The Evolution of Utopian Medicine

The Good Old Days

In the beginning….

The Good Old Days

Patients received pre-hospital care..

The Good Old Days

Ambulance

…and were transported to

hospital by ambulance

Ambulance

Trolley

The Good Old Days

They were provided with a trolley to rest their weary

bones

Ambulance

Trolley

Emergency

Department

The Good Old Days

…and wait review

Ambulance

Trolley

Emergency

Department

The Good Old Days

EmergencyMedicine

…in the Emergency Department

Ambulance

Trolley

Emergency

Department

The Good Old Days

EmergencyMedicine

Admission to the healing wards was

timelyHospital

Bed Admission

Whole Hospital

Ambulance

Trolley

Emergency

Department

Waiting Room

The Good Old Days

EmergencyMedicine

The Waiting Room was a

place for relatives…

Hospital Bed

Admission

Whole Hospital

Ambulance

Trolley

Emergency

Department

Waiting Room

The Good Old Days

EmergencyMedicine

….to tarry awhile therein

Hospital Bed

Admission

Whole Hospital

Ambulance

Trolley

Emergency

Department

Waiting Room

The Good Old Days

EmergencyMedicine

News travelled quickly

throughout the lands…

Hospital Bed

Admission

Whole Hospital

Ambulance

Trolley

Emergency

Department

Waiting Room

The Good Old Days

EmergencyMedicine

‘bout this place of healing…

Hospital Bed

Admission

Whole Hospital

Ambulance

Trolley

Emergency

Department

Waiting Room

The Good Old Days

EmergencyMedicine

…and thus the sick did arrive in waves and

drovesHospital

Bed Admission

Whole Hospital

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

The Good Old Days

EmergencyMedicine

Whole Hospital

Triage defined urgency for review and admission

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

The Good Old Days

EmergencyMedicine

Whole Hospital

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable

The Good Old Days

EmergencyMedicine

Whole Hospital

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable

The Good Old Days

EmergencyMedicine

Whole Hospital

Stable patients were able to

wait

Ambulance

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

The Good Old Days

EmergencyMedicine

Whole Hospital

Trolley

But those in greatest need…

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

The Good Old Days

EmergencyMedicine

Whole Hospital

..entered the treatment zone

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

The Good Old Days

EmergencyMedicine

Whole Hospital

Then one day

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

The Good Old Days

EmergencyMedicine

Whole Hospital

Came a terrible funding drought

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

The Good Old Days

EmergencyMedicine

Whole Hospital

…the sage soothsayers were right…

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

The Good Old Days

EmergencyMedicine

Whole Hospital

And so it came upon the land

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

The Good Old Days

EmergencyMedicine

Whole Hospital

An evil wind of change

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

The Good Old Days

EmergencyMedicine

…lack of support…

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP

EmergencyMedicine

The Good Old Days

and a ramping plague…

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP

EmergencyMedicine

The Good Old Days

…and in a flash

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP

EmergencyMedicine

…the ‘Good Old

Days’ were gone

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP

EmergencyMedicine

There rose a need

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP

EmergencyMedicine

For Peri-

Departmental Medicine

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP

EmergencyMedicine

…andUtopian MedicineWas Born

Utopian Medicine

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP

Utopian Medicine

Capable of: WalkingSittingTalking

Ramped patients were

assessed

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP

Utopian Medicine


…and re-directed

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP

Utopian Medicine

Unstable patients were

assessed..


Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP

Utopian Medicine

…and treated in monitored

chairs


Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP


AbusiveViolent

Uncooperative

Utopian Medicine

Virulence bred new contempt for the system

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP


CallSecurity

Utopian Medicine

AbusiveViolent

Uncooperative

…and force was required to

attain equilibrium

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP


CallSecurity

Police Station

Utopian Medicine

AbusiveViolent

Uncooperative

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP


CallSecurity

Police Station

Street

Utopian Medicine

AbusiveViolent

Uncooperative

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP


CallSecurity

Police Station

Street

Utopian Medicine

AbusiveViolent

Uncooperative

…yet the infestation continued

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP


CallSecurity

Police Station

Street

Too WellToo Drunk

Too Impatient

Utopian Medicine

AbusiveViolent

Uncooperative

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP


CallSecurity

Police Station

Street

Too WellToo Drunk

Too Impatient

Utopian Medicine

Sometimes the load became too great…

AbusiveViolent

Uncooperative

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP


CallSecurity

Police Station

Street

Too WellToo Drunk

Too Impatient

Utopian Medicine

AbusiveViolent

Uncooperative

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP


CallSecurity

Police Station

Street

Too WellToo Drunk

Too Impatient

Morgue

Utopian Medicine

AbusiveViolent

Uncooperative

Ambulance

Trolley

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP


CallSecurity

Police Station

Street

Too WellToo Drunk

Too Impatient

Morgue

Utopian Medicine

The Four Minute Rule

was introduced

AbusiveViolent

Uncooperative

Ambulance

Emergency

Department

Waiting Room

Hospital Bed

Admission

Triage

CheckVital Signs

Stable Unstable

RAMP


CallSecurity

Police Station

Street

Too WellToo Drunk

Too Impatient

Morgue

Trolley

Actually Sick:Too Sick for Monitored

Chair

Utopian Medicine

…to coincide with the Four

Hour Rule

AbusiveViolent

Uncooperative

Ambulance

Emergency

Department

Waiting Room

Triage

CheckVital Signs

Stable Unstable

RAMP


CallSecurity

Police Station

Street

Too WellToo Drunk

Too Impatient

Morgue

Trolley


Chair

ED Review

Utopian Medicine

EmergencyMedicine

And Flow returned

AbusiveViolent

Uncooperative

Ambulance

Emergency

Department

Waiting Room

Triage

CheckVital Signs

Stable Unstable

RAMP


CallSecurity

Police Station

Street

Too WellToo Drunk

Too Impatient

Morgue

Trolley


Chair

Utopian Medicine

EmergencyMedicine

ED ReviewTo the River of

Decision

AbusiveViolent

Uncooperative

Ambulance

Emergency

Department

Waiting Room

Triage

CheckVital Signs

Stable Unstable

RAMP


CallSecurity

Police Station

Street

Too WellToo Drunk

Too Impatient

Morgue

Trolley


Chair

ED Review

Utopian Medicine

EmergencyMedicine

Discharge

AbusiveViolent

Uncooperative

Ambulance

RAMP

Trolley

Waiting Room

Triage

CheckVital Signs

Street

Police Station

Admit

UnstableStable

Morgue

Too WellToo Drunk

Too Impatient


Emergency

Department

CallSecurity

ED Review


Chair

Utopian Medicine

EmergencyMedicine

Discharge

AbusiveViolent

Uncooperative

Ambulance

RAMP

Trolley

Waiting Room

Triage

CheckVital Signs

Street

Police Station

Admit

UnstableStable

Morgue

Too WellToo Drunk

Too Impatient


Emergency

Department

CallSecurity

ED Review


Chair

Stay in ED

Utopian Medicine

EmergencyMedicine

Discharge

AbusiveViolent

Uncooperative

Ambulance

RAMP

Trolley

Waiting Room

Triage

CheckVital Signs

Street

Police Station

Admit

UnstableStable

Morgue

Too WellToo Drunk

Too Impatient


Emergency

Department

CallSecurity

ED Review


Chair

Move to Corridor

Stay in ED

Utopian Medicine

EmergencyMedicine

Discharge

AbusiveViolent

Uncooperative

Ambulance

RAMP

Trolley

Waiting Room

Triage

CheckVital Signs

Street

Police Station

Admit

UnstableStable

Morgue

Too WellToo Drunk

Too Impatient


Emergency

Department

CallSecurity

ED Review


Chair

Move to Resus Area

Move to Corridor

Stay in ED

Utopian Medicine

EmergencyMedicine

Discharge

AbusiveViolent

Uncooperative

Ambulance

RAMP

Trolley

Waiting Room

Triage

CheckVital Signs

Street

Police Station

Admit

UnstableStable

Morgue

Too WellToo Drunk

Too Impatient


Emergency

Department

CallSecurity

ED Review


Chair

Professional

Tantrum

Move to Resus Area

Move to Corridor

Stay in ED

Utopian Medicine

EmergencyMedicine

Discharge

AbusiveViolent

Uncooperative

Ambulance

RAMP

Trolley

Waiting Room

Triage

CheckVital Signs

Street

Police Station

Admit

UnstableStable

Morgue

Too WellToo Drunk

Too Impatient


Emergency

Department

CallSecurity

ED Review


Chair

Review by admitting

team

Professional

Tantrum

Move to Resus Area

Move to Corridor

Stay in ED

Utopian Medicine

EmergencyMedicine

Discharge

AbusiveViolent

Uncooperative

Ambulance

RAMP

Trolley

Waiting Room

Triage

CheckVital Signs

Street

Police Station

Admit

UnstableStable

Morgue

Too WellToo Drunk

Too Impatient


Emergency

Department

CallSecurity

ED Review


Chair

Review by admitting

team

In-House Fighting

Professional

Tantrum

Move to Resus Area

Move to Corridor

Stay in ED

Utopian Medicine

EmergencyMedicine

Discharge

AbusiveViolent

Uncooperative

Ambulance

RAMP

Trolley

Waiting Room

Triage

CheckVital Signs

Street

Police Station

Admit

UnstableStable

Morgue

Too WellToo Drunk

Too Impatient


Emergency

Department

CallSecurity

ED Review


Chair

Review by admitting

team

In-House Fighting

Professional

Tantrum

Move to Resus Area

Move to Corridor

Stay in ED

Discharge

Utopian Medicine

EmergencyMedicine

Whole Hospital

With the addition of

AMAAMAUPDLIRAU

AbusiveViolent

Uncooperative

Ambulance

RAMP

Trolley

Waiting Room

Triage

CheckVital Signs

Street

Police Station

Admit

UnstableStable

Morgue

Too WellToo Drunk

Too Impatient


Emergency

Department

CallSecurity

ED Review


Chair

Hospital Bed

Admission

Review by admitting

team

In-House Fighting

Professional

Tantrum

Move to Resus Area

Move to Corridor

Stay in ED

Discharge

Utopian Medicine

EmergencyMedicine

Whole Hospital

…the hospital system was

saved

AbusiveViolent

Uncooperative

Ambulance

RAMP

Trolley

Waiting Room

Triage

CheckVital Signs

Street

Police Station

Admit

UnstableStable

Morgue

Too WellToo Drunk

Too Impatient


Emergency

Department

CallSecurity

ED Review


Chair

Hospital Bed

Admission

Review by admitting

team

In-House Fighting

Professional

Tantrum

Move to Resus Area

Move to Corridor

Stay in ED

Discharge

Utopian Medicine

EmergencyMedicine

Whole Hospital

…and the ‘Good Old Days’ returned once

more

The Good Old Days

AbusiveViolent

Uncooperative

Ambulance

RAMP

Trolley

Waiting Room

Triage

CheckVital Signs

Street

Police Station

Admit

UnstableStable

Morgue

Too WellToo Drunk

Too Impatient


Emergency

Department

CallSecurity

ED Review


Chair

Hospital Bed

Admission

Review by admitting

team

In-House Fighting

Professional

Tantrum

Move to Resus Area

Move to Corridor

Stay in ED

Discharge

Utopian Medicine

EmergencyMedicine

Whole Hospital

The Good Old Days

AbusiveViolent

Uncooperative

The Evolution of Utopian Medicine

Health & Medicine

Transcript of The Evolution of Utopian Medicine