Why is there no "first come, first served" emergency visit?

Health everyone talks about

We are all familiar with going to the hospital outpatient clinic, we all know that we are registered in line, and then wait in the order of treatment. However, there are also some patients who have gone to the emergency department to come back and complain, how can someone always cut in line? Unwell and don't want to go to the emergency room, can you carry it at home? If you are seriously ill, how should you judge?

Mei Xue, deputy director of the Emergency Department of Beijing Chaoyang Hospital affiliated to Capital Medical University, recently made a guest appearance in the "Health Everyone Talks" live broadcast room, and gave authoritative answers to the questions related to emergency medical treatment that the public is concerned about.

1

Why is there always someone "cutting in line" in the emergency department?

Mei Xue: This is because there is a difference between emergency and outpatient clinics. Most of the outpatients are in a slow condition, so the medical treatment is in the order of priority, and whoever registers first will see the doctor first. However, in the emergency department, some patients are critically ill, and their treatment is urgent.

Some diseases are only urgent, but not dangerous. For example, the high fever of 39 degrees is also very urgent, but most of the patients are not life-threatening. Even with the same symptoms, the degree of danger of the disease varies. For example, the same chest pain, some chest pain may be caused by herpes zoster, intercostal neuralgia, pleurisy, etc., the pain is also very severe, but the doctor's examination judgment, this chest pain is not fatal enough, and the chest pain caused by critical cases such as myocardial infarction is not the same. Therefore, emergency patients should be treated differently according to the classification of the disease. Patients with critical illness should naturally receive priority treatment.

The emergency department of the hospital has a set of scientific grading standards, what kind of patients have what symptoms, through scientific and objective grading, can say which patient is more serious. Emergency departments are prioritized, and the higher the level of patients, the more serious the disease, the priority will be given. If a patient does not receive priority treatment after going to the emergency department, they should actually be glad that their condition is not life-threatening.

The emergency department allows "cutting in line" in fact to save lives, and I hope that everyone can understand the sudden "queue" situation when they go to the emergency department in the future.

2

I feel particularly uncomfortable, is it seriously ill?

Mei Xue: Some critically ill patients can't wait, they must be treated immediately, then everyone must want to know, whether the illness is serious or not, who has the final say, I feel particularly uncomfortable, is it seriously ill?

In general, after going to the hospital emergency department, patients are triaged and graded first. Nurses measure vital signs such as blood pressure, pulse, breathing, and body temperature, and make a scientific classification of the disease by asking about the relevant situation of the disease. Nurses will score patients according to the scientific scale, and generally the higher the score, the more serious the disease. There are some patients who feel particularly distressed by themselves, and after grading, they may find that the condition is not very critical.

Of course, there are some critically ill patients, even if they do not do grading, they can immediately judge the need for emergency treatment, such as the patient has been comatose, the condition is clear at a glance, and there is no need to wait for grading. The biggest significance of grading is to identify those hidden risks in those diseases that do not look serious. Emergency department doctors also through scientific grading, so that the real critical patients get timely treatment, escort every patient's life safety.

3

If you are unwell, can you carry it?

Mei Xue: In fact, most of our physical discomfort is not critically ill, and we should leave more emergency resources to those who really need it. So, is it all uncomfortable to carry at home and wait?

Not all diseases can wait. There are some critical and severe cases, the early symptoms are not obvious, the patient feels tolerable, but the disease develops very rapidly, if you do not see the doctor in time, you may miss the best time for diagnosis and treatment, or even life-threatening. The vast majority of these critical illnesses are cardiovascular and cerebrovascular diseases, clinically known as "time-dependent diseases". Taking stroke as an example, the three or four hours after the onset of the disease is the time window for treatment, and once the patient is missed, the prognosis will be very 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 based on live broadcast content)

Doctor's business card

Mei Xue, Deputy Director of the Emergency Department of Beijing Chaoyang Hospital Affiliated to Capital Medical University, Secretary of the Emergency Party Branch, visiting scholar at the University of Paris VI and PITIE-SALPETIERE Hospital in France from 2004 to 2005, has rich clinical, scientific research and teaching experience in cardiopulmonary resuscitation and multi-organ failure treatment, and has conducted in-depth research and exploration in the construction of emergency information and the research and application of big data in acute and critical care in recent years. Presided over the national natural science foundation of China key projects (second host), Beijing Municipal Medical Administration Yang Fan project, Beijing "excellent talent funding" project and other research fund research, the first author published more than 30 SCI, core journal papers, editor-in-chief, deputy editor-in-chief of 4 books, in recent years actively advocate medical simulation training, and created the "Simteacher- medical simulation tutor course", in 2011 won the "Capital Top Ten Health Guards" title, in 2018 won the "Capital Labor Medal", The first members of the National Health Science Popularization Expert Database.

Introduction to "Health Everyone Talks"

In order to implement the "Opinions of the State Council on the Implementation of Healthy China Action", promote the popularization of health knowledge, give full play to the role of experts in technical support, and provide scientific health science knowledge for the people, at the beginning of 2020, the Healthy China Action Promotion Office announced the first list of members of the national health science popularization expert database to the public. In order to mobilize experts to actively participate in science popularization activities and form a series of brands, the Expert Database Management Office will carry out the "Healthy Everyone Talk - National Health Science Popularization Expert Series Live Broadcast Activities", which will be implemented by the New Media Platform for Healthy China Government Affairs, and strive to aggregate national expert resources, create high-quality science popularization columns, and promote them through the new media matrix of Healthy China Government Affairs to expand the dissemination of authoritative science popularization content.

Planner: Fang Tong

Text: Wang Jianying

Editor: Wang Jianying