Plan Ahead for an Emergency Room Visit

By Helen Frank

In a study conducted by George Washington University Medical Center in Washington, D.C., researchers found that nationally visits to emergency rooms by the elderly have increased more than 34% in the last decade.  Although it is unclear exactly why visits by the elderly have increased, the study surmises that the increase may be due to “older people surviving with chronic medical issues, as well as problems the elderly are experiencing accessing primary care doctors.”

According to the Centers for Disease Control and Prevention 43 out of every 100 people make a visit to the emergency room each year, and six of those visits will result in hospital admission. 

With this relatively high chance of needing to visit an E.R. at some point, it makes sense to prepare for that eventuality, but it may seem an oxymoron to think about planning ahead for an emergency room visit.  By their nature, these visits are usually unexpected and sudden, with little or no time to prepare, other than those valuable minutes waiting for paramedics to arrive and transport a person to hospital.

As with all things, planning ahead, and familiarizing yourself with processes and protocols will, undoubtedly, lead to a better outcome. Additionally, familiarize yourself with your local healthcare facilities.  If, as in urban areas, you have choices, do your homework, and find out which accept your healthcare insurance, and what specialties they are best known for.

Unless it is an obvious emergency, or life-threatening condition, try to stay calm enough to consider whether or not an emergency room visit is necessary.  When you dial 9-1-1 the person that answers may discuss other options with you.  Your health insurance may cover tele-medicine, and you can speak with a medical professional by phone or online for their advice, before going to the E.R.  Additionally, you may find a visit to an urgent care facility might be a better and cheaper alternative.  Don’t use an E.R. as a substitute for a routine doctor’s office visit – it is a waste of the valuable time and resources of already busy hospitals.

Dialing 9-1-1

When you dial emergency services, particularly, if you live in a rural area, be prepared to wait for the paramedics to arrive.  A study by the American Medical Association, found that there is an average wait time of 14 minutes, but this increases to 26 minutes for those that live in rural areas.

If it is not for a life-threatening condition, people often prefer to get to the E.R. by other means other than ambulance, often having a family member or friend drive them.  This can be quicker than waiting for first responders, but, be aware, that on arrival at the E.R, priority is initially given to those people who arrive in ambulances.

While the person will not have access to the expertise and equipment of paramedics, during the journey, self-transportation will be considerably less expensive than ambulance transportation.  The average cost of an ambulance ride is $1,200, but the final cost can escalate significantly, dependent upon the severity of care provided, equipment and supplied used, the number of staff treating you, and, even, mileage.  Ambulance companies often charge if they are called out, but, do not, ultimately, transport a person to hospital.

Providing information to first responders and hospital staff

A person will more quickly receive the most appropriate care from emergency responders and E.R. staff if those people have access to the person’s medical history, and a list of medications that they are taking. Keep this information readily available at home, and with you, when away from home. Remember to mention any over-the-counter medications, vitamins, and nutritional supplements that a person is taking. You should also have a copy of all healthcare insurance and Medicare/Medicaid for the person being treated, along with a copy of their driver’s license/photo ID. It is important to let the first responders have insurance information, since it my dictate to which hospital they transport a person. It is also vitally important to provide an original copy of any advanced health care directive or do not resuscitate orders that a person may have. If you are aware a person does not currently have health insurance, you should make first responders and hospital staff aware of this.

File of Life

As part of emergency preparedness efforts, the federal government promotes the File of Life program, which provides a magnetic pocket and forms, on which people can list useful information such as medical history, medications, and emergency contacts. This pocket of information is then attached to the refrigerator in the home, for quick access by emergency responders. A wallet-sized version is also available. Get a File of Life by going to:

Manage your expectations and stay calm

Be prepared to wait.  Unless the condition is life threatening, chances are a person may have an extended wait to be seen, when they arrive at an E.R.  This is not unusual.  Arrive with this in mind.  It’s not easy to see a loved one in discomfort, but remaining positive and upbeat will help them cope better, too.  Bring books and magazines, and, if you are accompanying the patient you may also want to bring snacks and drinks.  Do not let the patient eat or drink, unless allowed to do so by the hospital staff.  Also limit the amount of people accompanying you.  Waiting rooms can often be cramped and have limited seating and facilities for accompanying visitors.

Sheer panic and frustration can bring out the worst in people, and first responders and E.R. staff are often the brunt of unnecessary confrontations.  Try to remain calm, and be respectful to staff.  They are doing their best under, often, very difficult circumstances and great pressure of work.  It is not appropriate to vent your anger and frustrations on them.  It is not their fault that your health insurance provider doesn’t cover certain treatments, or that Medicare and Medicaid won’t provide for the services you feel necessary, or that first responders took an extended period of time to get to you.  Systemic issues are simply not their fault.

Be a good advocate.  Be calm, provide information and respond to requests when asked, ask relevant questions, and make notes. Ask for a care timeline, but remember it is not set in stone.  You may have been told that x-rays would be taken in 30 minutes, but, what you may not know is that in that time someone with a life-threatening emergency has been admitted, which has disrupted the schedule. Trust that the hospital is utilizing its resources as best they can, and that it is not their intention to keep you waiting. Be patient but persistent.  The key to getting great service is to be a great consumer.

Pack a bag

People with chronic conditions that find themselves attending E.R,s with some frequency will find it useful to have a weekend bag packed in readiness for a quick departure. What to put in your bag:

  • Copies of medical history, medication list, insurance coverage, advance healthcare directives, driving license/photo ID
  • Spare phone charger
  • Contact details for family and friends
  • Spare reading glasses
  • Paper and pen
  • Books/magazines
  • A small amount of cash
  • Underwear
  • Pajamas/nightgown/bathrobe
  • Indoor footwear
  • Toiletries – toothbrush/toothpaste/hairbrush/soap/deodorant etc.

Take the time to prepare for the next E.R. visit. You will find that having vital information at hand will help you to feel more in control, and it will ensure that appropriate treatment is rendered as quickly as possible.

- Written By

Helen Frank

Retired and award-winning gerontologist with more than three decades of domestic and international experience in the science of aging.