I pick up a lot on this job that helps make me a wiser and healthier consumer  tips for evaluating healthcare benefits and providers and making smarter lifestyle choices. And I recently learned something else: how to figure out when to go to the emergency room (ER).
One day this month we were finalizing the description for an upcoming audio conference, “Non-Urgent Emergency Room Usage: Proven Ways to Redirect Care to Appropriate Settings.†That evening, my 17-year-old daughter began complaining of head and neck pain, the result of a minor car accident that had occurred that afternoon.
By the time she shared the news about the accident, our primary physician’s office was closed. Not entirely sure that this warranted an ER visit but also disinclined to downplay the risk from a head injury, I took her to the hospital emergency room at around 9 p.m.
Most importantly, her injuries were minor and we were sent home around 1 a.m. with a prescription for muscle relaxants and rest. However, during our four-hour wait for care, I had a lot of time to consider whether I had made the right choice in bringing her there. It was certainly a decision colored by emotion, made by a parent with their child’s best interest at heart. But if I had taken the time to research, I might have come across these guidelines from Health Pages, an online consumer healthcare service that provides a list of good reasons and bad reasons to go to the emergency room. Severe bleeding, signs or heart attack or stroke, loss of consciousness or a major injury such as a head trauma (which, I rationalized, was where we fit in) are some good reasons for going, according to this resource. Sprains, sunburns, rashes, fever (unless the patient is convulsing) and colds, coughs and flu are bad reasons for an ER visit.
Also, a little preparation now can help you make an informed decision in case you or someone in your care needs medical attention outside of doctors’ office hours:
ï‚· Get a primary care physician. Having a regular doctor who keeps your medical history on file, who is available to see you in a pinch and who will take your phone call outside of office hours is one of your best recourses in an emergency.
ï‚· Research other healthcare facilities in your community. Sometimes 24-hour walk-in clinics and minor emergency centers can care for non-urgent conditions faster and less expensively than a hospital ER.
ï‚· 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, any allergies or chronic medical ailments you may have, 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, particularly if you are unconscious.
ï‚· Locate the best emergency rooms near where you live and work. Not all hospitals are equipped to handle every emergency or even have emergency care. Emergency facilities are rated Level 1, 2 or 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 what type of emergency services are available at the medical facilities in your community.
ï‚· Review Insurance Coverage. 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.
ï‚· If possible, call the ER before you go. There are no guarantees, but notification that you’re on your way may 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 to call the Emergency Medical Service (EMS), which can be reached in most areas by calling 911; what you can do before you arrive; what information you need to bring to the hospital; and whether you will be better off going to a different ER.
ï‚· Take advantage of your health plan’s 24-hour nurse line. Many health plans now provide a 24-hour nurse line that seeks to direct callers to the most appropriate level of care. Through one-on-one counseling available by phone any time of day or night, participants can make more informed decisions about their use of healthcare services.
The American College of Emergency Physicians also offers a list of warning signs that constitute a medical emergency.
Whether as providers advising patients or patients ourselves, we can do our part to reduce unnecessary ER utilization, preserving the service for those who need it the most.
