In the Emergency Room

An ambulance comes to a screeching halt in front of the Emergency Room (ER). With its sirens still blaring, a short ride on a gurney separates the patient from the ER. Hopefully, you will never be in the scenario where you or someone you care about goes to the ER, but just in case, there are a few good things to know. Dr. Roger Kapoor, one of Stanford Hospital's best medical interns, shares his insights with us.

Being prepared may be the single best thing you can do. What do I mean? There are a few pieces of information every ER physician will want to know and having a piece of paper such as this completed can not only help physicians care for you quicker but also facilitate a higher quality of care.

What can you expect when you come to the ER? Expect to wait! If you come in an ambulance, you will immediately be taken to an emergency room bed. If not, the ER is run on a triage system ensuring the sickest patients are seen first. After registering, you will be seen by a triage nurse who will ask you questions regarding what brought you to the ER and then you will return to your seat in the waiting room. When it is your turn you will be escorted from the waiting room to your emergency room bed. Typically, your room will include a little monitor used to follow your heart rate, breathing and blood pressure. Your room will not have much space and drapes will likely separate it from the next bed. Don’t be surprised if the ER is so busy that instead of a room you are simply asked to sit in a gurney in the ER hallway. You may be asked to remove your clothing and wear a hospital gown.

After you have settled in and a nurse has asked you some additional questions, a resident doctor (a doctor in training who has graduated from medical school and who does not typically look like George Clooney in "ER") usually speaks with you first and evaluates your issue. He or she will ask you several questions about your condition. After your initial evaluation, physician orders will be placed to further investigate what is causing your discomfort. This might include obtaining an X-ray, putting in an “IV” or intravenous line and obtaining blood and urine samples. Here is a list of medical jargon that you might hear while you are in the ER. If someone says something you don’t understand, don’t be afraid to ask questions. At every point during your evaluation, you have the right to refuse any treatment or method of evaluation that you are uncomfortable with.

The ER resident will present your case to the attending ER doctor (the supervising doctor over-seeing all care provided in the ER). The attending doctor then speaks with you, confirms your issues and gives you her impression of what is likely happening. The resident doctor will continue to check in with you frequently, updating you on lab study results, imaging studies and any changes in your treatment plan.

If your issue demands specialist attention, the ER doctors have the ability to enlist the aid of any specialty (heart doctors, ob/gyn doctors, surgeons etc.). In this manner, it is possible that you could see many faces during your ER visit. It is a very good idea to write down the names of people who come to see you and what specialty they are with. The majority of people who come to the ER are able to leave (perhaps with a prescription for medications or instructions on how to get better). Some patients are admitted to the hospital for further care and evaluation.

Finally, it is important for your primary care doctor to be notified of your arrival in the ER. The staff or a family member should call your doctor. He or she will be able to provide pertinent information to the ER staff to guide your medical care in the most optimal way possible.


Blog: courtesy of Dr. Roger Kapoor.

I will be on vacation from the blog for the next 2 weeks. In the meanwhile, please take time to fill out the first document in this post " My Medical Information ".