Knowing there are 136.3 million people in the U.S. who visit an emergency department every year might scare you off from your own trip there [source: CDC]. That's a lot of people. Wait times for care can be so long that it's easy to start thinking that the best way to get through a trip to the ER is to avoid going in the first place. Well, yes and no. If you're having severe chest pains, for instance, don't self-diagnose it as gastroesophageal reflux disease (GERD) when it could be a heart attack. But, on the other hand, if something like a wait time is enough to keep you away, maybe your medical emergency isn't really a true emergency. If you know what a medical emergency is and what it isn't, you can save both time and money by relying more on your doctor, urgent care centers or retail health clinics to treat your problem. Save the ER for when life or limb is in jeopardy.
While emergency care is intended for people in life-threatening medical circumstances, as many as half of the people visiting the ER aren't actually there for life-threatening problems [source: Cunningham]. Care is focused on treating patients who have the most severe or dangerous symptoms such as severe pain, severe vomiting, difficult breathing, severed limbs or appendicitis. So if you find yourself heading to the ER — either as a patient, a parent or a health buddy (we'll talk about that later) — expect that others may be in more critical condition than you, take a deep breath and prepare for the best.
No one plans to go to the ER, but planning ahead can stack the odds in your favor. When you arrive for emergency care, a member of the emergency team, typically a triage nurse, will assess the severity of your condition. For example, you could be assessed with a life-threatening condition requiring immediate care, an injury or illness needing urgent but not lifesaving attention, or, for many patients, a less urgent problem. Be prepared to answer questions about your health history, not just your current symptoms, as part of your ER check-in.
Along with your health insurance card, keep a wallet card with important personal health stats, including current and past health conditions, medications, supplements, allergies, vaccinations, previous hospital stays, previous surgeries and emergency contact information [source: Belchetz].
While it's likely that patients with less urgent needs will be able to verbally communicate their medical histories, you'd be surprised how the anxiety and stress of the situation makes it difficult for many of us to remember details. Obviously, those who are unconscious or in life-threatening situations can't take a minute to tell the medical team about their Cesarean section, cholecystectomy (that's gallbladder removal surgery) or knee replacement.
The more the emergency medical team knows about your health history, the better. The name and phone number of your primary care doctor, in addition to any specialists you've seen or are seeing, is important information to bring to the ER. In fact, it's a good idea to carry that information with you at all times, right along with your medical history.
Additionally, emergency workers and hospital personnel want every single one of us to carry in case of emergency (ICE) information, either tucked in a wallet or as an entry to a phone contacts list. ICE information should include, at the very least, the name and contact numbers for the person or people who should be called by the paramedics, police or ER staff if you're in an accident or have any other type of emergency. Make sure the person listed as your emergency contact knows that they'll be contacted if there's an emergency, and review your medical history and regular doctor's information with them.
Most Americans, 70 percent, take at least one prescription medication. That's not so bad, considering, for example, that one out of every three Americans has high blood pressure (hypertension). About 20 percent of adults take five or more medications [sources: Mayo Clinic, CDC]. When you look at elderly Americans, the number is much higher: More than 60 percent of people over the age of 65 take at least five prescribed drugs per week, and more than 15 percent of seniors take double that [source: Worth]. Who can keep track of all that information, from dosage to refills to the name of the doctor who prescribed what and when, right?
Keeping an updated list of all the medications and supplements you take, in addition to doses, frequency, information about your allergies and your vaccination history, can help reduce both drug interactions and allergic reactions. And you don't have to worry you've misremembered a dose or forgotten an important medication. Store your medications list on a piece of paper in your wallet, use a medical alert bracelet or download a medications app to keep track of your drug information across devices. At the very least, bring all current prescriptions, over-the-counter medications and supplements with you.
Additionally, if you use any assistive devices — such as hearing aids, glasses, a walker or other mobility aid — on a daily or frequent basis, bring those devices with you to the ER. The more the emergency medical team understands your wellness baseline, how you normally function during the day, the better your odds of receiving an accurate — and potentially faster — diagnosis.
Here's a statistic that may make you think twice about going to the ER: Patients admitted for hospital treatment after being first seen in an overcrowded emergency department have a 5 percent greater chance of dying than patients whose ER experience was less crowded [source: Groeger]. Timing your visit to the ER, which by the nature of the situation may not be possible, can be smart time management. And also, apparently, smart for your overall health — if you can pull it off. (Of course, accidents aren't always polite about happening at the most convenient time.)
Emergency departments have busy trends throughout the day and night, coinciding with the hours we're not at work or in school. For example, weekend trips to an ER are typically going to be crowded. Before work (before 8 a.m.) or after 5 p.m. on weekdays are busy, too. And Mondays in the ER can be brutal. Decrease your wait time by arriving between 7 a.m. and 3 p.m., preferably aiming to get there before 11 a.m. [source: Marte].
There's so much waiting going on in America's emergency departments. Administrative tasks such as registration (and discharge), initial evaluation and examination all add to wait times. You'll be cooling your heels even longer if you throw in a few tests for good measure.
While the average time spent waiting in the ER is a little longer than four hours, it probably won't surprise anyone that, in 2009, almost 400,000 people waited for 24 hours or more before it was their turn to be seen [sources: Marte, Rice]. And in 2007, most of the 2 percent of people who left the emergency department before being treated did so because of all that waiting [source: McHugh].
If you're able to do a little pre-ER planning, grab a diversion or two, such as a book, an electronic device or maybe your most recent knitting project to help the time pass.
OK, so a trip to the hospital might not make for great date or a fun girls' night out. But it can be incredibly helpful to bring a buddy with you to the hospital. Ask a family member or friend to take you, or meet you, at the ER as your "healthy buddy." This role is for someone who can and will help advocate for you if you're feeling too unwell to do so yourself. This person will ideally also be ready to listen and record the details of your visit, such as questions and answers, tests, diagnosis, new medication list or schedule, and any follow-up notes. It's not a light responsibility, so make sure it's someone you trust to handle your personal information.
Be aware that some emergency departments may limit the buddies a patient can have, though, as space can be tight. This is not the time to invite your whole tribe along; limit yourself to just a +1 to keep from adding to the chaos around you.
Not only is it good policy to call your primary care doctor to help determine whether your circumstance does, in fact, need urgent or emergency care, it's also helpful to reach out on your way to the ER because your PCP may be able to make the experience a little smoother. For instance, your doctor may advise you to go to an alternate facility more experienced or equipped to treat your condition. Or, in some cases, your doctor may want to treat you. Additionally, a PCP may call the hospital before your arrival to give the emergency medical team a heads up on your condition.
Your primary care doctor is also important once you're discharged from the ER. More than 60 percent of patients are referred to their PCP or another health care specialist for follow-up diagnosis and care, in addition to any long-term care after emergency treatment if it's required [source: Marte].
Patients who are overly dramatic or who demand specific medications may not even realize they're doing so, or they may try it as way to move to the front of the line. But that just ends up raising suspicions that they may be malingering, which is what doctors call it when patients intentionally fake or exaggerate symptoms. For instance, if you complain of severe abdominal pains and vomiting during your ER evaluation but nosh on vending machine snacks to pass the time in the waiting room, your attending doctor may be skeptical of your story.
Be as complete and as clear as you can when describing the symptoms that brought you to seek emergency care. That should include, at the very least, what those symptoms are, when each symptom began, whether these symptoms have happened in the past, and whether you can link your symptoms to a trigger or cause (such as a new medication, food poisoning or accidental slip of a kitchen knife).
Also disclose whether you treated the illness or injury at home before you decided to seek emergency care. Be specific about how you've self-treated, such as if you took any fever-reducers or painkillers, and when.
Disclosing all of your medications allergies to the medical team caring for you is important to help keep you safe. That includes not only drug allergies, such as penicillin (the most common drug people are allergic to) but also any other allergies (such as to latex or any foods). What the ER staff doesn't know can hurt you. Harmful yet preventable medical mistakes kill roughly 98,000 patients every year, although that statistic might be a little light; it could be closer to 1 million, as it's estimated anywhere from 50 to 96 percent of errors aren't reported across the U.S. [source: Chamberlain]. That's more than the number of people who die from complications of the flu and pneumonia combined each year [source: CDC].
Not all reactions mean you're allergic to a medication, but any and all adverse side effects should be disclosed to the doctor. Drug allergies may cause itching, rash, hives, swelling, wheezing and shortness of breath, among other signs, depending on the severity the reaction. Drug interactions happen when there's an adverse reaction between two (or potentially more) medications as the body metabolizes them. And when it comes to drug interactions, if you take two medications, there's a 15 percent risk you'll have a toxic drug interaction. That risk rises to 40 percent for patients who take five or more medications and to an 80 percent chance when taking seven or more medications [source: Moffa].
Interactions may cause gastrointestinal side effects, but they might also cause more serious problems such as kidney or liver damage or an overdose. For example, taking more than one sedative-hypnotic drug — those are drugs that depress the central nervous system such as Valium and Ambien — may cause life-threatening respiratory symptoms or coma and could be fatal.
In 2006, a 49-year-old woman complaining of chest pains, nausea and shortness of breath went to the Vista Medical Center Emergency Room in Lake County, Illinois, for evaluation, and two hours later she was found dead of a heart attack, sitting in the waiting room, still waiting for care [source: ABC News]. While that story is horrifying, it's also a rare example of what could happen in an ER. It's a good reminder why each of us needs to be our own advocate.
Patients in the ER are treated based on the severity of their condition when they arrived for treatment. But just because you didn't have a high fever, arm weakness or trouble breathing during your initial evaluation by the triage nurse doesn't mean you haven't developed new symptoms as you've waited for your turn to see the emergency physician. If you feel your symptoms have worsened as you've waited, it's time to speak up. Ask a nurse or another health care worker to take your vital signs again (that's your blood pressure, pulse, respiratory rate and temperature), or talk to the charge nurse about your potentially escalating symptoms.
Advocating for your own care doesn't mean it's OK to be rude, however. Most of us would admit it can be difficult to maintain a healthy level of patience when there's no discernible light at the end of the waiting room tunnel, but remember, it's not only the words you choose. As much as 70 percent of our communication happens nonverbally — it really does matter if you make eye contact or if you roll your eyes [source: Pola-Mondey]. Make an effort to remain calm and friendly, despite how long you have been waiting.
You might have seen ER wait times on a billboard when waiting to be seen. But are those ER wait times accurate? Find out.
Author's Note: 10 Tips to Get You Through a Trip to the ER
The emergency department, where you're first when you're at your worst.
More Great Links
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