Your care at emergency
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- Shauna Lily Norman
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1 Your care at emergency
2 Assessment Our aim This brochure explains how the Emergency Division functions, describes the various stages of your admission and provides information on the Geneva Emergency Network (Réseau Urgences Genève, RUG). You are ill or have suffered an accident and have come for a consultation to the HUG Emergency Division. What happens first? When you arrive at emergency, whether by your own means or in an ambulance, you are met by a specialized nurse. This health professional, together with a resident doctor, determines the severity of your case on the basis of your complaints and factors such as blood pressure, pulse, temperature and pain. Following this assessment, you are attributed a level of urgency. This establishes how quickly you will receive medical care and the most appropriate place for it. A resident regularly re-assesses the situation at the patient s request or as the nurse requires. 2
3 Levels of urgency Think RUG If your condition is not life-threatening, consider going to the RUG facility closest to you. For life-threatening emergencies: 144. How soon will you be treated? LEVEL OF URGENCY TREATMENT (2011) Level 1 = life-threatening Example: heart attack Level 2 = urgent Example: open fracture Level 3 = semi-urgent Example: abdominal pain Level 4 = non-urgent Example: superficial injury Immediate 76% of patients are seen within 20 minutes 73% of patients are seen within two hours Undetermined wait; patients are seen as soon as possible LEVEL OF URGENCY ASSESSED ON YOUR ARRIVAL Level 1 Level 2 Level 3 Level 4 Remember In the acute sector, it s the level of urgency, not the order of arrival, that determines where and how soon the case is treated. At 11 p.m., the out-patient sector closes and all emergencies are directed to the acute sector. Where will you receive medical treatment? The Emergency Division sector you are directed to depends on the level of urgency and what your needs are likely to be (observation, hospitalization): Acute sector â levels 1, 2 or 3 Outpatient sector â levels 3 or 4 YOU HAVE BEEN DIRECTED TO THE Acute sector Outpatient sector 3
4 Treatment What happens before you see a doctor? All life-threatening cases (level 1) are seen immediately by a doctor. In all other instances, a doctor assesses your case as soon as one is available and in the light of the service s caseload. While you wait, a health worker regularly re-assesses your condition and may, if necessary, already start treatment for pain. If you feel worse, it is important that you (or the person accompanying you) inform the health staff. Can someone tell me how long I ll have to wait? The staff can inform you at any time how busy the service is and give you an indication of the waiting time. However, given that new patients are arriving all the time, it may be difficult to tell you exactly how long you ll have to wait. If the division is very busy, you may prefer to go to another RUG facility (see on back). Numbers + In 2011, 59,360 emergencies, as follows: Level 1: 2,751 Level 2: 13,421 Level 3: 41,303 Level 4: 1,885 Why is there sometimes a long wait? Your treatment may take time because: each doctor supervises several patients at the same time and gives priority to the most urgent cases in addition to the medical assessment, your case may require lab tests, x-rays or the intervention of a specialist who is not always immediately available. 4
5 After assessment What happens once your case has been assessed and your condition determined? There are three possibilities: You go back home and the emergency doctor writes a report for your regular doctor. Your condition requires 12 to 24 hours of observation before you can be allowed to return home or are hospitalized. You are placed in the observation unit. You have to be hospitalized. In that case, it is our role to find an appropriate place. Depending on how occupied the hospital s services are, you may have to wait for a bed to become available. Info + Billing Should you choose to leave the hospital before you ve seen a doctor, the nurse s assessment on your arrival will be invoiced. This service is covered by the basic health insurance. Additional information Emergency Division facts and figures: 160 to 180 patients per day (60,000 per year) about 250 health, administrative and logistics professionals, working in teams round the clock, 7 days a week a technical platform (radiology, scanner, catheterization room) available 24/7 consulting doctors and specialists available 24/7 5
6 Practical information Emergency number 144 Emergency Division Prof. François Sarasin, head of division Isabelle Golard, in charge of care, Department of Community Medicine, Primary and Emergency Care Rue Gabrielle-Perret-Gentil 2, 1211 Genève (24/7) Emergency Division secretariat (Monday-Friday, 9 a.m.-12 p.m. and 2-4 p.m.): Acute sector: Outpatient sector: Hospital (main building, 24/7) Rue Gabrielle-Perret-Gentil 4, 1211 Genève (24/7) Réseau Urgences Genève (RUG) application for Smartphone users indicating average waiting times at the five RUG facilities The RUG comprises, in addition to the HUG Emergency Division, four facilities able to handle your case. Hôpital de la Tour (24/7) Avenue Jacob-Daniel Maillard 3, 1217 Meyrin Clinique des Grangettes (7 a.m.-11 p.m. weekdays, 8 a.m.-11 p.m. weekends and public holidays) Chemin des Grangettes 7, 1224 Chêne-Bougeries Clinique de Carouge (24/7) Avenue Cardinal-Mermillod 1, 1227 Carouge Groupe médical d Onex (24/7) Route de Chancy 98, 1213 Onex DMCPR&U : les urgences / Photos : Julien Gregorio / PHOVEA Septembre 2012 (version anglaise)
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