According to the National Center for Health Statistics, most of the people who went to emergency rooms (ERs) in 1992 did not need urgent care. The ER is one of the most expensive units in the hospital, and such inappropriate dependency on it can do more than just send the patient’s bill through the roof—it can cost lives by hampering the treatment of real emergencies.
A whopping fifty-five percent of the 90 million visits to emergency rooms in 1992 were unnecessary. That means 40.5 million people paid up to three times as much for routine care as they would have 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. Emergency rooms use a triage system of evaluation, meaning that they determine the urgency of a problem so that the most serious ones, like heart attack, and injuries from accidents and violent crimes, are treated first. Everyone else may have to wait for hours before being seen. In fact, the average wait for emergency treatment nationwide has been reported to be two hours.
When you feel sick, the last thing you want to do is to sit for hours in a heavily-trafficked ER facility before getting help. The best step you can take to avoid this often unnecessary discomfort and get the best medical care possible, is to read on and find out how to recognize and prepare for a real emergency.
The following are some steps you can take before an emergency occurs:
Get a primary care physician. Having a regular doctor who keeps your medical history on file and who is available to you in a pinch is one of your best recourses in an emergency.
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, your allergies, medical ailments 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, if you are unconscious.
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.
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 services. Emergency facilities are rated Level 1, 2 and 3. Those rated Level 3 are the most comprehensive trauma centers with high-tech equipment and specialists on the premises at all times. Level 1 and 2 centers can handle many kinds of emergencies, but may not have specialists on hand for some needs. Find out which is which in your community by calling nearby facilities and asking what their level is so you can plan ahead.
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; whether you should call the Emergency Medical Service (EMS), which can be reached in most areas by calling 911; what can be done for the person in need of assistance 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 your options with your lawyer.
Use good judgment in deciding when to use emergency medical services. Your best bet is to call your regular doctor and describe your symptoms. He or she can tell you whether you need to go to the ER, call EMS, or if you can wait for an appointment. 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 following are some general guidelines to help you decide when you or a loved one should go to the ER:
|Good Reasons to Go|
to an Emergency Room:• Loss of consciousness• Signs of heart attack that last two minutes or more, including: pressure, fullness, squeezing or pain in the center of the chest; tightness, burning, or aching under the breastbone; chest pain with lightheadedness.• Severe shortness of breath• Uncontrollable bleeding• Pain that is intolerable or uncontrollable• 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
|Bad Reasons to Go|
to an Emergency Room:• Earache• Minor cuts where bleeding is controlled• A minor dog bite where bleeding is controlled• A broken bone (if bone is showing or limb is deformed, go directly to the ER, otherwise call your regular doctor)• A sprain• A sunburn or minor burn from cooking• An insect sting or delayed swelling from a sting (if there is breathing difficulty, go directly to the ER)• A skin rash• Fever (if there is a convulsion, go directly to the ER)• Sexually transmitted diseases (STD)• Colds and cough, sore throat, flu