The emergency room has become an integral part of the American medical system. But how do you know when you should go to the E.R.? Lorraine Rapp and Linda Lowen, hosts of WRVO's health and wellness show Take Care, recently spoke with emergency physician Dr. Leana Wen about what you should know before you have to visit an emergency room.
Lorraine Rapp: Can you give us a quick overview of how emergency rooms have changed over the years—how it might affect us as patients?
Dr. Leana Wen: Forty years or so ago, it used to be that the ER was literally a room that nobody wanted to go. Patients didn’t want to go because they thought they’d get poor care there, and doctors didn’t want to go. It was a place where patients were triaged, that they were determined to either have a surgical issue, a medical issue, a neurological issue, and that’s basically all that happened there. Now though, there have been significant changes because people have recognized that special skills are needed, both from the doctor’s side and from the nursing side. So, emergency medicine is now a board certification that is required. And also now is the modern home of diagnosis, so it’s not just triage that happens in the ER, but actual diagnosis as well. The wait times have also significantly decreased because there is a lot more focus on ‘how can we make care patient-centered? How can we make patients and families feel cared for in a time of great need?’”
Lorraine Rapp: How do we make the decision whether or not we should be calling 911, going to the ER or going to urgent care?
Dr. Wen: I’d say that there are a couple things to keep in mind. The first is that there are a few things that are critical, absolutely critical. These things would be chest pain and stroke-like symptoms. So, if you have chest pain or difficulty breathing, these are symptoms of a heart attack or stroke, and you should definitely go to the ER at that time. If you have another symptom, and you’re relatively well, even if you feel ill but you’re a relatively healthy person, then likely you can wait longer. You can call your primary care doctor, call the coverage person, and get their advice.
Linda Lowen: How can you prepare for an ER visit, and what can you expect when you walk into the ER?
Dr. Wen: How to prepare—three key things. The first is to bring someone with you. If you’re sick enough to go to the ER, then you’re probably not feeling well. So, having someone else there who can serve as your advocate is really important, because they can remind you of things you left out and help ask questions when you feel too ill. The second is to bring your medical history and your medications. Don’t assume that your doctor, who has not met you in the ER, is going to know your past medical history. So bring the actual bottles of medication with you and write down in advance—you should have a card of your allergies and known medical problems—have that with you so that you can bring it to the doctor and make sure they have it. The third, and very important thing, is to write down your story of your illness and practice that in advance. Know that your doctor in the ER is going to have limited time with you.
Linda Lowen: Taking an ambulance versus walking into the ER. I know many of us, we’re faced with what may be an acute incident and we debate whether or not to call 911—is there a big difference?
Dr. Wen: Call 911. If you have an acute illness, if you think you’re very ill, do not delay by walking into the ER yourself.
That was Dr. Leana Wen speaking with Lorraine Rapp and Linda Lowen. More of this interview can be heard on Take Care, WRVO's health and wellness show Sunday evening at 6:30. Support for this story comes from the Health Foundation for Western and Central New York.