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Dr. Zach’s tips for Navigating the ER

BT Montreal | posted Wednesday, Aug 16th, 2017

The ER is often a very busy and crowded place.  It is the first stop for whatever ails you, and whatever ails anyone else.  The beauty of the ER, but also what makes it so crazy, is that all are welcome and people are prioritized on the basis only of how severe or life-threatening their medical issue.  The problem is that some very uncomfortable problems can wait a long time if they are bumped by life-threatening ones.  And Canadians visit the ER on average more often, and wait longer, than people in other commonwealth countries.  Reference https://www.cihi.ca/en/commonwealth-fund-survey-2016.


It is a good idea to find out what off-hours coverage your doctor’s office has.  Many offices share an on-call system whereby off-hour and holidays are covered by a doctor.  This could save you many hours in the ER for something that does not need ER care.


Given these facts it is important to understand how the ER works, in order not to spend any more time there than you have to.  Here are some tips and explanations:


  • Life-threatening problems are seen first, which means that even painful problems can wait.  Triage nurses evaluate you, determine how life threatening a problem is, and assign a triage code.  However, most ER’s do have policies in place whereby they can treat pain early.  It is important to let the staff know if something changes or gets worse because triage codes can and do change.  ER’s don’t want people collapsing in the waiting room
  • Come with an advocate if you can (or have one meet you).  Often you are not in great shape to advocate for yourself in an emergency situation, and if you need something or feel worse your advocate can advocate for you.  This person can also keep track of who you saw and what was said and done.  An ill person often can’t keep track of these things.
  • Carry a list of your regular medications, allergies, significant illnesses, and doctors with you.  This will allow the ER doctor to get make the most informed assessment possible.  Also, it will save them (and you) time searching for this information
  • If you are severely ill, call an ambulance.  There are several reasons for this: if you’re very sick it is not safe to drive.  The paramedics can begin life-saving treatment en route to the hospital.  The ambulance can usually get there faster than you can.  And the ambulance will know the best place to take you — in many large cities certain centres are deemed the stroke centre, or the heart centre.  You want to go to the right one first.  Of note, coming by ambulance will not get you seen faster if your problem does not warrant it
  • Keep in mind that you may not get a final diagnosis, especially for a chronic problem, in the ER.  ER doctors are specialized in resuscitating acutely ill people and ruling out life threatening conditions.  Once they have ruled out dangerous causes they may let you go home with follow-up for further testing
  • Make sure to ask any questions you have before you leave, to understand what the diagnosis is, the treatment, and where to follow-up.  And know the reasons why you should return to the ER


A visit to the ER is often stressful and can be frustrating.  Knowing how things work and following the tips above can help mitigate some of the stress and frustration.  Communication is key — if you have a question or concern then ask or say something.  The ER staff are people who will do their best to help you.  The more they know the better for everyone.