Emergency Room Care
How to Plan Ahead for Stressful Emergencies
For safer Care. For Peace of Mind
Don’t wait for an emergency
There are simple steps you can take NOW to help minimize potential complications and maximize efficiencies should you or a loved one end up in a hospital Emergency Room (also called an ER and ED – for Emergency Department).
And don’t forget, the ER may not be your only choice if an emergency arises. Become acquainted with the kind of care offered at your local Immediate Care Center. Typically, they have shorter waits (for some, you can wait at home until called), comfortable surroundings, less “hustle and bustle,” plus all the onsite testing equipment that ER’s have – and all at a lower cost!
If your loved one needs an ambulance to the ER, it’s okay to ask if you can ride alongside. It will help your case to explain that you can help keep your loved one calm.
Plan ahead for safe care
Whether you’re caring for an aging parent or chronically ill family member, it’s a good idea to have all of your Care Partner tools organized and ready to go at a moment’s notice.
NOTE: It’s really important that you know your loved one’s wishes and goals for medical care. A good resource to help you have those conversations is: fivewishes.org.
In a notebook or file folder, organize medical info, forms and records hospitals will need:
- Medical Power of Attorney
- Advance Directives
- Photo ID of your loved one and
- Insurance card (front and back)
- Medical records, including lists of all doctors, prior hospitalizations, all surgeries with dates, all vaccinations with dates, current and prior health care conditions. Bring CD’s with any scans performed (EKG, CAT, MRI).
- Medication list, including vitamins and herbal products, as well as information about alcohol, tobacco and recreational drug use.
- Medications – if you have time, put all your loved ones medications in a baggie and bring. You may have a long wait so remember to bring medications your loved one may need to take.
Having a patient’s medical information at your fingertips in the ER can help minimize complications and ensure your loved one gets the best treatment based on their history.
Organize your Care Partner tools in a “grab and go” backpack or tote:
- Notebook and pen
- Bottles of water – keeping your loved one hydrated and warm is key. Include powder packs of Gatorade too.
- Healthy snacks like little packs of nuts, granola bars, and protein bars
- Contact list of others to call for help (If stored on your phone, organize in group/s so you can find quickly–ie. Dad’s Doctors, Mom’s Neighbors)
- Antibacterial hand cleaner
- Antibacterial surface wipes
- Care Partner Project checklists – just in case your loved one is admitted to the hospital
- The Beers List of Medications
- Your chargers for phone or other electronics you bring (a power strip might be good, too).
When your loved one is elderly or chronically ill, it’s especially important to have a bag ready to go at a moment’s notice with all the essentials you’ll need at the hospital. Minutes count when a medical crisis occurs.
Bring comfort items for your loved one:
- A favorite personal item (A favorite sweet treat? Religious item? )
- A warm sweater, neck scarf, or hat
- A light blanket (the kind you get on the airline is a good example – folds up compactly but offers warmth)
- Items to help quell anxiety (choose what helps your loved one)
- Fidget-widget
- Headphones and favorite or soothing music on phone/ipad
- Noise cancelling headphones
- Sunglasses to shield eyes from fluorescent lights in hospital
How to support your loved one’s peace of mind and ER care
When Checking In:
- Provide Photo ID, Insurance Card and Medical Power of Attorney
- Tell the admission clerk you have all medical records and an up-to-date medication list with you.
- If your loved one suffers from dementia, or is experiencing confusion, ask if the hospital offers a separate “quiet room” to help your loved one feel calm and secure.
- If a quiet room is not an option and your loved one is truly disruptive and does not respond to the items you’ve brought in your “go bag,” be aware that a medication may be ordered.
- Look up every drug ordered for your loved one. If they are 65+, check it on the Beers List. Make sure it does not have a black box warning.
While Waiting for Care:
Ask your loved one to describe what they are feeling.
- Any Pain? Where?
- Pain level on a 1-10 scale?
- Other symptoms, worries, discomforts?
- When did they start? How? (Triggers?)
Ask your loved one:
- What do you think is wrong? Why?
- What are your questions for the doctor?
- What are your worries?
- What do you want to happen here? (Your goal for being treated at the ER?)
Take notes of this conversation to share with your loved one’s doctor/s and other care providers who may attend to your loved on in the ER (or if admitted, other nurses and doctors who may care for your loved one.)
Idea to consider: Take a photo of your notes with your phone and give your notes to the admission desk, telling them you are prepared to meet the doctor – this may be a gentle way of nudging you higher on the waiting list.
Ask before any medication is given to your loved one:
- Name of drug (as for its common name)
- Does it have Black Box warning?
- On the Beers list? The KIDs List?
- Look up on Medline Plus.
- Are there alternative medications?
During the Examination:
- Stay with your loved one.
- Ask permission to record conversations so you can listen carefully and take notes later. If helpful, ask if you can Face-time the visit with anyone else who may be involved with your loved one’s care.
- Be sure to include your loved one in all conversations. If hearing impaired, make sure the doctor knows so extra care can be taken to make sure your loved one is included – and not a bystander in his/her own care.
- If your loved one is experiencing confusion, let all Care Providers know if this is a temporary condition or their usual mental state. In older people, the new or sudden onset of confusion is a red flag for infection –often a urinary tract infection or a brain bleed (any age).
- Review your loved one’s medication list with nurse. Tell nurse of any medications that have been taken that day and a few days prior, including herbs, vitamins and any other “drugstore” type remedies.
- Describe your loved one’s medical concerns calmly and clearly to the nurse and doctor (notes will help).
At the Point of Diagnosis:
- Take time to fully understand the diagnosis. Don’t rush. (See The Care Partner Project’s diagnosis checklist.)
- Review and understand any new prescriptions. Side effects? Length of use? Dose? How and when to take? Use our handy form to help you keep track of these important details.
- ALSO, find out if any medications are on the caution lists:
- (For seniors) Is this medication on The Beers List?
- (For kids) Is this med on The Kids List?
At the time of Discharge:
- Ask for “Bedside Huddle” with Doctor, Nurse and Pharmacist.
- Review/RECORD/FACE TIME may be an option! Ask for permission to use.
- Ask questions and ask for plain terms.
- Ask for copy of record of visit, including the doctor notes.
For each test the doctor orders, ask:
- What will we learn?
- Is this information a “nice to know” or “need to know” in order to diagnose or treat?
- Ask the doctor for their initial thoughts, or diagnosis.
For every diagnosis, ask:
- What else could it be?
- See The Care Partner Project’s diagnosis checklist.
After a visit to the ER
Whether your loved one is recovering at home or in a nursing home/assisted care facility, they will need to be monitored closely, especially if new medications have been prescribed.