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 for a couple days 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.
Write down all your conditions and medications in case of emergency
Sometimes emergencies happen and you’re unprepared, but the vast majority of patients we saw in the ER came from home and had been sick for at least a couple days or weeks. Alarmingly, it was not unusual to see patients who took the same pill for five years but could not remember the name of the pill, and that could potentially lead to harmful drug interactions. We also had more than a few patients who knew they had some kind of condition, like "thyroid something" or "cancer somewhere" but could not be more specific, which was extremely concerning.
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 twice daily." Or, "I have hyper-tension and I take atenolol” and so on. Carry the slip of paper in your wallet just in case. Sit down with a family member and make a slip for them. It makes a huge difference, especially with geriatric, pediatric, or disabled patients. It's also good to do even if you're in mostly good health. No one’s going to know if the seizure you had at the mall when you were 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.
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 is not fun when you are a patient. 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. Furthermore, 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! Drug use isn't the only thing people lie about; things like sex injuries happen all the time and I personally saw scores of women who told us there was no possibility whatsoever of them being pregnant and then (surprise) they were pregnant.
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, 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 but firmly ask what’s going on. No one’s going to hate you for it. I saw patients ask important questions for themselves that we hadn’t thought of, like where they could breastfeed in private 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 someone forgot to order it, so please ask. Nobody likes errors, but they are a reality in the field of healthcare and you need to look out for yourself and your loved ones.