Protocol when going to ED

[peanutter]

This is actually untrue. The way they get to the hospital has nothing do with it, everyone is given a score upon arrival according to their symptoms, and are seen accordingly. Someone who was driven in with asthma symptoms would be seen long before someone brought in by ambulance with a broken leg. It sometimes appears that people who are brought in by ambulance see dr's quickly but in reality, they wait just as long as people in the waiting room, they just wait more comfortably.

As stated, my comment was from what I have been told directly and from what my DH saw while working in a hospital. While you may have been told (and observed) differently, and while it's certainly possible that the policy is as you say, my views are based on what I have been told (including by Drs working in hospitals).

No one should be taking this to extremes (eg: someone with a papercut in an ambulance is hardly going to be seen faster than someone with chest pains who has brought themself in) but that is what I have been told in no uncertain terms.

[Tinks]

It's not true, Peanutter. You can argue until the cows come home. It's not true.

[peanutter]

What's not true, Tinks? That Drs and other hospital staff that I know personally and my husband - working in various hospitals and in EDs - have observed and done this, or that they have said it to me?

And your statement that it's not true is based on what, exactly?

[Saffy]

Maybe they meant that people arriving in an ambulance were generally seen earlier cos they had more urgent cases on a whole.
I do believe the triage system applies to all and how you arrive has no bearing on it, (I've worked in hospitals all my working life)
I've also never heard of emergency departments not allowing people to arrive on foot, or car. I've never called an ambulance and always driven myself or others in. There's an ambulance shortage where I live and it's only 10minutes drive to the hospital from where I live, would be longer to wait.

[~clover~]

I think a lot of this walk in/ambulance would have to do with the hospital you're at.
Do people in an ambulance still get triaged? Or do they just use info the ambo's have passed on? Maybe they do get triaged faster? I have no idea.
I've never been in a big city hospital ED.

I've walked in/driven myself more times than I can count, for dislocations, asthma attacks (I didn't know it was happening. Dd1's one & only & not severe), suspected sprains etc.
The only time I wasn't happy was when DD2 was severely dehydrated, at 4, with tonsillitis & glandular fever, with a temp that wouldn't come down under 39, when I could get dd to swallow panadol & we sat for 4 hours before she was even triaged. It was when I told them I'd have to take her home they finally got her through.
Her dehydration was at the point where they could not, & did not get a vein. But she went through hell with them trying :/

They probably had a lot going on that night, I don't know. Or we were forgotten about? But I don't think I've ever been quite that worried about one of my kids.

I do believe they do their best though. I also know there are people who go in for a bed for the night, or attention. That really doesn't help the system any.

[peanutter]

I think they absolutely do their best - and to reiterate (in response to the OP) I don't think there's anything odd or problematic with presenting yourself to ED when there's an emergency

[Cassius2]

We have i reckon 99% of the time rocked up at ED on our own steam. I count ourselves really fortunate that we havent needed an ambulance each time.

The only two times i have called the ambos is when 1) DD1 at 4 weeks of age stopped breathing in her sleep at home and 2) when i had a PPH 5 weeks after DD3 was born.

I have come very close to calling an ambulance for DD3 after a spate of long seizures in the middle of the night, but opted to drive her in instead (with DH driving and myself with her in the back).

For us, the ambulance was immediate attention but that was also quite easily demonstrated that both instances needed immediate care. When we have walked in, we have had mixed results. There was only one instance where I think that the triage missed the boat but that was my own fault as I am an eternal optimist and do not do 'sick' very well and try to always look chipper and happy...even when i am passing out lol.

Also, with DD3 I think there was a situation where we took her in and again, because i do tend to downplay things we were triaged as potential febrile seizures (even though i knew they were not)...DD3 had a slight temp and appeared fine. So we waited quite a few hours (but i wasnt mad or anything as obviously unwell kids were going in with vomiting and dehydration etc), but once DD had a seizure in the waiting room and proceeded to decorate the floors with her vomit we were in within minutes. one of the nurses witnessed it, so that really helped.

We arrived two days later with DD3 for the same thing on our own steam and that time were seen immediately and admitted to neurology.

What i have summed up from my experience is that it really doesnt matter how you arrive. what matters is the nature of the emergency AND communication. the communication side is one thing that i have had a steep learning curve on since our issues with DD3. I need to be her advocate and have learnt how to communicate concerns and suspicions of her health and wellbeing much better. it has saved all of us (myself and the medical teams that work with us) a lot of time and unnecessary interventions/hoops etc.

[dinky]

I have done walk ins and ambulance transfers to our local ED. The triage system works quite well IMHO. Ambulances are triaged the same as walk ins, but they will try to get them off the stretchers asap. It doesn't happen fast enough though! It's how the public system works, and to be honest, we have received excellent treatment each and every time we have been there. I drove my DH to hospital when he had a heart attack, he refused to allow me to call an ambulance, but would allow me to take him to the local Dr, I took him straight to ED. He wasn't happy, but was triaged and in resus in under 5 mins and in surgery in 30 mins, it saved his life!

There is nothing wrong with taking yourself to ED. If you feel that it is safe to do so. I have been told by DH's specialist that I am NEVER allowed to drive him again and to call an ambulance straight away should he have more chest pain, which I have had to do a few times. Thankfully we are covered with our PHI. For a 10 minute trip it cost $1000. I myself, was taken from one hospital to another and then transferred to another, $4500 those cost me, but we were covered.

[surprised]

And if you're not convinced yet about having private cover for these things, imagine the cost of a helicopter transfer!

[Tegam]

I've worked as a nurse in emergency departments for over 12 years. I think it's cute people think drs know how people are seen, it's is ALWAYS the triage nurse that prioritise patients to be seen. The drs see patients by that priority, there are time limits set via these priorities. Like a category 2 paediatric patient must be seen by a dr in under 10mins. If there are two category 2 patients then it's first in first in! The system would fall apart if this wasn't the case.

[luna moth]

they wait just as long as people in the waiting room, they just wait more comfortably.

Lying on a spinal board is *not* comfy. That is all I have to add.

[Tegam]

Lying on a spinal board is *not* comfy. That is all I have to add.

Or a junior doctor trying to get some blood out of you

And on another note, Going to an emergency department should never be fun. If you are bored or cranky about the wait you are too well to be there!

[Lily Dust]

I myself, was taken from one hospital to another and then transferred to another, $4500 those cost me, but we were covered.

we have never paid for hospital to hospital transfer. I thought that was up to the hospital to pay? Perhaps it's different state to state? Thankfully though because our trips have been 25kms, 120kms & 160kms hospital to hospital!

And if you're not convinced yet about having private cover for these things, imagine the cost of a helicopter transfer!

You have to pay for those too!?!? There you go, I always just assumed that was free. Don't know why I did though...

[Little Chicken]

I think ambulance victoria ran an advertising campaign about this recently. A non complex short trip was about $900. A helicopter retrieval about $13,000, and yes, you do pay for helicopter pickups.

[Little Chicken]

Current costs of ambulance transport in Victoria taken from here Fees - Ambulance Victoria

FEES
The following are our standard fees for the different services we offer. For protection against these fees and total Australia wide ambulance fees, coverage is provided through genuine Ambulance Victoria Membership.

This outlines the costs and related billing charges from transport in an ambulance in Victoria.



Emergency attendance fees - no transport
Metropolitan, Regional and Rural $481.00



Emergency road transport fees
Emergency cases classified by the Emergency Services Telecommunications Authority as having a final priority of 3 or lower will be charged as emergency transports.

Metropolitan Emergency Road $1,115.00

Regional and Rural Emergency Road $1,645.00



Non-emergency road transport fees
Please note that where an emergency resource is used to undertake Non-Emergency Patient Transport, cases classified by the Emergency Services Telecommunications Authority as having a final priority of 4 or higher will be charged as non-emergency transports.

All Users Stretcher Clinic Car
Metropolitan Non-Emergency Road $301.00 $99.00
Regional and Rural Non-Emergency Road $509.00 $99.00


Air transport fees
The classification of emergency or non-emergency is not relevant for air transport fees. The type of transport - rotary or fixed wing - determines the fee. Reflecting the cost of service delivery, fees for air transport comprise two components: 1) a fixed charge based on respective usage which is levied separately in advance via a lump sum(s); and 2) a variable charge for each time the air transport is used which is levied per transport.

*For other users of fixed wing aircraft, this is combined into the one variable fee - charged per transport. For other users who use the rotary aircraft, Government has waived the fixed charge.

Air transport fees do not include any road transport associated with the air transport. Road transports a billed separately, as per the fees above.

TAC DVA VWA Public Hospitals Other users*
Fixed Wing
Variable charge (per transport) $1,977.00 $1,977.00 $1,977.00 $1,977.00 $4,651.00

Rotary
Variable charge (per transport) $9,946.00 $9,946.00 $9,946.00 $9,946.00 $9,946.00


All transport fees are GST exclusive.

[peanutter]

Yep, if it's not covered by your PHI, absolutely worth paying the membership fees, as even an uncomplicated trip can be equivalent to YEARS of membership.

And the brilliance of it being Australia wide doesn't go astray - the only time I've ever needed an ambulance was when DS1 wasn't breathing properly in Qld (first time he'd experienced genuine humidity, and it didn't go so well). Check whether your PHI has national ambulance cover, and if it doesn't, seriously consider getting your own.

Hopefully you'll never need it, but even needing it once can make it worthwhile.

[Taurean]

We've always taken ourselves (our DD's) into the ED. We have only called an ambulance once for DD2 when she's had a febrile convulsion but the paramedics cleared her for us to take her to our GP. DD1 has been to the ED 4 times and we've always driven her. She's been for severe gastro twice, a broken leg and severe hives. If any of us were having breathing problems, in extreme pain, had horrendous bleeding or were unconscious then I wouldn't hesitate to call an ambo but yes, it's definitely fine to 'walk in' to the ED.

[trishalishous]

Ive always just driven myself up. we live out of town, and ambulance is on the oppostie side of town, with the hospital in the middle. much quicker to go in ourselves