ER dos and don'ts: Deciding to go often is a matter of perspective

KCH Emergency Department Waiting Area

Chest pain, uncontrollable bleeding, a chopped-off finger - those are all no-brainers.

Go straight to the emergency room.
But how do you know something's truly an emergency?

But how do you know something's truly an emergency?

An emergency to one person may not to be an emergency to another. It is often safer for someone feels like they need to be seen, to be seen.

Consider these points the next time you're contemplating a trip to the ER:

When should I go?
If you or someone you know is experiencing suicidal feelings, coughing up blood, suffering headaches that don't respond to medication, or dealing with severe vomiting or diarrhea - especially if there's decreased urine output - these can be reasons to seek emergency care.

Doctors don't want to discourage people from getting what could turn out to be life-saving care. Even with bad cuts, it's better to be safe than sorry, they say, since time is of the essence.

Part of this decision depends on a person's age, said Dr. John McGoff, a spokesman for the American College of Emergency Physicians and emergency room physician with Community Health. Older people, especially those with a chronic condition such as diabetes or heart disease, might be better off being seen in an emergency room.

Although a fever in an older child might not be cause for alarm, in infants younger than 8 weeks old, it constitutes a true emergency, experts say. Call your pediatrician and see whether you should head to the ER.

Why do I have to wait?
Emergency rooms run on a system known as triage, derived from the French word "to sort." As soon as you walk through the door, a staff member will assess your condition and decide how quickly you need to be seen. The sickest patients will be seen first.

"Everyone that goes to the emergency department believes that they're the sickest person there," said McGoff, "and that's not necessarily the case."

How long is the wait?
It's hard to tell, say those who work in emergency rooms.

Most visits occur between 9 a.m. and midnight, Trappe said. Weekends and holidays, when doctors' offices are closed, also tend to be busy times.

Emergency-room visits can drag on for hours, according to a 2007 Press Ganey report. While you don't want to be too difficult about how quickly you're  seen, inform the emergency room staff if you start feeling worse while you’re waiting.

If your condition is changing or getting worse in any way, let a member of our staff know. We want to know about changes in your condition because we want to take excellent care of you.

Should you phone the emergency room first?

In a word: No. "Calling ahead never makes sense. It's not a restaurant," McGoff said.

What will it cost me?
Emergency rooms will not refuse care to someone who needs it - nor do they provide the service for free.

Some ER services, such as lab tests, may cost more there than in a doctor's office because they are expedited for faster results.

Depending on insurance, a co-pay also may be required for an urgent-care center visit. While it probably won't be as expensive as an emergency-room visit, it's likely to cost more than a doctor's office visit.

Parent makes the call
Because children may not be able to express how much they're hurting, a parent who has to make the call must trust his or her gut.

Parents may want to bring a toy, especially one that the child finds comforting.

And if it's at all possible to do safely, leave siblings at home with another family member or trusted individual.

What next?
In almost all cases, after visiting an emergency department or urgent-care center, you should follow up with your regular doctor. Neither the emergency room nor an urgent-care center is a replacement for a primary-care doctor, who can help you manage your health, rather than treat your immediate condition.

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