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The Importance of Nurse Triage for an Objective Medical Opinion
by Charu G. Raheja, PhD – Chair and CEO TriageLogic
Anyone can suffer from a serious medical condition, regardless of his or her diet, exercise habits, or education. The difficulty for many patients, however, is recognizing whether something is an emergency or just something that requires home care.
We have found that as many as 70% of the patients who thought that they needed an emergency room visit did not need to go in. However, about 8% of the patients that didn’t think they had an emergency were having a serious condition that required an ER visit. (for example: http://triagelogic.com/nurse-triage-roi/ and http://triagelogic.com/using-triage-improve-health/ )
My recent health problems illustrate how a healthy person can experience a sudden medical condition and have difficulty in evaluating its seriousness.
It was during my business trip to Miami earlier this year, when I started experiencing a severe headache. In the past, I experienced headaches from time to time, but this one was different. The pain was intense and localized to the left side of my head. I assumed that I was experiencing a migraine, triggered by heat or hunger. Determined not to let a headache hinder our evening, I tried to ignore the pain and keep our dinner plans with colleagues.
I tried to enjoy dinner, but as the evening progressed, the migraine persisted and became more intense. The entire room began to spin and I noticed that I was sweating profusely. No longer able to ignore the pain, I lay down on the bench next to me. My husband and friends quickly rushed to my side. My husband took me back to our room. Other doctors who noticed were concerned and wondered if this was a serious condition that required emergency care. However, given my age and overall good health, they were not extremely alarmed.
After returning to my room, the headaches and dizziness continued and I began vomiting. My husband tried to take me to the Emergency Room, but I was too tired and just wanted to sleep. He let me sleep and waited by my side. Part of my hesitation was going to an unfamiliar ER. Despite the persistent symptoms, I chose to rest and rehydrate. We flew back home the following day.
Over the next couple of days, the pain would return from time to time, and I would find myself having to lie down. I was very exhausted, but kept ignoring it because my focus was on work. We were going through the URAC accreditation process at TriageLogic, and my schedule was full of business meetings during the week. Finally, a week later, as the headaches persisted, my neurologist, Dr. Emas sent me to get a brain MRI.
We were all shocked to find that the MRI revealed a blood clot, measuring about 3 by 5 cm on the left front part of my brain, resulting from a brain bleed during my trip to Miami. The bleed had stopped on its own, and I was extremely lucky to be alive.
My case demonstrates the importance of an unbiased medical opinion. I was in the company of multiple doctors. While my symptoms could have been compatible with a brain bleed, my husband and friends felt a serious condition was unlikely because they knew me to be healthy and fit. I myself underestimated my symptoms.
In medical situations it is vital to have an objective opinion. This is exactly why nurse triage is such a beneficial medical service. Had I called an objective triage nurse and my symptoms been applied to the Schmitt Thompson protocols, I would have been referred to the Emergency Room for further evaluation.
Sometimes a loved one’s judgment has its disadvantages. They assess your situation with many other factors that a triage nurse would not find relevant. Their mind is naturally programmed to deny that a loved one may be having a serious illness. Having an unbiased assessment of a patient’s medical state is vital for appropriate care. In some situations like mine, it could be a life-threatening emergency.
Using Nurse Triage to Improve Health Outcomes by Charu G. Raheja, PhD http://triagelogic.com/tcspring2013-chairsmessage/
ROI from Nurse Telephone Triage Calls – Survey of Patient Calls http://triagelogic.com/nurse-triage-roi/