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What Your ER Doctor Wishes You Would Divulge

If you need to go a hospital Emergency Department, Dr. Dayner offers these recommendations to help get the best care with the least amount of anxiety:
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I'm not the greatest cook, admittedly. After preparing chicken breasts on the stove (dry as toast), I compensated by adding a dipping sauce to mask it. My 15-year-old arrived at the table (starving) and began wolfing down his meal. A minute later, he stood up, turned pale, and began gasping for air. He was choking.

Matthew managed to bring up some of the meat, but the rest remained lodged in the lower part of his throat. He could breathe and speak, but was frightened and uncomfortable. The 911 paramedics didn't take any action since he was able to breath and on-site treatment could make the situation more urgent. So Matt was transported to the local hospital ER.

Now that my children are teens, our visits to the ER are less frequent. I had forgotten how crowded and busy these places are and that you (and your child) may be ear-to-ear with strangers who are ill, or in pain.

It's a confusing place as an outsider and as a mother you sometimes feel anxious about waiting to see a doctor.

From watching medical programs on TV, you might assume most ER patients arrive at the hospital in critical condition. In the real world, most ER cases are not life-threatening.

I wanted to learn more about how the ER works "from the inside." I spoke with Dr. Jeremy Dayner, chair of the Department of Emergency Medicine and a board-certified emergency medicine physician at CentraState Medical Center in Freehold, New Jersey.

"If you are ill or injured after regular office hours, call your primary doctor first. Most physicians have after-hours call services for emergencies. Since primary doctors knows your history, they can sometimes diagnose and treat your situation over the phone," says Dr. Dayner.

"If the condition is not life-threatening, also consider going to an urgent care center. They are usually open nights and weekends and these doctors specialize in emergency diagnoses and care." Dr. Dayner adds that these centers can also usually treat you faster than an ER.

If you need to go a hospital Emergency Department, Dr. Dayner offers these recommendations to help get the best care with the least amount of anxiety:

Understand the goal of the Emergency Department
Only about 12 percent of patients who come through the ER are admitted into the hospital. The goal of the ER team is to stabilize patients until they can see their regular doctor--cardiologist, pediatrician, OB/GYN or family physician. We don't establish long-term relationships with patients. If hospitalization is required, we will transfer your care to the attending physician who specializes in your medical condition.

Bring one person with you but leave children with family or friends
Bring only one advocate who can help answer questions, give updates to family, and assist as needed. Since most ERs are overcrowded, having multiple family members present compromises the privacy of all patients. The ER is no place to bring children; there is no one to care for them while you are being treated.

If your condition is serious, don't drive yourself to the ER
It's understandable that you'd want to get right to the hospital, but a distraught driver is not a safe driver. If there is any question about you or your family member's condition, call an ambulance. Paramedics can begin many types of emergency treatment even before you get to the hospital.

We help the sickest patients first
You will be triaged based upon the severity of your condition and you can't shortcut the line in the ER. Critically ill patients are treated first.

We need to know all the medications you are taking
Your health history is the most important tool the ER physician has to help make the safest and most accurate diagnosis. Our persistence in getting an accurate list of your medications, even if you just need a finger sutured, is to make sure we don't give you a drug that will negatively interact with what you are already taking. Federal regulations mandate documenting every patient's prescription and non-prescription medication. Carry a credit card-sized list of medications, including vitamins, and any medical problems you have.

Be honest about your lifestyle
If you smoke, use drugs or drink heavily, we need to know in order to devise a safe and effective treatment plan. We are here to stabilize your medical situation, not judge you. If you are in any kind of dangerous or abusive situation, tell us. We have the resources to help.

This is not the place for ongoing treatment of your chronic medical condition
Unless your chronic condition has a life-threatening complication, the ER is not the place to seek care. We don't know your full medical history or the treatment protocol your regular doctor has in place. As a result, we are not able to adjust prescription medications or prescribe new medications, unless it is to treat a condition unrelated to your chronic disease.

Read the printed follow-up report our nurses give you
Healthcare is confusing. Patients are often not aware of the specific condition for which they were treated. Once you're home, sit down and read the report we prepared for you. It will state specifically what you need to do next to continue your recovery: prescriptions to fill, medical clearances for returning to work or school, and follow-up visits with a treatment provider.

Contact the Medical Records Department for a copy of lab tests and a treatment record
Your ER visit and treatment protocol is important information to give to your regular physician. Most hospitals do not automatically forward this information without your consent or request.

When you need to call 911
If you have any of these life-threatening symptoms, call an ambulance:

• Chest pain or other signs of a heart attack
• Stroke symptoms
• Difficulty breathing
• Severe bleeding
• Head trauma or seizures
• Drug or alcohol overdose
• Severe pain
• Loss of consciousness
• Sudden loss of vision or blurred vision
• Compound bone fractures that break through the skin

Calling 911 will provide professional medical assistance in the fastest way possible. These specially-trained paramedics will stabilize you and help keep your condition from worsening during transport to the hospital. They will also alert the Emergency Department to your medical emergency so that a team is ready to help you the minute you arrive at the hospital.

"If you are faced with a visit to the ER, understand providing first-rate care is going to take time due to the ever-increasing volume of patients we are treating," Dayner explains. "But emergency medicine professionals are also specially trained to diagnose and treat a wide spectrum of healthcare issues quickly and effectively. You're going to be in good hands."