Emergency Room

According to the National Center for Health Statistics, most people who go to an emergency room (ER) do not need urgent care. Find out why rushing to an ER for minor health problems is not a good idea. Also find out how to prepare yourself in the event you really do need emergency treatment.

Emergency Room Going to an emergency room instead of scheduling a doctor's appointment has become a trend in this country. In 1996, a whopping fifty-five percent of the 90 million visits to emergency rooms in were unnecessary. Translated into dollars and cents that means 40.5 million people paid up to three times as much for routine care as they would have paid at a physician's office. They probably wasted a lot of time too because emergency rooms are not set up to care for routine illness, and they do not work on a first-come, first-served basis as many people mistakenly believe. To ensure that the sickest patients get immediate care, emergency rooms use a triage (French for "sorting") system of evaluation so that critical cases, such as people suffering from heart attacks or injuries from serious accidents or violent crimes, are treated first. Everyone else may have to wait quite a while before being seen. In fact, the average wait for emergency treatment nationwide is about two hours.

When you feel sick, the last thing you want to do is to sit for hours in a heavily-trafficked emergency facility before getting help. Here's how you can spare yourself this discomfort and prepare for sudden medical problems.

Be Prepared

The following steps can help you get the health care you need:

Get a primary care physician. Having a regular doctor who keeps your medical history on file and who is available to see you in a pinch is one of your best recourses in an emergency.

Find out what other health care facilities are available in your community. 24-hour walk-in clinics and minor emergency centers can care for non-urgent conditions faster and cheaper than a hospital ER.

Keep important medical information on you. It's a good idea to carry in your purse or wallet a small card that notes the name and telephone number of your regular doctor, any allergies or chronic medical ailments you may have, and any medications (along with dosage) you may be taking. Also jot down whether you are pregnant. This will save the ER doctor a lot of guesswork when trying to diagnose and treat your condition, particularly if you are unconscious.

Locate the best emergency rooms near where you live and work. 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 1 are the most comprehensive trauma centers with high-tech equipment and specialists on the premises at all times. Level 2 and 3 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.

Insurance Coverage. Make sure you know which emergency services are covered and what instructions you need to follow in urgent situations. For example, if you go to an ER with an ear infection, your health insurance may not cover the cost. Also, some plans require that you notify them within a few hours of being admitted. If you don't, your treatment may not be covered.

If possible, call the ER before you go. Notification that you're on your way will cut down on your waiting time by allowing the staff time to prepare for it. You will probably talk with a triage nurse who will ask you about your symptoms (or those of the person you are assisting) and will tell you whether you need to come in; whetherto call the Emergency Medical Service (EMS), which can be reached in most areas by calling 911; what you can do before you arrive; what information you need to bring to the hospital; and whether you will be better off going to a different ER.

Parents should consider keeping a consent form on file with the local ER. If your child has a medical emergency while you are out of town or otherwise unreachable, a consent form will allow doctors to get right to work without having to deal with the red tape of trying to obtain a social worker or court approval prior to giving medical assistance. If you do not feel comfortable with such a blanket consent form, you may want to discuss options with your lawyer.

When Should I Go to the ER?

Use good judgment in deciding when to use emergency medical services. Learn the signs of serious illness and trust your instincts. If you are alarmed by unusually severe symptoms, it is best to seek immediate care. Call your primary care physician and describe your symptoms. The doctor can tell you whether emergency treatment is necessary. For urgent problems that don't require emergency care, most doctors will rearrange their schedule to squeeze you in that same day (so be understanding when such a problem means your appointment is juggled a bit).

A good primary care doctor is available 24 hours a day for emergencies or takes turns handling off-hour urgent calls with colleagues. Contacting your doctor is useful even if you do end up going to the emergency room. He or she can meet you there or call to give the ER doctors information on your health history.

The American College of Emergency Physicians (ACEP) recommends you become familiar with the symptoms of common illnesses and injuries such as those listed in the booklet Home Organizer for Medical Emergencies.

The following are some general guidelines to help you decide when a trip to the ER is ncessary:

Good Reasons to Go to an Emergency Room: Bad Reasons to Go to an Emergency Room:
Loss of consciousness.

Signs of heart attack that last two minutes or more. These include: 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, including: 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 symptoms.

Severe shortness of breath.

Bleeding that does not stop after 10 minutes of direct pressure.

Sudden, severe pain.

Poisoning (Note: If possible, call your local poison control center first and ask for immediate home treatment advice-certain poisons should be vomited as soon as possible while others should be diluted with water as soon as possible. Such preliminary home treatment could save your life.)

A severe or worsening reaction to an insect bite or sting, or to a medication, especially if breathing is difficult.

A major injury, such as a head trauma.

Unexplained stupor, drowsiness or disorientation.

Coughing up or vomiting blood.

Severe or persistent vomiting.

Suicidal or homicidal feelings.

Minor cuts where bleeding is controlled.

A minor dog or animal bite where bleeding is controlled (but see your doctor--a rabies shot may be necessary).

A broken bone (call your doctor to see if he/she can treat you the same day, if not-- or if bone is showing, limb is deformed--go to the ER).

A sprain.

A sunburn or minor burn from cooking.

An insect sting or delayed swelling from a sting (if there is breathing difficulty, go to the ER).

A skin rash.

Fever (if there is a convulsion, go to the ER).

Sexually-transmitted diseases.

Colds and cough, sore throat, flu.

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