Editorial Focus
patients waiting up to seven hours to be seen, so she’s got her hands full. Seven ambulances fill the bay in the back and they just don’t seem to stop coming. As I pass by the radio room, I pause to listen to the paramedics relaying their in- formation. The charge nurse shoots me a look, conveying her annoyance, as they report that the incoming patient has "suf- fered" a sprained ankle two days previ- ously. WHAT????!!! What a waste of time and resources, for sure. The patient is seen by one of our doctors and discharged home, the mode of transportation being a friend's car. If a patient can arrive by am- bulance and go home shortly thereafter via a ride from a friend — perhaps stop- ping off for a beer on the way — this sys- tem is out of control. Where have we gone wrong? What can be done to ameliorate this situation?
In my curiosity, I've asked many people just these questions. A few have tried to tell me that it is just a problem here in America because of "our health care sys- tem," although I find some of their rea- soning to be fallacious. In fact, a Medline search will yield articles from around the world with many countries trying to grap- ple with the same problem, including Aus- tralia, England, and Japan.
Why do people use ambulances to come to the ER? Before visions of Johnny Gage from Emergency's Station 51 leap to your mind, read this list of common, non-emergent reasons people call an am- bulance to transport them to the ER: • I didn't have a ride
• There was an argument at home • I thought I might be seen more quickly
• I wanted my family to know I was re- ally sick
Ambulance Abuse
Why It Happens and How to Fix It By Robert Donovan M.D.
The radio in the ER crackles to life. The incoming ambulance is alerting us to its imminent arrival to the ER. Could it be a gunshot wound? Perhaps a STEMI? Or a patient barely hanging on to life after a terrible MVA? Will we need to mobilize our resources to receive a critical patient
26 EMS PRO Magazine
and be on the ready to act quickly? We have some great nurses in our ER, and tonight's charge nurse is particularly capable. Her ears perk up at the sound of the radio, so she stops what she is doing to walk over to listen to the transmission. It's another crazy, busy night in the ER, with
• I needed a prescription refill
Just by looking at the statistics at my own hospital, it seems a number of pa- tients use the ambulance simply because they can. I sometimes ask patients why they come to the ER in an ambulance and rarely do they feel that their problem is life-threatening.
Take a look at what one study in Lon- don revealed: • 75,000 calls annually (approx. 16 per- cent) were unanimously considered to be inappropriate
• 93,000 additional calls (approx. an-
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