Simple Steps to Prepare For & Manage an Emergency Room Visit

Posted on December 13, 2023

To get the most of any visit to the Emergency Room for an injury or urgent medical problem, it is essential to be prepared to communicate the correct information. Advanced planning, whether you are planning ahead for yourself, and elderly family member or child, keep these tips in mind should you find yourself on the way to the hospital. Follow these guidelines to provide ER Staff with the details needed to lead to an accurate diagnosis:

To get the most of any visit to the Emergency Room for an injury or urgent medical problem, it is essential to be prepared to communicate the correct information. Advanced planning, whether you are planning ahead for yourself, and elderly family member or child, keep these tips in mind should you find yourself on the way to the hospital.

Follow these guidelines to provide ER Staff with the details needed to lead to an accurate diagnosis:

1. Bring important health information.

When minutes count, it’s helpful to have your medical history and information in writing.

Provide Photo ID, Insurance Card and Medical Power of Attorney.

Tell the admission clerk that you have all medical records and an up-to-date medication list with you.

Have a list of your doctor’s contact information, your medical diagnosis (es), allergy list and medications with doses you are taking. Keep the list handy in your purse, wallet, on a cell phone or download one of the many smartphone apps currently available. Be sure to keep the list undated when medications change.

Be aware, while health systems keep electronic medical records on patients, should an ambulance take him/her to a hospital out of network, those important health records may not be immediately available.

2. ICE your phone and keep it charged.

Save important number on your phone, either in the emergency contact information or add the label “ICE” (In Case of Emergency) in front of names of nearby family member or friends who might be able to provide information. ER staff know how to look for these numbers to help you contact loved ones for important information. In an emergency situation keeping your phone charged is important. Be sure to also bring along a charger.

3. Ask your physician to call ahead.

Some visits to the emergency department happen after being seen in person or following a telemedicine visit by your primary physician. If you are coming in on the advice of your physician, ask that the office staff notify emergency department be notified to let the ER staff know why you are coming. This will insure the most accurate information about your condition is communicated with the ER staff.

4. Health insurance cards.

Do not delay care during an emergency to look for insurance information. Make a point to carry cards in your wallet, purse or bag at all times.

During check-in:

If your loved one suffers from dementia, or is experiencing confusion, ask if the hospital offers a separate “quiet room” to help him/her feel calm and secure.

If your loved one is upset, agitated and nurse or doctor suggest a medication to calm your loved one ask about:

o A quiet room, instead

o If not an option and your loved one is truly disruptive and does not respond to the items you’ve brought along to distract while waiting, a medication may be ordered. Before it’s given to the patient, ASK:

Name of drug (as for its common name)

Does it have Black Box warning?[i]

On the Beers list? [ii]

o Look up on MedlinePlus [iii]

o Are there alternative medications?

Ask: When do you think a Doctor will see us?

While waiting for care:

Be prepared to share exactly what you or the person you are accompanying are feeling.

Where is pain?

Pain level on a 1-10 scale?

Consider or ask him/her:

o What do you think is wrong? Why?

o What are your questions for the doctor?

o What are your worries?

o What do you want to happen here? (Your goal for being treated at the ER?)

Take notes of this conversation to share with your loved one’s doctor/s and other care providers who may attend to him/her in the ER (or if admitted, other nurses and doctors who may take over care

(Insider suggestion:) Take a photo of your notes with your phone and give your notes to the admission desk telling them you are prepared to meet the doctor – this may be a gentle way of nudging you higher on the waiting list.

During the exam:

Ask if you can tape record conversations so you can take notes. If helpful, ask if you can Face-time the visit with someone else who may be involved with your loved one’s care.

Review his/her medication list with nurse. Be sure to let the nurse know of any medications that have been taken that day and few days prior, including herbs, vitamins and any other “drugstore” type remedies, that may not be on that list.

Describe clearly and calmly the medical concern to the nurse and doctor (notes will help).

For each test the doctor orders, ask:

- What will we learn?

- Is this information a “nice to know” or “need to know” in order to diagnose or treat? Ask the doctor for their initial thoughts, or diagnosis.

For every diagnosis, ask: What else could it be?

Stay with your loved one.

At point of diagnosis:

Take time to fully understand the diagnosis/don’t rush.

Review and understand any new prescriptions. side effects? If new prescriptions are started, how long are they suggesting the length of time on medication.

Ask or look up: Is this medication on The Beers List.

During discharge conversation:

Ask for a Bedside Huddle with Doctor, Nurse and Pharmacist.

RECORD and FACE TIME may be an option! Ask for permission to use.

Review findings from the visit, plan moving forward – including new medications/prescriptions and which meds, if any are to be discontinued.

Ask questions, ask for plain terms.

Ask for copy of record of visit, including the doctor notes.

For recovery at home:

Review and update existing and new prescription list, making sure to omit any medications that have been discontinued. Date the updated list and print.

Monitor closely any changes over the next 24-72 hours after taking new prescriptions. LOOK UP ON Drugs.com. [iv]

Keep a daily record log of each time medication is given. This will come in handy in case a rushed trip back to the ER is required.

For recovery at a skilled nursing facility, assisted living facility, nursing home:

Review new prescription list with facility charge nurse or supervisor. Review how to be given (by mouth or other route), strength and frequency.

Monitor daily prescription list with unit charge nurse for any change of care plan.

Review care plan and expected discharge date with care team.

Continue daily visits by family members or friends.

Continue monitoring for any type of change in your loved one. Are they getting out of bed, or doing breathing exercises? If not, continue to check for elevated temperature or wheezing.

Taking the time to prepare and plan help minimize potential complications and maximize efficiencies should you or someone you care about end up in a hospital Emergency Room.

Sources:

Brad Uren, MD, 6 Things to do When Visiting the Emergency Room, 4/27/2021. https://healthblog.uofmhealth.org/wellness-prevention/6-things-to-do-when-visiting-emergency-room.

TheCarePartnerProject.org. How to Manage an Emergency Room Visit. Emergency Room Care - The Care Partner Project.

[i] Black box warnings, also called boxed warnings, are required by the U.S. Food and Drug Administration for certain medications that carry serious safety risks. Often these warnings communicate potential rare but dangerous side effects, or they may be used to communicate important instructions for safe use of the drug.
They appear printed in bold font surrounded by a black border in the insert that comes inside a medication’s packaging, and on the drug manufacturer’s website, if it has one. Cleveland Clinic: healthessentials.
[ii] The Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, commonly called the Beers List, are guidelines published by the American Geriatrics Society (AGS) for healthcare professionals to help improve the safety of prescribing medications for adults 65 years and older in all except end-of-life care settings. They emphasize deprescribing medications that are unnecessary, which helps to reduce the problems of multiple drug prescribing (polypharmacy), drug interactions and adverse drug reactions. Wikipedia.org.
[iii] MedlinePlus. Health Information from the National Library of Medicine. National Institutes of Health (NIH).
[iv] Drugs.com. Drugs.com is the most popular, comprehensive and up-to-date source of drug information online. Providing free, peer-reviewed, accurate and independent data on more than 24,000 prescription drugs, over-the-counter medicines & natural products.