How Do You Know When To Go?
The Emergency Department Dilemma
by Pam Holmes, RN, MHA, EMT-P, CEN
You have just finished preparing a nice steak dinner when you accidently cut your finger with a steak knife. Your 1-year old son is up half the night crying and pulling at his ears. Your daughter just injured her ankle while skiing. According to the most recent government statistics, more than 300,000 Americans each day will seek care at one of our nation's emergency departments. This is more than 120 million patients each year.
Some conditions, such as an injury received in a car crash, or a person experiencing chest pain or difficulty breathing generally warrants a fast trip to your local emergency department. But, what about other times when you are not sure if your situation really is an emergency? How do you know if it is safe to put off seeking medical treatment?
First, if you think you or a loved one needs emergency care, go to the emergency department where you will be examined by a physician. If you think the condition is life-threatening or will become worse, call 9-1-1.
Listed below are the most common frequently asked questions about Portneuf Medical Center's Emergency Department (ED).
Q. What should I do if I am not sure that I need emergency attention?
A. First, contact your doctor or care provider to discuss the situation with him or her. If you cannot reach your doctor, it is better to be safe and come to the ED. Call 9-1-1 if you think it is life-threatening or the condition will worsen before you can reach the ED.
Q. What is a Life-threatening situation?
A. The American College of Emergency Physicians (ACEP) offers a list of warning signs that indicates a medical emergency. Among those include:
- Chest pain or pressure
- Difficulty breathing or shortness of breath
- Upper abdominal pain or pressure
- Coughing or vomiting blood
- Heavy or uncontrollable bleeding
- Sudden or excessive pain
- Changes in vision
- Suicidal thoughts
If you think the situation is life-threatening, don’t hesitate to call 9-1-1 or go to the ED.
Q. Should I call an Ambulance or drive myself?
A. No one wants to call an ambulance unnecessarily. However we suggest that you contact an ambulance if the following situations are present:
- Any condition that interferes with your ability to drive safely
- The condition could get worse on the way to the hospital
- You are experiencing:
- Difficulty breathing
- Dizzy or confused
- Having a seizure
- Have experienced a head, neck, or back injury
- Bleeding heavily
- Showing signs of shock (cold, clammy, pale, weak pulse)
Q. When is the Emergency Department open?
A. It is comforting to know that our ED is open and fully staffed 24/7 and stands ready to help with any emergency.
Q. Will I receive attention right away?
A. You will be triaged quickly, in less than 10 minutes, by a registered nurse. We always treat the sickest patients first, regardless of who arrived first.
Q. What type of specialized care is available?
A. Our Board-certified emergency physicians and skilled nursing staff treat a wide variety of medical emergencies ranging from minor illnesses or injuries to life-threatening conditions. Our ED is fully equipped to provide state-of-the art emergency care. In addition, Portneuf is ranked by Health Grades as having the best heart care in the state, receiving a five star rating three years in a row.
Q. What is FastTrack
A. When you enter the ED, a nurse will determine the complexity of your condition. If your illness or injury is minor but still requires prompt care, you may be treated in the FastTrack area. FastTrack is generally open from 12noon until 12 midnight and is staffed by Physician Assistants or Nurse Practitioners under the supervision of the ED physicians. They specialize in treating patients with less complex cases, freeing the main ED area to focus on the more complex and critical patients. Fast Track is part of the Emergency Department and therefore is billed as an emergency visit.
Q. How long is the usual visit to the Emergency Department?
A. The triage and admission process begins immediately upon arrival to the ED. As with any ED, patients with more serious illness or injuries may be taken ahead of other patients. A triage nurse (or RN) sees every patient upon arrival to the ED. They quickly identify those patients who may have serious emergencies.
Every effort is made to get patients to a treatment room as soon as possible. During busier hours there may be a longer wait to see the physician. Our staff does not like long waits, so they are constantly evaluating the needs of the patient and make every attempt to expedite care. Average time spent in the ED varies depending on whether you will need to be admitted to the hospital. Currently the overall average time spent in the ED is about 2 ½ hours. In the FastTrack area it is approximately one-hour.
If you think you have been overlooked, feel free to ask for an explanation. If you think your condition is getting worse, asked to be checked by the nurse. Nurses provide updates as often as possible.
Patients with minor conditions can receive prompt attention and shorter wait times during the hours when our FastTrack service is open. A separate area is open during select hours designated especially for our FastTrack patients. Your triage nurse will determine if your condition is best suited for FastTrack or will need attended to in the main ED.
Often times, additional tests such as lab and radiology exams will be required in order to assist the physician with making a diagnosis. Your stay may be extended if additional testing is necessary or if consultation with your physician or a specialist is needed.
Q. Are there any conditions PMC ED does not treat?
A. We treat, and are equipped to handle all emergency-type conditions. A physician or team of physicians will determine if specialized care is warranted that may require a transfer to another hospital.
Q. What information will be asked of me?
A. In order to gather the information necessary to treat your condition, you will be asked about your current and past medical history. At the time of registration and triage we may ask for the following information:
- Name of primary care provider or specialty physicians treating you
- Names and dosage of current medication
- Drug Allergies
- Recent medical problems or surgeries
- Date of birth
- Health insurance information
- Living Will or Advanced Directives
Q. What should I bring with me to the Emergency Department?
A. You should bring your ID and Health Insurance ID cards. If you are taking any medications it is a good idea to bring them with you or a list of medications and dosages. If you are responsible for caring for an elderly parent, it is a good idea to maintain a current list of medications or medical history.
Q. Can I have visitors during my visit to the Emergency Department?
A. For the safety for our patients and staff, visitors are limited in the emergency department. A patient is allowed 2 family members or visitors at a time whenever possible. In some cases, while examination and care is being provided by our physician and nurses, visitors will be asked to remain in the waiting room. We will provide updates to visitors on a regular basis. Visitors are asked to not bring food or drink in for the patient without permission from the staff in the ED.
Q. What happens when I am discharged?
A. Most patients treated in the ED are well enough to be discharged. When you are discharged, a physician or nurse will review discharge instructions and any prescriptions that you receive. If you have any questions about your care please ASK! You will be given a copy of your discharge instructions to take home with you. Patients are responsible for their own care after they leave the ED. Patients are also encouraged to make arrangements for follow-up care with a primary care provider.
Q. What happens if I am admitted to the hospital?
A. Some patients coming to the ED will need to be admitted for further testing, procedures, or care. If you are admitted to the hospital, you will receive additional admission information at that time.
Q. Can I call the ED and ask for advice?
A. Please do not call the ED for medical advice. The ED is unable to give medical advice over the phone. If you think you are having a medical emergency, call 911 or come to the ED. If you are seeking medical advice, contact your primary care physician.
Portneuf Medical Center’s ED staff understands that a visit to the ED can be stressful. We appreciate your understanding and cooperation in helping the staff to provide the most appropriate care and treatment. Following your visit, you may receive a phone call to check on your condition or a phone call regarding a Customer Satisfaction Survey. Your feedback is always welcome and much appreciative.
Pam Holmes, RN, MHA, EMT-P, CEN, is Director of Emergency/Life Flight Service, a registered nurse with certification in emergency nursing and is also a paramedic. Pam has a Master of Science degree in Health Administration and has been employed at Portneuf Medical Center for 37 years; with over 27 years of emergency nursing experience and 25 year of flight nurse experience.