Roy Exum: Use 'Tags' At Erlanger

Thursday, July 18, 2019 - by Roy Exum
Roy Exum
Roy Exum

When I was a senior in high school, the Vietnam catastrophe held the guys who were in my class spellbound. Back then, and has since been proven again and again, the conflict was a terrible error in our nation’s judgment and almost 60,000 young and promising Americans died in some stinking South Asian battle zone that didn’t mean squat to our freedom or our nation’s future.

In the first place, we didn’t have a government with the courage to win. We had the greatest military ever assembled and, instead of ending it in just one weekend with our collection of bombers and three of our nuclear submarines, guys in my neighborhood went to funerals instead. Each of us had a lottery number and when a date was called, you were forced to go.

At one point the life expectancy of a 2nd Lieutenant was 30 minutes on his first time in the jungle. Whew, don’t get me started, especially since my older brother felt so strongly about it at Lonnie Floyd’s funeral, he promptly enlisted, and arranged to report to the Marine Corps the day after he got his diploma.

Again, Vietnam should have gotten the likes of Lyndon Johnson and Robert McNamara their just dues. But as in every tragedy there are lessons to be learned, and quite possibly one of my strongest emotions that was stirred during the Vietnam fiasco came one week when Life magazine featured “the tag system.”

About 50 years ago, I first I thought it was a bigger atrocity than the war itself but when it was fully explained to me, I realized that as brutal and as calloused as it first appears, the use of tags was actually a genius stroke that not only saved thousands of lives but would have accomplished much the same thing in Korea, World War II, or any other conflict between two adversaries where multiple deaths are an occurrence.

After I lambasted our Erlanger Hospital’s Board of Trustees and top management earlier this week over my disgust of giving a sick or injured patient no option other than to wait five or six hours to be seen in our Level One trauma center, I got close to a dozen email responses – three readers including they first learned of this in Vietnam.

At first it seems too simple but the Erlanger bottleneck has been allowed to go on for so long – without so much as a care in the public’s opinion – it is adversely affecting patients’ decision to avoid “anything Erlanger” by all measures. The ER debacle is a huge part of a “no confidence” letter to the Board of Trustees because one of the biggest ways staff physicians are referred new patients is – hello! – through the ER.

Because Erlanger has failed to meet the challenge for three years (and Memorial Hospital’s wait times are equally atrocious) my readers believe a skilled triage team could see any incoming patient within five or 10 minutes. In Vietnam, when several MedVac helicopters would bring as many as 50 wounded GIs at the same time to a field hospital, everybody knew that a “first come, first served” plan was lethal.

Remember the TV show, M.A.S.H.? Pandemonium would break out until the triage nurse would calmly and very professionally, affix one of five tags within minutes:

* * *

COLOR CODES COMMONLY USED DURING LARGE ARRIVALS AT FIELD HOSPITAL

* -- RED: CRITICAL – May survive if simple lifesaving measures are applied. This is a full emergency case. Priority 1.

* -- YELLOW: URGENT – Likely to survive if proper care is received within hours. Priority 2.

* -- GREEN: NONURGENT – Minor injuries – Care may be delayed while other priority patients are treated. Priority 3.

* -- BLUE: CATASTROPHIC – Patient unlikely to survive, or those who require intensive care within minutes. Priority 2 or 3.

* -- BLACK: Those who are dead or severely injured and not expected to live. No priority.

* * *

It is important to note the Head Triage Nurse constantly monitors every tagged patient constantly. The head nurse can change priority codes in the triage unit, administer pain meds, allow fluid or food intake on a surgery-pending basis and oversees the next case called.

Reader suggestions for Erlanger is to install and activate a fully functioning out-patient “Insta-Care” clinic nearby. The triage nurse could send many emergency patients to be seen in a non-ER setting. The nurse could also advise the patient their health problem does not merit an ER visit but could make an appointment at the Family Medicine for the next day or in the future.

There is one study that shows the average wait in a doctor’s office is 20 minutes as compared to a four-hour wait in an emergency room.  Another study shows behavioral cases can be evaluated, alternate care suggested, and, if necessary, would-be patients can be banned from the ER at the discretion of a law enforcement officer. If the waiting area is full, those who are accompanying a patient and not being seen can wait in an auxiliary waiting area rather than disrupt the treatment flow.

* * *

CORRECTION: "In a story that I wrote on July 15, “A Nursing Shortage?” I mistakenly identified Erlanger Hospital as one hospital that offers prospective nurses a $20,000 signing bonus.

"A hospital spokesperson said this is not true and I apologize for confusing my sources and committing the error."

royexum@aol.com


Positional Asphyxiation - The Danger Of Babies Sleeping In Car Seats

Roy Exum: The Saturday Funnies

Impeachment Should Happen - And Response


This is an important article many new parents may not be aware of. This is only the second time I've heard of danger, positional asphyxiation, of placing young babies, mainly less than one year ... (click for more)

This guy marveled when he read to his wife from the morning newspaper: “It says here that researchers have found women speak twice as much as men do.” His wife calmly replied, “That's because ... (click for more)

Loudly our Commander in Chief is committing treason in front of our eyes. Calls to Ukraine and Russians getting involved in elections. Talks with Kim Jun Ung of South Korea. Priceless military ... (click for more)


Opinion

Positional Asphyxiation - The Danger Of Babies Sleeping In Car Seats

This is an important article many new parents may not be aware of. This is only the second time I've heard of danger, positional asphyxiation, of placing young babies, mainly less than one year old, leaving them to sleep in their car seats. I shared this story with a young couple out west who are relatives the first time I heard of this danger. They recently had a new addition ... (click for more)

Roy Exum: The Saturday Funnies

This guy marveled when he read to his wife from the morning newspaper: “It says here that researchers have found women speak twice as much as men do.” His wife calmly replied, “That's because we always have to tell you twice!” So, as we embark on this week’s Saturday Funnies and you realize that if you live in the United States your driveway is accessible from any other driveway ... (click for more)

Breaking News

Man Shot In Shoulder By Officer After Domestic Disturbance Call At Charleston, Tn.

A man was shot in the shoulder by a police officer at Charleston, Tn., early Sunday after a domestic disturbance call. At approximately 2:02 a.m., Bradley County Sheriff’s Office deputies responded to a 911 call reporting a domestic disturbance between a male and a female involving a firearm near Laguna Drive in Charleston. The 911 call was made by a female reporting that ... (click for more)

Woman Injured In Red Bank House Fire Saturday Evening

A woman was injured in a house fire Saturday evening in Red Bank. A 911 call was made reporting a house fire at 133 Flora Circle. At 6:30 p.m., Red Bank Fire Department responded to the scene and arrived reporting heavy smoke and fire on the back of the residence. The Red Bank Fire Department immediately requested a mutual aid response for additional manpower. The Signal ... (click for more)

Sports

Tennessee Gets First SEC Win Over Mississippi State

Limiting Mississippi State to a season-low 10 points in the game, Tennessee secured its first SEC victory of the season, winning 20-10 over the Bulldogs Saturday afternoon in Neyland Stadium. Mississippi State's (3-3, 1-2 SEC) Kylin Hill came into today's game as the SEC leader in rushing yards with 119.2 yards per game. Tennessee (2-4, 1-2 SEC) held Hill to just 13 rushing ... (click for more)

Covenant Scores Big USA South Win Over Maryville On Riggs PK

Jesse Riggs' penalty kick in the 77th minute and a stout defensive effort from the Covenant men's soccer team lifted the Scots to a pivotal, 1-0, victory over Maryville in USA South action on Saturday night at Scotland Yard. Covenant (11-2-1, 8-0 USA South) gains sole possession of first place in the USA South West Division with the win. The Scots finish the regular season ... (click for more)