On Triage

Somewhere in my ramblings across the Internet today, I came across a bitchy blog entry from someone who waited a long time to be seen at an emergency room with a broken wrist. The person went on to complain about how people with bloody faces and impaired motor function were seen first.

What is it with needing to be seen “first”? I realize that complaining about emergency rooms is practically an international sport, but I don’t really see the appeal. There seems to be a consistent lack of awareness about other people’s problems, combined with a reluctance to comprehend that there may be an overarching system going on which you don’t know about.

When I was at [famous university], I had a severe asthma attack. It was a hot day, I had been relying heavily on my inhaler, and I was still having difficulty breathing. I was able to walk into the school’s urgent care facility, where I requested medical attention. My breathing was labored and I was pale, two indicators that things were not going well for me, but I settled into a chair with a book to wait, nonetheless.

While I waited, I saw a few more people arrive and get processed, I watched people bitch about not getting seen yet, and I saw a man who had arrived before me, also having difficulty breathing, get rushed through to a treatment room. To my surprise, only a few minutes after I sat down to wait, a nurse called my name. So I got up and started to walk over to her, when a blond jockish type thrust himself in front of me.

“I was here first!”

“Er…sir, if you could sit down, someone will be with you shortly.”

“No, I was here first! You can’t let that bitch go ahead of me, she got here way after me! This isn’t fair.”

“Uhm, sir, we have a triage system here to determine who is seen first. Our priorities are based on medical urgency, rather than arrival. I’m sure that someone will be with you shortly.”

The diminutive nurse ushered me towards the door while he continued to carry on, and right after I slipped through the door, he tried to slide in after me. The tiny nurse, who couldn’t have weighed more than a buck and change, said:

“I wouldn’t do that if I were you,” with a sort of tired, long suffering expression.

“Why, what are you going to do?”

“Well,” she said, pushing him bodily back out into the waiting room and slamming the door after us, “this. Now then dear, let’s get you to a doctor.” I even forgave her for calling me “dear” after that performance.

I imagine that it must be frustrating to wait in an ER, which is why I highly recommend bringing a book along. The thing is that the hospitals generally prefer people not to die. This is why they see people with profusely bleeding faces before broken wrists, because they do not know how severe the bleeding is, and a head injury, which could turn very serious, needs to be treated before a broken wrist. This is also why someone who is experiencing chest pain will be seen before someone experiencing stomach pain, why someone who can’t breathe will be rushed past someone with a bleeding face.

The triage system is fairly effective. It certainly fails now and then, sometimes fantastically. But as a general rule, it works. It would work even better if people only went to emergency rooms for emergency conditions, if we had more medical professionals, and if more people had health insurance. But it’s a pretty damn good start.

If you’re one of those people who likes to bitch about how long you wait in emergency rooms…you might want to reconsider that stance. Because you never know when you might be the one who can’t breathe.