The serious effects of overcrowding of ERCNN reported on a heartbreaking, terrible story that was a very terrifying case for me as a professional ER doctor and as a parent. The author has treated this subject very seriously to her credit and without involving a lot of sensationalism; she provides a critical look at the current status of national ER overcrowding crisis and sheds some light on the likely cause. The author obtains a great explanatory metaphor as highlighted below.

An illustration to overcrowding of ER

According to the president of the American College of Emergency Physicians, Dr. Sandra Schneider, backups usually result from emergency departments struggling to find some beds to accommodate patients admitted in them. She advises that you look at an emergency room just like a typical restaurant where there are people coming in and going out. Now, picture a restaurant where customers only come in without leaving. The customers come for breakfast and stay there for both lunch and dinner. After being admitted to a hospital, a patient requiring additional procedures end up taking beds reserved for inpatients and causes a domino effect.

The explanation given above by Schneider is easily understandable by a layperson trying to figure out the rather complex dynamics associated with ER patient flow. But why do I have some scores to settle with this article? To start with, it seems like the example of human interest has been wrongly used and somehow illustrates a completely different point contrally to the author’s intention. Actually, the major cause of the outcome on this child isn’t just related to ER overcrowding by the error made by the triage nurse that nearly killed the child. A febrile child suffering from purpura or petechia is a real medical emergency which represented one of the cases where triage nurse misses.

The best thing would have been to rush the child back no matter what was going on at the time. ER overcrowding was just a contributing factor but not the primary factor what was actually the medical error. An unknowable or secondary issue was that medically, the child was sick with purpura when presented at the ER and already in DIC. This would have probably resulted in a similar outcome such as amputations regardless of how long the child waited at the ER. Obviously, it is certain that the delay didn’t help the child in anyway and this is better debated by the malpractice attorneys.

Why this story saddens me

But what really touched me was the use of ‘human interest’ scenario just to make this story ‘work’. This saddened me as the tragic human interest aspect of the story overshadows and distracts everyone from the actual problem. Everyone reading the article is just going to be very pitiful to the child and her family get angry with the nurse while the real issue of ER overcrowding is sidelined to the last paragraphs and no one will really care about it while it should have made the headline.