The ER — What to Expect and When to Go

by Margaret Minuth
June 2009

With over 325,000 patients being seen in hospital emergency rooms across the nation each day, hospitals are challenged to treat every imaginable ailment quickly and efficiently.

Emergency rooms operate on the severity of the patient complaints, which are categorized through a triage system. Those patients with immediate, life-threatening conditions are seen first — even if you’ve been waiting awhile to be seen. Next seen will be those who have urgent but not immediately life-threatening illnesses, and finally, those with non-emergent conditions.

The triage nurse is typically the first person you’ll see. She/he will take your vitals, interview you, and begin treatment protocols. After you see the triage nurse, you’ll go through registration. If you arrive by ambulance or have a life-threatening condition, this step may be done after treatment at your bedside. Once you have registered, you’ll be taken back to an exam room where most of your treatment will take place.

While you are in your exam room, the nurse and doctor will ask you many questions to develop the best treatment plan for you as possible. It’s important to be as honest and truthful about the events and symptoms leading to your emergency visit. Embellishing answers to speed up care or minimizing responses to downplay your condition can mean you won’t get the care that you need — and that can put you at risk.

If you require diagnostic tests, those may be done in another department. Treatment likely will continue in the exam room until discharge. If your medical condition requires treatment other than discharge, you may be admitted to the hospital, placed in a room for observation, or taken to surgery at this point.

When you are discharged from the ER, you’ll be given instructions on how to care for yourself until you can follow up with your family physician. You may also be given a prescription for a limited supply of medications. You will need to see your primary care provider for additional treatment, more medication, and follow-up care.

So how do you know if a trip to the ER is necessary? The American College of Emergency Physicians (ACEP) offers a list of symptoms that may suggest a medical emergency:

• Difficulty breathing, shortness of breath
• Chest or upper abdominal pain or pressure
• Fainting, sudden dizziness, weakness
• Changes in vision
• Confusion or changes in mental status
• Any sudden or severe pain
• Uncontrolled bleeding
• Severe or persistent vomiting or diarrhea
• Coughing or vomiting blood
• Suicidal feelings
• Difficulty speaking
• Shortness of breath
• Unusual abdominal pain

These are typical indicators that emergency medical care is needed. If you don’t have those any of these symptoms and are in doubt that you can wait until morning to see your doctor or are worried that you will get worse during the night, go to the ER and put your mind at ease. We’ll be happy to treat you.

BE PREPARED

Being prepared for an emergency visit will help alleviate the stress. Here are some tips for a positive ER experience:

• Know the fastest routes to your local ER. Only use an ambulance if you absolutely need it.
• Carry a list of your medications with dosages and why you’re taking them. Be sure to include any supplements or homeopathic remedies you take as well. Many hospitals offer free medication pocket cards to patients to record their medications.
• Take your insurance cards with you.
• Contact your physician before you leave or on the way to the hospital.
• If you are waiting to be seen and begin to feel worse, let the triage nurse know immediately.
• Ask questions about your care if you are unsure or don’t understand what the doctors or nurses are saying.

If you are not satisfied with your care, ask to speak with the patient advocate or nurse manager. Hospital administrators don’t want patients to leave unhappy.

Margaret Minuth is Director of Marketing and Public Relations for Central Carolina Hospital in Sanford. Their emergency room sees on average 2,500-3,000 people monthly.