Disease, risk and community

It is just before midnight. The ambulance is five minutes out, carrying a four-year-old with a known history of asthma who awoke with marked respiratory distress. The ambulance personnel have reported that the child is alert but breathing 50 to 60 times per minute, working hard, and that the O2Sat (the amount of oxygen in her blood stream) is abnormally low.

The charge nurse has cleared a bed and another nurse has been pre-assigned.

Sounds like a good opening for a TV show, right? Except that, like a TV show, it's a construct, a fabrication. There really isn't much of an emergency here.

But the notion of risk with respiratory conditions is deeply ingrained. It is transmitted by stories arising from rare personal experience, circulated in the community and reported in the media. What makes it stick? Fear and love, which are, frankly, the emotional staples of parenthood.

Health care workers, says pediatric emergency doctor Brett Taylor, are no less susceptible to this than the general public.

He says emergency room clinicians should make patients and staff resistant to sensationalist, frightening stories that generate false memes, and sensitive to those that represent sober, considered risk assessments. But health-care workers are often too busy fixing what ails you to spend much time on information management.

Taylor suggests that health-care workers we need to start with themselves. "If we transmit overblown, inappropriate memes of risk and need, we have only ourselves to blame when a frightened public misuses our preciously limited resources."

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