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What You Should Know Before Heading to the ER

After my husband’s visit to the ER, I learned some invaluable lessons. Here they are.

Photo credit: Getty Images/vm

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My husband, Eriq, didn’t look right. His skin was pale, and he was sweating and struggling to stay upright. In a slow and quiet voice, he said, “I think you need to take me to the ER.”

Eriq does not often ask for help, and I normally have to prod him to make a doctor’s appointment. On this morning, though, he looked at me with tired eyes and asked for my help. To go to the hospital.

What was happening?

I grew anxious as I threw on some shoes and grabbed my keys. At first, I thought he might be dehydrated or overheated from working so hard outdoors, but it wasn’t particularly hot for a D.C. summer. I worried he might collapse before I could get him to the car.

As a longtime health writer, I’m familiar with the healthcare system. But I found that I wasn’t prepared for how to advocate for my husband in a busy emergency room (ER). In hindsight, there are several things I wish I had known before we headed to the hospital that Sunday morning. I spoke to Robert Glatter, MD, attending emergency department physician at Lenox Hill Hospital in New York City, about how people can prepare themselves to get the best possible care.

1. Know when to go.

First things first: In a true emergency, you need to stop what you are doing and call 911. If you are experiencing chest pain, weakness or numbness, a change in mental status, or the worst headache of your life, call an ambulance. When the situation is dire, the care needs to come to you.

But most symptoms, while scary or painful, are not life-and-death. So you may be left wondering if you should jump in the car and head to the ER, or if there are other options. For people who have serious or chronic illnesses—like heart disease, diabetes, high blood pressure, COPD or cancer—it’s usually wise to head to the ER where they are well-equipped to handle complex medical needs.

In many cases, though, there is time to first call your doctor’s office or answering service (keep the number stored on your phone) to get a professional opinion on whether you should go. Your physician can also give the ER a heads-up, which may help you get more personalized care. “Especially for children, it may make you feel more comfortable that the ER staff, who have never met you, are armed with information about your child and his particular situation,” Dr. Glatter explains.

Another option if you can’t reach your doctor: Call your insurance provider’s 24-hour helpline, which is typically staffed by nurses or nurse practitioners. “They can offer good advice about whether to go straight to the hospital or take a ‘wait and see’ approach,” Dr. Glatter explains.

If you don’t think you actually need the ER, head to urgent care instead. As anyone who has ever been to an emergency room knows, patients are prioritized in order of urgency. If your situation isn’t critical, you’ll likely end up waiting. Urgent cares treat colds, the flu, strep throat, and minor broken bones or sprains. Most are equipped to do X-rays and provide splints and braces.

2. Prepare now, before an emergency happens.

“Ultimately, being prepared when you come to the ER is one of the most important things you can do,” Dr. Glatter says. Important health information should be stored in one place for easy access. He suggests keeping an updated list (ideally on your phone) of the medications you and your family members take, plus information about allergies and medical history, including previous surgeries, serious illnesses, recent lab work or information from recent doctors’ visits. There are several phone apps that can store medication names and doses and even allow you to scan pill bottles so you don’t have to type in all the data.

If you don’t have an updated medication list, grab your pills—in their original bottles, if possible —and take them with you. No time, or you don’t have the bottles? Just bring the loose pills—physicians can sometimes use their own apps to identify drugs, Dr. Glatter says.

3. Don’t be intimidated and try to be patient.

If you’ve ever been to an ER, you know that an emergency room can feel crowded and hectic. Staffers are often rushing from one patient to the next, and you may hear sounds of people who are distraught or in pain and lots of beeps and alarms from the machines monitoring patients.

“Prepare yourself by getting in the mindset that the ER is a busy, chaotic place,” Dr. Glatter says. “I think most people feel nervous when they are in an emergency room. There’s a frenetic pace. Just know this is normal.”

When you arrive, a triage nurse will take your vital signs, like blood pressure, heart rate and temperature. This information serves a key purpose: It helps the staff determine how critical you are and where to place you in the queue. Then you will likely be escorted through the ER doors where the real wait often begins. It may seem like you’re being overlooked, but Dr. Glatter says that waiting inside the actual emergency room is a good thing. Physicians and nurses are trained to see these patients and keep an eye on them, even when they are not actively working on them. He explains that when medical staff can actually see their patients, it helps decrease wait times. Additionally, when patients can see their caregivers, it has a reassuring effect.

4. Get super specific.

When it’s time to tell the doctor or nurse why you’re there, start with the most urgent-seeming symptoms. But also focus on telling a complete story. “We’re looking for information,” Dr. Glatter says. “It’s like when you write a newspaper article: What happened? When did it happen? Where did it happen? What precipitated the event?” His tip: Write down your story while you’re waiting so you don’t forget any important details.

ER physicians use this information to piece together the puzzle of your illness. “We work often on a lack of information. In fact, that’s part of what draws people into emergency medicine—we’re good at figuring things out,” Dr. Glatter says. “We can understand a patient and look at the whole picture and put it together.”

5. Speak up and be your own advocate.

Don’t be afraid to ask staff for things that might make you or your loved one more comfortable (blankets, snacks or drinks, even newspapers or magazines to read while you wait). 

And, Dr. Glatter adds, please do ask questions. “It’s not going to offend us if you ask questions,” he says. “That is part of taking care of your family member as well as being a wise consumer.”

It’s not a bad idea, also, to remind staff of your story, especially after a shift change when you might be dealing with a new doctor or nurse. It may seem redundant, but this will ensure better follow through and consistency in your care.

6. Your care doesn’t end at discharge.

When you leave the emergency room, you will be handed discharge papers, which outline your symptoms, the cause (if known), treatment, tests and recommendations. Make sure you understand not only the follow-up instructions, but also the “return precautions”—symptoms or problems that indicate you should return to the ER.

Within a day or two, be sure to call your primary care physician (PCP) or the suggested specialist. This will give you and that doctor the chance to review the ER recommendations and make sure you get any additional tests or treatments needed. Here’s a tip to get in quickly: Let the office staff know that you were just in the hospital. You don’t want to wait weeks for a follow-up appointment.

No one ever hopes for a trip to the ER. But by preparing ahead of time, you’ll be ready to jump into action. We made the right decision to go when we did—the doctors stabilized Eriq and ruled out the worst possibilities. IV antibiotics began to quickly knock out whatever infection was knocking him around, and he started to feel better after several hours. A simple blood test during a follow-up visit with his primary care doctor a few days later revealed he had Lyme disease. We agreed with his doctor’s approach to treat the disease aggressively. He was prescribed three months of daily antibiotics and regained his strength after a few weeks. A follow-up blood test revealed no sign of the disease.

While I don’t look forward to any future ER visits, I know it’s always a possibility. Life happens. But this time, I’ll be better armed with ways to prepare ahead of time and advocate while I’m there. 

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Published December 7th, 2017

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