King County Emergency Medical Systems Essay

14 million Canadians visit Emergency Departments (ED) every year, and also reported to having the highest use of EDs (Ontario Hospital Association, 2006). ED overcrowding in Canada has become an epidemic. ED overcrowding has been defined as “a situation in which the demand for emergency services exceeds the ability of an (emergency) department to provide quality care within acceptable time frames” (Ontario Ministry of Health and Long Term Care, 2014). This has been an ongoing problem across Canada. Ontario has developed an initiative to reduce ED wait times by implementing a variety of strategies and collaborating with other institutions. This paper describes the Emergency Room National Ambulatory Intuitive (ERNI), an

EMS organizations also have their contract options for funding. According to the Centers for Medicare and Medicaid Services (2013), they developed a fee schedule for ambulance services, in order to contain costs. This schedule is written into a contract. Many patients that are transported by ambulance are Medicare beneficiaries. The government will only reimburse the companies for services rendered during transport, unless contraindicated by the patient’s medical condition. There are codes associated with treatment that either replace or supplement ICD-9 codes. The fee schedule also corresponds with BLS and ALS levels of care, rating treatment from routine to complex (Brennan, 2012). Private insurance companies like Blue Cross Blue Shield include ambulance services for their patients when other transportation would otherwise harm the patient. Cities and hospitals create contract agreements with private ambulance companies for services.

Any patient brought into the Emergency Department, is first signed in at ED receptionist desk and triaged by a triage nurse, prioritized and brought to patient room by a charged nurse either by wheelchair or stretcher or walking by the patient depending on patient’s illness. A nurse is assigned to the patient. Emergency Doctor comes in and if the patient illness is life threatening it is stabilized and the Doctor orders test such as blood work and x-ray if necessary to be conducted. Based on the test result the patient is either discharged or admitted. Certain times the emergency department is filled with a lot of patient that there is no place to sit and patients keep coming in and creating

The new operating policy observed by the EMS is fairer than the previous rule in this regard. The previous rule of allocation for Emergency Medical Services gave priority on a first-come first-serve basis for the calls that were demoted to “routine” versus the calls which were not. This meant that no matter the severity of the situation of the patient, whoever was first in line would take priority. This is in contradiction with the “worst-off, sickest first” rule.

Suppose there is a patch call with a patient exhibiting chest pain and the ambulance is five minutes out. In this case, the room is equipped and prepared with all the essential needs for the chest pain patient upon their arrival in the ambulance. After the patient has arrived, the primary nurse on duty receives a report from the Emergency Medical Technician (EMT) that accompanied and provided initial care to the patient in the ambulance. At the same time, the secondary nurse and ERT become technical, or hands on. The patient is administered oxygen, cardiac monitors are placed, an EKG is administered, locks and labs are drawn, normal saline is administered, and a urinalysis is taken along with the patients’ blood glucose level. Each of these tasks is initiated prior to the Emergency Room Medical Doctor (MD) seeing the patient, or at the same time. Emergency

From my experience volunteering in the emergency department at my county’s largest healthcare provider, Union Hospital, I recognize the medical issues,

Assess the current Models of Care in their Emergency Departments using the given criteria It is recognised that not all of the Models of Emergency Care are applicable for all NSW Emergency Departments. Decisions to implement them will be made based on the staff, patient presentations and space available in the ED to operate each model. Assess the potential to introduce models to their hospitals that may improve patient care and flow, the patient experience and clinical outcomes

The role of the emergency department is to diagnose and treat acute and urgent illnesses and injuries. Patients are seen in order of medical urgency. The emergency department bases the patients urgency for treatment based on levels. Level 1 is critical and life-threatening. This is usually related to ABC’s (Airway, Breathing, and Circulation). These patients are top priority and require a lifesaving intervention. Level 2 is also considered high priority and can also be life-threatening. Psychiatric patients are considered level 2, and patients arriving to the ED with chest pain. Level 3 patients require resources such as sutures, x-rays, CAT scans, MRI, etc. Level 3 patients are provided treatment services only after Level 1 and 2 have been addressed. The emergency department at CEMC also has a trauma room and a SANE room. The trauma room is equipped with life-saving medications (such as antidotes for drug overdose) and medical equipment. The SANE (Sexual Assault Nurse Examiner) room consists of equipment used to assess a patient who has been sexually assaulted. The equipment takes pictures of the patient for the SANE nurse to later provide to law enforcement. A SANE nurse is a specialty nurse and CEMC has one on call 24/7.

Emergency department (ED) overcrowding has become an international health crisis and been identified as a major threaten to public health. As defined by Australasian College for Emergency Medicine, overcrowding is a situation in which ED patients’ demand for services exceeds the staffing capacity to provide care within a reasonable length of time, thereby impeding ED function. Some has called ED as the safety net of the health care system, given its unique role in public health. However, the increasing problem of crowding and the associated impacts has strained this safety net to the “breaking point”. ED overcrowding and prolonged waiting time are associate with adverse consequences towards quality of care and patient safety, as well as

Working in the Emergency Department for the past five years I have seen the need for improved health care access. As much as we like to believe that our health care is universal and equal to all, I have seen that this does not ensure that everyone gets the care or the access to care that they need. The geriatric population, people of low Socio economic status and marginalized populations often end up using the Emergency Department because that is how they see they can get the care they need.

America’s emergency rooms see this type of critical events as a daily occurrence. Often you will find that people will go to the emergency department for care because the ER cannot refuse to care for that come to be seen. If we look into the Emergency Medical Treatment and Active Labor Act any person seeking care must receive assessment and immediate care for their ailment. Often the issue is financial, if a patient is seen at a doctor’s office co-pay or full payment is required at the time of service. With many Americans that do not carry medical insurance their ability to attend to the issue prior to it becoming an emergency is not

The Emergency Medical Service(EMS) are the people who will usually respond to a 911 call relating to medical emergency.

Einstein Medical Center, located in North Philadelphia, is a leading Level 1 Regional Resource Trauma Center and Certified Stroke Center. The facility has 772 beds and maintains one of the busiest emergency rooms in Philadelphia. Einstein’s emergency department treats over 95,000 patients each year, providing cutting edge care to patients with a wide variety of illnesses and injuries. The emergency department utilizes start-of-the-art systems to assist physicians and enhance patient care such as “digital radiography, and ED-based CT scanner, the Vocera Phone System, emergency bedside ultrasound, automatic patient tracking, and much more” (Einstein Medical Center Philadelphia). Despite the advanced care options, the recent passing of

Paramedics and EMTs alike work twenty four hours a day, every day of the year. These highly trained individuals respond to 9-1-1 calls all over the country keeping citizens safe from harm. Unfortunately this same service is abused by many individuals who tax the system and slow down response times. Recently, many state government officials began to propose community paramedic programs where patients can be evaluated and even treated at home depending on their nature of illness. Although the start off for these programs can be costly, the benefits outweigh the cost as community paramedics can benefit the health system by preventing illness and reducing the amount of emergency transfers to the hospital.

Thus, emergency physicians cannot rely on earned trust or on prior knowledge of the patient's condition, values, or wishes regarding medical treatment. The patient's willingness to seek emergency care and to trust the physician is based on institutional and professional assurances rather than on an established personal relationship. Fourth, emergency physicians practice in an institutional setting, the hospital emergency department, and in close working relationships with other physicians, nurses, emergency medical technicians, and other health care professionals. Thus, emergency physicians must understand and respect institutional regulations and inter-professional norms of conduct. Fifth, in the United States, emergency physicians have been given a unique social role and responsibility to act as health care providers of last resort for many patients who have no other feasible access to care. Sixth, emergency physicians have a societal duty to render emergency aid outside their normal health care setting when such intervention may save life or limb. Finally, by virtue of their broad expertise and training, emergency physicians are expected to be a resource for the community in pre-hospital care, disaster management, toxicology, cardiopulmonary resuscitation, public health, injury control, and related areas. All of these special circumstances shape the