Guide to the emergency room

The Accident and Emergency Unit at the Cayman Islands Hospital is a 24/7 facility that treats people in emergencies and in urgent need of medical care.

The specially-trained doctors and nurses who staff the emergency room are highly qualified to deal with any and all emergency cases.

As with all the services available at the hospital, the skilled and compassionate medical personnel at the emergency room are dedicated to providing the best possible care to the people of the Cayman Islands.

All patients who visit the emergency room are triaged by a nurse. Triage may take place at the bedside for emergency patients or in the triage room for walk-ins and urgent patients.

Triage is a medical assessment of how urgent each patient’s medical problem is. This ensures we treat medical emergencies first, but no one seeking care at the emergency room will be turned away without receiving medical treatment, even if the triage nurse determines the needed care is not an emergency and could safely wait.

It is important to be aware of the process by which emergency staff assesses and treats patients which will help us provide the best and most efficient urgent care possible. The triage method used by the Health Services Authority is well-established within the international medical community.

Each patient’s medical concerns are important and we understand that sometimes it is difficult to determine when a condition requires a trip to the emergency room or can be treated in a less urgent manner. Our triage nurses are specially trained to carefully consider each patient’s needs to decide the order of treatment.

The following list, while not comprehensive, provides a good cross-section of the conditions that represent a medical emergency:

Loss of consciousness

Signs of heart attack that last two minutes or more including pressure, fullness, squeezing or pain in the centre of the chest; tightness, burning or aching under the breastbone; chest pain with light-headedness

Signs of stroke including sudden weakness or numbness of the face, arm or leg on one side of the body; sudden dimness or loss of vision, particularly in one eye; loss of speech, or trouble talking or understanding speech; sudden, severe headaches with no known falls, especially when accompanied by any other stroke symptoms

Severe shortness of breath, such as an asthma attack

Shortness of breath with chest pain

Bleeding that does not stop after application of direct pressure

Sudden, severe pain

Poisoning

Severe or worsening reaction to an insect bite or sting, or to a medication, especially if breathing is difficult

Major injury, such as a head trauma

Unexplained drowsiness or disorientation

Coughing up or vomiting blood

Severe or persistent vomiting

Drowning or near drowning

The emergency room is constantly responding to new patients who are brought in by ambulance or private vehicles. Sometimes these patients need immediate emergency treatment and are given priority over patients who have already been triaged.

This may result in changes to the length of time that one has to wait to be seen by a doctor. Our aim is to update patients in the waiting room about these changes in the wait times as they occur.

We care about every patient and will do whatever we can to help mitigate the stress of visiting the hospital. To this end, our triage nurse will often begin treatment of medical problems while patients wait to be seen by a doctor.

Our staff appreciates that a sick child is an especially anxious time for parents. A young child suffering from a cold accompanied by a high fever, for example, can be very scary for a new parent, but our triage nurses still need to assess all patients who present for care at that same time.

We understand the concerns of any parent but, as always, the most important consideration must be to treat emergency cases first.

We also appreciate that some kind words of reassurance can help alleviate anxieties while waiting for care. All patients will be attended to as quickly as possible based on the triage criteria.

We have all experienced the frustration of wait times that feel too long in an emergency room waiting room and we will continue to work to decrease those wait times as much as possible.

The Health Services Authority is committed to ensuring the best possible health care and emergency treatment for everyone in the Cayman Islands, residents and visitors alike. If the situation requires immediate care, everyone has the assurance of knowing they will have access to the services of the emergency room.

Be assured, we will continue to help our patients understand how best to use the resources available so we can provide the highest quality care and the most efficient and effective emergency services possible. Patient feedback is important to us in our constant efforts to improve our services.

This is the latest in a series of a regular articles by the Cayman Islands Health Services Authority.

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