public has about them comes from television. As an emergency response worker, you are crucial to this system! You may be the single most important point of communication for the ER. By better understanding how things work at the ER, you can ensure the smoothest transition and best possible outcomes for patients who depend on you.
First on the Scene
Unexpected things happen all the time. People’s health also varies a great deal from person to person. When someone gets seriously hurt or sick, you arrive to help.
Typically the EMS is called when the situation is serious. The people involved have identified that someone needs your professional, life-saving help. Your expertise improves the patient’s chances of survival on the way to the hospital.
When you, the EMS responders receive the 911 emergency call, the dispatch gives you the description of the situation. Use every piece of information, no matter how seemingly insignificant to prepare. In a moment, you will be thrown into action.You are likely the first medically trained professional on the scene.
As you transport a patient to the ER, the hospital is already preparing their next steps based on information you provide.
Life in the Emergency Room
Life doesn’t occur at a steady pace. As with your job, activity at the ER often comes in waves. It can be quiet then suddenly, it can get very busy with sick and injured arriving faster than the staff can handle. Also like you, ER staff has to be ready for a tremendous range of different conditions they might encounter.
Generally a nurse conduct triage. Remember, he or she must assess not only the needs of the patient you’re bringing in but how that patient fits into everything already happening at the moment in the ER. The triage nurse may repeat steps you’ve already completed, like taking vital signs and history of the situation.
The moment you transfer a patient to the care of the hospital is critical. The Southwest Texas Regional Advisory Council has implemented a time-out procedure to ensure they have all the correct information for this specific patient. They use the acronym”MIST.” M describes the Medical problem; I is a complete description of the Injury from head to toe and the time it happened; S stands for Vital Signs including the first taken and any changes since that time; T tells the ER nurse the Treatment you’ve been giving during the time the patient has been in your care.
Before the transfer is complete, the patient care transfer report must be given to the hospital in written or electronic form. This report documents the treatment the patient received from the time the EMS arrived at the scene, to the time the patient is delivered to the hospital.
Plus, an ER stands ready to handle many different kinds of needs. This careful identification and describing of where this patient is in the whole process eliminates mistakes like misdiagnosis and overdoses of medication.
The whole emergency response system must continuously consider the way the parts work together.
Some hospitals in Australia designate a special position, a Hospital Ambulance Liaison Officer (HALO) to help bridge this gap. These officers work at the hospital but coordinate with the EMS system. Frankston Hospital reports a 90% increase in speed of patient transfers.
With strong communication, treatment can move more swiftly for this patient and for all the others that follow. Medical professionals who encounter a patient with missing information may have to pause their flow in the system to make sure they understand what is going on. Valuable moments could be saved when the information has the added assurance of being complete and correct.
Everyone in the emergency response system, from the 911 operator, the EMS responders and the hospital staff must always treat one another with respect. In a heated moment, it is difficult to see how filing a routine report is so important to a patient’s safety. These procedures ensure correct information arrives with the patient. The smooth operation within this complex system, depends on this flow of information. It may not be this patient whose life is affected. A slow moment now, might reduce the chances of the next patient to arrive.