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Nothing is more terrifying than a health emergency of your own or a loved one.  The fear can make it difficult to think clearly–but this is the most important time to have your thoughts together.  

Help yourself, and help the doctors and nurses trying to care for you, by some taking some precautions beforehand and, if you find yourself in the ED, following these few points: (1) Prepare yourself–be the steward of your own health history (2) Go to the RIGHT ED  (3) Maximize your ability to help the physicians take the best care of you and understand your condition

 

(1) Prepare yourself–Be the Steward of your own health history!

-Many patients assume that, since their primary doctor (or other specialist) works in a group that has the same name as the hospital, that the ER doctor will be able to access those records.  I wish that were the case!!!! Nothing is more frustrating, nor takes more time away that I could be spending time with the patient, than trying to investigate and make phone calls to get list of medications, medical conditions, or allergies.  So, until the medical records allow for sharing of information, the patient must be the steward of their health history with the following lists that you keep in your wallet.  For families with children or elder parents, all parents and/or caregivers should also have this in their wallets, as you never know who would be the first to actually arrive to the ED with the child

1. Medication list — keep this up-to-date with exact medications and doses.   Most important is to just have the NAMES of the medications

2. Allergies — write the specific allergy, and KNOW your reaction.  Many times I’ve had patient’s whose care was delayed because they had an extensive list of allergies but did not know their reactions, and the medication that I needed to give them was on that list.  Often, the allergy was just a little bit of a sensitivity, or maybe even the effect of taking two drugs.  This is crucial to know, as a particular medication that could be life-saving could be delayed as we spend time trying to figure this out. 

3. Medical Conditions — You dont have to drive yourself crazy with the level of detail here, but just have a list.  If you’ve had a pacemaker or defibrillator, have that written.   Diabetes, high blood pressure, a history of a heart arrythmia–these are all important

 

(2) Go to the Right ED

-The “RIGHT” ED is the place where you have received care in the past.  If you had a surgery or procedure done at a particular medical center, or your primary care doctor uses a specific center, then it’s important to go to that Emergency Department, and to go to that same one EVERY time that you need emergency care.  Swapping ED’s based on one being closer or some other convenience factor, when all of your prior care has been received at a different hospital creates a disservice to you, as inevitably the doctor will spend time trying to figure out your past medical history that they could otherwise be spending with you. As an ED doctor, being able to pull up a patient’s old admission records, an old EKG, or just to be able to get your surgeon or other specialist on the phone (and come into the hospital to see you, if its urgent), is crucial, and decreases delays in your care, and unecessary transportations to other hospitals. 

 

(3) Help the physicians to take the best care of you that they can

-ED’s can be so busy and pressured today–stressful for both patients and providers alike–Trust me! When a patient is ill, I want to drill down to their condition as QUICKLY as possible to be able to alleviate their suffering, so there are a few things that patients can do to help.

1.  Tell me your exact symptom–when it started, if it has been constant, if it fluctuates, and what makes it better/worse

2. Have you ever had this same symptom before? If you did, did you seek care, and what did the doctor say it was? (Nothing is worse than, after a 10 minute conversation, the patient telling me off-hand  “well, yes, I felt pretty much the same way the last time I had a heart attack”)

3. Sometimes patients will try to help me by saying where they think the pain is “ie: I think the pain is coming from my spleen” (An acceptable and useful statement if you’ve had spleen pain in the past that was diagnosed, but just distracting if it’s just a guess).  The most helpful thing you can do is point to where it hurts, tell me what makes it worse.  Let me try to figure out which organ it is– otherwise, you can miss giving me important facts, which is the most important thing you can do. 

4. If you think that your family member is waiting too long, or has been triaged inappropriately, calmly but firmly go speak with someone.  If they do not seem to get your message, a great thing is to call your own doctor–be it primary care doctor or specialist related to your complaint.  Speak to them on the phone–if they are concerned, then they can call into the ED, speak to the ED doctor, and accelerate your care. 

As emergency physicians, we truly want to take the very best care of you possible.  I went into this specialty because you see patients at their point of greatest need, and are truly able to intervene and to help them.  As we face more shortages of emergency rooms and greater demand,  taking these steps to maximize the time your doctor can spend at your side (and not running around tracking down your history) will help you to get the best care that my colleagues and I can provide.

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