Emergency Room Visit - Twelve Things You Need to Know

Medical Author: Melissa Conrad Stoppler, MD
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

Visiting the Emergency Room (the ER) of a hospital can be a traumatic and stressful experience for anyone. Taking a moment to learn how the ER works and what to expect can help reduce anxiety and ensure a smoother process should you or a loved one require emergency services. The ER is also often referred to as the Emergency Department.

1. If you're in need of medical care after office hours, find out if your health plan offers a toll-free advice line. Many plans have toll-free numbers that you can call to speak with a nurse who can help you decide if a trip to the ER is even necessary.

2. Some ERs, especially at large hospitals, are divided into different divisions such as pediatric ER for children, trauma services, and observation units. ERs may also offer a "fast track" option for those with less severe problems.

3. The American College of Emergency Physicians recommends keeping an "emergency file" containing your insurance cards, a list of all medications you are taking, a list of any chronic conditions you may have, operations you have had, and allergies (particularly drug allergies) that you have. These can be kept in a folder that you can easily grab on the way out the door should an ER visit be necessary. You can also include copies of recent laboratory or diagnostic test results. Doing so may help reduce both the cost and waiting time associated with your ER visit.

4. Upon arrival at the ER, unless you arrive by ambulance with a life-threatening injury, you will most likely be assessed by a triage nurse, who will take a brief history of your condition, measure your vital signs (blood pressure, temperature, pulse and respiratory rates), and prioritize your case in terms of urgency.

5. If you have a chronic illness that requires frequent visits to the hospital, utilizing emergency services at the same location can help speed your care, since the doctors have access to all of your medical history and information.

6. Know that emergency rooms are often staffed differently. Some hospitals staff the ER with only board-certified emergency physicians, while others may rotate physicians from other specialties for ER coverage. You can find out in advance if your preferred hospital ER is staffed by board-certified emergency physicians if this is of concern to you.

7. Be aware that if you must be admitted to the hospital, you may have to wait some time before you are taken to your room. Likewise, plan for longer waiting times in the ER if your problem is not urgent (bring something to occupy your time such as a book or magazine to read, and if you have small children, something to occupy their time such as toys or coloring books). Many busy ER physicians will require time in order to assess the most urgent patient care issues prior to evaluating less critical problems. Remember, the ER is the first entry point for the most serious of medical illnesses.

8. Ask about out-of-pocket costs. Even if you are treated at a hospital approved by your health plan, some hospitals employ doctors (particularly ER physicians, radiologists, and pathologists) who may not participate in your group plan. You may receive a bill for services from these providers.

9. Don't be afraid to ask questions. Emergency departments can be crowded, confusing places. While errors are uncommon, they may occur. When you receive any medications, diagnostic procedures, or treatments, ask what is being done and why. Don't hesitate to speak up if you are unsure of anything.

10. Many ERs have social workers on staff to help you resolve insurance issues, health plan approvals, and similar situations.

11. Before you leave the ER, get all your discharge instructions in writing. Be sure that these include the names of physicians that you saw, the diagnosis that was made, follow-up instructions, and any prescriptions you may require.

12. Calling an ambulance may restrict your choices of an ER facility, since ambulance drivers may be required to take you to the nearest facility that is accepting patients. However, calling 9-1-1 is always best if your emergency situation poses any threat to life or if you are physically unable to travel by car. The paramedics who arrive on the scene can begin treating your emergency immediately and can continue treatment en route to the hospital.