The ER: How To Tell If You Really Need To Go

Going to the emergency room has become a trend in the United States.  More and more people are heading to emergency rooms rather than urgent cares or general physician visits.

Emergency room (ER) visits in 2003 rose to 114 million, up from 89.8 million in 1992, a 27 percent increase.  According to the CDC in 2003, about 13 percent of those 114 million emergency department visits were considered non-urgent.

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The Realities of the ER

ER’s are set up as a triage, meaning patients are prioritized from most ill to least ill.  Patients who have life threatening injuries or illnesses are treated first, while others who have minor injuries or illnesses have to wait.  According to the CDC, patients in 2001 on average waited 3 hours in the emergency department from arrival to discharge.  Some waited more than 24 hours.

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When you are ill or don’t feel up to par, the last thing you want to do is sit and wait for treatment.  So, the question remains how do you know when you should go to the ER?

Using good judgment and references are your decision points when knowing what kind of medical attention you may need.  Learning the signs of serious illnesses and using your instincts are your best judgment.

Prepare To Act

After doing everything you can to prevent emergencies, the next step is to prepare for one. Some basic steps are:

• Keep well-stocked first-aid kits at home, at work, and in your car
• Learn how to recognize emergency warning signs
• Organize family medical information. Make lists of medications (and dosages) taken by you and your family; include allergies
• Identify and eliminate safety hazards in your home
• Take a first-aid class.
• Post emergency numbers near the telephone.

When To Act

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Emergency medical care is defined as a medical condition that manifests itself by acute symptoms of sufficient severity, including severe pain, to lead a prudent person who possesses average knowledge of health and medicine to reasonably conclude that lack of immediate medical attention will likely result in any of the following:

• Serious jeopardy to the person’s health or, with respect to a pregnant woman, serious jeopardy to the health of the woman or her unborn child;
• Serious impairment to the person’s bodily functions; or
• Serious dysfunction of one or more of the person’s body organs or parts.

Not every cut needs stitches, nor does every burn require advanced medical treatment. If you think someone could suffer significant harm or die unless prompt care is received, that situation is an emergency, and call 9-1-1 or the local hospital for help. Get help fast when the following warning signs are seen:

• Chest pain lasting 2 minutes or more
• Uncontrolled bleeding
• Sudden or severe pain
• Coughing or vomiting blood
• Difficulty breathing, shortness of breath
• Sudden dizziness, weakness, or change in vision
• Severe or persistent vomiting or diarrhea
• Change in mental status (e.g., confusion, difficulty arousing)

How To Act

• Be ready, willing, and able to help someone until emergency services arrive. Action can mean anything from calling paramedics, applying direct pressure on a wound, performing CPR, or splinting an injury. Never perform a medical procedure if you’re unsure about how to do it.
• Do not move anyone involved in a car accident, serious fall, or who is found unconscious unless he or she is in immediate danger of further injury
• Do not give the victim anything to eat or drink
• Protect the victim by keeping him or her covered
• If the victim is bleeding, apply a clean cloth or sterile bandage. If possible, elevate the injury and apply direct pressure on the wound
• If the victim is not breathing or does not have a pulse, begin rescue breathing or CPR

Most health situations do not require emergency medical care.  In fact, you can save time and often save money by using one of the many urgent care clinics available to you through your health plan. Examples of conditions when a visit to urgent care may be appropriate include:

• Lacerations – deep cuts or wounds that may require stitches
• Sprains, strains, or deep bruises
• Mild to moderate asthma attacks
• Ear infections
• Urinary tract infections
• Upper respiratory infections
• Coughs and congestion
• Diarrhea
• Sore throats
• Insect bites
• Rashes