What a f**cking day, at the NHS.

[Deleted]

Already answered at the top of this post

No you didn't

Everybody with a brain cell know that the NHS isn't perfect but on average is awesome. That's why the majority are pro-NHS, also if you're not happy with the NHS you just go private

[Deleted]

what? what information?

You said you would have had to pay £150 to see a consultant if private. I'm saying the resources in order to make an informed choice should be available to you directly if you were capable of understanding them.

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No you didn't

Everybody with a brain cell know that the NHS isn't perfect but on average is awesome. That's why the majority are pro-NHS, also if you're not happy with the NHS you just go private

If people aren't using the NHS seriously and people don't know the deeper workings of healthcare then how can they say whether the NHS is good or not?

[Deleted]

If people aren't using the NHS seriously and people don't know the deeper workings of healthcare then how can they say whether the NHS is good or not?

What does this even mean

[AeneasBK]

What does this even mean

Dunning-Kruger. If someone doesn't understand something, how can they pass judgement on it. Kinda like me voicing my opinion on good movies, I don't know what makes a movie good or not and generally get very little out of them, therefore my opinion on them is worth less than someone who, for example, has studied cinematography or filmmaking.

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You said you would have had to pay £150 to see a consultant if private. I'm saying the resources in order to make an informed choice should be available to you directly if you were capable of understanding them.

Legit, because you mentioned this before, are you essentially arguing that every aspect of medical knowledge in the UK should be publically available?

I'm not saying I disagee necesarily, I just want to check that is what you mean with this "information should be available for free" idea.

[medievalman1]

You had to wait to get treatment for an injury that didn't require urgent attention, and you're still complaining about free treatment, x-ray and consultation?

Fuck me, free shit is terrible, isn't it?

Yeah, dislocations do require urgent attention though (again, not on the same level of strokes, MI's, Triple A's, etc.). Dislocations can have nerve and vascular involvement and compromise. Additionally, the longer a dislocation is untreated can lead to dramatic interventions including surgery to actual fix.

[Deleted]

I'm not saying I disagee necesarily, I just want to check that is what you mean with this "information should be available for free" idea.

Sure, why not.
If even American doctors can put more information on their websites then a socialized healthcare system could do a better job and people would know better what to use A&E for.

[Cien]

What does this even mean

people do abuse the NHS, paracetomol on prescription when it costs 20-40p from most shops, boots, tesco etc, or go to the GP demanding antibiotics to treat their cold or go to a&e because they can't get seen as quickly as they'd like at their GP, or get so god damn pissed they choke on their own vomit and have to go to a&e because they are too stupid to drink within reason or can't handle their own limits. really depresses me when i overhear people talking about these kinds of things when people for surgery end up waiting months for vital surgery.

really hope people have a heart and sort themselves out, with all these cuts we don't need the NHS destroyed by invalids

[Deleted]

Yeah, dislocations do require urgent attention though (again, not on the same level of strokes, MI's, Triple A's, etc.). Dislocations can have nerve and vascular involvement and compromise. Additionally, the longer a dislocation is untreated can lead to dramatic interventions including surgery to actual fix.

Doctor's appear to disagree, if it required urgent attention it'd get urgent attention.

[draykorinee]

][/COLOR]



If people aren't using the NHS seriously and people don't know the deeper workings of healthcare then how can they say whether the NHS is good or not?

I work in it

[medievalman1]

Doctor's appear to disagree, if it required urgent attention it'd get urgent attention.

Having worked in an ER as an RN-and specifically the triage role-your view is naive and incomplete. There are numerous factors that go into if a patient is seen or not in a timely fashion. And adopting the post-incident view of whether they received urgent attention or not is faulty reasoning-I once saw someone go for 3 hours in a lobby after a rollover ATV accident where alcohol and/or other substances were involved, the individual had a pneumo- and hemothorax. You better believe those are medical emergencies-far more so than a dislocation (which still needs emergent treatment).

Additionally, doctors are far from infallible, they make mistakes and bad judgement calls like anyone else (albeit they, in general, have received training and have experience that should dramatically lessen these occurrences).

My comments regarding the emergent nature of a dislocation are more directed to those saying the OP shouldn't have a) taken an ambulance b) gone to an emergency setting for proper treatment or that they c) should have treated it themselves.

Here, let me provide some reading material/resources to back up what I'm saying:

https://www.ahrq.gov/professionals/s.../esi/esi3.html

This is a link to the Emergency Severity Index. This index has been (I presume still is) the most popular triaging tool ERs use in the US-every patient that comes to an ER is categorized by this tool-this allows ER staff to prioritize who gets what over others.

Under the above link, dislocations are mentioned as follows:

Patients with signs and symptoms of compartment syndrome are at high risk for extremity loss and should be assigned ESI level 2. Other patients with high-risk orthopedic injuries include any extremity injury with compromised neurovascular function, partial or complete amputations, or trauma mechanisms identified as having a high risk of injury such as serious acceleration, deceleration, pedestrian struck by a car, and gun shot or stab wound victims.

Patients with possible fractures of the pelvis, femur, or hip and other extremity dislocations should be carefully evaluated and vital signs considered. These fractures can be associated with significant blood loss. Again, hemodynamically unstable patients who need immediate life-saving intervention such as high-level amputations meet ESI level-1 criteria.

There are 5 levels in the ESI. For simplicity sake, if you are a 3, 2, or 1, there is absolutely nothing wrong with being evaluated and treated in an ER. A level 1 means immediate intervention is required to save life. Dislocations are triaged as an ESI 2. Most other fractures are triaged as an ESI 3. Lower the number, more severe the problem.

[draykorinee]

Sorry, I work in ED if I'm moved from icu, ain't no way a dislocated shoulder is getting an ambulance to us, ever.

I'm fine with him going to ED, but if he's in pain and no other symptoms he needs to wait.

[medievalman1]

Sorry, I work in ED if I'm moved from icu, ain't no way a dislocated shoulder is getting an ambulance to us, ever.

I'm fine with him going to ED, but if he's in pain and no other symptoms he needs to wait.

Not sure on what exactly you mean here. Regardless, you, having worked in an ED, know that you don't get to choose which patients come to you via an ambulance. Regardless, he should wait for higher acuity things-yes. However, a dislocation is, in and of itself, a much higher acuity issue than the majority of other legitimate reasons for an emergency room visit.

[draykorinee]

Not sure on what exactly you mean here. Regardless, you, having worked in an ED, know that you don't get to choose which patients come to you via an ambulance. Regardless, he should wait for higher acuity things-yes. However, a dislocation is, in and of itself, a much higher acuity issue than the majority of other legitimate reasons for an emergency room visit.

No, but I know the ambulance drivers well enough to know that it isn't happening.

[medievalman1]

No, but I know the ambulance drivers well enough to know that it isn't happening.

I've seen plenty of abuse of the ambulance system-people coming in because of hang nails, colds, ingrown toenails, taxi services, etc. But, refusing a dislocation? I'm sorry, but that's dangerous for the patient, negligent/incompetent of the paramedic, and unethical. The fact that you advocate/acknowledge and expect/respect/want that? You've gotta be kidding me. Sure, let the person who's in a significant amount of pain with a certainly compromised and minimally functioning extremity drive/walk themselves to get treatment. There's absolutely no harm in that for anyone.

[AeneasBK]

Sure, why not.
If even American doctors can put more information on their websites then a socialized healthcare system could do a better job and people would know better what to use A&E for.

.

.

As Medieval and Dray seem to work in the field, maybe you can settle this for us; is all the information you would have studied when getting your qualifications available for free online? Jeffyman was suggesting it should be; and I had no idea whether it was.

[Rotted]

Dislocated my shoulder this morning, called an ambulance, they said, order a taxi as it was not an emergency. I did, finally in hospital, was sitting for around 3 hours to see a DR for 2 min, he told me, go do an x-ray, what do you know? Another 1 hour wait. Bare in mind my shoulder was still dislocated and the pain I was in I could not explain. I waited after the x ray I needed to rejoin the 3 hour queue again, what a nightmare. Fuck it, I am going private next time.

rant over.

Sorry, but your lying or someone is completely incompetent at their job

By law an ambulance / ambulance base / 999 isn't allowed to ignore a call or redirect it. They might have said it would be faster for you to get a taxi as you were low priority, which a dislocated shoulder really is. But there is 100% no way they'd tell you no to one. Fuck me I've known ambulances to get sent out to drunken students wanting a box of paracetamol. Its a retarded law but its there.

As for your waiting time, depends on the hospital. They prioritise people. Heart attack, car accidents, strokes etc over something like a dislocated shoulder. Dude, I've been in A&E before with a crohns attack throwing up blood and being curled up in ball from the pain. They had people with higher priority than me, I can live through what was happening to me, the girl who got forced fed a cup of bleach on the other hand was a more severe case. And the X ray department once again is a different department,

[medievalman1]

As Medieval and Dray seem to work in the field, maybe you can settle this for us; is all the information you would have studied when getting your qualifications available for free online? Jeffyman was suggesting it should be; and I had no idea whether it was.

Admittedly, I haven't looked all that much for the information I studied and if its found online for free-I know of a few online college programs that are quite affordable though. I would say that the majority of the information likely is-but the organization of learning the information-i.e. that found in college courses is not available for free. More importantly (in a practical sense) the certifications/degrees are certainly not free either.

Here's the main issue with what Jeffyman said though. In general, people are only able to know their symptoms and not the actual cause for them. A great deal of symptoms are from generally benign issues but can be shared with life threatening/altering conditions. There would be no practical means for a trained medical doctor to compile a list of symptoms that could, with 100% certainty, allow patients to stay away from emergency departments without potential repercussions for their health. Couple this with the wonderfully (/s) litigious society we find ourselves in (in the US, at least) it makes providing this information fraught with pitfalls. Yes, there are advice lines and what not, but if there's any question to whether something is actually an issue or not, the advice is to go to an ER (or pcp) for further evaluation.

[draykorinee]

I've seen plenty of abuse of the ambulance system-people coming in because of hang nails, colds, ingrown toenails, taxi services, etc. But, refusing a dislocation? I'm sorry, but that's dangerous for the patient, negligent/incompetent of the paramedic, and unethical. The fact that you advocate/acknowledge and expect/respect/want that? You've gotta be kidding me. Sure, let the person who's in a significant amount of pain with a certainly compromised and minimally functioning extremity drive/walk themselves to get treatment. There's absolutely no harm in that for anyone.

They should get a taxi, because when they get to ED they aren't getting in front anyways, so why the hell would they waste a valuable ambulance spot? To rush them to the waiting room. Makes sense.

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Sorry, but your lying or someone is completely incompetent at their job

By law an ambulance / ambulance base / 999 isn't allowed to ignore a call or redirect it. They might have said it would be faster for you to get a taxi as you were low priority, which a dislocated shoulder really is. But there is 100% no way they'd tell you no to one. Fuck me I've known ambulances to get sent out to drunken students wanting a box of paracetamol. Its a retarded law but its there.

As for your waiting time, depends on the hospital. They prioritise people. Heart attack, car accidents, strokes etc over something like a dislocated shoulder. Dude, I've been in A&E before with a crohns attack throwing up blood and being curled up in ball from the pain. They had people with higher priority than me, I can live through what was happening to me, the girl who got forced fed a cup of bleach on the other hand was a more severe case. And the X ray department once again is a different department,

There is no legal right to an ambulance, there used to be an unwritten rule that ambulances did always send one but that ended in 2001.

They find when they reduced the ambulance call outs for non ife threatening reasons there was an overall decrease in time to get to life threatening reasons. That's why dislocated shoulders should get a taxi.

In one of the pilot sites, cardiac arrest patients received a response 30 seconds quicker than they did previously, the evaluation by Sheffield University found. If this was repeated across the country, it could save 250 lives.

[Rotted]

They should get a taxi, because when they get to ED they aren't getting in front anyways, so why the hell would they waste a valuable ambulance spot? To rush them to the waiting room. Makes sense.

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There is no legal right to an ambulance, there used to be an unwritten rule that ambulances did always send one but that ended in 2001.

They find when they reduced the ambulance call outs for non ife threatening reasons there was an overall decrease in time to get to life threatening reasons. That's why dislocated shoulders should get a taxi.

No it's not, I've lived with a paramedic for three years, if you phone for an ambulance they have to respond. I could go on to list a fuck ton of stories he came back with, but we'll be here all night.

Most paramedics nights consist of making local rounds to people who know the 'buzzwords' to get their hit of morphine every 4 hours or drunken arses holes. That paracetamol example I gave was a legit example from him last year. The reason being they have to respond is incase they don't and just that one time it might be genuine.

But absolutely, if you have a fracture or minor break or dislocation to anywhere bar your skull or spine you should look at alternative means to get to a hospital. Well, age and condition dependant of course.

[TirielWoW]

The emergency room we go to has never had a wait. We go to the emergency room like 6 times a year so... This is in the US btw.

Never has a wait? I'd love to see where that is. The ones here always have a wait, except the charity hospital.

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Doesn't work like that. My insurance provider knows where to send me based on what has happened.

Does the UK have hospital specialties like the US?

For instance, if I get shot, I get sent to Parkland in Dallas, if I get burnt, or my liver is damaged, I go to Baylor in Downtown Dallas, if I'm in a car wreck and have severe trauma to my chest, I go to JPS in Ft.Worth. Our hospitals are as large as the biggest bank buildings in Dallas, so wait times are spread out pretty good across the metroplex. I can't just waltz into Baylor with a broken toe bone, flash my insurance card and get priority. . . . . they will send me to a specialist that day, and hopefully within a few miles.

So you're saying that every single one of those hospitals is in-network with your insurance? And that your doctor has admitting privileges at all of those hospitals?

Oh, and specialist the same day? LOL. I'm sorry, you lost me here. Unless it's a really terrible specialist, that simply doesn't happen no matter how good your insurance is.