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5 Things You Should Know – Part 295

Here are 5 things you should know.

1. You can get Microsoft Office 365 for free if you’re a student or educator with a valid school email address.

Here’s a link:

https://www.microsoft.com/en-us/education/products/office

It includes Word, PowerPoint, Excel, and more.

2. If you’re passing a pedestrian on a bike not announcing your orientation puts you both at serious risk for injury.

If you are on a bike trail, sidewalk or sharing any track with pedestrians you need to let them know you’re coming. They often can’t hear you (especially over traffic) and often make adjustments for puddles, potholes or obstructions. It’s not just proper etiquette it’s a serious safety issue.

3. How an emergency department’s triage and flow process works (USA).

Most emergency departments in the US use a triage system that uses 1 through 5 for acuity with slight variations, some are color coded, some reverse the scale but the concept is the same; very sick to not at all sick. In this example 1 is someone who if not seen in the next few minutes will likely significantly worsen, die, or is already trying their best to be dead. Think impending respiratory failure, cardiac arrest, GSW to the torso, actively seizing, unresponsive. The opposite of that, level 5, is someone who could wait in the waiting room for literal weeks and will not likely die. Think voluntary STI screening without symptoms, chronic symptoms that are not changed, or medication refill for a nonessential medication.

The system takes into account as many objective pieces of data as possible such as chief complaint, vitals, gender, age, medical conditions, etc. There is sometimes a little wiggle room for triage level but most often not. Additionally, this looks at the grand scheme or big picture of illness, so even though you may feel very sick with something like the flu you may not be triaged as sicker because of some of the other factors. For example, a person who says they are having 10 out of 10 pain but has completely normal vital signs and are playing on their phone, walking without difficulty, and are otherwise healthy is not going to be triaged as highly as someone with similar concerns but looks very sick and has abnormal vital signs.

You will be seen and evaluated by a nurse and assigned a triage number. Occasionally, if the emergency department isn’t busy you will just get to go back to a room and they will complete the triage process there.

Now comes the waiting part. If you are a level 1 you will be seen as soon as a doctor is available. Sometimes the doctor gets pulled out of other rooms (including in the middle of seeing you) if the other patient is ultra sick. If you are a level 2 you will wait for any level 1s that come in at any point from you getting there to you being seen and any level 2s that have been waiting longer. Similarly, if you are a level 3 you will wait for any level 1 and any level 2 and every level 3 that has been waiting longer than you. Etc etc. i.e. if you are a level 5 (least sick) you will wait for a long long long time at most busy EDs. This often applies even when you have already been roomed.

Even if the waiting room is not busy that doesn’t mean the actual rooms aren’t all full with patients who are still being evaluated. Additionally, EMS crews bringing patients in by ambulance sometimes have priority for rooms (please don’t abuse this, EDs absolutely put people brought in by EMS in triage to wait like everyone else, you will be charged more and piss people off if you abuse EMS). On top of that is staffing issues meaning not every room can be used and a certain number of rooms have to be kept for level 1 patients who may show up.

Sometimes emergency departments have what could be thought of like a built-in “urgent care” where certain rooms are designated for things like sore throats and other minor concerns in healthy people where people are seen with more limited resources. So you may see people who don’t look sick getting called back to a room before you even if you’ve been waiting a long time.

There are variations, and the staff does their best to see people in a timely manner while also treating the sickest patients. The downside of triage and limited resources is that you may wait longer than you would like. The good news with that is that if you are waiting longer it probably means that you are not the sickest person in the ED.

4. Instead of buying overpriced water at the airport you can take an empty reusable water bottle through security and fill it up in the bathroom.


This can save money on your travels.

5. If you Google “wildlife rehabilitation centers near me” it will tell you where to take injured or orphaned wild animals.

And always make sure they actually need your help before capturing them. Be sure to get a wildlife rehabber on the phone for advice before taking any action. Sometimes things that you think might help (like giving food or water) can actually harm an injured wild animal.

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