Tuesday, June 21, 2016

Adventures in the Icelandic Emergency Medical System

I am currently on my honeymoon in Iceland. As part of our adventure, we decided to go caving. We explored a cave that had been created by a lava flow, that was approximately 1km long and easily accessible. We were provided with helmets and headlamps

And our guide led us through a beautiful cave. We crawled, scooted & shimmied through stunning formations of lava. On my way out of the mouth of the cave to the car, I stepped into a hole that went up to my thigh. I caught myself with my hand. I heard a crack, but didn't think too much of it. 

By the next morning, my finger looked like this:

Bent, purple and swollen. We arranged an online consult with a physician service in the USA called Dr On Demand, through our insurance company. I FaceTimed with a Dr in Maryland who instructed me to go to an Icelandic emergency room based on pain in a specific area of my hand, the "snuffbox", or navicular area. This is a bone that has poor blood supply and doesn't heal on its own without intervention. So off to the ER we went. 

Just to make sure, I contacted an Icelandic RN via 1700, which is a non-emergent way to get a medical consultation. This was a Sunday, so the only place I could get x-rays was the hospital. 

Reykjavik has several large hospitals, but the ER is located at the main branch. I walked right in and a triage nurse assessed my hand immediately. I completed paperwork in English and another RN did additional manipulation of my hand. I was sent upstairs to the "minor injuries unit." A triage RN asked me if I needed an ice pack and pointed out the location of a water cooler. I waited about 45 min, then was taken back to meet with a doctor. 

Perla, the doctor, put us immediately at ease. She ordered X-rays & said she would order a CD also that I could provide to my USA doctor.  A tech took the X-rays, and I was sent back to the ER and received a CD of the images almost  immediately. We waited for awhile longer while my X-rays were read. 

Diagnosis, probable Scaphoid Fracture. The doctor stated that I would be receiving a cast and would need to be re-examined & re-casted when I returned home once the swelling went down.


A nurse took me in for casting and explained that she was unsure how my rigid cast would work with a long flight. The Dr consulted a specialist about this, while I waited for the cast to harden. 

Once my cast was complete, we checked out with the cashier. I thought this would be the scary part. Most US health insurance doesn't cover international care, although it's possible to be reimbursed. 

Total cost for three hours in ER, X-rays, physician and specialist consult, casting, CD of imaging, and English transcript of records? 

Only $530 for this "uninsured foreign national." 

Plus I was given personal discharge instructions & follow up care required by a physician. 

I experienced nothing but care, respect and concern from phenomenal nurses & physicians who spoke flawless English. I received high quality care for a reasonable cost. I'm not sure why ER care in the US is so expensive. 

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