Many people often wonder when they should make the decision to call 911 or go to an emergency room if they are sick or injured. What precisely constitutes an emergency?
In general, the emergency room should be utilized for urgent, life-threatening situations, or ones that are too complicated or severe to be handled in your regular doctor’s office or an urgent care facility. Scenarios where going to an emergency room would often be the best course of action include suspected heart attacks, blood clots, strokes, acute exacerbations of chronic obstructive pulmonary disease or asthma, and infections like urinary tract infections or pneumonia that have not responded adequately to oral antibiotics. Other examples include complicated lacerations, trauma-related fractures requiring urgent management, or burns that require rapid care if not evaluation by the appropriate specialist as well.
However, as anyone who has worked in an Emergency Room knows, some days in an E.R. it can feel like every patient is there with an issue that isn’t “really an emergency,” such as a cold or chronic issue like low back pain. Some patients have even related stories to me of how, when they presented to the E.R. with their issue, the staff there greeted them with some variation of, “Why are you even here? This isn’t an emergency!”
This can be extremely frustrating for all parties. Like many issues in modern American health care, it is a nuanced situation. Some people repeatedly seek medical care in emergency rooms because of a lack of financial resources or a primary care physician, so they go to the E.R. knowing that they will be seen regardless of ability to pay at the point of care.
Others go because they have chronic, complicated medical problems that have not been fully addressed by their regular doctor, sometimes due to complexity and others due to lack of available resources. The patient with chronic low back pain may have been suffering from severe, incapacitating pain for months or even years, and going to the hospital is a last resort to try and get help.
Such situations bespeak the inherent flaws in our medical system and are likely beyond the scope of this column to fully address. I will never chastise my patients for going to an E.R. in such situations, although I will try and communicate that if any chronic, complicated issue, pain or otherwise, is so poorly controlled or impacting their life to such a degree that they feel the need to go to the E.R. or hospital repeatedly to please let me know how “bad” things are so that I can intensify my efforts as a primary care doctor to help them.
Ideally, anyone concerned about these symptoms or conditions would take the time, if available, to discuss what is going on with their primary care doctor and seek expert advice. Almost all, if not all, primary care practices have someone on call and available by phone 24 hours a day, seven days a week, who can be reached to provide emergent advice. If you know that you’re suffering from a potentially life-threatening situation, then don’t waste time — call 911 or have someone drive you to the nearest emergency room.
On the other hand, if you think you might need to go to an emergency room but aren’t quite sure, call your doctor’s office to discuss with your doctor or whoever is on call for them. Many times, just 10 minutes on the phone with someone is enough to determine a plan that is reassuring and safe for everyone.
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Joshua Potter, D.O., a physician with Stony Brook Southampton Hospital’s Meeting House Lane Medical Practice, oversees the practice’s Shelter Island office. He specializes in family and neuromusculoskeletal medicine. Opinions expressed in this column are his personal and professional views and not necessarily those of his employer.
