My German ER experience

This was my first experience in a German ER (Berlin), so I wanted to document this in case it is helpful to anyone. A few things trouble me and I am not sure if this is par for the course.

The accident: sliced off about 1mm from the tip of my thumb in the kitchen during stupid, distracted vegetable chopping.

Language: my German is good enough for ER conversations. All the doctors were also able to clarify in English anything that I didn’t understand.

In hindsight this accident may have been better suited to the 116117 hotline and treatment by a regular doctor, but with a piece of my thumb on the board and blood everywhere, my first instinct was to go to the ER (which happens to be nearby).

The triage nurse saw me immediately, checked my wound, wrapped it in clean gauze and told me to keep pressure on it until my name was called. This took about 1 hour. There were 3 other people waiting to be seen before me.

The first doctor did a quick inspection of the wound, rewrapped it and said his colleague would come by to clean it and dress it. Half an hour later the second doctor came, didn’t clean the wound, and put on a PolyMem brand finger dressing. It goes on the finger like a condom, and the blood from the wound is supposed to activate the chemicals in the dressing which promote coagulation and healing.

Doc #2 told me he would check on me to see how the clotting is going. After an hour, with no one checking on me, Doc #3 came to tell me he needed the room and I should wait in the hallway until my name is called.

There were several other patients waiting in the hallway, including a wheelchair bound man with no legs with a catheter draining into a bag, an old woman in a bed who was visibly in pain who was waiting with her husband, a man with a young boy who had an arm injury, and a very frail old woman on a gurney who had some sort of dementia and feebly shouted “Hilfe, hilfe” nonstop for the entire 3 hours I was in the hallway. She was unable to stand but kept trying to get off her gurney (she was unrestrained) – I was worried she would fall so I told the people at the front, and they just returned her to the gurney and told her No, she couldn’t go home and had to stay here. This happened 3-4 times during the 3 hours. At one point she was 3/4 off the gurney, her legs dangling and just the edge of her hip on the gurney, barely holding onto the rail with one hand – I was really worried about a fall at this point and told them again. Other than this no one in the hallway received attention.

I don’t like to be a vocal patient because I assume doctors are seeing people in order of priority. However, when I went to the front of the treatment area, several doctors were standing chatting, including Doc #3. By now, my thumb condom had completely filled with blood and looked like a bloated red balloon – [NSFL pic](https://m.imgur.com/a/tOuHyaZ). The liquid pressure inside the bandage was so high that I could feel it constricting circulation in my thumb. I told this to Doc #3 and asked if someone was going to change my dressing and he said no, it would stay on for a week until changed by my family doctor, and that I could have left after it was first put on (contrary to what Doc #2 told me). He then discharged me, but not before finding time to make a joke about my surname.

Didn’t have to pay anything.

At home, I googled the PolyMem brand and found that the usage instructions indicate changing the dressing if it is soaked through. I also asked on /r/AskDocs and they gave the same advice. I changed the dressing myself, putting on a non-adherent bandage and wrapping in sterile gauze.

Overall impressions:

* The intake process was smooth and hassle free, and I received triage care immediately.
* The waiting periods are understandable given the doctors are probably seeing other patients in need.
* It is strange to me that no one cleaned my wound. This version of the PolyMem bandage does not have any antimicrobial properties.
* Discharging me with the bandage in that condition did not seem right, and my gut tells me it would have been dangerous to leave it on overnight.
* Conflicting advice from Doc #2 and Doc #3.
* Didn’t appreciate the name joke.
* I’m grateful I live somewhere I can see an ER doctor fairly quickly (in order of priority) and at no cost.
* Next time, my threshold for an ER visit even with a traumatic wound (if small) is going to be much higher.