What to Expect in the Emergency Room

A trip to an emergency room (ER) is something you or a loved one may never have to face. Because ERs in the United States treated 136 million patients in 2009, up from 96.5 million in 1995. However, there is a good chance you will see the inside of an ER at some time in your life.

In the interest of protecting yourself, it's best to learn about emergency medicine before you find yourself in an ER.

How ambulances work

A private company, a government agency or an individual hospital may dispatch the ambulance that picks you up. Most, but not all, ambulance services allow patients to choose which hospital to go to, even if it's not the closest one. If an ambulance is dispatched by a particular hospital, though, you may have no choice but to go to that facility.

The people that arrive on the ambulance may be emergency medical technicians (EMTs) or paramedics. Paramedics are EMTs with the highest level of training and are able to perform many medical procedures.

Your rights as a patient

Federal law says that all hospitals with ERs must admit emergency patients. You can't be turned away because you can't pay or have no proof of insurance. If an emergency exists, the ER staff must stabilize your condition. If a hospital doesn't have the facilities or the doctors to treat a problem, it has the right to transfer you. It's in your best interest to allow the hospital to transfer you to a properly equipped facility.

The first person you are likely to see in an ER is a nurse specially trained to help triage and treat emergency patients.

Doctor qualifications

Many ERs are staffed by "emergency medicine" doctors, a medical specialty in which doctors are trained to treat emergencies such as chest pains, broken bones and lacerations. Other ERs, however, are staffed by family doctors, general surgeons and other nonemergency doctors who have arranged with the hospital to "cover" the ER. Often these nonemergency doctors have extensive experience in emergency medicine and are trained to provide quality care. You're within your rights to ask about the specialty of the doctor assigned to you and whether he or she is "board certified" in that specialty. You also have the right to ask for a specialist.

Access to service

Once you or a loved one enters the ER, you should expect service. But you need to be aware that ER patients are seen in the order of need, not arrival. If you have a cut on your arm and someone with a gunshot wound to the chest comes in, you'll have to wait. Knowing there are legitimate reasons for a delay can make waiting less stressful.

Procedures

If you or a loved one must undergo a procedure, you have a right to understand what the procedure should do and to know the risks. Consents for these procedures must be signed by the patient or consenting family member. Make sure you understand what you are consenting to and what the expected outcome and risks are.

Treatment plan

Don't leave the ER without a clear understanding of which treatment you've received and when and how you should complete or continue your care.

Do your research

It makes sense to research local hospitals if you're an elderly person, someone with a serious health problem or a parent. Pay brief visits to their ERs. Find out which ones are staffed by emergency doctors and which ones provide 24-hour coverage. Such knowledge helps you determine which hospital you'll prefer in an emergency. The ER is about the last place anyone wants to go. Most medical emergencies can be treated efficiently on the spot, however, and most ER patients are released almost immediately after treatment.

Your health insurance plan

The American College of Emergency Physicians recommends that you find out the following information before you need emergency help:

• Will you have to make copayments or meet a deductible for emergency room visits?

• Do you need to call your primary care doctor before going to the emergency room for a condition that is not life-threatening?

• Do you need to notify the insurance company within 24 hours or emergency care to have the expenses covered?

• Find out which hospital emergency rooms are covered by your insurance plan.

• Find out what process you could use to appeal a claim that is denied.

By knowing what to expect and what questions to ask, you can make an unwanted but necessary experience less painful.