Why isn’t there a “first come, first serve” approach to seeing a doctor in the emergency room?

Health Talk

All of us are no strangers to going to the outpatient clinic of the hospital. We all know that we have to register and queue up, and then wait for the doctor in order. However, some patients who had been to the emergency department came back and complained, why are there always people jumping in the queue? I feel sick and don’t want to go to the emergency room. Can I carry it at home? How do you judge whether you are seriously ill or not?

Mei Xue, Deputy Director of the Emergency Department of Beijing Chaoyang Hospital Affiliated to Capital Medical University, was a guest at the “Health Talk” live broadcast room recently, and gave an authoritative report on the issues related to emergency medical treatment of public concern. answer.

1

Why do people always “jump in the queue” to see a doctor in the emergency room?

Mei Xue: This is because there is a difference between an emergency room and an outpatient clinic. Most of the outpatients are in mild condition, so the order of treatment is followed, and whoever registers first will see the doctor first. However, in the emergency department, some patients are in critical condition, and their treatment is urgent.

Some illnesses are urgent but not dangerous. For example, a high fever of 39 degrees is also very urgent, but most of the patients are not life-threatening. Even with the same symptoms, the risk of disease varies. For example, the same chest pain, some chest pain may be caused by herpes zoster, intercostal neuralgia, pleurisy, etc., and the pain is also very severe, but after the doctor’s examination, the chest pain is not enough to be fatal, and it is caused by critical illnesses such as myocardial infarction. Chest pain is different. Therefore, emergency patients should be treated differently according to disease classification. Critically ill patients should naturally be given priority for treatment.

The emergency department of the hospital has a set of scientific grading standards. What kind of patient has what kind of symptoms, and only after scientific and objective grading can we say which patient is more seriously ill. The emergency department implements emergency diagnosis and treatment. The higher the level of the patient, the more serious the condition, and the priority will be given to treatment. If a patient is not given priority treatment after arriving at the emergency department, in fact, they should be glad that their condition is not life-threatening.

The emergency department allows “queue jumping” to save lives. I hope that everyone who goes to the emergency department will have a better understanding of the sudden “queue jumping” situation.

2

I feel very sick, do I count as seriously ill?

Mei Xue: Some critically ill patients cannot wait and must be treated immediately, so everyone must want to know who has the final say whether they are seriously ill or not , I feel very uncomfortable, can I be considered seriously ill?

Generally, patients are triaged and graded after arriving in a hospital emergency room. Nurses will measure vital signs such as blood pressure, pulse, respiration, body temperature, etc., and make a scientific grading of the disease by asking about the relevant conditions of the disease. Nurses will score patients according to a scientific scale. Generally, the higher the score, the more serious the disease. Some patients who feel particularly distressed may find that their condition is not very critical after grading.

Of course, some critically ill patients can immediately judge that they need emergency treatment even without grading. For example, the patient is in a coma and the condition is clear at a glance, so there is no need to wait for the grading. The greatest significance of grading is to identify those lurking risks in diseases that do not appear to be serious. Emergency doctors also use scientific grading to allow real critical and critical patients to receive timely treatment and escort the life safety of every patient.

3

I feel sick, can I carry it?

Mei Xue: In fact, most of us are not feeling well and are not critically ill. We should reserve more emergency resources for those who really need it. people. So, is it possible to carry all the discomfort at home and wait for a while?

Not all diseases can wait. There are some critical and severe cases, the symptoms are not obvious in the early stage, and the patient feels that they can bear it, but the disease progresses very rapidly. Most of these critical illnesses are cardiovascular and cerebrovascular diseases, which are clinically called “time-dependent diseases”. Taking stroke as an example, three or four hours after the onset is the time window for treatment, and once the patient is missed, the prognosis will be poor. Therefore, once a sudden cardiovascular and cerebrovascular disease is suspected, the patient should go to the emergency department of the hospital as soon as possible.

(This article is organized according to the content of the live broadcast)

Physician Business Card

Mei Xue, Deputy Director of Emergency Department of Beijing Chaoyang Hospital Affiliated to Capital Medical University, Secretary of Emergency Party Branch, from 2004 to 2005, she was a visiting scholar at Paris VI University and PITIE-SALPETIERE Hospital. He has rich clinical, scientific research and teaching experience in cardiopulmonary resuscitation and multi-organ failure treatment. In recent years, he has conducted in-depth research and exploration in emergency information construction, emergency and critical big data research and application, etc., and chairs the national natural sciences. Fund Key Projects (Second Moderator), BeijingResearch funded by the Yang Fan project of the Municipal Hospital Administration and the Beijing “Excellent Talent Funding” project. The first author has published more than 30 papers in SCI and core journals, and the editor-in-chief and deputy editor-in-chief have 4 books. In recent years, he has actively advocated medical simulation training. And created “Simteacher-Medical Simulation Tutor Course”, won the title of “Top Ten Health Guards in the Capital” in 2011, won the “Capital Labor Medal” in 2018, and was the first member of the National Health Science Expert Database.

Introduction to Health Talks

In order to implement the “Opinions of the State Council on Implementing the Healthy China Action”, promote the popularization of health knowledge, give full play to the technical support role of experts, and provide the people with scientific knowledge of health science, in early 2020 , the Healthy China Action Promotion Office announced to the public the list of the first batch of members of the National Health Science Expert Database. In order to mobilize experts to actively participate in popular science activities and form a series of brands, the expert database management office will launch “Health Talks – National Health Science Popularization Expert Series Live Events“, which will be implemented by the Healthy China Government Affairs New Media Platform. Strive to gather national-level expert resources, create high-quality popular science columns, and promote them through the new media matrix of healthy China government affairs to expand the dissemination of authoritative popular science content.

Planning: Fang Tong

Text: Wang Jianying

Editor: Wang Jianying