The Real Secrets of the Emergency Room
Dan Morhaim writing on secrets in the emergency room…
You want to use the Emergency Room (ER) appropriately when it’s really needed. The hard-working staff there can address many problems and get you treated or referred in the right direction.
But if you use the ER when it’s not needed, you’ll likely get a long wait, a big bill, and no progress on your problem.
While care must always be individualized, there are basics about how to avoid ER visits, how to know when to go, and how to manage the visit. What follows is not medical advice but some common sense and a few inexpensive ideas to help avoid or improve your ER visit.
Falls are the most serious common injury to the elderly. Broken hips are the worst, leading to disability and death in 25% of cases. Most of these falls occur in bathrooms, so handrails, no-skid surfaces, and shower chairs go a long way in preventing injury. Be sure loose carpet is tacked down and that stair railings are secure. Ask someone else to change light bulbs (I’ve treated too many seniors who fell doing this), and be sure the smoke alarms all work. Have someone check on seniors living alone: too many stay on the floor for hours or days until help arrives.
Seek help when you feel unwell
Identifying a heart attack early can avoid damage. Take chest pain seriously. Women may have unusual symptoms of heart attacks, such as fatigue. Similarly, weakness (especially of an arm or leg), numbness, severe dizziness, trouble speaking, facial droop, and blurred vision are some of the early signs of a stroke. Prompt treatment improves recovery.
Inform your doctor about medicines and records
Always bring all medicines with you to any medical visit, especially to an ER where your records may not be available. Bring a copy of key medical records with you (medicines, EKG’s, recent discharge summaries, advance directives)when travelling. This could help avoid needless tests and wrong medications.
Treat simple problems at home
Generally, you do not need to go to the ER for simple injuries such as a broken toe or bruised nose. Unless the injury is greatly deformed, there is no special treatment, even in the case of a fracture. No need to go for a standard common cold or flu without complications, such as high fever or trouble breathing. You’ll just be exposing yourself and others to more serious infections.
Many people come to the ER after minor fender benders, and often these visits are for insurance or legal purposes. However, most people feel okay right after the accident and then are sore the next day. If you don’t require a hospital visit for insurance reasons, minor injuries can be managed with home care and basic drug-store medicines.
Carry out follow-up treatments at home
Some patients return to the ER to have sutures removed for routine lacerations that have healed without complications. If you – or someone else – are comfortable doing this, it can be done safely at home. All you’ll need is a pair of tweezers (to grasp and pull the thread) and scissors (to cut it).
Communicate with your primary care provider
If you have a primary care doctor or nurse, always contact that person first and then let him/her know after you’ve had an ER visit so that your records can be updated. In some cases, this will allow you to avoid future visits. For example, if you got a tetanus shot in the ER then you won’t need a booster for 10 years.
Take health and safety precautions
Wear your seatbelt, don’t smoke, avoid excessive alcohol, and don’t use recreational drugs. Keep up with vaccinations, especially the yearly flu shot if you have underlying problems. Exercise regularly and safely, and be as close as you can to your ideal weight. Take a First Aid course and have a kit handy. Take a CPR course too. And, if in doubt about a major problem, call your doctor, call 911, or go to the ER.
Make your house identifiable
When you call an ambulance, be sure they can find your house quickly. Have your house number in large size and posted where readily visible. Why? Walk in your neighborhood and check out homes at night or in the rain. Now imagine you are an ambulance driver trying to locate a specific address to get to someone…when every minute matters.
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