Emergency Room Emergency Question (not an emergency)

I am not having an emergency right now. I was just reading in the Times about the emergency room people who treated the people shot near Denver recently.

I was surprised to learn some morning-shift people did not hear about the situation until they showed up at their usual time. Imagine that.

In any case, my mind was racing. Say a doctor from New York was in the area. **If an unknown doctor showed up in a swamped emergency room situation, would he be allowed to pitch in? **

I was just an EMT, but once the patient was on their gurney we were to get clear. Someone who does not work in that hospital will no nothing about patient logging, where things are located, and how best to function as part of the team. You don’t want a FNG in the middle of a shitstorm, he will probably be more of a handicap than a help. There are usually only a handful of MD’s in the ER at a given time the vast majority of the folks doing the hands on stuff are RNs and MICNs. If he has some decent ER chops he can help run codes and such, but I dont think hospitals smile on having un"doc"umented folks incurring potential liability on the part of the hospital.

Is he really a doc?
Is someone going to be able to verify his licence status?
Did he just escape from prison after killing 16 of his patients?

Huge liability issue, limited usefulness in unfamiliar setting. Maybe with Katrina level disaster, but not Denver.


OK, thank you both.

My SO (an ER physician) tells me that in addition to the problems already mentioned, a doctor wouldn’t be allowed to work in the ER unless already credentialed to do so. Her ER also has strategies in place for mass casualty situations, so it’s not as as though they would need extra ER docs during these events.

Why would they know about it? Unless the situation was dire enough in the hospital to need to call in extra staff, the day shift staff would sleep through the night, wake up with their alarm clocks, and trudge into work. Unless they checked the morning news before getting to work, then they wouldn’t have known what happened until someone filled them in.

Even in a bad situation, the hospital isn’t likely to call everyone to see if they could come in - there’s usually en emergency call list of some sort established.

IANAD, but I believe it’s standard procedure for a major (yet not apocalyptic) disaster to have the victims transported to several different hospitals, instead of overburdening the nearest hospital with mass casualties. So the most critical patients will go to the nearest trauma center, while less severe injuries get treated at hospitals further away.

There may also be community-wide plans for calling in extra docs in certain situations (terrorist attacks, explosions, crashes).

Like Antigen said; the day shift would find out about it when they came in. I am not a doctor and I don’t work in allied health, but I’m sure that the Denver area 911 and associated EMT systems would take patients to the hospitals with the appropriate levels of trauma care. Triage at each hospital would mean that each patient would be prioritized according to their injuries. The ones who were wounded but stable wait until the priority cases are treated.

Pulling the day shift in early probably wouldn’t get more people through the ED; it wouldn’t get more people through surgery, and it would mean that the day shift would be wiped out at the end of a 16+ hour shift, and they would still have to make the same decisions and do the same procedures.

Any hospital of size has disaster plans and holds regular disaster drills. Anything less than Katrina-scope (as already mentioned) should be nicely managed with said plan.

Some random McDreamy wandering around with gloved hands offering assistance would probably be told to get out of the way.

Correct For example Fresno county in my EMT days, in any mass casualty situation

Of every 10 patients:
4 to Valley Medical Center 2 to Fresno Community Hospital, 2 to Saint Agnes Medical Center, 1 to Sierra Community Hospital, 1 Clovis Community Hospital.

Critical cases were always sent to VMC or FCH regardless of distance until SAMC and or CCH had time to prep for it.

I worked one mass casualty situation, a large car accident/freeway pileup, around 100 patients transported. Fortunately, that nightmare started at just before 7am, so when the first units on scene called in for Incident command system and disaster plan activation, the hospitals were notified immediately and night shift stayed on to help with the incoming load and day shift was settling in as the first ambulances rolled in with patients. In that way, it worked out perfect. If it had happened 30 min later…most of day shift would have been gone and heading home.

The one thing a stray doc can do in a true mass casualty situation is help monitor folks in staging areas or at the incident site. Once patients enter the emergency department house staff only.

One interesting scenario I was involved in where ambulance crews were able to be a huge help to ER was a huge fight that broke out in a lockdown psych unit. Turned into quite the brawl between hospital security and about 30 patients, alot of people got seriously hurt. We were alot better able to help package and move the injured quickly to ER than the in house staff, as we have alot of practical experience dealing with folks not already on gurneys/properly immobilized/in odd positions.


Fuckin’ new guy