Last year, I worked as an ER medical scribe and was present for over three thousand patient encounters. I was there for cases with people who had chronic conditions, people who felt ill and brought themselves in, and other cases like heart attacks, gun shot wounds, strokes, and car accidents. While the patients were diverse, I noticed that it always helps to have the same things, and you can take steps to help yourself if you ever need an ER visit.
Have a copy of all your conditions and medications ready in case of emergency
Of course sometimes emergencies happen and you’re unprepared, but the vast majority of patients I saw in the ER came from home and had been sick for at least a couple days or weeks (a big issue we can talk about another time). Alarmingly, many patients had chronic health conditions that they knew nothing about (a bigger issue we can talk about another time).
If you can, take a moment when you aren’t ill to write everything down on a slip of paper or on your cell phone (or both!). For example, “I have asthma and I take albuterol and Qvar. I have hypertension and I take atenolol. I’m prediabetic and I control that with diet”. Carry the slip of paper in your wallet just in case. Sit down with your mother or child and make a slip for them. It will make a huge difference. No one’s going to know if the seizure you had at the mall by yourself was new, due to a brain surgery you had earlier in the year, or because of chronic epilepsy. Also, when you’re in distress, the last thing you want to do is try to remember long complicated medication names.
I’ll always remember this one patient we saw with Crohn’s and chronic rectal bleeding who had a folder full of copies of his results from previous visits and information about his chronic conditions, which helped us determine his baseline blood levels and the severity of his current bleed. He had even tracked the days and times that he’d had bowel movements with bleeding. He was very organized and meticulous and it was an abundance of information, but it all helped to determine the amount of blood to transfuse and which doctors to call for his admission and consults.
Know That Your Health Information Is Probably Not “In The Computer”
There’s a misconception that hospitals have one huge database where they dump all their data and that every employee can access anything, but that could not be farther from the truth. Medical databases are extremely complicated, and patient privacy is no joke, so it is nearly impossible to view charts from your past unless we have personally contributed to them, and even then there are rules regarding that.
If you go to a different hospital for an emergency than where your primary doctor is located, the new hospital will likely have no data on you. Furthermore, even if you go to the same hospital all your life, including for emergencies, there is no guarantee that they’ll be able to access any of your information aside from your name, birthday, and address in the ER as opposed to in your primary’s office. Instead of assuming that the ER will know all your conditions, please bring a copy of your information.
Know who your primary doctor is and where they work
It hurts my brain that there are people out there with insurance, with the capability of seeing their primary doctor, with absolutely nothing preventing them from seeking primary care, and they still don’t know the name of their primary care doctor. This is important information if you’re ever admitted to the hospital from the ER as we often call primaries. This goes double for specialists you may see, like maybe your cardiologist or endocrinologist. You can write their name on your slip from before. “Primary: Dr. John Doe at Kaiser Sunset.” Boom, done.
Ask for copies at the end of your visit, or instruct a loved one to
The ER sucks when you are a patient. It is not fun. Once you’re able to transfer to an inpatient room or go home, you want to leave immediately. However, it helps to ask for copies of any imaging or tests that you had. ERs often instruct patients to visit their primary doctors within the week for recheck, and it would be helpful for your progress to provide your primary with copies of what happened. For the patient with the rectal bleeding we talked about before, it probably helped his primary to see the information regarding blood transfused, blood count, associated findings, imaging results, etc. rather than to just be told “I had another episode of bleeding.” Your primary often has more time to go over the results with you too if you want a second opinion or more guidance.
This has been said a thousand times before, but please be honest. There’s a big difference in a 40 year old male who has a high heart rate because he has anxiety, or because he has a heart problem, or because he used cocaine earlier in the day. Then again, maybe he could have all three! Regardless, it is a lot easier to admit “Hey, I did cocaine” than to submit yourself to various unnecessary (and expensive) cardiac tests. There’s a big difference in someone who has convulsions and fevers because they have a mysterious infection, and in someone who is in methamphetamine withdrawal. Please be honest. You will still have a thorough checkup and you won’t get in trouble (provided of course you don’t hurt anyone). We can also guarantee you that most likely, it will be far from the worst thing we’ve ever seen or heard.
Advocate for yourself
People make mistakes, and healthcare staff are people too. It doesn’t help to second guess your doctor at every turn because you watched too much Grey’s Anatomy for the past decade, but it doesn’t hurt to ask questions. If you feel your doctor didn’t answer all your questions, or you’ve been waiting three hours just for a prescription, speak up and politely ask what’s going on. No one’s going to hate you for it. The patients who genuinely annoy staff are those who are overly aggressive (the ones who physically get in your face and become a threat to safety), patients who try to take pictures of the drama and bloodshed (just don’t do it. Why would you do it? Are you serious?), and patients who flirt with staff (please don’t do that, please). No one’s going to fault you for being invested in your health. I saw patients ask important questions for themselves that we hadn’t thought of, like where they could breastfeed a child or get a vegetarian hospital tray. We wouldn’t have known they needed those things unless they asked.
Doctors and nurses work long, tiring shifts, and if you can feel yourself slipping through the cracks, make sure you ask for what you need and explanations if it’s denied to you. Sometimes you won’t need a CT because it’s unnecessary radiation and your labs were normal, and sometimes you’ll need it but your doctor forgot to order it because he got a phone call that his daughter sliced her finger cutting apples while she was home alone (this actually happened), so please ask.