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Remember why Emergency Rooms are there
If you can remember that ER’s are designed for life and death emergencies, broken bones, stitches, problems that require hospital admissions, not the kinds of things people see their doctors for routinely such as sore throats, etc., it will help you know when to use the ER and when to go somewhere else! Those kinds of things are best done at doctor’s offices or urgent care offices. With the elderly or those with other health issues, you often have potential life-threatening issues to deal with if you let things go until the next day. Your doctor can let you know which things are serious for your patient.
You can call your doctor on call (sometimes, it will be your doctor) to clarify which category you fall into at the time. It won’t take long to know. You will save yourself many hours in the ER if you understand what the purpose of each treatment area is.
The caveat I must mention here is that one problem for people who are having a stroke or heart attack is often denial. They think they are imagining their symptoms or that their symptoms aren’t serious enough to be seen. When in reality, that may not be the case. If you are likely to be having a heart attack or stroke, you must go to the ER. They are the best people to care for you. They will be able to tell you if you actually are having one of those things. after some lab work and other tests. Waiting until the next day can cost you your life.
Trauma patients, as well as critical patients, will get in ahead of you in the ER unless you have a heart attack or stroke. (Timelines are involved so if they suspect those are happening, They will start IV’s and get lab work quickly.) It is important to know this when you head to a certain place for your felt emergency. It is also wise to go to the same hospital or group of hospitals for your emergencies. They have your records. (Often, the records are available at a sister hospital that may have a less busy ER. Whether your specialist is available is another story.) That is where your doctors are. It will save you a lot of time and delays. Over time, you will sort out pros and cons for the needs your loved one has. Feel free to ask questions. Your medical insurance may also affect how well the ER is paid for from one hospital to another. This is something you should know before you get sick.
What if I fall apart or don’t know how to handle the emergency?
Remembering that you will be able to manage what happens is going to be helpful for you. The more you tell yourself that you don’t know what to do or this emergency is more than you can handle, the more rattled you will become. When you realize you are in the middle of an emergency, it won’t hurt to pause. Take a couple of slow deep breaths to calm yourself. Yes, even nurses have to do it to collect ourselves.
Then do the next thing. If you know you will need an ambulance, call 9-1-1. If you aren’t sure what to do next, call them and they will guide you to the next step. Knowing they are on their way will help you stay calmer. If your loved one is safe, go unlock the front door so the paramedics can get in.
- Make sure your loved one is safe. If breathing is difficult, add a pillow or two. If he is passing out, put him flat on the bed or floor.
- If he is unconscious, be sure he is in a safe place on the floor or on a bed (don’t lift him to get him onto the bed.) If needed cover him to keep him warm. Be sure he is safe from falling. There is a difference between being unconscious and still and unconscious and flailing around of course. The second makes it much wiser to have him on the floor.
- Watch to be sure he is breathing. Occasionally monitor pulse.
- If he is awake, reassure him that help is coming.
If you aren’t sure if they are sick enough for the Emergency Room, call your doctor to see what you should do. He will guide you re whether to go to the ER or not. Try to be as concise as you can be with the doctor but tell him why you are concerned. You want the doctor to see what you see. Give her a picture of what you are seeing/hearing/feeling
- Is he having trouble breathing?
- What is his breathing like?
- Is his skin warm, cold/clammy, sweaty, hot?
- Is he having any pain? What number is his pain from 1-10 with 10 being the worst pain in the world.
- Where is his pain?
- Is he confused?
- Does he know his name? where he is? the date/month/year? the president of the US?
- How long has he been this way?
- Is his color different than usual?
- How? Is he pale, yellow, gray, blue, flushed?
- Is he weak on one side? (If you aren’t sure, grab his hands in yours and ask him to squeeze.)
- A very important sign to check is his mouth. Have him smile. Is it symmetrical?
- Have him stick out his tongue. Does it go off to one side?
- If his mouth or speech is affected, don’t allow him to take anything by mouth. His swallowing ability may be affected and he could choke.
- Does he have a fever? how long? Has he had Tylenol or Advil? Do not give him any medication at this point unless told to do so.
If you have symptoms of a stroke, chest pain or possible heart attack? GO TO THE ER! Time is of the essence. Chills in an older person? Go to the ER.
Do not be anxious about anything,
but in everything by prayer and supplication with thanksgiving
let your requests be made known to God.
And the peace of God, which surpasses all understanding,
will guard your hearts and your minds in Christ Jesus.
Be strong and courageous.
Do not be frightened, and do not be dismayed,
for the Lord your God is with you wherever you go.
Martha, this is a great series…might I suggest a third installment, one that addresses the issue of someone who needs to go to the ER, but refuses?
i’ll have to think about that one. refuses to go to the ER b/c he doesn’t want any treatment? b/c he doesn’t want to be bothered with going there? b/c he doesn’t want to pay the $$? or do you even know? that would help me.
Martha, for me it’s a combination. I don’t have insurance, and so would be leaving Barb with a crippling bill. Also, there isn’t anything that can be done beside immediate pain relief and putting me on an IV to try to relieve the burden on the pancreas for 24 hours or so. It’s a very temporary fix, and just doesn’t seem worthwhile.
Too, I don’t do well with any of the pain relievers that are commonly used, either opioids or psychotropics used in pain relief. So the whole exercise seems kind of futile.
thanks andrew. that is helpful input. i’ll add that to my part III:) in your situation, i do think hospice could help you. it would be worth looking into. they are very flexible in their treatment, wanting to make your final days more comfortable to your situation. it isn’t dependent on insurance. they receive donations as well. it would be worth checking into if you haven’t. you can always decide against it.
I have trouble bringing myself to GO to the doctor or ER for anything! I’m terrible that way. I know that I would not hesitate with these symptoms however.
One other resource we use is the nurse line. They are invaluable at 3am.
the nurse line is another great resource, christy. the context of the post, however, is the series for people who are chronically ill and usually are well known to their primary care doctor. in that case, calling him or his doctor on call is a much better decision because they are usually more familiar with his situation and when it is best for him to go to the ER and when it is better to treat over the phone.