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Take charge: Emergency room self-defense

Hospital emergency departments (EDs) are busier now than ever. In 1999, there were 103 million ED visits in the United States, according to a new study by the Centers for Disease Control and Prevention. That is up from 90 million in 1992 — an increase of 35,000 patients a day.

Due to dwindling health-care budgets, examining rooms and equipment are in short supply. Doctors, nurses and technicians are overworked. No wonder the average wait to see a doctor is 49 minutes — with many ED patients waiting hours.

For better emergency care…

Call 911 or an ambulance if you suspect heart attack or stroke, two “time-dependent” conditions that can quickly worsen. Ambulance technicians will begin your care on the way … and you’ll be seen by a doctor as soon as you arrive at the hospital.

If your condition isn’t truly an emergency, arriving by ambulance won’t make a difference. The sickest patients always get taken care of first — but your insurance company may cover the cost of the ambulance if you thought it was an emergency.

Go to the closest hospital if you think you have an emergency. The majority of all hospital EDs are now being staffed with board-certified emergency physicians. Teaching hospitals are staffed with attending emergency physicians and many residents and interns. In nonteaching hospitals, there will be only one or two doctors on staff. You may spend time waiting in either setting.

Don’t wait for a referral from your doctor. It is no longer necessary to bring a referral or get prior approval from your doctor before going to the ED.

Everyone who enters an ED undergoes triage. That’s the process by which each patient is evaluated by a nurse to determine how serious his/her condition is and who is to be seen first by a doctor.

Know the names and phone numbers of all your doctors — especially your primary-care physician but also any specialists you may have seen. Your private doctors often have medical information that can assist the emergency physician in treating you and with follow-up after you are discharged.

Bring all of your medications. ED staff will learn a lot about your health history simply by reading the labels. If you’re going to need drugs, it’s vital that the doctors know what medications you’re taking.

Helpful: Keep a list of all your medications, along with the details of other health information (serious allergies, for example), on the refrigerator door. If you’re unable to talk, the ambulance crew can take the list to the ED.

Even better: Bring the actual bottles — the printed labels are easiest to read.

Report changes in symptoms immediately. Don’t suffer in silence in the waiting room. You’ll see a doctor more quickly if you inform the staff that your symptoms are getting worse. You should be given medication, if necessary, even before you see a doctor.

Christopher is chief of the division of emergency medicine at Thomas Jefferson University Hospital in Philadelphia. Reprinted with permission of Bottom Line/Personal, 281 Tresser Blvd, Stamford, Conn. 06901-3246 (www.BottomlineSecrets.com).


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