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dancing-drama
03-14-2013, 08:38 PM
Hi! :)
My family and I have been very lucky hospital-wise... so all I know about going to the ER is that hot young doctors wait there for you and the person you least expect is going to die and there will be sad music. (Grey's Anatomy, anyone?)

Anyway: The character is a 19 y.o. girl who has been beaten up to the point of losing consciousness. Two of her friends (approx. same age, don't know her too well) get her to the hospital. And then... what would happen? She's not a minor anymore - would her parents be alerted anyway? She's not exactly on speaking terms with them, but I have no idea how the whole emergency contact thing works...
Can somebody explain just how the behind-the-scenes stuff works if you bring a barely legal, beaten up and unconscious girl (that you're not related to) to the ER?

I'd be so, so grateful! :heart:

Rockweaver
03-14-2013, 09:10 PM
I think it will depend on the hospital and the town. its possible that the police may become involved due to the trauma.

as to the ER. they will 1st look for medical info aka allergies etc.. they will also assess her to determine the degree of damage (aka surgery etcl) needed to stabilize her.

family will be contacted If they have an easy way to get that info. if the friends bring her in then the staff will ask them questions
what happened
is he alergic bla bla bla.
how old who is her next of kin contact info.

ER rooms are not quite what you see on TV. i have been in a few and the Dr.and nurse staff have always been very calm and polite. (woke up in a ER after a accident) they 1st rule is to get the patient stable and out of danger. then they move forward with next greatest need. for me it was assess at 4pm 2am cat scans then off to a room 2 days later surgery to rebuild the broken body. each case is different.

if you have friends who are nurses they can prob give you a better view on the day to day and methods my memory is just from being in my self or my kids taking them in.

jclarkdawe
03-14-2013, 09:13 PM
You're not "just barely" an adult. It's a legal term and it's real simple. In the US, if you are 17 and 364 days, you're a minor. If you're 18 and 0 days, you're an adult.

The hospital would check for the patient's record and see if there is a next of kin. But it's not going to be a big deal for quite a while. An unconscious patient is assumed to consent to reasonable medical treatment. For medical treatment, that's going to hold the situation for at least six hours, and probably for 12 or more.

Depending upon the hospital's protocols, the police may or may not be contacted. Even if the police are not contacted, her injuries will be recorded, and a good hospital will take pictures for later legal evidence.

Her friends would probably be allowed to stay with her, consistent with treatment needs.

Best of luck,

Jim Clark-Dawe

Dandroid
03-14-2013, 09:44 PM
I'm wondering why her friends didn't activate EMS?

Beachgirl
03-14-2013, 11:12 PM
I'm wondering why her friends didn't activate EMS?


Because her friends are young and stupid? Been there, done that. When I was 20 I was at a party and a friend had a little too much to drink. He dove into the pool and hit his head. No one else was in the pool, but we all heard the "thunk" and saw it happen. He wasn't completely unconscious, just didn't know his name or where he was. But instead of calling an ambulance, we loaded him into my car and drove him five minutes to the ER. The doctor asked us what happened, examined him, ran some tests, kept him for a few hours, then sent him home with instructions for one of us to keep an eye on him for the next 24 hours. They never asked about next-of-kin.

storygirl99
03-14-2013, 11:21 PM
If you are looking for a way for her parents to be notified because you need it for the story, is it possible that she could still be on their health insurance policy? Children can be on their parents insurance legally until the age of 26 if they are students or do not have access to health insurance, and surely that would be something the hospital would need to know.

Dandroid
03-15-2013, 01:30 AM
Well if you were to bring someone into an ER, the nurses might have some quick questions for you...and perhaps police if they show up...beyond that there isn't much involvement if you don't have a lot of information...if they don't have a patient history, then they may try to search out family...mostly they'd just try to stabilize the patient....run some fluids..do some diagnostic imaging, etc...if they don't have the resources, they'd ship the patient to a trauma center...

Crayonz
03-15-2013, 03:17 AM
If she's been to the hospital before (for whatever reason) and her parents are on her account, they might be notified. However, if she is unable to say and her friends tell the staff that she wouldn't want her parents there, they won't contact them.

melindamusil
03-15-2013, 03:49 AM
Speaking as one who was brought into the ER as an unconscious girl (but 17 y/o)...

Type of hospital would affect the immediate response. In my case I was in a car accident in a reasonably urban area, so the hospital I was brought to was/is the area's major teaching hospital. However if the accident was in a more rural area, the patient might be taken to a smaller hospital, which would then try to stabilize her and transfer her to a bigger hospital.

Also, when I had my accident, there was a brief debate about which hospital to send me, the major teaching hospital or the pediatric hospital next door to the major teaching hospital. They had not yet found my ID and I looked young. (17 is still pediatric.) They went with the grownup hospital because they're better at dealing with patients who have traumatic brain injury.



as to the ER. they will 1st look for medical info aka allergies etc.. they will also assess her to determine the degree of damage (aka surgery etcl) needed to stabilize her.


If she is unconscious, then as jclarkdawe says...



An unconscious patient is assumed to consent to reasonable medical treatment. For medical treatment, that's going to hold the situation for at least six hours, and probably for 12 or more.


In other words, they are NOT going to waste time trying to figure out if she is allergic to a particular medicine. In that moment, the risk of NOT giving the medicine is worse than the risk of giving the medicine and dealing with an allergic reaction. (The only exception is when the patient is wearing a medic alert necklace or bracelet, which EMS would likely have already discovered.) Once the patient is stabilized a bit, then they can worry about getting an accurate medical history.

Over here in the US, at least, if she's 19, you're gonna have to deal with HIPPAA. Under 18, they can talk to her parents. Over 18, it depends. I'm honestly not sure how insurance would work for over 18 but under 26 - I don't know if that automatically entitles the parents to know the medical stuff.

In my case, I wasn't identified until after they'd cut off all my clothes and found my drivers license in my pocket.

Also, my neurosurgeon wasn't nearly as cute as McDreamy, but he was much more intelligent so I'm okay with that. :-)

ebbrown
03-15-2013, 04:10 AM
Hi! :)
My family and I have been very lucky hospital-wise... so all I know about going to the ER is that hot young doctors wait there for you and the person you least expect is going to die and there will be sad music. (Grey's Anatomy, anyone?)

Anyway: The character is a 19 y.o. girl who has been beaten up to the point of losing consciousness. Two of her friends (approx. same age, don't know her too well) get her to the hospital. And then... what would happen? She's not a minor anymore - would her parents be alerted anyway? She's not exactly on speaking terms with them, but I have no idea how the whole emergency contact thing works...
Can somebody explain just how the behind-the-scenes stuff works if you bring a barely legal, beaten up and unconscious girl (that you're not related to) to the ER?

I'd be so, so grateful! :heart:

Unfortunately, as an ER nurse, I have seen this scenario way too many times. Technically, us medical folks are governed by a law called HIPAA. We have to take it very seriously, even when we disagree with it, because our jobs and our license to practice depend on it. HIPAA protects the privacy of the patient. In the situation you describe, no, her parents would NOT be called (at first) unless the patient woke up and asked for them to be called. If we have a positive identity on a patient and she is not critical, we treat the patient and wait for her to wake up. Then she can give consent for us to call her family if she so chooses. We have many, many, young people brought in by EMS who have overdosed, and I am not allowed to call their parents, even if they are 18 years old, at least not without consent to do so.

If your character has an emergency contact card in her wallet, then yes, we consider this consent for someone who is unconscious, and we will contact them. If a weapon was used in the assualt or if the injury is life-threatening, then we can call the police. The police can call whoever they want, and they will. I have had many young women who were beaten badly wake up and simply sign themselves out AMA because they do not want the police or other family involved.

If I was the nurse in your scenario, I would speak to the girl's friends and gain their trust. I would urge them to call the girl's family, and I would try to get them to call the police. When someone comes in unconscious, without anyone to speak for them, we go through their belongings to try to find identification and an emergency contact to call.

Unfortunately, the whole HIPAA thing makes me nuts, and most ER staff bend over backwards to do the right thing when there is a kid involved.

And yes, we are all having sex in the elevators and med rooms, just like TV. ;)

dancing-drama
03-15-2013, 12:44 PM
Thank you guys! All this helps a bunch and will get me through the next two chapters :) What would I do without the AW folks? Cookies for everyone!

GeorgeK
03-20-2013, 12:17 AM
Ri
If she's been to the hospital before (for whatever reason) and her parents are on her account, they might be notified. However, if she is unable to say and her friends tell the staff that she wouldn't want her parents there, they won't contact them.

No the word of a friend will not be taken at face value. If the patient is unresponsive they will try to contact family regardless of age if only as another target to bill. Friends are notorious for getting medical history wrong.

GeorgeK
03-20-2013, 12:23 AM
If we have a positive identity on a patient and she is not critical)

That's the crux. I was assuming unresponsive plus head trauma equals critical.

MariePinkerton
03-21-2013, 05:20 AM
[deleted]

ebbrown
03-21-2013, 11:17 PM
That's the crux. I was assuming unresponsive plus head trauma equals critical.

Nahh, not always. We have lots of drunks who fall down, are unresponsive from being drunk, and we have to wait for them to sober up. They usually hit their heads, and we give them a CT to rule out any critical injury to the head. Those are the complicated patients. They can sleep it off in the ER for several hours, and be discharged with a minor concussion.

ebbrown
03-21-2013, 11:24 PM
Does this legally get around HIPPA?
No. I strongly dislike HIPAA. Too many times I think, "what if this was my child sitting here?" I feel quite powerless sometimes as an ER nurse. I'm not allowed to contact the patient's family if the patient says not to, but if her friends wants to, that is up to them. If a parent called the hospital looking for their child in a situation like that, technically if the patient says she doesn't want them to know, I can't even say the patient is there.
It stinks, being a parent, and seeing stuff like that.

GeorgeK
03-22-2013, 05:33 PM
Nahh, not always. We have lots of drunks who fall down, are unresponsive from being drunk, and we have to wait for them to sober up. They usually hit their heads, and we give them a CT to rule out any critical injury to the head. Those are the complicated patients. They can sleep it off in the ER for several hours, and be discharged with a minor concussion.

Yep, reminds me of an M&M report as a resident where I had to write up all the traumas. One was, "Lip Abrasion." Of course all the surgeons were aghast that a full trauma response was called for such a minor thing. As it turned out the guy was royally drunk, drove through his own garage and crashed into his porch. He got out of the car, looked around and then called 911 to report that someone had vandalized his home. Then he passed out outside and somewhere along the way scraped his lip. The police arrived and found the guy bleeding from his face and the place all torn up. He was unresponsive so they called the trauma unit. He arrived in our care on a backboard, got the full twice over and yes, just needed a few hours to wake up. I doubt he ever paid that hospital bill.

Summerwriter
03-23-2013, 08:09 PM
That's nasty case.