The Promise and Peril of Emergency Rooms

    Highly trained emergency room staff
There are any number of reasons why a person might be rushed to the hospital and we'll never know most of them. But the medical staff who receives those people is highly knowledgeable and will know what to do the minute each person arrives. The triage nurses are the first to assess each new arrival. Their job is not to not learn exactly what the problem is, but to take your vital signs, ask you questions, make a quick check of your mental and physical condition, and send you with some documentation to an appropriate doctor. Each doctor on duty has to be flexible as to switching focus for each new patient - specialists will be further along the line the patient may take.

An emergency room staff is on duty all the time, with no exceptions, not even Christmas Day when most businesses close. They work in an atmosphere of perpetual crisis and must make quick decisions so as to move each person towards the exact treatment needed and start attending to the next new arrival. This is a work environment only some people can handle for any length of time.

Better to be admitted on a weekday?
A study published in 2007 in the New England Journal of Medicine had followed 231,164 heart attack patients. They had all been admitted to New Jersey hospitals between 1987 and 2002. One finding was that those who were admitted on weekends were less likely to be given aggressive treatment and they had a 12.9 percent death rate, as opposed to the 12% for weekday patients.

Perhaps a difference of less than one percent is not earth-shaking, but it's food for thought. Another study published in the Annals of Surgery in November, 2007 had looked at 188,212 patients admitted for non-emergency surgery. Again, one finding was the those who had their surgery on a Friday and then spent the weekend in hospital to recover were 17% more likely to die during the following month than those who had their surgery Monday to Thursday.

What to make of such findings?
One response is that staff working on weekends is for some reason less oriented towards aggressive care. Or perhaps staffing numbers are lower during weekends. Or it could be that weekend patients are sicker and more likely to die anyway, perhaps because they delayed seeking care, struggled through their work week, and then collapsed.

Or perhaps more severe injuries happen on weekends when there's more traffic on the roads at night, more drinking and partying, and more reckless behavior everywhere. Maybe people slip and fall more often, or control their boat or jet ski less well, or have more time to argue with neighbors and get injured. Those factors might speak to the higher death rates.

But there's still the issue of weekenders receiving less aggressive care. Perhaps more study is needed of that, to gather more specifics on what care could have been given that wasn't, and why it wasn't. Lots of room here for more research.

Meanwhile, if you need medical care it might be best to seek it early in the week rather than postpone it until you're in an emergency situation.

If you lost a loved one who was treated in a hospital emergency room, and are wondering whether the right treatment was given, or enough treatment, please contact us for a free case evaluation.

# # #