How long do you wait in the ER?

[DrParasite]

Kind of a weird question, but how long do you wait in the ER until you get a bed?

Where I work, our field units (ALS and BLS) generally get 10 minutes from the time they call arrived at the hospital until they are available for the next call (of course, exceptions are made for truly sick patients). This includes getting a bed and giving report for the nurse. This was in a busy urban environment, including a Level 1 trauma center.

at my former job, we (ALS and BLS) were considered available once we arrived at the hospital. This meant we could be assigned a job, and if we hadn't turned over our patient, they would need to wait. usually we were out of the ER in less than 15 minutes (working in a small urban environment surrounded by busy suburban towns, including a level 1 trauma center).

I have heard rumors that some people end up waiting 30 minutes to 2 hours for a bed. is this the norm for a 911 agency?

please post what your typical wait time is to get a bed, and where you are (generic location, no need for specifics)

 

[JPINFV]

Anywhere from zero (walk in and see "ABC ambulace, 60 y/o M. Bed 12" on the white board) to 3-4 hours. I've heard stories for much longer. Of course the advantage of non-911 companies is that they have the ability to say, "If you keep triaging our ambulance patients like they just walked into the lobby while not taking over care from our crews, we'll stop bringing patients here."

 

[medicdan]

Yeah, just about the same. Some take note from our entry note, and assign us a room, but most often (at the hospitals that take entry notes), its "Room on Arrival", and a wait of 5-10 to get a bed. In Boston, it all depends on the time of day and hospital.

Starting just about a year ago (Jan 1, 09), ambulances are no longer obligated to honor ED diversions, and hospitals have basic stopped issuing them, except for internal disasters. The times of hour-long-waits at Mass General or Brigham and Womens seems to now be over.

In Boston, I work for a private ambulance company, but we have to maintain some tact (a decent relationship with ER staff, on behalf of the company)... and just nod and smile when told to wait (while then calling dispatch to let them know we will be delayed).

 

[Aidey]

The longest I have ever personally waited was 30 minutes. The wait probably would have been longer, but the pt went into respiratory arrest on the gurney and they were like "Oh, damn, we better get her in a room!"*

Usually we walk in and see our assignment up on the white board, or we are met by a registration person who takes the pts info and tells us where our room is. Other times we end up waiting around 5 minutes for the charge RN to figure out where we are going.






* Yes, the staff knew the pt was that bad off. We watched her go from Cheyne-Stokes, to Biot's to Ataxic to agonal. (Stroke pt, onset of symptoms nearly 24 hours previous).

 

[claytondirk]

we walk in give a report and they either have a bed or they wait in triage they dont make us wait at all.

 

[Tincanfireman]

Pt either gets a bed or a trip to the chairs, usually on arrival. We are available as soon as we call out at the ED, so our charge nurses try to get us out the door as quickly as possible.

 

[EMSLaw]

We usually get a bed (or a trip to the waiting room) immediately upon arrival. It takes 15 minutes or so to clear the hospital from our arrival, but some of that is waiting for the charge nurse to come out from wherever she is, assign us a room, move the patient, etc (one hospital has a HUGE ED, and it's a long walk to some of the beds, even if you don't get lost, which you likely will).

 

[wyoskibum]

Not any longer than necessary

Kind of a weird question, but how long do you wait in the ER until you get a bed?

If the ED is busy, I'll be nice and give them 10 mins to step up. After that, I track down the charge nurse and give report to them. If the pt is unstable, I'll get the ED docs attention and give report directly to them.

We are expected to go back in service in 10 mins for BLS calls and 20 mins for ALS. I try to clear as soon as the truck is put back together even if I'm still writing the PCR.

 

[JPINFV]

We are expected to go back in service in 10 mins for BLS calls and 20 mins for ALS. I try to clear as soon as the truck is put back together even if I'm still writing the PCR.

I always hate time frames like that. On one hand, it takes as long as it takes to clear. If it takes 25 minutes to transfer care, finish paperwork, and clear, then it takes me 25 minutes. Same with on scene time. If it takes me 30 minutes on scene for what ever reason, it takes me 30 minutes. However, if companies don't set time limits, then you get the idiots who drag everything out as long as possible to avoid calls. Of course if you do set time limits, at least one a-hole will pull the line, "I've got 20 minutes, and I'm going to take it period."

 

[Seaglass]

Usually we don't wait to get a bed, unless it's a busy night. The longest I've waited is maybe half an hour.

As for restocking and paperwork, depends on the call and hospital. If it's a BLS call to the well-stocked, well-organized hospital, we might be out of there in 10 minutes. If it's an ALS call to the place where the medic personally has to do pretty much everything, 30 minutes is a good time.

We let dispatch know as soon as we've dropped the patient off and restocked, and we let them know when we're leaving the hospital. They won't dispatch us until we leave unless it's a really crazy night.

 

[bunkie]

When I did my ER rotation they never waited longer then 5 minutes, if that. There was almost always a bed ready if they were coming in. And that was on a super busy night at a busy hospital.

 

[thegreypilgrim]

Longest I've ever waited is 6 hours. Personal record of which I'm proud, and happily credit SFM (for those of you in the LA area) with the honor of assisting me in this accomplishment.

That was back in my 911 BLS days, now because all I do are ALS transfers I don't really wait. 911 ALS run wait times depend on the time of day and hospital. Usually they don't wait all that long (maybe 8-10 min. at the most...any longer and the medics will bounce leaving the patient with the private contractor EMT's), but some hospitals are terrible at being even remotely prepared to accept patients for whom they have a heads up about.

 

[JPINFV]

any longer and the medics will bounce leaving the patient with the private contractor EMT's

Umm... if the hospital hasn't accepted care yet and the patient didn't meet downgrade criteria, isn't that abandonment?

 

[thegreypilgrim]

Umm... if the hospital hasn't accepted care yet and the patient didn't meet downgrade criteria, isn't that abandonment?

Probably, not saying I condone the practice. Usually they've given report, but the bed just isn't available yet.

 

[NomadicMedic]

None of my ALS calls have ever had to wait, but BLS is a different story. Most of the small ED will get your patient to a bed, even if it's a hallway bed, so you can clear your stretcher. However, if you're going to Harborview in Seattle with a BLS patient, be prepared to wait... and wait...

And for the other posters that state they are marked as in service the moment they arrive at the ED... well, that makes no sense to me.

It takes us, at minimum, 10 minutes to get a patient into a bed, report given to the RN, the truck to be cleaned and restocked and the stretcher returned to ready state. How can your company justify putting you in service as soon as you arrive?

I tell the dispatcher, "as soon as I'm done, I'll be available." Nobody ever gave me grief, but I also never lollygagged at the ED.

 

[Epi-do]

We get assigned a room right away, or the pt gets sent to the chairs in triage. If we have a critical pt, we will get a room assigned at the time of the radio report. As for marking back in service, since none of the hospitals we transport are in our city, whenever we are done at the hospital and back in our area we mark in. (The city I work for is on the east side of Indy, and just sort of "blends in" to Indy due to urban sprawl.)