Is it an Emergency?

Keeping Your Family Safe and Healthy "Everyone should learn how to recognize a medical emergency and when to seek professional medical attention. It's one of the most important things you can do for your family's health.

Qualified emergency physicians, specially trained to care for you and your family, are available 24 hours a day, seven days a week. Knowing how and when to properly use this valuable resource can help protect you and your family from tragedy.

" Gregory L. Henry, MD, FACEP Former President American College of Emergency Physicians Recognizing Emergencies How do you tell the difference between a true emergency and a minor problem? Certain symptoms are so alarming that the need for emergency care, or even an ambulance, is obvious. But what should you do about more common illnesses and injuries?

Only a doctor can diagnose medical problems. But you can protect your family's health by learning to recognize certain symptoms. Know which symptoms to watch for. According to the American College of Emergency Physicians, the following are warning signs of medical emergencies: Difficulty breathing,shortness of breath Chest or upper abdominal pain or pressure Fainting Sudden dizziness, weakness or change in vision Change in mental status (such as unusual behavior, confusion, difficulty waking) Sudden, severe pain anywhere in the body Bleeding that won't stop after 10 minutes of direct pressure Severe or persistent vomiting Coughing up or vomiting blood Suicidal or homicidal feelings You should also be familiar with the symptoms of common illnesses and injuries such as those listed in the complete edition of the booklet, Home Organizer for Medical Emergencies, which is available free of charge by calling (800) 446-9776. Talk to your regular doctor before you have an emergency. Ask what you should do if you think someone in your family needs emergency care.

Should you call the doctor's office first? Should you go straight to the emergency department? What should you do when the doctor's office is closed? Many other factors, including the time of day, other medical problems or state of mind, can make an otherwise minor medical problem an "emergency." Trust your instincts. If you are alarmed by unusually severe symptoms that you believe could be an emergency, it's best to seek care. When to Call an Ambulance When should you call an ambulance instead of driving to the emergency department?

Ask yourself the following questions: Is the victim's condition life-threatening? Could the victim's condition worsen and become life-threatening on the way to the hospital? Could moving the victim cause further injury? Does the victim need the skills or equipment of paramedics or emergency medical technicians? Would distance or traffic conditions cause a delay in getting the victim to the hospital?

If the answer to any of these questions is "yes," or if you are unsure, it's best to call an ambulance. This is true even though you can sometimes get to the hospital faster by driving than by calling an ambulance. Paramedics and emergency medical technicians are trained to begin medical treatment on the way to the hospital. This prevents any delay that could occur if the patient is driven to the emergency department. The ambulance can also alert the emergency department to the patient's condition in advance. If you live in a community with a single emergency number, calling for help is easy. Just dial 9-1-1. If your community does not have the 9-1-1 emergency number, keep the numbers of the fire, police and emergency medical services departments near your telephone.

When you call for help, speak calmly and clearly. Give your name, the address, phone number, location of victims (such as upstairs in the bedroom) and nature of the problem. Don't hang up until the dispatcher tells you to. They may need more information or need to give you instructions. Choosing an Emergency Department You should always know the location and the fastest route to the nearest emergency department. Keep the telephone number posted by the phone, along with your other emergency numbers. The emergency department should be open and fully staffed 24 hours a day, seven days a week, by specially trained emergency physicians and nurses who have chosen careers in emergency medicine. If there is more than one hospital nearby, ask your regular doctor where he or she practices and then plan to go to that emergency department. If he practices at more than one hospital, ask him which emergency department he recommends for you and why.

Be careful not to delay care by traveling to a more distant hospital emergency department. Your doctor or the hospital's emergency department director can explain the types of emergency medical care available in your community and when you might need them. In most cases, you or your family will be treated in the community hospital emergency department, which is staffed and equipped to provide life-saving emergency care for patients of any age. If necessary, a patient may be transferred after stabilization to a hospital with special capabilities, such as a regional trauma or pediatric center.

About Your Insurance Coverage When choosing which health insurance is best for your family, you need to consider more than the cost and the choice of doctors. It's also important for you to understand what kind of emergency coverage your insurance plan provides. Keep in mind that although your insurance plan can deny payment, they cannot prevent you from obtaining emergency care. Under federal law, you cannot be refused treatment for a true emergency because of lack of insurance or inability to pay. Check with your insurance company or your employer's benefits department to find the answers to the following questions: If you are required to contact your primary care doctor for care, is he or she available evening or weekends to treat minor conditions?

Do you have to call your doctor or the insurance plan for permission before going to the emergency department? Is there a limit on how long you may have to wait for approval? Can you use the nearest emergency department or must you go only to participating hospitals? Will the emergency physician have to call your insurance plan for authorization before treating you or your family? Does your insurer pay for your visit only if you were diagnosed with an emergency condition or are you covered for emergency visits based on the severity of your symptoms?

Is there a separate deductible or copayment for emergency visits? If you have to be transferred to one of your plan's participating hospitals after you are stabilized, who will decide when it is safe for you to be transported? Does your plan cover transport from the scene to the hospital and from one hospital to another? Does the plan require an observation period before admission to a hospital for certain diagnoses? Are there restrictions on follow-up care with specialists or emergency facilities? What are the facilities and coverage for mental health emergencies? Your plan should not discourage you from calling an ambulance or going to the emergency department when you feel it's necessary.

If your insurance plan denies payment for legitimate emergency services, you can appeal your plan's decision. Contact the plan's grievance system and notify the agency that licenses insurance plans in your state. What to Expect in the Emergency Department In the emergency department, the most seriously ill or injured patients are treated first. This process is called "triage" (pronounced tree-ahj), from the French word meaning "to sort." Usually, the first person you'll see in the emergency department is the "triage nurse." The triage nurse checks vital signs including temperature, heart rate, blood pressure and breathing and asks questions about why you are there.

The triage nurse will also ask the name of your regular doctor. Unless you need to be treated right away, the triage nurse will direct you to a registration area. You'll be asked for your name, age, address and the name of your health insurance company. It's a good idea to keep this information written down along with your medical history, so you'll have it when you need it. If your condition is not life, or limb, threatening, you may be asked to wait in the waiting room until your name is called.

If your condition gets worse while you are waiting, let the triage nurse know. There are many reasons why a trip to the emergency department can take longer than a doctor's office visit. Unlike a doctor's office, where appointments are spread out, many emergency patients may arrive at once. Also, you must wait for the results of any x-rays or tests done in the emergency department. This way, the emergency physician can immediately begin your treatment. You can help make the time pass more quickly if you plan ahead. If possible, take along a book or toys for the children when you head for the emergency department.

And remember - you will only be asked to wait if it is safe for you to do so. Be sure that all of your questions regarding your care are answered by the doctor or nurse.

Dealing With Common Illnesses and Injuries Excerpts from the Home Organizer for Medical Emergencies, a Guide from the American College of Emergency Physicians. ©1996, American College of Emergency Physicians, Dallas, Texas For a free copy of the complete 16 page booklet, Home Organizer for Medical Emergencies, call (800) 446-9776. Is it an Emergency? Be prepared for the unexpected Take fear out of Emergency Department Visits General Medical Info

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