Before coming to the ER

As a Physician Assistant working in the Emergency Room (ER), I wanted to share a few things that some patients should attempt to do before coming to the ER. Obviously, these tips don’t apply to the person who is unconscious, intubated, and being wheeled into our department by EMS. But some of these tips may may make your hospital stay more pleasant and the whole process run smoother.

Please note, if you feel like you’re having an emergency then do not delay care and call 911.

CALL YOUR FAMILY DOCTOR / SPECIALIST

You have a family doctor, right?

Say you’re having cold symptoms or even just a sore throat (with or without a fever)… does your family doctor’s office have room today for a sick visit? Many offices are setting aside time in the afternoon precisely for this.

This won’t work with every complaint. For example, if you’re having chest pain and you call your family doctor; they’ll likely tell you to go to the ER. But continuance of care is an important consideration and it doesn’t hurt to keep your in the loop.

Likewise, consider that you just had recent surgery or a complicated GI issue. Are you able to get in touch with the surgeon who did the procedure to see what they recommend? Sometimes they have an appointment available that day and are able to take a look at your wound – other times they will relay you to the hospital.

KNOW YOUR MEDICATIONS AND HEALTH HISTORY

If you’re the type of person who is on multiple medications and you wouldn’t be able to recall them – write them down in a word doc and stash that into your purse or wallet. You should also keep track of certain last immunizations such as your TDAP as it is one we ask about often in the ER.

Nowadays you can use apps or even just your smartphone to track your medical records and history. The only reason not to do this is if you have privacy concerns.

Having your medications on hand makes triage a lot easier for the nurse and also helps the person in charge of your care to avoid administering medications that could harm you.

CONSIDER YOUR KIDS & PETS

It’s fine to bring your kids with you to the hospital, but there are some nuances. Would you have someone who can get the kids from daycare or school? Do you have a babysitter on hand? Is your spouse able to leave work early? These are some things to contemplate.

Likewise for your pets, you should leave them ample food and bring them inside or take them outside (for the bathroom) before coming to the ER. This is more so true if you don’t have a trustful neighbor or a family member who could do this for you if you’re being admitted to the hospital. You won’t believe how many times we want to admit somebody and they protest or even sign out Against Medical Advice to get their pets situated.

UNDERSTAND YOU MAY BE ADMITTED

If you come to the hospital for any complaint and we evaluate you – just know that we may find something which warrants you having to stay in the hospital.

For example a person with “just a cut” that warranted IV antibiotics, hospitalization and a surgery consult or the diabetic who said their sugar has been high and they’re in DKA.

We will explain the reason we want to keep you in the hospital and what the plan is going forward towards making you better.

The reason for hospitalization may be for something completely unrelated to why you came in.

Or it may be due to the risk factors and your chief complaint. From our standpoint – it’s difficult to let someone with a prior heart attack, multiple cardiac risk factors, and an abnormal ECG to go home after they came in with the complaint of “chest pain.”  Now, compare that to a healthy 30-year old without any family history of sudden cardiac death, no risk factors, and no concerning history or findings.

UNDERSTAND YOU MAY WAIT A WHILE

I hear stories of patients who visit the larger tertiary care centers who spend six or eight hours in the waiting room alone.

Our ER is pretty good at getting people back quickly to be seen. Many of our patients are seen within the first few minutes of arriving to our hospital and leave our facility within 2 hours. While this is typically what happens, you need to understand that the more tests and imaging we require – the longer your stay tends to be.

Believe me, we aren’t trying to keep you around waiting longer for no reason. We want you to go about your normal day if possible. But you put us in a difficult situation when you come to the ER at 3 PM and start demanding to leave at 4 PM because you have some sort of appointment or thing to get done in the next half an hour.

If you’re coming to the ER on your own volition, you should figure the next two to four hours (or more) may be consumed by being at the hospital.

Conclusion

I hope this article helped to highlight a few things you should do or consider before coming to the ER. Any additional tips will be updated at a later time.

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