About Medicine: What To Expect At the Emergency Department

William Torres Jr.
EMS Department Head
Marcus Daly Memorial Hospital
1200 Westwood Drive
Hamilton, MT 59840

What To Expect At the Emergency Department
Calling 911 is a decision we wrote about last week. This week we can review the decision to travel to the emergency department for a medical emergency. In some situations, you and your loved one have already decided that treatment is necessary. The difficult decision is the venue or destination. Do you contact your health care provider, travel directly to Convenient Care or the emergency department?

The American College of Emergency Physicians has great resources that outline when the emergency department is the best destination. They list warning signs and symptoms when the emergency department should be accessed as:

Warning Signs and Symptoms
  • Difficulty breathing, shortness of breath
  • Chest or upper abdominal pain or pressure lasting two minutes or more
  • Fainting, sudden dizziness, weakness
  • Changes in vision
  • Difficulty speaking
  • Confusion or changes in mental status, unusual behavior, difficulty waking
  • Any sudden or severe pain
  • Uncontrolled bleeding
  • Severe or persistent vomiting or diarrhea
  • Coughing or vomiting blood
  • Suicidal or homicidal feelings
  • Unusual abdominal pain
In addition they have provided some guidance to consider when deciding if you should drive your loved one to the emergency department or call 911 for an ambulance. Some questions to consider are:

Should You Drive or Call an Ambulance
If you answer "yes" to any of the following questions about a person experiencing a medical emergency, or if you are unsure, it's best to call an ambulance, even if you think you can get to the hospital faster by driving yourself.
  • Does the person's condition appear life-threatening?
  • Could the person's condition worsen and become life-threatening on the way to the hospital?
  • Could moving the person cause further injury?
  • Does the person need the skills or equipment employed by paramedics or emergency medical technicians?
  • Would distance or traffic conditions cause a delay in getting the person to the hospital?
  • If you drive to the hospital, know the location and the fastest route to the nearest emergency department.
Regardless of how you travel to the emergency department there are some items that will expedite your registration process and care. It is important to bring photo identification and your insurance card which includes your policy number. Having these will allow staff to verify your identity and allow them to utilize your insurance. In addition there are some items that will expedite your care and allow emergency department staff to consult with or contact your health care provider to coordinate your care. This coordination is important since your health care provider can often provide your medical history and receive information from the emergency department staff. The exchange of this information is very valuable to your overall health.

Bringing a list of your current medications and knowing your allergies to medications will assist the staff with providing quality, accessible, personalized health care. These are two of the question that will be asked as part of the assessment you as a patient.

As you arrive at the emergency department you will be greeted by registration staff or a member of our EMS department. They will welcome you and discuss your main sign or symptom. This information is immediately provided to our nursing staff. The nurse will perform a triage to determine the severity of your sign or symptom. This is performed regardless of how you traveled to the emergency department. One misconception is that traveling to the emergency department by ambulance will accelerate your care. The emergency department is one venue where 'first come, first serve' does not apply. Patients are seen by their level of severity.

When you are triaged you will either be brought to a treatment room or be escorted to the waiting room. This is solely based on the number of patients in the emergency department and the level of severity. For example, someone with chest pain will be seen before someone with a sore throat for two days. Our waiting includes comfortable chairs, a television, and a child's play area. If you are asked to remain in the waiting room a member of our staff will keep you updated.

You will be assigned a registered nurse who will keep you informed and updated regarding your care. The emergency department physician is responsible for your care in the emergency department. This care will often include diagnostic testing including an x-ray, blood specimen, and electrocardiogram. The technicians who perform these tests will introduce themselves and provide updates to your assigned nurse and emergency physician.

While waiting for the results of the diagnostic testing a member of our staff will keep you informed and inquire to see if you need a warm blanket or assistance in using the bathroom.

The emergency department physician will discuss the results with you and provide you with a recommendation. These recommendations may include discharge with follow-up to your health care provider or specialist, admission, transfer to a facility capable of providing a specialty not provided. It is important to discuss any questions with the emergency department physician or nurse. You may receive a follow-up phone call to ask how you are progressing and answer any additional questions. The feedback you provide is important to our staff.

Our mission statement is quality, accessible, personalized healthcare.

The health column is a brought to you by collaboration amongst the Ravalli Republic and Marcus Daly Memorial Hospital. For questions and or comments about this week's health column, please contact Willie Torres, Jr., EMS Department Head at Marcus Daly Memorial Hospital, 1200 Westwood Drive, Hamilton MT 59840. Working together to build a healthier community!


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