(Washington, DC) Hot off the heels of the latest national conference, ACEP leadership unveiled a plan to help crowded Emergency Rooms across the country. Previously, patients have been divided into 5 categories based on acuity, with a designation of 1 being cardiac arrest or something similar, and category 5 being a patient that simply needs a note to go back to work.
“Category 6 is a new designation,” reported Dr. Matthew Lawson. “It is designated for patients who have been screened by triage and determined they do not need to be in the ER at all. They stay in Waiting Room purgatory until they become disinterested and leave.”
Although this sounds like a cold approach to “solve” the issue of overcrowding in Emergency Rooms, it was passed by unanimous approval by ACEP members. This update targets ‘frequent fliers’ who abuse the Emergency Room. Criteria may include, but is not limited to:
- More than 1 visit/week for 1 year, staff knowing patient by name without seeing wrist band, patient knowing staff by name without seeing name tag
- Prior diagnosis of “worried well”
- History of leaving AMA
- More than one visit/month requesting medication refills
- Allergies to Morphine/Tramadol/Toradol/Ibuprofen/Acetaminophen
- Patient providing list of ER physicians he/she is unwilling to have treat them due to poor pain coverage on prior visits
- Requests for pregnancy tests
- Stating “my lawyer sent me for x-rays after my car accident”
- Self-induced vomiting to expedite treatment
All patients are medically screened in triage by a PA or NP with a level 1 note written to avoid legal trouble.