The emergency department (ED) or emergency room (ER) is the portion of the hospital that treats people experiencing an emergency.
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People get to the ED by different methods. Many drive themselves or are driven by someone else. Some people arrive by ambulance or even helicopter.
After arriving at an ED, the person, if conscious and stable, will be asked for personal and insurance information at the registration desk. The person is then evaluated by a triage nurse. This nurse decides whether the person needs to be taken right away into a treatment room, or if they can stay in the waiting room for awhile.
People with conditions that are unconscious or have life threatening problems will be taken immediately into the ED.
Hospital EDs are set up to handle trauma and life-threatening cases. They do not work on a first-come, first-served basis.
The triage nurse will ask what brings the person to the ED, and a medical history will be taken. It is very important to know what medications and dosages the person is presently taking - including over-the-counter medications, herbs, vitamins and supplements. Vital signs will be taken, including temperature, heart rate, and blood pressure.
The person will be assigned a bed, and asked to change into a hospital gown. The doctor comes into the room at this time to review the patient's history and to do an examination.
Depending on the situation:
blood may be drawn for testing and an intravenous or IV may be started. Both of these procedures involve sticking a needle through the skin and into a vein. Usually, a vein on the hand or forearm is used.
X-rays or imaging studies (such as a CT scan or MRI) may be ordered.
- A small clip may be placed over a finger to painlessly measure the oxygen level in the bloodstream and oxygen may be given by facemask or through nasal canula, if needed.
- Medications may be administered by mouth, by vein or by a shot.
- A heart tracing, call an EKG, may be performed.
- The person may be attached to a monitor, which is used to get a heart tracing, called a telemetry.
Initially, family members may not be allowed into the treatment area. Once a person is thought to be stable and has had initial treatment, family and friends can often visit. There may be a limit on the number of people allowed to visit at one time. This limit is meant to ensure that the ED doesn't get too crowded, and to protect the privacy of the other patients.
A waiting period is normal in the ED and is not a sign that the staff there don't care about the person awaiting treatment.
It is important to be honest when answering questions. Embarrassing questions may be asked about sexual history, drug and alcohol use, menstruation, and other sensitive issues. These questions can help to determine the cause of an illness.
After the doctor finishes the history and examination, he or she may order further tests, such as X-ray studies. The test results can sometimes take several hours to come back. In the meantime, treatment will be given as needed.
Once all the test results are back and any treatment has been given, the person is evaluated again.A decision is then made on whether the person is well enough to go home or needs to be admitted into the hospital.
If the situation is a life-threatening emergency, such as a heart attack, this process will occur very quickly. Otherwise, the process may take several hours.
When a person is admitted to the hospital, their primary care physician will be called to assume care of the individual. If the patient has no primary care physician, an "on call" physician will be assigned to care for the patient. The admitting physician may choose to consult with one or more specialists.
If a person is going home, it is important that they follow all instructions from the doctors and nurses involved in their care.
Many EDs are now opening urgent care areas to deal with injuries and illnesses such as torn or cut skin (abrasions or lacerations) and sore throats. This may be separate from the main ED, allowing a person to be treated in a more timely fashion.
Most healthcare is best provided by a persons' primary care physician. In an emergency, however, the ED is always open.