Sunday, September 20, 2009

How to Make an Emergency Room Visit a Safe One

clipped from bulletin.aarp.org

Finding Your Way: How to Make an Emergency Room Visit a Safe One

By: Carolyn M. Clancy, M.D., AHRQ | Source: AARP Bulletin Today | September 2, 2009



You hope an accident or illness won't send you to the emergency room. But being prepared for such an event can help you get good, timely care when the need arises.





Unfortunately, U.S. hospital emergency rooms are severely overcrowded. In 2006, America's emergency rooms cared for 120 million patients, according to data from my agency, the Agency for Healthcare Research and Quality (AHRQ). And—because the nation's health care system still relies on largely paper-based medical records—chances are, if you land in the emergency room, the doctors won't have information about your medical history.


Emergency staff won't know what medicines you take or what medical problems you have unless you are able to tell them. Even if you are alert, you're likely to forget important information about your health, such as medicine allergies or your blood type.


Being prepared for a trip to the emergency room—whether because of an accident or illness—increases your chances of getting safe, high-quality health care. It might even save you money, depending on your health plan's policy for emergency room visits. Know what your health plan policy is. Some health plans require you to get authorization for emergency care if it isn't a life-threatening emergency.


That's why it's important to have updated, thorough information handy. Keeping your information either on paper or in an electronic form, like on your cellphone, may help you receive better, safer care in a medical emergency.


There are several ways you can prepare this information before you ever need it. Keep essential information typed or written in your wallet. Emergency doctors recommend that people with cellphones add "ICE" entries into their cellphone address books. ICE stands for "In Case of Emergency." Medical providers can use it to notify your emergency contacts and to obtain needed medical information if you arrive unconscious or unable to answer questions.





Here is a basic list of information that you should have available in case you ever need to go to the emergency room:


• Medical conditions or illnesses you have, such as heart disease or diabetes, and any surgeries or treatments you've recently received.


• Medicines you take, including prescription, over-the-counter and herbal medications, along with dosage information. Some drug interactions can be deadly, so it is essential for emergency room staff to know which medicines you take and in what amounts. If you have time, bring your medicines in a bag, or keep in your wallet an updated list of all your medicines and dosages. AHRQ's model pill card can be created on a computer.


• Allergies or known reactions you have to medicines, foods or latex (a material in many medical supplies, including some types of gloves and adhesive tape).


• Names and contact information of your primary care doctor and any specialists, such as a cardiologist, treating you.


• Contact information of family members or close friends who may know your medical history in case you are not able to communicate it.


• Other important information to have handy includes personal identification—such as a driver's license, insurance information and an advance directive, if you have one. Advance directives are legal documents that state your wishes about health care, including end-of-life care.


Increasingly, people are creating and maintaining electronic personal health records (PHRs). These can be very useful if they're portable and easy to access. There are several PHR options available for you to choose from. Some of them allow you to keep a copy or summary of your health history, medicines and allergies in one safe place that you control. Check to see if the PHR you prefer allows you to keep the summary. It can be kept on a secure website, or stored on your computer or another electronic device, or on paper.


Regardless of how you keep your vital medical information, it is important to keep it updated. It is also important that your family members know where this information is in case you are unable to do so in an emergency. And when you leave the emergency room, make sure you understand the instructions given to you by the hospital when they let you go home, called discharge instructions. These can include directions for follow-up visits or changes in medication.


I'm Dr. Carolyn Clancy, and that's my opinion on how to navigate the health care system.



Carolyn M. Clancy, a general internist and researcher, is an expert in engaging consumers in their health care. She is the director of the U.S. Agency for Healthcare Research and Quality.


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