US Emergency Care Infrastructure Stretched to Breaking

American emergency services are stretched so thin, they threaten to snap. According to a study composed and released by the Institute of Medicine, once every minute an ambulance is turned away and sent to a distant hospital because of overcrowding.

At a time when Americans are relying most heavily on their ERs, the facilities are least equipped to provide that care.

www.usatoday.com...

"If you can barely get through the night's 911 calls, how on earth can you handle a disaster?" asked report co-author Dr. Arthur Kellerman, Emory University's emergency medicine chief.

That ERs are overburdened isn't new. But the probe by the IOM, an independent scientific group that advises the government, provides an unprecedented look at the scope of the problems — and recommends urgent steps for health organizations and local and federal officials to start fixing it.

Topping that list is a call for coordinating care so that ambulances don't waste potentially lifesaving minutes wandering from hospital to hospital in search of an ER with room. The idea is to set up regionalized systems that manage the flow much like airports direct flight traffic. That also should direct patients not just to the nearest ER but to the one best equipped to treat their particular condition — making sure stroke victims go to stroke centers, for example.

This is very distressing. Even under normal conditions the system is stretched to breaking - what do people think will happen when something untoward happpens?

There is no excuse for spending billions on national security, without addressing this situation. It's par for the course, but that doesn't mean we have to settle. I'm no surprised that Americans don't care now, but they will...

Just like the water and food supply. Nobody cares now, but they will...

Any thoughts on remedying this situation? Perhaps there're ways to reduce the reliance on ERs, and that would help the day-to-day, but I don't think that adresses the core issue (which is readiness in the midst of a catastrophe).

I saw an interview with the US Director of the Center for Infectious Diseases.
He stated that this is one of the situations that will be part of the problem when the Avian Flu reaches the US. There wil be an instant overload of ERs and hospitals. This is why he believes most folks will be on 'their own' in dealing with the flu, regardless of what level of illness a person contacts.

I have just two words for my neighbors to the south 'Universal Healthcare'.

Up here we do not have to pay for Doc visits or trips to the hospital. the only services we have to pay for are dental and eyecare etc.

Its a huge problem and more and more you are going to see marginal hospitals close thier doors. We see this now in pediatrics. Childrens hospitals make money. However all the community hospitals that used to have a pediatric floor say 4-12 beds are shutting them down because they cannot afford to operate them. So in the SF Bay Area where there is 3 childrens hospitals: packard Childrens, UCSF Childrens, and Oakland Childrens, it is common that a sick child in an ER cannot get in to one of them becauyse they are full. At Packard we routinely run at about 90% capacity and the ICU's are suualy at 95-98% full. Most hospitals are geared for a sustainable 70-75% and we are seeing internal systems starting to break down.

You couple this with onerous mandated documentation and practices designed by a committie and not the people that have to carry them out and its a wonder ANY hosptial can stay open.

ER's are in the same boat. For many people the ER is thier primary source of health care. This overwhelms the system THAT has to change. You can get millions to do a liver small bowel transplant in a child (its a nightmare and the mortality rate is 80% and thats considered a sucessfull program :dn but to get a small amount of money to do preventaive care in poor areas good luck.