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posted 240 days ago by canada_is_communist 240 days ago by canada_is_communist +79 / -0
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– Benevolentdictator 7 points 240 days ago +7 / -0

I was puking, feeling really sick, and feeling my heart pound out of my chest finally convinced me to go get medical help.

I showed up at 9h30 AM on a sunday morning. I waited a grand total of 10 hours before being told the doctor (no "s") had left for the night and I'd have to wait until the next morning (at best). That's 22 hours of waiting minimum. I was hungry and, well, I work in the morning, so I left. Keep in mind we are now 8am and I would STILL be waiting there had I stayed. Also keep in mind I complained of chest pain and this is supposed to be an "urgent" case.

As someone with some medical background, I read your anecdote & am still unsure the exact reason why you went to the ER & what your expectations were.

Your initial "Chief Complaint" was vomiting. Emesis is a pretty vague initial presentation that isn't considered terribly urgent unless there is specific suspicion of a surgical cause associated with it (appendicitis, bowel obstruction, etc).

You also include that you felt "very sick" which is a descriptor of severity & not really diagnostically helpful either.

Thirdly, you mention that you were experiencing heart palpitations severe enough to warrant seeking medical help. The OP mentions being 50 pounds overweight, implying that you seem to be worried that this could be a primary cardiac problem rather than simply an elevated heart rate from being ill with a virus, febrile, being in pain, being anxious , being dehydrated , etc.

Again, from your outline, I'm not sure what your primary goal & expectations were?

  • Was it to stop the vomiting? Were you expecting IV fluids, antiemetic drugs and diagnostic tests?
  • Did you believe you simply had a very severe stomach flu bug and needed supportive measures as outlined above?
  • Were you simply frightened & concerned with the severity of your sudden symptoms and unsure what it could be
  • Were you concerned enough that the vomiting and feeling unwell with tachycardia had an emergency surgical cause (appendicitis, bowel obstruction, pancreatitis, gallstones, etc). Your description didn't include acute severe abdominal pain in a particular location & pattern as one wouod anticipate with a surgical cause, making it sound more like a gastric bug.
  • Your description mentions concern over heart palpitations & chest pain that should've bumped you up the urgency queue in your opinion. But chest pain wasn't the "Chief Complaint" in your description, more of an ancillary one. ER triage is very heuristic & human algo driven. How your case is handled is often categorized by the first symptom you provide them & handled accordingly. It sounds like yours was more vomiting/feeling sick/palpitations rather than "chest pain".
  • "Chest pain" also isn't a magic word to get seen faster. How chest pain is triaged depends a lot on demographic factors. Again, as above, if it's not the "Chief Complaint", it's inclusion gets downgraded. A lot of it also depends on demographics & gestalt. Walk into the ER instead of arriving by ambulance? Downgrade. Report chest pain but aren't standing there ashen with a closed fist against your pecs? Downgrade. A lot of it depends on age as well. Chest pain in young men & women really isn't treated as serious without much compelling evidence.
  • Did they do your vitals? They probably weren't that impressive besides perhaps an elevated HR to leave you sitting there for 12 hours. Did they at least do an EKG? A normal looking EKG in a low risk presentation at least gives some due diligence in triaging someone as low risk for hours upon hours. Did they draw any blood to send out for Troponin levels? Similarly, zero trops essentially rules out an actual cardiac cause.
  • The fact that the ER doc "left" at 10 pm on a Sunday or whatever suggests you weren't at a full service, urban hospital. Most likely a much smaller rural one. Or an urban "urgent care" center one that can only handle uncomplicated cases and doesn't admit patients overnight/have an OR, surgeon on-call/has no specialists/perhaps has no CT scanner which is the primary tool of ER medicine, particularly for possible surgical causes of abdo pain. Thus, you have to adjust your expectations accordingly. You may have to go to the big city if suspect you may actually need any of the above services if you are legit "specialist/surgeon: sick. The rural/urgent care day hospital is likely staffed by an underqualified, underressourced family doc type rather than an actual 5-year ER trainee with specialist support. There's definitely a postal code lottery in Canada where sometimes your likelihood to survive is based more on geography simply because not all docs/hospitals are the same.
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▲ 7 ▼
– deleted 7 points 240 days ago +7 / -0
▲ 1 ▼
– Niemo 1 point 239 days ago +1 / -0

Time to start doing some research. How high was your bp and hr?

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