St. Mary's Healthcare Center

When to use the ER

Updated by Robin Gadd, Director of ER, ICU and ACU 2006

When to use the ER Emergency room usage is on the rise not only in our country but in our area as well. The reason for increased usage may not be what you think.

Many people have grown accustomed to using the ER rather than scheduling an appointment with a physician. The most important factor to remember is that most ERs are not devised to care for routine illness. They are there for critical care and emergencies. What may seem urgent to you is certainly a concern but it may not necessarily mean it's an emergency.

If I come into the ER am I guaranteed immediate treatment?
A common misconception is that if you go to the ER, you will get immediate treatment. This is simply not true; ERs do not work on a first-come, first-serve basis. The patient with the most severe illness or injury gets the immediate care. If an ER has multiple patients, hospital staff and physicians use a triage system to assess the conditions, and treat the most critical cases first. You may have heard the term "triage" which is French for "sorting." For instance, if you came into the ER with a sprain and another person is brought in with serious injuries received in an accident or crime, be prepared to wait. This holds true regardless if you were in the ER first or not.

Are the costs different in comparison to using the ER or a clinic?
Some people are surprised when they receive their medical bills after utilizing the ER. All hospital/clinic charges vary but when comparing the difference in costs no matter what city or state you are in, expect to pay three, four, or five times more when you come into the ER rather than schedule an appointment with a physician. Emergency treatment is not always limited to care given by a physician or nurses but it can also include staff from the laboratory, pharmacy, respiratory care, and radiology as well as other medical personnel.

St. Mary's ER is now staffed with a physician and a designated ER nurse 24/7. Providing this type of specialty coverage is desirable; however it is costly.

Am I guaranteed to be treated by my primary care provider?
Effective July 2003, a physician is on St. Mary's site 24 hours a day, 7 days a week. Physicians are scheduled on a rotating basis. If you come into the ER during those times, you could be seen by a physician other than your primary care provider. Physician Assistants are on-call at all other times.

When is it necessary to use the ER?
There are many situations when people need immediate emergency care. You need to trust your instincts and use good judgment. Good reasons to go to an emergency room include (but are not limited to): loss of consciousness, signs of heart attack or stroke, severe reaction to insect bite, head or spine injury, severe shortness of breath, bleeding that does not stop, disorientation, suicidal or homicidal tendencies, sudden-severe pain, hemorrhaging, or poisoning. A child under three-months-old with any temperature above normal range should be brought into the ER right away. Again, use your judgment and err on the side of caution. Please be assured that St. Mary's ER will evaluate and treat anyone who presents for care.

When is it not necessary to use the ER?
If you have an earache, minor cut, sprain, minor burn, insect sting (unless severe reaction is present), skin rash, sexually transmitted diseases, cold, cough, sore throat, flu or fever (unless convulsions present or if a child is under three-months-old).

Here are other tips that will make emergency treatment run a little more smoothly:

Call in advance. If you're coming to the ER, please call in advance to inform hospital personnel so they can readily prepare. Give the patients name, age details of the illness or injury and other pertinent information. We discourage anyone from using a cell phone while driving.
Let the healthcare professionals do their work. It's totally understandable to want to be beside your loved one during a severe illness or injury but if you interfere with the patient care, you're hindering, not helping your loved one. Limit the number of immediate family members and keep the visits brief. Keep your voices at low levels and if you are asked to wait in the reception area, don't take it personally: the healthcare professionals want to provide the best possible care for the patient. The staff and/or physicians will give you updates about his/her condition.
Don't use your cell phone in the ER area. St. Mary's policy prohibits the use of cell phones in the ER as well as other hospital areas. Using cell phones in direct patient care areas can negatively affect patient care by interfering with critical care equipment.
Refrain from calling the switchboard or ER for patient information. Please refrain from calling the hospital with questions about a patient. The patient's medical condition demands our staff's full attention. Interruptions from phone calls or from walk-ins to ER can interfere with patient care.

Protecting patient confidentiality is not just a choice, it is the law. With the new HIPAA laws, we are limited to the information we can release

Ask questions. Take responsibility for the healthcare of yourself or your family or friends. Oftentimes asking questions will open the lines of communication and you'll be better informed of the person's condition.
Get a primary care physician now. When you or someone you know comes into the ER, it can be a hurried, critical, chaotic situation. You can be better prepared by getting a primary care physician now. If you can be your best resource as he or she will be familiar with your health history and know what medications you take.
Keep your medical information on you at all times. This should include the name and phone number of your primary physician. List the medications and dosage you use for prescriptions, over-the-counter medications, and any supplements. If you are pregnant, have this recorded as well. List several family members names and phone numbers as emergency contacts. List your organ donor information so they can refer to any legal documents you may have.
Keep consent forms in your clinic/hospital chart or in your children's charts. If you are going to be out of town, choose someone you know well and authorize them to bring your child in for any necessary emergency treatment. Keep a general consent form in your child's chart that will allow physicians to treat your child for emergencies. If you have questions consult an attorney.
Give your child an identity. To ensure rapid identification and emergency contacts of your child, place an ID sticker on your child's car safety seat. In the event that the driver and other
passengers are incapacitated, the identification will assist emergency medical personnel. As your child grows and you upgrade to larger seats, remember to replace the sticker as well. These stickers, designed by the SD Office of Highway Safety, are available by contacting Anita Fahey at 605/224-3211.
Complete a living will or Power of Attorney. Keep copies of these in your charts. This will inform medical personnel of your wishes and lessens the burden on your family members so they do not have to make critical decisions. You can obtain the proper forms through an attorney or through St. Mary's Healthcare Center's Spiritual Care Department at 224-3182. As always, if you have questions, seek legal counsel.

This article disclaimer advises you to exercise your own judgment when seeking emergency treatment and medical care. We disclaim any liability arising from the information used in this article.