Poll: Immediately to ER or Wait 24 hours?
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  1. #1

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    Poll: Immediately to ER or Wait 24 hours?

    When you have a non-life threatening injury from a crash, do you opt to rush directly to the ER for x-rays and to lighten your wallet, or do you hole-up with anti-inflam's and 6 videos to wait and see?

    Normally I'm a rusher. If it's swollen at all, I get myself x-rays pronto. Now that I'm without insurance, I find it necessary to wait. I waited this weekend and am glad I did. My knee is definatly not broken, and its unlikely that I've torn any ligements (something the ER could not have diagnosed anyway). On the back-end, I'm wondering how many of my past ER trips were truly necessary. But when it only cost me $25 out-of-pocket to visit the ER, I figured, "Why not?" (Then again, did it only cost me $25?) When I was growing up, no parent ever took their kid to the ER unless something was gushing or bending in the wrong direction.

    Can non-displaced, weight-bearing fractures and torn ligaments be safely treated 24-48 hours later?

  2. #2

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    they'll have to drag me in

    I don't go to the hospital unless I've been knocked out or have an obvious broken bone. Avoid hospitals at all costs, unless it's a head injury, is my rule.

    Doug

    Quote Originally Posted by Free2Pedal
    When you have a non-life threatening injury from a crash, do you opt to rush directly to the ER for x-rays and to lighten your wallet, or do you hole-up with anti-inflam's and 6 videos to wait and see?

    Normally I'm a rusher. If it's swollen at all, I get myself x-rays pronto. Now that I'm without insurance, I find it necessary to wait. I waited this weekend and am glad I did. My knee is definatly not broken, and its unlikely that I've torn any ligements (something the ER could not have diagnosed anyway). On the back-end, I'm wondering how many of my past ER trips were truly necessary. But when it only cost me $25 out-of-pocket to visit the ER, I figured, "Why not?" (Then again, did it only cost me $25?) When I was growing up, no parent ever took their kid to the ER unless something was gushing or bending in the wrong direction.

    Can non-displaced, weight-bearing fractures and torn ligaments be safely treated 24-48 hours later?

  3. #3
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    Quote Originally Posted by Free2Pedal
    When you have a non-life threatening injury from a crash, do you opt to rush directly to the ER for x-rays and to lighten your wallet, or do you hole-up with anti-inflam's and 6 videos to wait and see?

    Normally I'm a rusher. If it's swollen at all, I get myself x-rays pronto. Now that I'm without insurance, I find it necessary to wait. I waited this weekend and am glad I did. My knee is definatly not broken, and its unlikely that I've torn any ligements (something the ER could not have diagnosed anyway). On the back-end, I'm wondering how many of my past ER trips were truly necessary. But when it only cost me $25 out-of-pocket to visit the ER, I figured, "Why not?" (Then again, did it only cost me $25?) When I was growing up, no parent ever took their kid to the ER unless something was gushing or bending in the wrong direction.

    Can non-displaced, weight-bearing fractures and torn ligaments be safely treated 24-48 hours later?
    Rule of thumb...any major laceration or loss of consciousness- go directly to ER. Any extremity injury...wait 2-3 days...if pain does not get better or gets worse- get xrays. No harm in waiting...btw...no such thing as weight bearing fracture, except of upper extremity or perhaps little toe...anything else, you ain't gonna be able to bear weight...unless you are Tyler Hamilton. =)

  4. #4

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    wait

    Quote Originally Posted by Free2Pedal
    When you have a non-life threatening injury from a crash, do you opt to rush directly to the ER for x-rays and to lighten your wallet, or do you hole-up with anti-inflam's and 6 videos to wait and see?

    Normally I'm a rusher. If it's swollen at all, I get myself x-rays pronto. Now that I'm without insurance, I find it necessary to wait. I waited this weekend and am glad I did. My knee is definatly not broken, and its unlikely that I've torn any ligements (something the ER could not have diagnosed anyway). On the back-end, I'm wondering how many of my past ER trips were truly necessary. But when it only cost me $25 out-of-pocket to visit the ER, I figured, "Why not?" (Then again, did it only cost me $25?) When I was growing up, no parent ever took their kid to the ER unless something was gushing or bending in the wrong direction.

    Can non-displaced, weight-bearing fractures and torn ligaments be safely treated 24-48 hours later?
    Yes, and as a medical rehab professional, most people that tear tendons, ligaments, or cartilage wait at least 24 hours before going to the doctor. The main issue is excessive swelling can make the x-ray's and other imaging studies harder to read. Heck, all the ER is going to do is put you in a brace, give you pain killers, and tell you to ice and rest. Now the medical field will tell you to rush to the ER becuase there are many rare injuries or complications that do need immediate care, but all those same people do not rush to the ER themselves, they want to save the cash (and usually $75+, $25 is unheard of these days). Breaks and head injuries are another story all together-get in quick.

  5. #5
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    public health care

    I can not imagine having to make a decision about whether or not to go get help based on money... Our system up here in Canada is not what it once was but it sure beats paying out of pocket.

  6. #6

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    Quote Originally Posted by greyghost
    Yes, and as a medical rehab professional, most people that tear tendons, ligaments, or cartilage wait at least 24 hours before going to the doctor. The main issue is excessive swelling can make the x-ray's and other imaging studies harder to read. Heck, all the ER is going to do is put you in a brace, give you pain killers, and tell you to ice and rest. Now the medical field will tell you to rush to the ER becuase there are many rare injuries or complications that do need immediate care, but all those same people do not rush to the ER themselves, they want to save the cash (and usually $75+, $25 is unheard of these days). Breaks and head injuries are another story all together-get in quick.
    Yeah my copay is $75 for an ER visit these days.
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  7. #7

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    I guess I had a good plan then. Perhaps it was $50/visit

    Quote Originally Posted by Bocephus Jones
    Yeah my copay is $75 for an ER visit these days.
    Whichever it was, at the time I was working, it seemed like a nominal cost.

  8. #8
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    Quote Originally Posted by Free2Pedal
    When you have a non-life threatening injury from a crash, do you opt to rush directly to the ER for x-rays and to lighten your wallet, or do you hole-up with anti-inflam's and 6 videos to wait and see?

    Normally I'm a rusher. If it's swollen at all, I get myself x-rays pronto. Now that I'm without insurance, I find it necessary to wait. I waited this weekend and am glad I did. My knee is definatly not broken, and its unlikely that I've torn any ligements (something the ER could not have diagnosed anyway). On the back-end, I'm wondering how many of my past ER trips were truly necessary. But when it only cost me $25 out-of-pocket to visit the ER, I figured, "Why not?" (Then again, did it only cost me $25?) When I was growing up, no parent ever took their kid to the ER unless something was gushing or bending in the wrong direction.

    Can non-displaced, weight-bearing fractures and torn ligaments be safely treated 24-48 hours later?
    Assuming you don't have any underlying, life-threatening injuries, it's safe to wait 24-48 hours to treat muscluloskeletal injuries.

    You've done a good job demonstrating one of the reasons why health care insurance has gone up so much over the last decade. With flat co-pays, patients have little incentive to wait and see if it gets better. And doctors don't have any incentive to say, "It looks fine to me. Come back in a couple of days if it doesn't go away on it's own."
    "The team wasn't just riders. It was the mechanics, masseurs, chefs, soigneurs, and doctors. But the most important man on the team may have been the chiropractor."

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  9. #9
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    Wait by all means...

    ERs pretty much are useless unless you A. been shot B. have bones sticking through your skin C. blood coming from your ears...I agree with Ghost, all an ER is going to do with an orthopedic injury is brace it and tell you to see an orthopod. As for walking around with a fracture, it is possible. I work with college athletes on a daily basis and have seen numerous athletes try to compete to later find a fracture. Heck, when I was in high school I jumped from a hay loft and broke a bone in my foot. I went 3 days of walking around, bad walking but walking none the less, till I went to a doctor.

    ANYWAYS for ortho stuff you can probably stay away from the ER for awhile.

    e

  10. #10
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    I'm not a doctor, but I play one on a forum???

    For me, unless I'm bleeding profusely or I'm positive I've got a broken bone, they'll have to carry me in an ambulance to get me to the ER. And in my case, ER treatment is absolutely free.

    Sorry to hear about your accident, hope you get better soon, let us know how you turn out.
    Ride in Peace....Enjoy every sandwich......Mike

  11. #11
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    Depends....

    We all end up going down once and awhile, cuts and scrapes and road rash can be fixed up at home. The only time I was ever hosptalized (in my whole life) is when I crashed 4 years ago and was knocked unconscious and felt a slight pain in my chest. They threw me in a aumbulance and I ended up in the ER for 4 hours, which resulted in a 7 day hospital stay. I had 4 fractured ribs. I hate to think what I would have felt like the next morning if I had refused that ambulance ride. I'm lucky, my medical insurance covered everything....depends on the pain and the injuries, best not to take chances on some stuff...worse pain to me was my ego...

  12. #12
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    If you can walk, and you don't see dead relatives waving you towards a bright light, it's better to just go home and jump into the shower and clean off the wound. If you have to wait 2 hours before you clean it, it's going to hurt like hell.
    I've only had to go to the ER for a crash once, and that was because 1) I had to call for a ride, and 2) I wasn't making any sense in my explanation of what happened ( well less than normal)
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  13. #13
    djg
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    That depends.

    I'm well insured, so the money isn't really an issue. If I think it's an emergency I go. If I think it might be a broken bone, then I go to the ER if it's a weekend and my doc's office (and his preferred x-ray lab) is closed.

    This winter I injured my ankle playing indoor soccer on a Friday night. Come Saturday morning, I still couldn't put any weight on it so I went to the ER--if they were going to have to set it I didn't want to wait until Monday.

    You know, people complain about the expense of ER treatment but I got quite a bit of free "care" on my last visit. For instance, a woman came into my little alcove and administered an EKG for which the ER never even billed me.

    Me: "Are you sure they want an EKG? The problem is my ankle."
    Her: "I just do what they tell me--the doctor said you need an EKG."
    Me (just wondering--gee, just how bad was my blood pressure at the triage desk?)

    So, it turns out that my heart was fine, despite an incredibly swollen ankle. And no charge to learn that--not even to the insurance company.

  14. #14

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    Did they bill your insurance for the EKG?

    An EKG for a swollen ankle? To quote John Stossle, "Give me a break!" I'm wondering if they billed your insurance company for the EKG. You know, just snuck it in on the back end. With all of the penney pinching and greed in the health care system, I'm surprised a hospital would give free unecessary tests. After my last ER visit (car wreck), I caught several companies reaching for my pockets (Hospital, doctor & both of my insurance companies).



    Quote Originally Posted by djg
    I'm well insured, so the money isn't really an issue. If I think it's an emergency I go. If I think it might be a broken bone, then I go to the ER if it's a weekend and my doc's office (and his preferred x-ray lab) is closed.

    This winter I injured my ankle playing indoor soccer on a Friday night. Come Saturday morning, I still couldn't put any weight on it so I went to the ER--if they were going to have to set it I didn't want to wait until Monday.

    You know, people complain about the expense of ER treatment but I got quite a bit of free "care" on my last visit. For instance, a woman came into my little alcove and administered an EKG for which the ER never even billed me.

    Me: "Are you sure they want an EKG? The problem is my ankle."
    Her: "I just do what they tell me--the doctor said you need an EKG."
    Me (just wondering--gee, just how bad was my blood pressure at the triage desk?)

    So, it turns out that my heart was fine, despite an incredibly swollen ankle. And no charge to learn that--not even to the insurance company.

  15. #15
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    If I Crack A Helmet...It's ER Time

    I don't like going to the doctor, but I'll go if it makes sense. Two trips to the ER later has given me this rule of thumb: if you fall on your head hard enough to crack your helmet, you should think about going. Both times that this happened I was diagnosed with a concussion. The first trip involved some memory loss (I couldn't tell my wife when or where I had fallen, nor could I remember riding home), and the second involved being hit by a car.

    Oh, if you ever have the bad luck to be hit by a car, by all means go to the ER. My one unscheduled trip over the hood of a Honda earned me an ambulance ride to the hospital. You also get much better service when you come in an ambulance.

    On my first trip to the ER, I was a walk-in. After the nurse took my blood pressure and ascertained that I wasn't going to croak on the spot, I was told to go wait in the lobby. The nurse told my wife to watch me carefully and to call her if I nodded off to sleep, as that would be a "bad" development. After waiting for four hours as a guest of the fine collection of vomiting and vermin-encrusted street people who normally call the Emergency Room waiting area their home, I finally saw a doctor. It was three more hours before I went home. It was a good thing, however, that I went because I had a pretty good concussion. Contrast this experience with the time that I arrived at the ER by ambulance: I was seen immediately by a doctor, who whisked me into x-ray. While they were reading the X-rays, I talked with the fine policeman who took down the details of the accident (and served me a subpoena to appear at the trial of the driver). Diagnosis -- concussion and shoulder strain. I was home in about two hours with some most excellent muscle relaxers.
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  16. #16
    Arrogant roadie.....
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    When you're talking about arms and legs, trust me, if you have a broken bone, it's gonna hurt like h3ll. If you f*** your knee up, even 24 hours isn't going to make things too much worse.
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  17. #17
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    Unless it is life-threatening, don't go.

    That's what ER's are supposed to be; not expensive family-practices. I'm not a Dr, but I do work as a medical technologist. Do yourself (and others) a favor-if it doesn't get better in 24, see your family Dr or an orthopedic Dr.
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  18. #18
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    Does it?

    Quote Originally Posted by Frith
    I can not imagine having to make a decision about whether or not to go get help based on money... Our system up here in Canada is not what it once was but it sure beats paying out of pocket.
    My Canadian co-worker, who makes the same money as I do, pays about twice what I do in income tax. Now we have three kids and also give heavily to charity, so my taxes are comparatively low even for an American, so maybe it's 50% more on average, but the point is the same. You're still paying for it, you're just doing it through much higher taxes. I'm not sure in Canada, but my British and Aussie co-workers, who all have national health systems, all also carry private insurance so they can get a higher standard of care in a reasonable amount of time. Sounds like the worst of all worlds to me - higher taxes AND high health insurance costs.

    Actually, I think both national health care and low insurance co-payments have contributed to the problem, by encouraging us to go unquestioningly to the doctor without even thinking about the cost or about whether we really need to go. When we had a $10 co-pay and the kids got sniffles, my wife always wanted to run them to the doctor just to be sure. Now that we don't have that anymore, we think about what they're really going to need.

    Anyway, don't want to turn this into one of the political arguments that belongs in the Non-Cycling Discussions forum. My point is simply that health care is extremely expensive everywhere. You can shift costs around, but you're still paying for it somehow.
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  19. #19
    hi, I'm Larry
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    Wait unless you suspect internal or head injuries

    Or if you heard a bone snap, see it sticking out or are just certain it is broke.

    I cracked a rib last year and did not go to the ER or doctor. There wasn't anything the Doc could do anyway other than tell me to stay off the bike. Just took it easy for about 4 weeks (but continued to ride) and let some air out of the tires to smooth the ride out some. It healed completely in 6 weeks.

    Depends on the injury. Broken legs and such need to be set properly or you can have long term problems, other things fix themselves.

  20. #20
    djg
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    No bill--"free" was a joke.

    They did actually administer an EKG test, but it was pretty obviously a mistake. The doc apologized and assured me that there would be no bill for the test. I've seen the statement that went out to the insurance company (I got a copy)--it's just not on there. So, it really was free in the sense that neither I nor the insurer was charged for the "service," but not a free good in that, for me, the test was entirely unnecessary and without positive value--it just wasn't a good that I wanted to consume that day at any price.

    Mistakes happen in hospitals all the time. This one was cheap--just a minor write-off for the hospital--and nobody got hurt.

  21. #21
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    That was the first thing I thought reading the OP. People going to the ER willy-nilly with non-emergencies is a contributor to the cost of health care and the wait times at ERs.

    My rule of thumb is...when you need to go to the ER, it will be obvious that you need to go to the ER. When some part of your body no longer bears the same shape it had prior to the fall, it's time to go. If you feel good enough to debate cost with yourself, you're probably OK.

  22. #22
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    Quote Originally Posted by Free2Pedal
    Can non-displaced, weight-bearing fractures and torn ligaments be safely treated 24-48 hours later?
    Yes, non-displaced, weight-bearing fractures and torn ligaments can safely be treated 24-48 or MORE hours later. On Feb 2 of last year (my freakin' birthday no less!) I completely severed my MCL, partially tore my ACL, did damage to both medial and lateral meniscus and put a 12mm impaction fracture in my tibial plateua. I didn't have surgery, however, until March 11. I was, however, on crutches in less than a week after my injury. The first orthopeadic surgeon I went to basically said if it doesn't really hurt to walk on it, then walk on it, while the 2nd opinion surgeon (the one I ultimately went with) said I shouldn't be on that leg at all, and recommended the crutches. BTW, this wasn't a cycling related injury - it was from a snowboarding accident.
    -Jeff

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