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The Medical Minute: Planning ahead for a potential emergency department visit

Medical emergencies, by their nature, come with very little or no warning. While any injury or illness that requires a trip to the emergency department will likely cause distress, putting an action plan in place now can help minimize the anxiety and fear of a future visit.

Where you’ll seek care

The first step in an emergency care plan is determining where you would want to go in the event of a sudden or severe illness or injury. That will require some homework, according to Dr. Susan Promes, chair of the Department of Emergency Medicine at Penn State Health Milton S. Hershey Medical Center.

“You’ll want to know what’s available in your area, and what options they offer,” Promes said. Being conveniently located is important, but the capabilities of the emergency department and hospital are, too.

“Every emergency department offers general emergency care. But are the doctors trained in the specialty of emergency medicine? If you have children, you may also want to know if there are physicians with additional training in pediatric emergency medicine.”

To learn whether an emergency department has care providers who are board certified or board eligible in emergency medicine, visit the hospital’s website, click on the link for its emergency department, and then click on the providers to see if they’ve had specialty training. The website should also provide information about whether the hospital is a trauma center equipped to stabilize and treat critical injuries.

“We’re a Level I trauma center for both children and adults,” Promes said. “That’s the highest accreditation possible. If a patient goes to their preferred emergency department and it turns out that the hospital isn’t equipped to provide the level of care they need, they can be transferred here.”

Medical records and more      

Emergency department staff may need to gather and review pertinent medical information before they can begin treatment. To help streamline this process, create a list of any current medical conditions, medications and doses. Also include any known allergies.

“I’d even list any previous surgeries and their dates,” Promes said. “It would also be helpful to know who your doctors are and what their phone numbers are in case the emergency medicine physician needs more information to provide the best care.”

Promes suggests keeping a piece of paper with all of the health information in a purse or wallet — or storing it on a cell phone.

“Add the list as a file, or take a picture of the document,” she said. “And put your emergency contacts into your phone, too. If you’re incapacitated, someone else can look at your phone and know who to contact.”

One other document that Promes recommends having on file, especially for older adults, is a POLST form — Physician Orders for Life-Sustaining Treatment. “If you’re critically ill, it’s really important to be able to communicate what your wishes are,” she said.

When to call 911

Even with planning and preparation for a hypothetical visit to the emergency department, one question may linger. What warrants a call to 911?

“Severe chest pains. Extreme shortness of breath. Difficulty seeing. Not being able to move part of their body. The inability to speak. Those are all emergencies and you should be calling 911,” Promes said. “Those situations need emergent intervention.”

When in doubt, a patient may call his or her primary care provider for guidance. “Call their helpline,” Promes said. “They typically have advice nurses. Or go ahead and call 911. EMS is ready to respond and help you.”

Regardless of whether they drove, were driven by someone else or arrived in an ambulance, when patients arrive at the emergency department, there may be a wait for care.

“Emergency departments prioritize patients, not by when they arrive but rather by the acuity of their problem,” Promes said. “If you were the person who got in a car accident and didn’t have good vital signs, we’re going to take you first, even if someone came in before you.”

After a patient has been examined, the waiting may continue if lab tests, x-rays or further evaluation by a doctor is necessary. Promes recommends patients bring something to help them pass the time if they’re able.

“Because of COVID, patients shouldn’t bring lots of people to the hospital with them,” Promes said. “Most hospitals have restrictions on the number of support persons or visitors who can accompany a patient. Bring a cell phone so you can communicate with your family.”

The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.

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