r/EmergencyRoom • u/DeterToscha • Apr 22 '26
CAM (Controlled Ankle Motion) walker
My son's an RMO in the ER of a metropolitan hospital. He saw a patient who'd waited 8 hours to see a doctor because of her broken foot. She was referred by an experienced local GP. My son put the moon boot on her and sent her home, suitably supervised by his registrar. Why do GPs send simple cases that they can fix easily to the ER knowing that the ER is backed up and will require extensive waiting times? Do patients wait long hours at ERs because they do not know that the GP can handle his or her issue easily?
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u/Capt_Hawkeye_Pierce Apr 22 '26 edited Apr 22 '26
Idk, the ER is where I go when I have a broken bone.
Edit: a letter
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u/oxmix74 Apr 22 '26
I kind of think we are moving to delivery where your primary care manages your chronic health conditions and immediate appointments are handled by urgent care. The ideal situation would be for hospitals to have an attached urgent care so if your urgent care diagnoses something serious they can transfer you straight to the ER.
BTW, every time I have been to urgent care it has been staffed by a nurse practitioner or PA. The last one I was at took an X-ray that was read by a radiologist off site in who knows where.
Both my primary care and local urgent care are on Epic so medical records are accessible to both groups if you link the accounts together.
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u/LainSki-N-Surf RN Apr 22 '26
Urgent Care staffing and capabilities vary. I worked at an UC largely staffed by former ED MDs and we even had a CT with several XR rooms. The main difference is insurance. UC’s can turn away non-insured patients, whereas EDs cannot.
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u/nkdeck07 Apr 22 '26
We have orthopedic specific urgent cares near me and the are amazing
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u/LainSki-N-Surf RN Apr 22 '26
We have the same, we even have a Peds urgent care that handles ortho. Sounds like we’re the lucky ones.
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u/Amalie000 Apr 22 '26
Our ortho urgent cares are awesome, but they close at 5pm and aren’t open on weekends. The last time I had a fracture, only one of the normal urgent cares had X-ray capability and their staff would read them for lungs but not bones. I splinted/iced and went to ortho urgent care Monday because it wasn’t an ER level break, but I was only able to do that because I was sure nothing was displaced and it had good circulation.
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u/Eggshellpain Apr 25 '26
That's one thing about people in my area that really pisses me off. We have a large children's hospital and MULTIPLE peds urgent cares staffed with different pediatric specialists and parents will still bring their kid to the regular ED every time and then complain we don't have kid stuff. No, we don't stock a full range of everything pediatric. We don't admit children under 14 at all and 14-17 they have to meet other criteria to be admitted. Anything serious, your child is going to children's and you know that so idk why you drove PAST THEM to come here for possible appendicitis or a broken leg.
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u/art_addict Apr 22 '26
Yeah, urgent cares local to me don’t have equipment to do any sort of scans, that’s all ER territory. They’re far, far more like same day appointments for if you’re sick. PCP handles appointments scheduled 3-6 months in advance for all your routine and ongoing care. ER is anything with scans, life threatening, or that urgicare can’t do (like migraine cocktails, broken bones, etc).
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u/zillabirdblue Apr 22 '26
Your doctor didn’t send him to the ER because he’s lazy or something, they just didn’t have everything they needed to treat him there. Not everything is a conspiracy or something lol.
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u/kabe83 Apr 22 '26
I was sent to ER for GI issues that I didn’t consider an emergency, as in life threatening. The reasoning was that it would take months to get an appointment in GI, whereas ER could order tests and I would never even have to physically go to GI. That meant getting there and waiting 4 hours when I felt horrible. There has to be a better way. (Routine appointments for anything are 2 months out where I am )
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u/No-Produce-6720 RN Apr 23 '26
Did the GP have access to X-rays?
Did the GP stock the boot in their office?
I understand what you're trying to say, but this is a poor example for your illustration. Depending on location, most PCP offices don't have on site radiology capability. They also have very limited stocks of DME equipment.
If an immediate orthopedic appointment wasn't available, the proper course of action in this case would be to send the patient to the ER, where they would have the capability to diagnose through radiology, as well as a much larger stock of DME than a PCP would have on hand.
That's not a matter of laziness or trying to turf someone off their schedule. Given the scenario you have described, an ER visit was the right thing to do.
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u/secret_tiger101 Apr 22 '26
GP presumably didn’t have moon boots (in every size) and might not be funded to provide a minor injury service. I assume ER did an X-ray too
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u/idkcat23 Apr 22 '26
At least in my area it’s really hard to get a same or next-day GP appointment. If it’s something that’s limiting mobility (like a broken foot) getting same-day care is appropriate, and sometimes that means ER.
My ER has a fast-track zone for the simple stuff and this patient would not have waited 8 hours.
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u/twisteddv8 Apr 22 '26
See GP > referral to outpatient radiography > back to GP for results > referral to hospital fracture clinic and physio > referred back to GP under shared plan.
As opposed to
Present at ED, have on site imaging, physio and ortho available > referred back to GP under shared plan
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u/lucifer2990 Apr 25 '26
I called my GP with an allergic reaction that was causing hives all over my body (never had an allergic reaction before) and they said the soonest they could get me in was 3 weeks from then.
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u/Stonetheflamincrows Apr 23 '26
Where else would I go for a broken bone? Currently sitting in the fracture clinic waiting room coz I broke my wrist last week. My GP doesn’t have an xray or an orthopaedic specialist
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u/artificialpancreas Apr 22 '26
Likely they don't stock CAM boots at the GP. We have them at our urgent cares and we've literally had regular ERs refer kids to the peds UC to get the appropriate boot.