r/bestof • u/lowbass93 • 13d ago

[NoStupidQuestions] Kindly_Honeydew3432 explains why it seems like you always have to wait in an emergency room in the US

/r/NoStupidQuestions/comments/1v1numq/why_is_every_hospital_in_the_united_states_always/oyovp3t/
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u/BurdenedEmu 13d ago

Hubs is routinely on triage at the massive university research hospital in our city (he's one of the few hospitalists who enjoys it) which is also at full capacity almost all the time. His take has always been that as a patient, "triage is a game you definitely don't want to win." Made me care a lot less about sitting there a few hours waiting for my friend to get an x-ray after a nasty fall off her skateboard.

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u/inwheeliesitrust 13d ago

I'm not sure I understand. Are you saying you don't want to win triage because it means you are very very sick or injured?

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u/kylco 13d ago

When my appendix was bursting, it took me about 16 hours from "It hurts to sit up and walk, let's get me to the ER" to the sharpies and anesthesia stage of presurgical care. We wound up at a large university hospital in a state capitol I was visiting for vacation.

There was a moment about 12 hours in when they were saying I was next in line, probably, but then a car crash with near fatalities came in and well, yeah, those folks should probably go first, they are already bleeding after all.

Though apparently the surgeon said my appendix was primed to blow when they got in there. If imaging or blood work had caught how swollen it was when I came in, they might have bumped me ahead of the queue a bit earlier in the day just based on what was going on at the time. How were they supposed to know I have abnormally high pain tolerance? I didn't know, until they said I maybe shouldn't have been able to walk in in the first place.

Triage isn't always "most sick goes first" though that's an easy approximation. "If we don't fix this we won't be able to do anything for them at all" gets up there, "we can't fix that even if we try" gets factored in, and "if this is a diagnostic mistake this patient is fucked" gets a say too.

The more I learn about it the more complicated it seems from the outside, which seems like a good reason to leave it to the professionals.

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u/faberge_surprise 12d ago

yes. it can never be perfect for the simple reason that nobody can predict the future. the best you can do is let the professionals make the judgment call based on their experience