emergency room

Surviving the emergency room: a brief guide

You’re feeling like hell and realize you can’t ignore your problem any longer. It may be time to get to the emergency room (ER). But how can you ensure the smoothest visit possible – and get out of there with your health (and wallet) still intact? Here are our top six pointers to help you stay alive.

1. Avoid the ER altogether, if you can

If you sustained a major trauma; or you’re experiencing severe chest pain, shortness of breath, or weakness; or you just have this vague feeling that death may be imminent, then you should call 911 and get to the ER as soon as possible. Every second may count, and paramedics can begin treatment en route to the hospital. (Plus, as a kid, didn’t you always want to ride in an ambulance?)

If you feel you could wait a few hours to go to the ER – then go somewhere else. ERs are crowded, high-stress areas where sick patients are competing for attention. Try an urgent care center instead. The wait time is shorter, the experience generally smoother, and the prices often lower.

Urgent care centers are especially good at handling complaints like sports injuries, minor burns and wounds (even if stitches are needed), and subacute symptoms (present for a few days, like fever or cough).

If your needs are really not urgent, and you have a primary care doctor, you should just call for a same-day appointment if possible.

2. Be nice – no matter what

We know you’re stressed out and not feeling like yourself – but please, resist the urge to complain or yell. The doctors, nurses, and other ER staff are all working under high-stress conditions, usually with everyone giving them a hard time. Berating someone and insisting they be faster or more attentive will likely have the opposite effect. If a disgruntled waiter can pee in your soup, just imagine what a nurse can do if you’re being unruly.

3. Know your own history

Bring a list of your medications, vitamins and supplements – including the dose and frequency. If necessary, call your pharmacy or a family member back at home while you’re waiting to be seen.

Know your medication allergies, including the reactions. Know the basic details and dates of all prior surgeries/procedures.

If you’ve had a prior electrocardiogram (ECG), take a picture and keep it on your smartphone, so doctors can look for changes if they perform a new one.

The ER doctors will be able to provide much better care if they know the details of your past history.

4. Be prepared to wait

You’ve probably seen billboards for ERs advertising short waiting times, practically inviting people to come in. But don’t be fooled – that’s not necessarily how long it will take to be seen by a doctor face-to-face, and it’s definitely not how long it will take to complete your visit.

Note that some hospitals artificially keep their waiting times down by having patients do a quick triage visit with a doctor, only to have them wait a few hours for the actual evaluation.

The bottom line: unless you’re extremely sick or you’re rolling in at 3am, you should be prepared to wait a few hours. Throwing a fit won’t make your experience any faster (see #2 above)

5. Keep your primary doctor updated

If you have a regular primary care doctor, call his or her office to let them know about the visit. Your doctor may be able to provide additional information to enhance the decision-making – and perhaps even eliminate the need for expensive diagnostic tests, like a CT scan or MRI.

6. If you’re getting new medications, call your pharmacy before leaving

If the E.R. decides to send you back home, you may get some prescriptions electronically transmitted to your pharmacy. Do yourself a favor and call the pharmacy before leaving to make sure the transmission was received, and that they’re even still open. Otherwise, good luck troubleshooting your missing prescriptions after leaving the ER.

Marc Eisenberg, M.D., F.A.C.C.

Marc Sabin Eisenberg, M.D., F.A.C.C., is an associate professor of medicine at Columbia University Medical Center and an attending cardiologist at NewYork-Presbyterian Hospital.

Christopher Kelly, M.D., M.S.

Christopher Rehbeck Kelly, M.D., M.S., is a cardiologist at North Carolina Heart and Vascular and UNC Rex Hospital in Raleigh, North Carolina.