Life Hacks for your ER Visit

A few things to make life easier and simpler

Nobody wants to go to the emergency room. Heck, many days I don’t either and I work there. But since it’s not unusual for any of us to end up there, I have a few ideas that might make your visit easier.

This is especially relevant when hospitals are struggling with volume due to lack of staff and when even primary care clinics and urgent cares seem to divert folks to the ER more than ever. (Not surprising given the complexity of the medical problems many individuals face.)

So here goes:

I

We all seem to carry around an incredibly expensive and powerful computer in our pockets. This is broadly known as a ‘smart phone,’ and comes in several flavors. Sadly, we often use it in ‘dumb’ ways. It makes us miserable with social media and the pain of near constant contact. But there are ways it can be useful.

If you take medications, use that phone to take pictures of the medication bottles. Or write up a computer document with all of those medications on it and save it to your phone (or take a photo of it). This can be especially helpful when you have just been hospitalized then discharged. You can ask for a ‘discharge summary’ which tells what was done and what diagnoses you had, and what medications you were prescribed. It may also have your follow up physicians’ names on it.

(Also, if you have family who help you, send copies of those photos or files to them.)

While it’s fine to keep paper copies of such documents in a file folder and carry it around, there will be a time when you’ll leave that at home. Odds are you won’t do that with your phone. (If you do, how will you play Words with Friends or Call of Duty?)

So, keep these things on your phone. In addition, if you have had an electrocardiogram (EKG), ask if you can take a photo of it. If you have chest pain and come to the ER, it’s helpful for us to see an old EKG to see if things have changed.

FYI: not all electronic medical records systems are connected. That was the idea when widespread use was initiated under President Obama, but we’re far from it happening. So unless you’ve been to a facility (or one of it’s sister facilities) we don’t ‘have your records.’

II

If you have recently had a complicated medical procedure and are having some problems, be sure to call and talk to the physician or advanced practitioner on call for them. It may be in your interest to go directly to the place where that procedure was done…if possible. If you go to your local ER, and they see you and want to transfer you, there may not be a bed available in the other hospital. (This is an increasing problem even after COVID due to staffing shortages.)

Also, that hospital where your procedure was done does not necessarily have to take you in transfer right away. However, if you go to their ER, they are required by law to see you. The big exception is this: if you feel unstable, have high fever, shortness of breath, chest pain, severe headache, severe abdominal pain, pass out or have other worrisome problems, please do NOT drive a long distance to the other hospital. Go local and the staff will figure it out.

III

Many people have medical conditions that require specialty care. Despite the fact that every hospital on television has everything (‘Call the left ear specialist!), there are many things that small hospitals lack. A simple but common example is that not every hospital has a labor and delivery suite, a nursery or even an obstetrician. So, if you’re pregnant it’s a good idea to find out (well ahead of time), what hospitals in your area have maternity care. Hopefully you’ll be established with a physician and her group and hospital. But things happen, and you may need to go elsewhere.

If you are having pain or bleeding, contractions or fever and need to go to the ER, if the distance is the same between two hospitals, you should go to the ER where there is obstetric and neonatal care. Any hospital ER can deliver a baby and stabilize mom and child when things move fast or are complicated. But if there’s time, it’s best to be where there is the highest level of care. Best for mom, best for baby and best for the ER doctor who doesn’t deliver a lot of babies and breaks out in a cold sweat when he things about it. (That’d be me.)

Honestly, in my opinion every hospital should put up signage and advertising that makes it clear what services they do, and do not, offer. This could be done with the same warnings I gave above, but it’s helpful for patients to know what they can, and absolutely cannot, expect at any given facility.

IV

If you are on dialysis, and are traveling, find out what hospitals have inpatient dialysis. Many do not have it and if you have problems the local ER will have to try and transfer you. Folks on dialysis can have assorted complications like infection, difficulty breathing due to fluid build up and electrolyte abnormalities. Any ER can stabilize this for a while, but there’s no substitute for the dialysis machine.

V

I hesitate to say this but it’s just reality. Increasingly we can’t find ambulances to transport patients to other hospitals. I have seen people sign out ‘against medical advice’ and have family or friends drive them to the other facility where they can get the care they need. It isn’t optimal. And it should never been done for patients who are unstable; that is, having heart attacks or strokes, shortnes of breath, bleeding, confusion, in active labor, etc. But having watched patients wait for days and days to be transported, I kind of get it. Just throwing that out there.

VI

Wait times can be very long now. We feel bad about it. But it’s just the reality of things. So, bring your phone and charger (see #1 above), bring something to read, bring a sweater or jacket (it’s always cold) and if you aren’t the patient with abdominal pain or some severe symptom, bring snacks. We don’t have many. If we did, we’d eat them.

VII

I hope you don’t have to go to any ER, ever. But if you do, maybe these ‘life hacks’ will make the experience better than it would have been otherwise.

If you have any of your own, I’m happy to see them in the comments!