Emergency Room: Next Stop After the Crime

For crime victims and perpetrators as well, hospital emergency rooms are often the first stop on a long journey of recovery, compensation or punishment.

Around 100 million people visit emergency rooms in the United States each year. The medical ER staff works long hours sorting through the ailing bodies, wounded spirits and disordered lives of a diverse population. Although overburdened and understaffed, these caregivers deal with stabbings, shootings, heart attacks, rapes, drug overdoses, diseases and mangled bodies from car accidents.

One of the first steps taken when a new arrival hits the ER is triage, a French word meaning “to sort.” A new patient is triaged to determine the most critical treatment priority. What to deal with first, a heart attack, fractured femur or a drug overdose?

Vital signs

An initial exam consists of the ABCs: airway, breathing, circulation. All three are crucial to sustaining life and are measured by taking the vital signs. When that has been done, a thorough head-to-toe examination can follow. A quick analysis of appearance and sometimes odor can tell the doctor a lot of information. Is the patient cold and clammy, hot and flushed, bluish or blue-gray, or yellow-orange? How does the breath smell? These are questions that must be answered.

Sometimes death is swift and uncontrolled, a violent car crash for example, or slow and expected when a fatal disease is involved. However, as much as one-fourth of the human race will die from potentially reversible problems. Their deaths could have been prevented if the proper measures had been promptly applied.

Patient revival

In the 1940s the concept of reviving and resuscitating patients with “hearts too good to die” began to take shape. By the 1960s it was an accepted practice and many patients with “hearts too good to die” have been saved.

This is the case with hospital patients who are found not breathing or with no pulse. In such situations a “code” is called to summon a crash team to the bedside. Such teams can consist of cardiologists, anesthesiologists, nurses, a respiratory therapist and sometimes a pharmacist, all depending on the size and resources of the hospital and the staff available.

The equipment mobilized could include a defibrillator with an ECG monitor, IV fluids, drugs and tubes.

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