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Health & Medicine

2006-09-01 15:33:00

When is a good time to go to the ER

QUESTION: When should one go to the emergency room?

ANSWER: There’s definitely no clear cut answer about when one should go to the emergency room, try to find his family doctor or perhaps seek care in a  walk-in clinic.  There are some times that I feel are imperative that one call 911 without hesitation.  Definitely if a person has chest pain and the pain lingers more than a few minutes, particularly if there is any associated weakness or sweating there should be no attempt to call one’s doctor or to drive to the hospital but simply to call 911 to come and pick you up and take you to the hospital.  A heart attack is something that is a common event and time is very precious in the early moments of a heart attack.  People often die before they get to the hospital or while they are trying to make a decision about whether or not to call 911.  Other patients who should seek immediate help are those who have had some signs of a TIA or mini-stroke.  That is the loss of neurologic function, particularly sudden weakness, inability to comprehend or speak properly, loss of vision or inability to understand what is going on around them.  These episodes cannot be treated lightly and must have immediate medical attention.  In this case the decision should be made very early to simply call 911 and not attempt to take yourself or have someone take you to the emergency room.  Severe abdominal pain, loss of consciousness, any kind of severe bleeding event should be dealt with by calling 911.Entirely different situations occur, however, when it is not a clear-cut emergency.  Even as a physician I have often struggled about what to do in the middle of the night with a child who is crying, has a fever and seems to have an earache.  In this instance, I always tell patients it is better to check it out than to try to deal with these some of these problems on your own.  Certainly, it is also often difficult to get in touch with your physician and discuss the matter over the phone.   Children with febrile illnesses, accidents, sprains, suspected fractures, falls and countless other things fall in this category.  Patients often feel guilty or embarrassed if they go to the emergency room and then find they really don’t have a broken bone or they really aren’t having a heart attack or they really didn’t have a stroke.  I tell them always to celebrate the fact that nothing terrible happened and to not feel guilty or embarrassed because it is always better to be seen and understand the basis of the problem than to take chances with either yourself or one of your loved ones.  There are countless other ways that one can get in a situation where you feel insecure and feel that you need immediate medical care.  When it is possible to go to a walk-in clinic or see your family doctor to get counsel urgently, that is certainly something that one should consider immediately.   Physician’s offices however, are very busy during the day and working patients in may be difficult.  Often times, these patients go to emergency rooms to be seen.  This situation happens around the country on a daily basis. Unfortunately, these are often characterized by long waits as more severe patients keep coming in the door.  This remains one of our largest challenges in healthcare in the US today and will continue to be a challenge.  In the meantime, I simply tell everybody, that “When in doubt, check it out”.