Welcome to the Emergency Department

A man holds a hand to his head, where blood is oozing from a gash. A woman sits off by herself, arms crossed, eyes darting suspiciously. A group of people huddle together, glancing toward the nurses impatiently.

This is Bloomington Hospital’s Emergency Department.

Sarah Abel is the night shift clinical manager for the Emergency Department at Bloomington Hospital. She said the number of patients in the ED fluctuates throughout the year.

“Many of the chief complaints involve alcohol, assault or stress reactions,” Abel said.  
IU’s schedule heavily affects the ED, Abel said. During IU’s Welcome Week, the number of patients each night increased by 20 percent from the summer.

“Volumes go up with IU football games. We staff heavy for those events,” Abel said. “I try to add two to the nursing staff and one technician.”

There are also four doctors and two nurses on-site at football and basketball games. Abel tries to be on-call or present at certain events, such as the Little 500.

Loretta Cox is a registered nurse and has worked at Bloomington Hospital for 13 years, three of which she spent in the ED. Sara Truax is also a registered nurse and has worked in the ED for two and a half years.

Both agreed there are four main complaints they receive from college students. From most common to least, these are intoxication, assault, lacerations and stress.
intoxication

Truax said the ED usually sees intoxicated patients on Thursdays, Fridays and Saturdays.

“Thirsty Thursday,” Truax and Cox said in unison.

There’s a sharp increase in the number of intoxicated patients with certain IU events, Truax said.

“We know when it’s Little 500, the first week back, homecoming, any big event,” she said.

When someone comes in intoxicated, nurses check blood sugar and fluids and provide anti-nausea medication. A doctor does a full medical assessment, focusing on the airway. If the patient is vomiting, they are given an IV, Cox said.

How the ED handles an intoxicated patient also depends on who brings them in, Cox said. There are different procedures when someone is brought in by a friend, an ambulance or the police.

The ED staff will usually wait for a patient to become sober before sending them home if they were brought in by a friend or the ambulance. When dealing with law-enforcement, the hospital may not wait until the patient is sober to release them back into police custody.

“We see them walking around, talking, fine. We see them slurring their words and not making sense. They still go to jail,” Cox said.

ASSAULT
Cox said the most common cases of assault are two men who get drunk and start fighting one another. People are sometimes jumped coming out of parties, she said. Truax said there are also complaints of sexual assaults.

Cox is a Sexual Assault Nurse Examiner, or SANE. This is a nurse who has been specially trained to handle sexual assault complaints.

She said most women come in on Sunday nights, when they realize what happened.
Sexual assault patients are first examined for overall health. They are then taken to a private room, where a SANE takes over.

An examiner will try to figure out the details of the assault, Cox said.
A rape kit may or may not be used depending on how long it has been since the attack.

If a rape kit is used, it can be kept on file in the event that the patient does not want to immediately report the incident to the authorities. The hospital will call the police only at the behest of the patient.

If the victim is younger than 18 years old, Child Protective Services is always contacted.

LACERATIONS
Lacerations are usually related to intoxication, Truax said. People get drunk and fall down, they get angry and hit a glass object, glass breaks at a party and someone gets cut.

“These are typically on the face, hands and arms,” Cox said.
The worst case Cox has seen was between two drunk men, and it involved a broken beer bottle. One received cuts on the back, chest and arms.

“They were deep,” Cox said. “And made by, supposedly, a friend.”

STRESS
“People lose support when they leave home,” Truax said. This can make it hard for some to cope.

Therapists are called in for all but the mildest cases when a patient displays stress symptoms, Cox said.

People often feel short of breath. Their arms, legs, toes and fingers start to tingle. They know something is wrong, but don’t realize it’s stress, Truax said.
Students are referred to psychological services at the IU Health Center.

“IU has so many of its own resources they can utilize for free,” Abel said. “We are very interconnected.”

Abel said students who find themselves in many of these situations could have prevented them by changing their perspective.

“Try to be responsible,” Abel said. “We get concerned about the choices students are making and their safety.”