A few weeks ago I had a phone call from one of the writers at Redbook Magazine. She was writing an article about the proper use of the ER and how to make sure you took full advantage of such a visit, should it be necessary. I’ve written in the past about when not to go to the ER and have given many examples of some of the strange and wondrous reasons that bring people to our department. I was intrigued by her question, and agreed that this was an important topic, and something that might prove helpful. So, with that in mind, her are the main points I shared with her.
First, and this should go without saying, only use the ER when you have a true emergency—something life or limb threatening, or a condition that a prudent person has reason to believe might become so. When emergency departments are overcrowded with minor, non-critical problems, the staff’s ability to efficiently handle a true emergency can be dangerously compromised.
Let’s imagine you or your loved one has chest pain, an unusual and severe headache, or worsening shortness of breath, and you find yourself in the ER. At the very first opportunity, communicate. Be clear with the front desk or triage staff about your dilemma and make sure they understand. You might need to ask them to repeat what you’ve just told them, just to be sure. But be clear when you tell them about your problem. Don’t assume that anybody there is a mind-reader.
The nursing staff and physicians will need to know about any medical condition you have, such as diabetes, high blood pressure, or heart disease. It used to be fashionable to wear a medical alert necklace, letting people know you had a significant medical condition should you find yourself unable to speak. These aren’t foolproof, as a late-night visitor to the ER once demonstrated.
“John, looks like you have diabetes.” I had glanced down at the medical alert tag resting on his chest. Diabetic was emblazoned in red ink.
The forty-year-old followed my gaze, grabbed the tag, and held it up.
“Oh this? No, I don’t have diabetes. I have seizures. The drugstore didn’t have one of those, so I just got this one.”
Say what? Sadly, it’s happened to me more than once.
A better way to convey your medical information is through use of your smartphone. This could be a connection to your current medical record, the names of all of your physicians, as well as a complete list of your prescription medications. That’s important. The ER staff has to know what you’re taking, and to tell them “a little white, round pill and an oblong yellow one” won’t cut it. If you’re technologically challenged, keep a written or typed list with you. The name of the drug needs to be noted, as well as the dosage and frequency taken. Sounds simple, but too often the information is not to be had.
And don’t forget to list your herbal medicines and vitamins. These are important as well, since serious interactions can occur. Frequently, these have been the very cause of ER visits, proving to be dangerous as well as perplexing if we don’t know what you’re taking.
It’s also a great idea to keep a copy of your EKG, should you have one, on hand or again on your phone. The ability to compare a cardiogram in the ER from one done in your doctor’s office can be time saving, as well as helping avoid unnecessary procedures and even hospitalizations.
These are simple but important things to remember. Once you’ve clearly informed the ER staff of the reason you’re in their department, and provided them with a list of current medications and any medical conditions, and your treatment has begun, don’t hesitate to ask questions. Be patient and as calm as possible, but ask about procedures, lab work, possible diagnoses, and recommended treatments. A good ER physician will never feel challenged by such questions, and should welcome the opportunity to engage with you or your loved one and develop a plan together. Be patient, but be persistent.
And finally, it turns out your mama was right after all. Any time you leave the house, make sure you’re wearing clean and presentable underwear. You just never know…
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