Monday, April 25, 2011

Door to Door

The moment I saw him, I knew something was wrong.

He had been sleeping all day, while I was at work, but now that I was home, he came out of the bedroom to greet me.

The first thing I noticed was that his legs were soaked. With urine.  And he didn't seem to realize it.  He stumbled, and nearly fell down the stairs.

I grabbed the phone.  Called the doctor's office.
Got the answering machine, telling me to call the back up Doc if I had an emergency.

Was this an emergency?
Well... it wasn't a good thing, that's for sure.
I called the back up number.
Got a message saying to press one for an emergency, and to wait on the line otherwise.
I waited.
And waited.
No answer.

So I hung up, called back, and pressed one.

The woman who answered wanted to know what my emergency was, and I told her I wasn't sure it was an absolute emergency. I explained what was going on, and we agreed that I should head for the ER, and she would let them know I was coming.

On our arrival, we were met at the door.
The patient was ushered back to be examined, while I filled out paperwork. Before I had the chance to sit back down after handing the paperwork to the person at the desk, the doc had come out to find me.  Sat down with me, briefly explained what she had found, asked what I wanted to do, had me sign papers giving permission for the procedures, and went back to start prepping the patient for surgery.

Total elapsed time, including the drive:
25 minutes.

The shortest time from noticing symptoms to definitive care I have ever seen.

The interesting part?

This wasn't a trauma center.  It wasn't even the local hospital.

It was the Vet Hospital's Emergency Department.

The patient is my cat.

If our situation had been reversed, if I was the one who was sick, things would have gone quite differently.

First, someone would have had to notice I was sick, if I wasn't able to express it myself.
Then, they probably would have had to argue with me about whether or not to call an ambulance.
Assuming I was too ill to put up much of an argument, they'd call.
I don't know if my kids would go to the station to get the rescue or not- probably not, unless they needed the AED.
So we'd wait for the ambulance.
That would take from 10-15 minutes or more, depending on the priority given to the call, how busy they are, and where, exactly they are coming here from.
They'd spend at least 5 minutes on scene.
The drive to the hospital is about 15-20 minutes.
Giving all those the best possible time, that's half an hour already. 

Once at the hospital, things would likely slow down.  The ER is busy, most of the time, and unless I was clearly critical at that moment, I'd be put in a room, asked to change into a gown, and a nurse would put me on the monitor there.  If an IV hadn't been started before, it would be now.  Blood would be taken for testing. I'd be asked a lot of questions. Might be asked to pee in a cup.

And then, most likely, I'd sit there. Might be for hours.
A doctor would come in at some point.  Might be before or after the results from the blood and urine tests.
May, or may not, order further testing.

If I had the same problem as the cat, and needed surgery... I honestly don't know how long that would take.  It's a relatively small hospital. I might need to be transferred to a larger hospital, more set up for emergency surgery.
That would be an hour trip.

At any rate, the total elapsed time from noticing symptoms to definitive care- to prep for surgery- would be considerably longer than it was for my cat.

Why is that?

There are several reasons that all contribute to the difference.

The most obvious reason is that at the vet hospital, there wasn't a waiting room and ER full of people who didn't really need to be there.  We didn't have to wait because there isn't the rampant abuse of the system.  

We drove ourselves to the vet, which reduced some of the time.  But paramedics can start some treatment, so it's hard to say which of those options is "better." It depends on the specific situation.

But don't forget the other likely reason for any delay of MY treatment...  I'd argue against considering it an emergency, and wouldn't want to go.

The cat didn't do that. :-)

Next... what's going on? Information flow... or not.

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