Top 5 Things You Need to Know Before Your Next Trip to the ER

By Richard Westgate, MSN, RN Richard Westgate, MSN, RN, is the Catheterization Laboratory, Emergency Department and Radiology Nursing Director at Williamson Medical Center. His background is in pediatric and adult emergency medicine. More By this Author

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Top 5 Things You Need to Know Before Your Next Trip to the ER

A trip to the emergency room (ER) is never something a person plans to do. It’s an unforeseen circumstance that sends you or a family member to seek emergency medical help. And while we are lucky here in Williamson County to have a first-rate EMS system and Emergency Department who work really well together, there are multiple things we need our patients to know so that we can all work together for the best outcome possible.

We all have expectations, and our goal is to make sure that yours align with what will actually happen when you come to our ER. We see nearly 47,500 patients in a year, which is up from 28,000 in 2007.

1. EMS

If I could only tell you one thing about coming to the ER, it would be to call 911 and use the county EMS service if you are experiencing chest pain. Many people think they can get to the ER quicker if they just drive themselves or have a family member drive them. But that’s a big misconception. If you think you might be having a heart attack, you should not try to come in a personal vehicle.

And here’s why.

The EMS responders can initiate an EKG at your house that is transmitted to us immediately. If you are having a heart attack, we can call interventional cardiology and the cath lab team. All of these specialists will be setting up to receive you. Their goal is to be ready for you when you get here.

If you drive yourself, you might get here sooner, but none of the activation has started happening in the ER while you are on your way.

Time is muscle when it comes to your heart. The longer it goes without blood, it starts to die. Statistics show about half of all heart attack victims wait at least two hours before seeking help.

2. Registration

For any patient who walks through the front door, the first thing that will happen is you will speak to someone who will get you registered. This person will get some important information from you such as your name and date of birth. We use electronic medical records to allow for your information to travel with you throughout the ER more efficiently.

It may seem like an unnecessary step to some, but it’s very important that we get you in our system. The process is usually very quick, and a vital part of a successful visit to the ER.

3. Triage

The next step begins the triage process. This is a function, not a location. When possible, we do direct bedding, which means we try to take you straight to a bed and then find out more about your symptoms at that point. The triage process is a quick assessment where we get your vital signs, ask what brings you in, get some medical history, allergies and that type of information that anyone who cares for you will need to know.

We use the Emergency Severity Index (ESI), where you are assigned a number between 1 and 5. We look at what is wrong with you based on your vital signs. The system calculates the resources needed to care for you based on that number. If you don’t require a lot of resources, you would be a 5. If you are having a heart attack, you would be a 2.

4. Care Team

We have a very extensive team of professionals that will care for you while you are in our Emergency Department. They include physicians who are board certified in emergency medicine, nurse practitioners, physician assistants, nurses trained in emergency nursing, ED techs, paramedics and others who might be involved such as respiratory therapy, lab, radiology and specialists as needed. In our children’s ER, we have a child life specialist who works with children to help them understand what’s happening and cope with the situation.

Paramedics are wonderful and often augment what the nurses are doing during busy times. They can start IVs, give medications or anything else that they would do out in the field.

5. Diagnosis

Keep in mind when you come to the ER, you are seeing a generalist when you see an ER physician. If you come in and state you have stomach pain, there’s a good chance your diagnosis will be “abdominal pain.” It’s our job to rule out anything that’s life threatening.

With multiple conditions that cause abdominal pain, we may give you medications for pain management or nausea to treat you and then will refer you back to your primary care physician or a specialist for further diagnosis.

In emergency medicine, we access all of your symptoms and look for each possible cause of your condition. We always strive to give you a definitive diagnosis when you leave the ER.

About Richard Westgate, MSN, RN:

Richard Westgate, MSN, RN, is the Catheterization Laboratory, Emergency Department and Radiology Nursing Director at Williamson Medical Center. His background is in pediatric and adult emergency medicine.