¿Urgencia? Dónde acudir. Aprendiendo a utilizar racionalmente nuestro Sistema Sanitario


 
Es frecuente que no se conozcan los recursos, ni los canales de acceso al sistema sanitario. ¿Cuáles son los más adecuados en cada situación?

En este post del blog, nos gustaría exponer los recursos que tenemos a nuestro alcance cuando consideramos que tenemos una urgencia médica. Seguro que, teniendo información, podremos decidir adecuadamente donde acudir, con ventajas para todos.
 

Urgencia- Emergencia. ¿Hay diferencia?

  • Emergencia: Mi riesgo vital es alto, es decir, peligra mi vida si no soy atendido inmediatamente.
  • Urgencia: He de ser atendido en las próximas horas para que mi situación no se complique, pero mi vida no corre peligro actualmente.

 

Si yo he llegado antes que él, ¿Por qué tardo más en ser atendido?: El triaje

El orden de atención en las Urgencias hospitalarias no se efectúa por hora de llegada, sino por prioridad según el sistema de triaje. Al llegar, una enfermera o un médico, clasificará nuestra situación mediante un sistema informático protocolizado, de tal forma que los casos más graves se antepongan a los menos graves.
Habitualmente hay 4 o 5 niveles, ordenados por números o colores.  Las emergencias pasarán inmediatamente, y después las urgencias en orden de gravedad. De esta forma, por ejemplo, un accidente de tráfico con colisión frontal pasará inmediatamente, y un resfriado de varios días de evolución, con buen estado general del paciente, podrá esperar horas. Lo que nos lleva al siguiente punt :
 

Tengo un resfriado, me he hecho daño en la espalda, no paro de vomitar…¿dónde acudo?.

Tengo a mi disposición varios recursos
 

  1. Consulta de demanda en mi centro de Salud, con mi Médico de Familia.
  • Habitualmente podemos conseguir consulta en unos 2 o 3 días.
  • Se atenderá por hora de cita previa
  • Es el sistema adecuado para cualquier problema de salud que precise actuación no inmediata, siendo beneficioso valorar su evolución, y que será atendido por mi Médico de Cabecera, que conoce el resto de mi historial médico y sociofamiliar, dándome un trato más cercano y accesible.

Ejemplo: Estoy congestionada desde hace 2 días y hoy he comenzado con dolor de garganta y fiebre.
 

  1. Urgencias en mi centro de salud, con mi Médico de Familia.

Aunque sea olvidada por muchos, esta opción existe, si mi motivo de consulta ocurre en el horario de consulta de mi Médico, habitualmente de mañana (8h-15h).

  • Se atenderá según la disponibilidad del Médico, incluyéndose a mayores en la lista de citas de ese día. Habitualmente, tras finalizar el tramo de consulta correspondiente
  • Es el sistema adecuado para un motivo de consulta que precise atención inmediata que pueda resolverse con medios habituales por un profesional que ya me conoce.

Ejemplo: He comenzado con náuseas y vómitos ayer. Los vómitos hoy me impiden ir al trabajo.
 

  1. Urgencias en el Servicio de Urgencias de Atención Primaria, fuera del horario de consulta.
  • Según la zona de Salud a la que estés adscrito, corresponderá un centro u otro. Por ejemplo, la zona de Valladolid Oeste cuenta con dos Centros de Salud que atienden urgencias: en horario de tarde Delicias (15-22h) y tarde-noche Arturo Eyries (15h a 8 h del día siguiente).
  • En este sistema se atenderá por orden de llegada, habitualmente menos de 2 horas tras la llegada
  • Es el sistema adecuado para un motivo de consulta que precise atención inmediata que pueda resolverse con medios habituales en un horario en el que la consulta ya no está disponible

Ejemplo: corte en el dedo, poco profundo pero sangrante, mientras estaba preparando la cena.
 

  1. Urgencias Hospitalarias.
  • Disponibles 24 horas.
  • Se atenderá mediante el sistema de triaje que hemos explicado anteriormente.
  • Habitualmente, la atención se llevará a cabo más de dos horas tras la llegada, siempre en función de la urgencia de la patología por la que se consulta.
  • Es el sistema adecuado para una patología que precise atención inmediata y que requiera de medios hospitalarios para su resolución

Ejemplo: Dolor abdominal intenso que se acompaña de fiebre y no cede tras analgesia habitual
 

  1. 112
  • Disponibles las 24 horas.
  • Se atenderá tras contactar con una centralita general que decidirá si es pertinente el uso de una unidad sanitaria de transporte. Si se trata de una emergencia, el 112 acudirá inmediatamente a la localización
  • Es el sistema adecuado cuando el paciente no puede desplazarse de su domicilio a un centro sanitario y por su gravedad no es posible que lo desplace otra persona en un automóvil.

Ejemplo: Una persona anciana sufre una caída con un traumatismo craneoencefálico y pierde el conocimiento.
 


El hospital no es la solución a todo. Hay vías más rápidas y resolutivas que se pueden utilizar de acuerdo a tu situación de urgencia.  Utiliza bien el sistema. Cuídalo, y te cuidará.


Irene García Álvarez

Médico especialista en Medicina Familiar y Comuntaria, Centro de Salud Arturo Eyries

 
REFERENCIAS:
Portal web Sacyl: https://www.saludcastillayleon.es/PacientesHRH/es/urgencias
 
Revisado: Octubre 2018.

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