Emergency department mixups
Stroke patients should never miss out on essential treatments
A fifty year old woman experienced a sudden onset of visual disturbances, abnormal hallucinations, and confusion. She had seen the ads on television, saying ‘if you feel you are having a stroke, go straight to the emergency department’. She felt sure this was happening she was having a stroke.
So she rang a taxi, and made her way to an emergency department within in half an hour. She told the triage nurse at the front desk all about her symptoms. The nurse checked her vital signs then told her to sit and wait.
She sat in the emergency department. And waited. Emergency was very busy. Nurses and doctors were rushing past. Finally she was taken inside the department. But instead of being quickly assessed, she was moved by attendants from one cubical to another. It seemed like a game of ‘musical beds’. At one stage a nurse appeared, asked a few questions, got her to change into a gown, took some blood then rushed off.
At one stage a junior doctor came to see her, ordered an ECG, then rushed off again. Six hours later, after three sets of observations, one set of bloods and with her symptoms still not resolved, another doctor ordered at CT scan of her brain.
This scan showed that she experienced an ischaemic stroke, caused by a clot in one of her brain blood vessels. It had blocked off part of the brains blood supply.
By now it was too late for her to be given clot busting drugs. The emergency doctor explained that the clot busting drugs can only be given within three hours of a stroke occurring. “But I’ve been waiting here for six hours” cried the woman.
“I told the nurse at reception that I was having a stroke. I’ve seen the symptoms on the TV. Why didn’t anyone see me sooner?”
The doctor apologised. The nurses were so busy swapping patients around they couldn’t even listen to her story. The woman was admitted to a stroke ward. A neurologist came to see her the next day. He told her that she had missed out on very important treatment and expressed his frustration about the mixup up in the Emergency Department.
The only treatment the woman was now able to receive, was to be put on a blood thinning tablet. After several days she was then discharged home.
That afternoon, the woman suffered another stroke. She was readmitted to the same Emergency Department. She was very distressed and angry, crying out that ‘nobody cared’.