Tests in the hospital emergency room

Those who visit a hospital emergency room for the first time may not know what to expect when they first meet the emergency physician. The emergency room is a place where every second lost is a second that could have been used to save another, making every second count.

That being said, the job of the emergency physician is tough. Responsible for quick diagnoses and intuitive treatments, the emergency physician must see a patient, gather the right information, and prescribe the correct treatment. Emergency physicians are also specialists, requiring a three-to-four-year residency program devoted to acute care before practicing in the emergency room.

Assisting the emergency physician is the emergency room physician assistant, responsible for providing diagnostic, therapeutic, and preventive health care services. They are also responsible for ordering and interpreting laboratory tests and making diagnoses.

Diagnostic tests acts as a tool for determining symptoms and a subsequent diagnosis. In hospital emergency rooms, diagnostic tests and their accuracy, relevance, and timeliness are integral to the success of the physicians. For first time visitors to the hospital emergency room, these tests may be confusing and frightening. Here is a list of common diagnostic tests found in the hospital emergency room, and what they may say about your health:

Urine sample: This simple tests find urinary infections and screen for metabolic conditions, such as diabetes. It also confirms pregnancy and diagnoses dehydration.

Blood test: Blood tests are used to identify infections, look at blood counts, analyze blood clots, and determine electrolyte composition of bodily fluids. Doing so can determine whether or not a hospital patient is dehydrated or low on sodium or potassium. At times, a blood test will be ordered to target a specific organs or confirm diagnoses.

EGG or EKG: An EGG or EKG, or electrocardiogram, uses electrodes placed on the arms, legs, and chest to record the electrical activity of the heart. An EKG spots signs of cardiac problems, such as heart failure or irregular heart rhythm.

X-ray: X-rays are a form of electromagnetic radiation used for medical imaging. They are often used to diagnose lung and heart disease, pneumonia, heart failure, broken bones, degenerative joint disease, and internal trauma.

CT scan: A CT scan, or computer tomography, uses high-dose ionized radiation to provide a three-dimensional picture of a patient. During a CT scan, a hospital patient is placed inside a machine while an x-ray tube rotates around the body. They are used to diagnose bone tumors, cancers, and fractures; as well as detect internal injuries and bleeding. CT scans can also find the exact location of an infection, tumor, or blood clot. These tests are only ordered in specific circumstances as they are expensive and may force an overexposure to radiation on the patient.

MRI: A magnetic resonance image uses strong magnets and radio waves to create a picture of the inside of the body. MRIs are used to find tumors, bleeding, blood vessel diseases, infections, and bone and organ damage in different areas of the body, including chest, head, bones, spine and more.

Infection Preventions

Infection is one of the leading causes of preventable death in hospitals every year. The Center for Disease Control and Prevention estimates that there are approximately 2 million preventable infections in hospitals every year, leading to 90,000 unnecessary deaths. The importance of keeping hospitals clean and infection free is greater now than ever, as information regarding the patient safety and the effectiveness of prevention efforts continues to grow.

Evidence shows that almost all of these infections are preventable if hospitals would follow proven protocols. Last year, Medicare stopped paying for preventable infections and The Joint Commission, a non-profit organization that evaluates and accredits hospitals, has released a number of strategies for preventing infections.

Hospitals are responsible for maintaining a safe environment in which infections are not easily spread. The following are 5 tips that a hospital can keep in mind when preventing infection:

1. Wash your hands

The most effective was to protect a hospital from spreading infection is to enforce strict hand-washing protocol. All physicians should clean their hands before treating any patient — so it doesn’t hurt to ask them to do it in front of you. Hospitals should consider placing alcohol-based hand cleaners in each room, or in close proximity of rooms to keep harmful bacteria off the hands that will be touching sick, weakened patients.

2. Keep equipment clean

Stethoscopes are commonly contaminated with Staphylococcus aureus and other bacteria. A central line catheter that is antibiotic-impregnated or silver-chlorhexidine coated can reduce chance of infection. It is also important to keep bodily fluids intact by covering the mouth and nose when sneezing or coughing.

3. Keep the sick away from the healthy

If a patient’s sickness is infectious, it is important to keep them quarantined or separate from other patients and employees, especially those whose immune system is weakened. Consider investing in single-patient rooms or better air-ventilation systems.

4. Constantly change IVs

Patient IVs should be changed constantly, at a pace of every 3 to 4 days. Make sure that the IV is inserted and removed under clean conditions, and that the attending nurse or physician is wearing clean gloves.

5. Encourage patients to prevent infection

Patients are as much in control of their infection as the hospitals that treat them. Help the patient to understand the importance of washing their hands, covering the mouth and nose, avoiding close contact with others, and possibly getting vaccinated.

When an ill person walks into a hospital, they expect quality health care and healing, not contracting a new infection. Hospitals are responsible for providing an environment that is conducive to this expectation. Keeping the hospital clean and keeping both employees and patients aware of the importance of preventing infection is key. Fighting the spread of infection requires a combination of discipline, routine, and forward thinking.

Patients of Hospitals

Whether it is your first or tenth time visiting the hospital, there is always something you can do to improve the quality of your stay. As hospitals are a constantly changing and fast-paced environment, it is not uncommon to get lost in the shuffle. Staying aware and being vocal is important to your hospital experience.

The hospital can be an intimidating place for someone who is not sure how hospitals work. From the moment you step into the hospital, there are moments that can overwhelm the average citizen. Keep these tips in mind the next time you or a loved one must visit the hospital.

1. Speak up!

The most important thing that you have control over during visits to hospitals is your participation in your own health care. Open communication between a hospital physician, especially pertaining to your symptoms and history, will help you obtain the best possible treatment at the most rapid pace — the physician will not have to find out your symptoms if you tell him or her you symptoms.

2. Write it down

Always keep a written log of your medical history, including chronic illnesses, past surgeries, and current medications or therapy. Keeping this information ready in hospitals will help your physician in diagnosis and treatment. It is always important when visiting hospitals to keep a list of questions regarding the expected treatment, therapy, tests, length of stay, diet, pain control method, and more. Doing so will keep you aware of where your condition stands.

3. Keep an advocate

When in hospitals, always keep an advocate by our side to keep track of treatment, including medication, that was ordered on your behalf. This person can also take notes of the advice given by your physician and relay information between the patient and the physician or nurses.

4. Clarify everything

One of the most important thing when visiting hospitals is to make sure that you understand everything that is being said to you. If you do not understand what the physician or nursing staff is saying, you must ask for clarification. Before you are discharged, ask your physician about the details of your stay, your medication plan, and any follow-up appointments to the family doctor.

5. Ask questions

As you can see, the overarching theme is to speak up. Ask questions and answer their questions as accurately and honestly as you can. All hospitals are required to have written patient rights given to patients. Many hospitals have patient advocates, to whom unresolved concerns can be brought.

Hospitals remain one of the busiest institutions in all of the world. Offering the complete continuum of health care, they provide necessary medical attention to their patients. Follow these tips when visiting hospitals to take an active role in your own health care — do what you can to help them help you.

Patient Safety

A hospital is different from most other health care settings in that it provides thousands of inpatients with care for hundreds of different medical reasons. The sheer number of physicians, patients, and cases under one roof gives hospitals responsibilities unrivaled in any other institution. They are in charge of the lives of their patients.

Whether a hospital takes steps to become more environmentally friendly or fight against infections in the hospital, it is important for a hospital to keep their standards for safety and procedure high and consistent. As there are thousands of both healthy and sick people in a hospital at any given time, medical errors and preventable infections that occur in hospitals can be more dangerous than in other systems. Hospitals should follow these patient safety tips to keep their patients alive and healthy.

1. Prevent venous thromboembolism: Hospital-acquired venous thromboembolism (VTE) is the most common cause of preventable deaths. Hospitals should use an evidence-based guide to create a VTE protocol that teaches essential first steps, identifies best practices, analyzes care delivery, and much more.

2. Change hospital discharges: Create a simple discharge plan for each patient that includes a medication schedule, a record of upcoming appointments, and emergency contact information. Taking these steps can heavily reduce preventable re-admissions.

3. Prevent central line-associated blood stream infections: Every time a central venous catheter is inserted make sure that the nurse or physician washes his or her hands, uses full-barrier precautions, cleans their skin with chlorhexidine, avoids femoral lines, and removes unnecessary lines. Doing this eliminates the chance of the infection.

4. Educate patients about blood thinners: Teaching patients about blood thinner and their potential dangerousness can prevent the common adverse drug event.

5. Work with a Patient Safety Organization: Report and share patient safety information with a Patient Safety Organization to prevent avoidable errors. These organizations collect, aggregate, and analyze data to improve quality by reducing risks associated with patient care.

6. Work out a better shift schedule: Tired or fatigued medical residents are more likely to make mistakes — residents should be required to get enough sleep daily and limited to 80-hour workweeks. For residents working 30 hours shifts, they should treat patients for only 16 hours and have a sleep period between 10 p.m. and 8 a.m.

7 . Design your hospital safely: Make sure your hospital has well-designed patient rooms and allows nurses easy access to patients. Singlebed rooms, better air filtration, and hand-washing statements will reduce hospital infections.

8. Make sure your hospital staff understands patient safety: Surveying hospital staff can help you measure the patient safety culture in hospitals. After measurement, steps can be taken to improve patient safety culture.

9. Insert chest tubes safely: Remember to take the Joint Commission’s protocol “UWET” when inserting chest tubes. That is, universal precautions; wider skin prep; extensive draping; and tray positioning.

10. Build better response systems: Create a system where effective communication and teamwork skills are encouraged

When should you visit to a clinic

There are over 115 million visits to the many United States emergency rooms every year, or more than 300,000 Americans per day! Patients go to the hospital emergency room for many different medical conditions ranging from second-degree burns to gunshot wounds. As the large number of visits show, hospital emergency rooms are busy places, with physicians and nurses constantly running back and forth to meet the emergency medical needs of their patients. As such, it may not always be the right move to visit an emergency room.

Emergency room visits are costly, often requiring thousands of out-of-pocket costs for patients. There also may be a line for emergency treatment as well as a triage system that may keep you from receiving immediate medical attention. It is for these reasons that you should always determine first whether your medical condition rises to the level of a medical emergency.

There are many different indicators of a medical emergency, some more serious than others. Be aware of your symptoms, should any of them match one of these indicators, you may need a trip to the emergency room:

* difficulty breathing or shortness of breath
* changes in vision
* suicidal thoughts or feelings
* difficulty speaking or pronouncing words
* shortness of breath
* strange or unusual abdominal pain
* pain or pressure in the chest or upper abdominal region
* fainting or weakness
* severe or sudden pain
* uncontrolled bleeding
* persistent vomiting or diarrhea
* coughing or vomiting blood

Each of these indicators could very well mean that you have a medical emergency that needs immediate treatment. However, for other, less serious medical conditions, you may want to consider visiting a clinic. Doing so will guarantee that you save money and time, as you will avoid the extensive costs and long lines of a hospital medical room.

A clinic is a small health facility that cares for outpatients, or patients who visit a medical professional and does not stay overnight at a hospital. They are usually run by general practitioners, in contrast to a hospital, which employs specialists, surgeons, and nurses as well. A hospital usually has an associated clinic which can provide outpatient services at much less of a cost and time commitment. Some of these clinics function as a place to be seen by a triage nurse or other health professional. As said before, less urgent illnesses or injuries can be brought to a clinic. Don’t fret, should you require a trip to the hospital emergency room, you may be moved from the clinic directly to the emergency room. However, these clinics are not open 24/7/365 like hospitals.

Visiting a hospital emergency room can be a costly and time-consuming experience. If you are in need of emergency medical attention, find somebody to bring you to the emergency room immediately. If your symptoms are not indicative of a medical emergency, consider visiting a clinic or family doctor — it will save you some money that you can save for holiday gifts.

Hospital Emergency Room Tips

There are over 115 million visits to the hospital emergency room every year. A victim who is shot in the arm will go through the emergency room process and receive necessary medical care going through a busy, likely hectic section of the hospital. There are, however, a number of things that you should keep in mind if you ever require an emergency room visit, God forbid.

The emergency room is a special hospital department for one reason: it serves medical emergencies, increasing the importance of the time factor in determining the type of health care you may receive. For this reason, it will be important for you to understand what has happened in the emergency room and what will happen after you leave the hospital. Here are 5 tips that you can follow to make your next emergency room visit a good one:

Always bring your health information with you: In addition to your insurance card, which you should carry at all times, you should carry an emergency health information card. A physician can benefit greatly from the dissemination of your health history. Be sure to bring your current medications, as they can add to the picture you paint for your physician in obtaining the right diagnosis and treatment for your emergency room visit. This step is particularly important, as it is the first and most important thing you can do to help you get the best treatment possible.

Ask your physicians questions: The communication between a doctor and a patient in a hospital has to be a two-way street. While I understand that some patients are more shy and possibly intimidated with the entire environment, it is important for you to speak up. After all, physicians are unlikely to give an answer if a question has never been asked! Make sure that you are 100% honest with your physician and give him or her all the information that you have. This is especially important in the hospital emergency room because, as mentioned before, time is a large factor.

Don’t go alone: You should also find somebody to go with you to the emergency room, whether it be a family member, friend, or spouse. This person can help give your health information to the physician, especially if you are too sick. They can also take notes about what the emergency room physician and nurses say and assure that discharge instructions are followed.

Make sure you understand the plan: It is important that you fully understand the plan for after you are discharged from the hospital emergency room. This can be achieved by telling your emergency room physician everything you remember and ask questions! Make mention about your medication plan, diet, and follow up.

Ask for a copy of tests and results to share with your family physician: You should always ask for your own copy of tests and results from your visit to the hospital emergency room. Although many emergency rooms automatically send a report to your family physician, keep in mind that it may get lost or take a while to arrive.

Hospital Emergency Room

The process of triage determines a patient’s priority in the mind of physicians, particularly as it relates to patient treatment. It is necessary to ration patient treatment, especially when hospital resources are insufficient for all to be treated immediately. Based on the severity of their condition, patients in the emergency room may experience a difference in the order of emergency treatment. Additionally, triage may determine where a patient is kept or sent.

A patient will have his or her own opinion about their right to receive medical treatment, but in cases of mass casualties or serious injury, the hospital physician’s final decision about whether to provide treatment to the patient is what will make the difference. A system is always necessary for an institution function as it desires. While there are obvious ethical implications in triage, for an emergency room to function correctly, it must have a system. In the end, triage is necessary for a hospital emergency room to work efficiently and treat all of its patients in the most effective way.

In the past, triage was much more primitive. It was often simplified into three basic categories: those who were likely to live, those who were likely to die, and those whose life may depend on medical care. This system of triage still applies today, however, apart from hospitals’ triage systems. For example, in emergency medical services systems, an overabundance of patients may cause paramedics to use the above model. There is no doubt that instinct plays a large part in the effectiveness of emergency medical services.

Conversely, triage in the emergency room usually follows two types of triage — simple triage and advanced triage.

Simple Triage: Simple triage is used primarily in a mass-casualty incident, an incident which emergency room medical services are overwhelmed by casualties, and is used to sort patients into two categories: those who need critical attention and those with less serious injuries. Patients are categorized and often flagged with printed triage tags to distinguish one category from the other.

The S.T.A.R.T model of triage is a simple system that is easily performed by hospital emergency personnel in emergency room situations. It has been field-proven for mass casualty incidents such as public transportation accidents and natural disasters. In the S.T.A.R.T. model, hospital emergency rooms separated patients into four different groups:

0: the deceased
1: the injured who can be helped by immediate transportation
2: the injured whose transport can be delayed
3: those with minor injuries, who need less help

Advanced Triage: Advanced triage, on the other hand, determines whether or not seriously injured people should receive advanced care due to their unlikeliness to survive. This is where the ethical implications come in.

Since treatment is intentionally withheld from patients, people will always comfort the procedure with ethical “right-or-wrong” questions. But again, advanced triage is just as necessary to preserve scarce resources for those who can benefit from it more. Those implementing the triage process often undertriage or overtriage patients, leading to complications with incorrect patient labeling.

Triage is constantly changing and checked to ensure that the priority remains correct: to ensure that the hospital emergency room provides medical care to those who need it the most.

Hospital and Hospitals Association

When a child first experiences a hospital for say, a broken arm, they are greeted with caring nurses, knowledgeable physicians, and extensive medical equipment. They leave the thinking that hospitals are a place where healing occurs, and smile. For hospitals to be empowered to provide high quality care and medical treatment, they must have competent medical staff, sufficient funds, and proper legislative representation.

Fortunately, in the United States, there are hospital associations representing every state in the nation. These organizations promote the quality provision of health care by hospitals and health care networks through their myriad of efforts. Hospitals and health systems generally make up the members of each association, though some health professionals and health-related institutions may also serve as members.

Each organization varies in services provided to their members. The majority of the organizations, however, focus their efforts on representation and advocacy in both state and federal legislation. Acting as the unified voice of their members’ interests, hospital associations fight for beneficial bills and defend their members from damaging bills. Other common efforts include:

Education: Hospitals serve their community in more ways than just providing medical care to their patients. They also provide community service, education, and economic impact. That being said, hospital associations also focus their efforts on providing education to their members, usually in the form of continuing education for medical professionals. These educational efforts are usually webinars, conferences, or lectures, and the calendars are usually posted on the websites.

Research: Many hospital associations also conduct research in the interests of their members. Research topics include health and hospital trends and policy research.

Communication: Hospital associations also act as a liaison between hospitals, health systems, other health-related institutions and their community, patients, and colleagues. They bring all of these parties together, offering communication necessary to provide high quality health care.

With all of these efforts together, one can see how important hospital associations are to the function of their member hospitals and health organizations. From taking care of a child’s broken arm to the research facilities searching for a cure to cancer, the medical services offered to patients is just one way that the hospital benefits their community. Since hospitals contribute billions to the economy every year in the form of jobs, it is also important for hospital associations to look out for the interests of the millions of hospital employees.

While advocacy and representation is usually the focal point of hospital associations, they also provide education, research, and communication. Their existence is vital to a hospital’s ability to function as a collaborative institution.

Physicians, nurses, and other hospital staff all benefit from their respective hospital associations, whether it be through a webinar that teaches patient safety or a bill that would cut funding being rejected.

Special Surgery

For those struggling with musculoskeletal disorders and autoimmune diseases, Hospital for Special Surgery (HSS) in New York City is a godsend. The specialty hospital, nationally ranked No. 2 in orthopedics, No. 3 in rheumatology and No. 24 in neurology by U.S. News & World Report’s “America’s Best Hospitals” issue and offers patients a hope with industry-leading patient care and medical innovation. Hospital for Special Surgery prides itself on better diagnosing and the use of specialized use of arthroscopic surgery to assist patients with their mobility. For example, HSS were pioneers of the first artificial knee –an example of how they are helping patients gain access to new therapies for their treatment of orthopedic conditions and rheumatic diseases.

HSS is continually working to bring new innovations to their medical field. In September, they announced their new Center for Hip Pain and Preservation, which provides patients suffering from hip pain with effective treatment and accurate diagnoses. The Center for Hip Pain and Preservation works to slow or even reverse the progression of degenerative hip disease, allowing patients to live their life normally and avoid serious surgeries. The Center boasts the expertise of many of the top health care professionals in the nation, including top radiologists, physical therapists, and musculoskeletal experts all under one roof. In October of this year, HSS found that patiens suffering from femoroacetebular impingement (FAI) may benefit from hip arthroscopy.

The Center is just another example of how HSS is always striving to be at the top of the hospital game. Some current issues that scientists at HSS are working on include bone biology, bone healing and soft tissue repair. In addition, scientists at HSS are continually studying autoimmune diseases, including rheumatoid arthritis and systemic lupus erythematosus.

With uncompromising quality in diagnoses, treatment, and research, HSS has set the bar for specialty hospitals around the nation. HSS provides patients suffering from debilitating diseases with improved mobility and overall quality of life with their stellar health care. One can say with certainty that HSS will continue to grow and help patients, with no end in sight.

Fear of the Hospital

Having a fear of the hospital is not uncommon.  Hospitals can be a scary place, with sick and dying people lining every room.  Some procedures in a hospital may cause fear in a lot of people, as they are often painful and embarrassing.

However, if one is so afraid of hospitals that they can not physically step into a hospital without feeling extremely anxious or scared, it may be time to do something about it.  Such an extreme fear of hospitals will eventually get in the way of treating your own medical illnesses or visiting a sick friend or relative.

Overcoming a fear of anything is not as simple as movies or book may make it out to be.  While “facing your fear” is a very broad statement, many people will automatically associate it with the literal action of forcing yourself to do what you are afraid of doing, or experience what you are afraid of experiencing.  In the case of a hospital, facing the fear may be expected to be as simple as physically taking a step into the hospital.  In reality, overcoming a fear of hospitals may take a long time, and will likely expend more effort than just the taking of a physical step.

There are a few methods to go about facing one’s fear of hospitals, and this article will hopefully provide some of those methods.

1. Find a therapist or a doctor

Whether you are afraid of what is under your hospital bed or afraid of spiders, therapists will be able to help you.  Therapists are professionals whose responsibilities partially include helping individuals deal with their fears (also known as phobias).  Doctors may also be able to help with your anxiety, providing advice on dealing with issues that can affect your medical health.  Ironically, therapists and doctors can both be found inside of hospitals.  For someone with a fear of hospitals, however, it is recommended that you make an appointment with them outside of hospitals.

2. Understand your fear

It may be a number of things about hospitals that scare you.  Get a pen and paper and sit down to write a list of your fears.  Why are you so frightened of hospitals? Understanding your own fear will give you a better chance of overcoming that fear.

3.  Tackle the list

When you have made a list of your hospital fears, begin to deal with them one by one.  If you are scared of the workers in the hospital, research what it takes to become a doctor or a nurse.  If you are scared of the cleanliness of the hospital, talk to an expert about the health and cleanliness code of hospitals.

4.  Go to the hospital

If you are not yet ready to go in the doors, take a few hours and sit outside.  Here, you can observe the workers and patients to better understand how it works as a whole.  When you are ready, take the step into the hospital doors.  Do it as many times as you need until your mind is ready to accept it.  It may take a long time, but do not give up!

5.  Enjoy your medical freedom!

With hard work, your fear will hopefully have subsided.  Congratulations!