Before Going to the Emergency Room
Tips to Keep You Prepared
Determining If or When You Should Go
In 1996 over one half of the 90 million emergency room visits made in the US were considered unnecessary, pointing to a bizarre and costly trend among the Americanpublic to forego scheduling a doctor’s appointment in favor of simply going to the ER. This, despite the fact that routine emergency room costs are sometimes three times as much as a visit to a physician’s office, a figure that does not include the time wasted waiting at the ER—which, considering the system in place, is a substantial waste of time for non-urgent patients.
An Emergency room operates according to the ‘triage system’ in an effort to make certain that the patients who need truly urgent care get that care. That system worksby instituting an evaluation system that, appropriately, moves certain patients to the ‘front of the line’. Those whose evaluation did not disclose an urgent case wait an average of around two hours before they are seen by a physician.
No one wants to wait two hours to be seen by a emergency room doctor when you do not feel well, especially in the lobby of a frantic emergency room. The following tips can prepare you for sudden medical problems and help you avoid spending so much wasted time at the emergency room.
Have a regular doctor
A regular physician, one with your complete medical history and one who can arrange to see you in a moment’s notice, is your best defense against emergencies.
Research health care options in your area
Urgent care and minor emergency clinics are significantly cheaper than a visit to ahospital ER, they will most likely require less of your time, and you will still be seen by a licensed medical doctor.
Carry important medical information with you
Like the medical ID bracelets worn by people with food allergies or other medical conditions, you should consider keeping, in your wallet or in your purse, important medical information about you as well, whether or not you have such a condition. The information should include:
• your doctor’s name and number
• any illnesses you have
• any medications you take and the dosage
• whether or not you are pregnant
The information can prove valuable to any emergency medical care worker who is attempting to diagnose you.
the kind of ERs at local hospitals
Not all hospitals are equipped to handle every emergency. In fact, some
hospitals don't have any emergency care. Emergency facilities are rated Level
1, 2 or 3. Those rated Level 3 are the most comprehensive trauma centers with
high-tech equipment and specialists on the premises at all times. Level 1 and 2
centers can handle many kinds of emergencies, but may not have specialists on
hand for some needs. Find out what type of emergency services are available at
the medical facilities in your community.
Check with your insurance carrier
In short, not all emergencies are covered by health insurance. Those that are may have restrictions or instructions attached to them, such as the need to contact your carrier within a certain time frame after you’ve been admitted to the ER.
Call the ER before you leave
Calling ahead of time may reduce the time you wait at an ER, if it gives the staff a chance to get ready for your arrival. You will probably speak to a triage nurse, who may consider your symptoms over the phone but can not diagnose you. Depending on a number of factors, the nurse may or may not recommend that you:
• come in to the ER
• call 911 and Emergency Medical Services
• do or carry out certain things (such as stem any bleeding) before you reach thehospital
• go to a different ER, one that is perhaps better equipped to deal with your emergency
A word to parents: Parents ought to give consideration to filing a consent form with your community ER that permits physicians to initiate medical treatment on your child in the event you are unreachable for whatever reason. If a consent form like this makes you uncomfortable, bring up alternative options with your lawyer.
Of course if you experience any symptoms that you believe to be an emergency, do not hesitate—seek medical care immediately. Otherwise, be prudent about whether or not to seek the services of an emergency room.
If possible you might consider calling your regular doctor first and relaying to him or her what your symptoms are. The doctor can then advise you accordingly. Many physicians will work you into their schedule if they feel you need medical attention but do not need to visit an ER.
Primary care doctors are generally available 24 hours a day or they function within a group of doctors who rotate being on call at certain hours.
The American College of Emergency Physicians (ACEP) recommends you familiarize yourself with the signs and symptoms of illnesses and injuries such as those listed in the booklet Home Organizer for Medical Emergencies. For a complimentary copy, call ACEP at 800-446-9776.
Emergency Rooms: Considerations
Below are some guidelines and considerations you might give thought to when determining whether or not your condition warrants a visit to the ER.
Conditions that call for the ER
• Loss of consciousness
• Signs of heart attack lasting longer than two minutes, such as: pressure, fullness, squeezing or pain in the center of the chest; tightness, burning, or aching under the breastbone; chest pain with lightheadedness;
• Signs of a stroke, such as: sudden weakness or numbness of the face, arm or leg on one side of the body; sudden dimness or loss of vision, particularly in one eye; loss of speech, or trouble talking or understanding speech; sudden, severe headaches with no known cause; unexplained dizziness, unsteadiness or sudden falls, especially when accompanied by any other stroke symptom;
• Significant shortness of breath;
• Bleeding which, despite direct pressure for ten minutes, does not stop;
• Instantaneous and severe pain;
• Poisoning (Note: If at all possible, first contact the local poison control center; request immediately applicable advice, since some poisons must be vomited immediately and other poisons must be diluted with water immediately. Acting quickly in this manner can save a life.)
• An allergic reaction to an insect bite, sting, or medication, especially if breathing becomes labored (your symptoms will progressively get more severe)
• Serious traumatic injury (i.e. to the head)
• Unexplained stupor, drowsiness or disorientation.
• Vomiting or coughing up blood.
• Severe or persistent vomiting
• Suicidal thoughts
Conditions that generally do not call for the ER
• Minor cuts in which bleeding has been stopped;
• A bite from an animal which has stopped bleeding (nonetheless you should call your doctor in the event a rabies shot is required);
• A broken bone (instead of the ER, contact your doctor. If that isn’t possible, or if the fracture is evident, then head to the ER immediately).
• A sprain, rash, sunburn or minor burn
• Sting from an insect (unless you experience labored breathing; in that case, go to the ER or call 911 immediately).
• Fever (if you are convulsive, then go to the ER).
• Sexually-transmitted diseases. (STDs)
• Colds, coughs, a sore throat, or flu symptoms