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Getting out Alive
A Guide to Surviving Hospital
Michael Alexander Contents Introduction PART I: Before You Go to Hospital Expectations Sheep Risk factors Know your body
Allergies versus side effects
Know your symptoms
Record keeping
The GP versus the ER
PART II: Navigating the Emergency Room
Triage
Things to do when in the Emergency Room
Things not to do when in the Emergency Room
Basic tests
An ECG (or Electrocardiogram)
Urine check
Getting ahead
PART III: The Inpatient
Error versus complications
Common errors and how to help reduce them
Medication Error
New medicines
Mistaken identity
Surgical error
Pain
Infection
Mobility means staying alive
Mobility exercises
Preventing falls
Who’s who
Discharge
Post hospital care
Conclusion
About the Publisher
Whether you hail from deepest Africa or the bright lights of New York, it is likely that at some stage of your life you will fall ill or be injured and find yourself admitted to a healthcare facility. It may be a tiny, overcrowded clinic in the slums, or it may be a highly prestigious hospital paid for by private medical insurance. Whatever the place, there are three definitive factors in deciding whether you make it out or not: your nurse, your doctor and you. I have more than eighteen years of nursing experience behind me and I can confidently say I’d rather have a caring, knowledgeable, hardworking nurse practitioner in a busy clinic than be treated by an overconfident doctor working in an over-managed hospital full of unpractical and sometimes pointless protocols. During my years as a nurse, I’ve worked in dozens of environments, and in most settings imaginable. From the Emergency Room to the neonatal ward, intensive care, and the psychiatric ward, I’ve seen the full spectrum of what really goes on in your local hospital. Fortunately it’s mainly good stuff: fantastic hardworking staff perform life-saving work, even in overcrowded and understaffed conditions. Unfortunately, there’s no denying that sometimes things do go wrong. Often it is fate – it’s meant to be – but there are times when tragedies could have been prevented. I want to share with you some ways in which you can improve your chances of coming out of hospital alive. In this guide you will find easy to understand, short-and-sweet advice on staying safe and being proactive during your care. This book is designed to make your hospital experience as fast, smooth and comfortable as possible for both you and the medical staff treating you. Some of the things mentioned in this book might seem obvious or even overkill, but that’s because staying healthy and avoiding complications often is a matter of common sense. I hope you will be able to see this by the end, and take practical steps to help yourself. By the end of this book, you will have an understanding of how health professionals approach illness and illness prevention, and of what we can and can’t achieve. This knowledge, I believe, can be just the motivation we need to make positive changes in our lives. You are in need of medical assistance. Maybe you’ve never needed help yourself before. What are your expectations? The chances are, you expect to enter medical care and be cured. It may seem strange, but in reality not a lot of curing goes on in hospital. Indeed, trainee nurses and doctors are often told not to expect to do much curing … I’m afraid, yes, you did read that right. For all our incredible medical advances, much of our treatment involves treating the symptoms when they flare up, then helping to reduce the chance of them happening again. For an example, let’s look at a common problem like asthma. The medicine for asthma – such as inhalers and steroids – is used to treat the symptoms. When the symptoms no longer cause distress, patients are given medicine to hopefully help prevent another flare-up of their condition. But they cannot be cured. Even medical equipment, from intravenous drips to urinary catheters, is used to help the body assist itself in getting better. Take Bob. Bob was a fit forty-year-old man who unexpectedly developed a nasty bout of diarrhoea and vomiting. Normally these afflictions would last between 24 and 48 hours, and resolve on their own. However, in Bob’s case, on day three he still was unable to hold down anything solid, and was even struggling to drink water. Bob was admitted to hospital. He was put on a drip, and while he was being rehydrated his blood was tested to rule out bacterial or parasitic causes for his infection. As is often the case, his illness was caused by a virus, but after 24 hours of intravenous fluids he felt much better and was discharged home, without antibiotics. The key thing here is recognising that the drip didn’t fix Bob’s problem; rehydration didn’t cure the virus, all it did was help maintain water levels adequately whilst his body fought off the illness. Another prime example is Max. Max is recovering after a ‘heart attack’. The heart attack caused a part of his heart muscle to have a shortage of blood, and by consequence a shortage of oxygen, for long enough that a portion of the muscle has been damaged, or more accurately, some of the muscle has died. Once a heart attack has occurred, the damage is done;
