Do I need to go to the ER?

Dunno...what are you doing with your next 4,6 or 9 hours...if you can get in?

I was bitten at work by an cat this week with no known history of rabies vaccine. There’s a whole set of things that then go into motion when that happens. First call is to the worker’s comp nurse line. That’s a whole bunch of fun because I get to try and communicate across crackling phone lines to a nurse who doesn’t have the faintest idea of the risk I am in. That aggravating call done, I received an email allowing me to go get treated! Huzzah!

Then the choice comes in…do I go to Urgent Care across the street? No…they don’t know a thing about rabies says the vet tech who went last month in the same situations.

Do I head to one of the ERs in the Longwood Medical Center? Maybe…that’s probably a better shot at getting treated than Newton-Wellesley, where I am sure they are very nice, but are unlikely to have a crackerjack Infectious Disease Department that’s going to assess the threat 1- in a timely manner and 2- accurately.

Good thing I am a veteran, so I bundle myself off to the West Roxbury VA. I mask up and am seen within about 5 minutes of walking in the door. After triage, they send me back to the waiting room till a bed comes open. After about 10 minutes the attending comes out and invites me into his office and we talk about what happened. He looks up my last tetanus, we chortle that I am actually getting my rabies booster (after WAY too long) next week and he writes me a script for an antibiotic. I then grab my stuff and fast walk down to the pharmacy, grab my script and head out the door. Total time ~50m from climbing out of my car and calling my husband that I was headed home.

As I routinely say…thank you American taxpayer for footing the bill for my health care (Also…great job Army this week!! Go Army! Beat Navy!). I am blessed with the best healthcare America has to offer. Within days I had a call from Infectious Disease and we have a plan around what to do and what’s the risk that I’ve contracted rabies (thankfully, next to zero).

I had one of the best experiences one can have at an ER facility. The VA bends over backwards for other medical officers and for that I am profoundly grateful.

Here’s the thing though…most people don’t get that experience. Most people have to wade through the civilian system (my husband and kids do) and it is almost universally terrible for all the reasons everyone knows.

Veterinary medicine has the same issue (though, no VA healthcare for pets unless you live close to a base). Our ERs are just absolutely over run. Docs who used to see 20 cases a shift and are now handling 40-50 . We are burnt out and less productive. ERs are closing.

And thus, wait times go up.

One of the things my ER colleagues say is that they are seeing more and more non-emergencies at the ER. Ear infections, skin infections, anal gland issues. Folks…this stuff is for your GP veterinarian.

The ER is for the ABCs: Airway, Breathing, Circulation.

A list found on the internet of signs your pet may need emergency care include (my commentary in parenthesis):

• Pale gums (that are NEW)

• Rapid breathing (especially in a cat but also in elderly dogs)

• Weak or rapid pulse (I really question whether the average pet parent would know what to look for)

• Change in body temperature (below about 98F or above 104F)

• Difficulty standing (acute, not something that’s being going on for months)

• Apparent paralysis (again, acute or accompanied by screams of pain, especially a cat)

• Loss of consciousness (this is obvious…run to the ER)

• Seizures (if they last longer than the trip to the ER)

• Excessive bleeding (think…red paint the wall diarrhea or bleeding you can hear)

That’s about it! Combine those things, and your likelihood of an ER trip goes up.

Don’t go to the ER for an itchy dog. Go to your GP (General Practitioner) veterinarian.

But that’s the thing right? Do you have a GP vet? Do you have someone who you can call and get in?

Please, if you don’t, call during business hours after you read this and spend the money on an appointment to become a client. Every pet deserves the dignity of having a veterinarian. And when that pet gets sick, a vet you’ve already seen is MUCH more likely to actually get you in when you need it. I’ll bend over backwards for someone who calls and says Fluffy has an ear infection and is really uncomfortable.

Most clinics have openings within a couple of days. My clinic, like most, holds open “same day sick” appointments so you can get in and stay out of the ER.

Please…let the ERs take care of the animals that need them.