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Medical Emergency? The Hospital Isn't Always the Answer

Learn what to do and where to go so that you can act quickly.

Your stomach starts to cramp. The pain is so sharp and sudden that it’s hard to walk. What do you do?             

Health emergencies are rarely anticipated, and in the panic of the moment—when seconds matter—it can be difficult to know the right action to take and what to expect each step along the way.

The more you know about what to do and where to go, the better equipped you’ll be to act quickly and decisively.

Here, a guide for navigating a health emergency.        

When Should You Call 911?   

“Anytime a person is unresponsive or has a major change in behavior, head to the emergency department,” says Jeffrey L. Pellegrino, Ph.D., professor of health sciences at Aultman College in Canton, Ohio.

Other reasons an ambulance should be called include breathing problems, chest pains, bleeding that can’t be stopped with direct pressure, severe burns, broken bones, coughing up or vomiting blood, sharp abdominal pain, an unexplained seizure, and signs of a stroke (facial drooping, arm weakness, or speech difficulty).

If you’re unsure about whether something is a real emergency, many insurers offer 24/7 nurse lines, in which a trained professional will help you assess the severity of a situation. Check with your insurance company to see whether this service is provided under your plan.    

What Happens When You Call?   

All 911 calls are answered by trained dispatchers, who can first help determine whether emergency services are required.

Be prepared to answer questions about the nature of the problem as clearly and calmly as possible.

The dispatcher will also ask for your phone number and your exact location (or the location of the person in need of aid), including details such as whether your front door is unlocked or your house has a gate.    

Which Ambulance Will Come? 

The answer “has nothing to do with your insurance or your complaint,” says Latha Ganti, M.D., a professor of emergency medicine and neurology at the University of Central Florida College of Medicine in Orlando. The ambulance provider that covers your geographic area will be the one that responds.

You’ll generally be taken to the closest facility for treatment, but if you’re stable, you can ask the EMTs whether they would consider taking you to a preferred facility, Ganti says.

The cost of an ambulance is often covered, but the bill can be high when it’s not—if the service is out-of-network or deemed unnecessary, for example.    

Can You Drive Yourself?   

In a true emergency, driving yourself or having someone else drive you is fraught with risk and uncertainty, Pellegrino says. You could put your life at risk, especially if your situation becomes more serious on the way there.

If your condition is less obviously risky (say, you have dull abdominal pain), using a ride-sharing service or having someone drive you could be reasonable, says David Marcozzi, M.D., an associate professor in the department of emergency medicine at the University of Maryland School of Medicine in Baltimore. But, he says, there are “so many caveats,” and in an urgent health emergency, an ambulance is always the fastest and safest route to an ER.

Ambulances and EMTs are equipped to handle an escalating emergency, and the hospital will know about your condition and be ready to treat you quickly if necessary when you arrive.    

An ER or Urgent Care?   

Emergency departments, whether freestanding or attached to a hospital, are staffed by emergency physicians and open 24/7, equipped to treat or stabilize patients. Freestanding facilities, however, don’t allow surgery, for example; should you require more extensive care, you’ll be transferred. All ERs are required to provide service regardless of a patient’s ability to pay.

Urgent care centers accept walk-ins, and wait times are usually shorter than at emergency departments. Unlike ERs, however, at urgent care centers—which aren’t always open 24/7 and aren’t required to provide service to people who can’t pay—you might not see a physician. Instead, these centers are a convenient option for treating less serious illnesses and injuries, such as ankle sprains, cuts, the flu, a fever, nausea, and rashes.    

Can You Just Call Your Doc?   

For minor but persistent illnesses that require lab tests or throat swabs, Pellegrino recommends making an appointment with your primary care provider as soon as possible to avoid a trip to urgent care or an emergency department altogether.    

What Happens at an ER?   

The more serious your condition, the more quickly you’ll be seen.

If you’re deemed to be at immediate risk, medical staff will treat you on arrival. Otherwise, a triage nurse will assess the urgency of your condition, says William Jaquis, M.D., president-elect of the American College of Emergency Physicians.

Should your condition worsen while you’re waiting, tell the nurse on duty, Jaquis says, because it could “change how you are processed.” Once you’re called for treatment, you will be examined by an emergency physician, who will ask questions and order any relevant tests. When the results are in, you’ll be prescribed a course of treatment, along with any necessary medications.    

What Happens at Discharge?  

You should expect to leave with verbal and written instructions for how to care for your condition, as well as any necessary medications, Jaquis says.

Ask for copies of any medical test results or reports from your stay—in most cases, according to Jaquis, the hospital should provide them—and give them to your primary care provider so that he or she can add them to your medical history.

Only 9 percent of visits to an emergency department result in a hospital admission.    

Preparing for the Unexpected  

A health emergency can be stressful and overwhelming. Get this essential paperwork ready in advance. It could help save your life.

1. An up-to-date list of medical conditions and current medications, along with any over-the-counter drugs or supplements you take. Keep a copy on your fridge and another in your wallet, along with your health insurance card. If you arrive at a hospital unconscious, the medical team will go through your purse, wallet, or phone in search of this information.

2. Contact information. “Every single person should have a list of who to contact, the name of their primary care doctor, and any specialists,” Ganti says. Also add an In Case of Emergency (ICE) contact to your phone and to a sticker on your case.

3. Legal and medical documents. William Jaquis, M.D., of the American College of Emergency Physicians, recommends keeping all your relevant documents together and accessible, including a complete medical history for each family member, consent-to-treat forms (for children), durable power of attorney, living will, and healthcare proxy info.    

Editor’s Note: This article also appeared in the April 2019 issue of Consumer Reports On Health.

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