Ten Commandments of the Emergency Room

I. Thou Shalt Plan in Advance Your Emergency Room of Choice

Do not wait for a crisis. Do research now. Learn which hospitals are best for trauma, pediatric and heart care. Perhaps a local community hospital offers fine care for basic medical emergencies? Ask your doctor at which hospital he or she has admitting privileges or find a doctor who holds privileges at your hospital of choice. Map out the shortest drive to those hospitals.

II. Never Delay Seeking Help for unfamiliar or severe chest pain, shortness of breath, abdominal pain, limb numbness or weakness, worst-ever headache. Have someone notify your doctor while you wait for the ambulance. Do not drive yourself.

III. Know Thy Emergency Physician

Know who is treating you or a loved one. Is it a physician? Nurse practitioner or physician assistant? Doctor in training or student? If a doctor is treating you – what is his or her training background and experience level? Politely inquire – it shouldn’t offend a confident provider.

IV. Know Thy Medicines and Their Dosages

Carry an updated med list in your wallet or bring all the bottles with you to the emergency room. Over-the-counter remedies like aspirin or antacids are also medications. Herbal remedies and vitamins as well as creams, eye drops and injections should not be forgotten.

V. Thou Shalt Carry in Thy Wallet a Laminated, Miniaturized Copy of Your Electrocardigram (EKG)

This is key if you have a heart condition, diabetes or are over fifty years of age. The diagnosis of  heart attack does not always jump off the electrocardiogram. Comparing an old to a new EKG and detecting changes is more accurate.

VI. Never Consent to Any Test, Treatment or Procedure unless the doctor clearly explains its purpose, and associated risks versus benefits. Politely ask if  safer alternatives exist and if the test is truly needed. It is your right as patient to refuse a test that wreaks of “just in case, but not necessary.”

VII. Thou Shalt Not Worship X-rays, Blood Tests, Medications or Doctors

Avoid High-tech, pill-popping, white-coat idolatry; kneel only to compassion and common sense.

VIII. Thou Shalt Stick With One Hospital (and Doctor) When possible

Old records may have key information like medication allergies and might help avoid needless repetition of tests or treatments. Exception to one-hospital rule: Very sick children should ideally go to a pediatric hospital or emergency room; Crushing chest pain or complicated heart disease warrants a trip to an ER with a chest pain unit and access to invasive cardiology; Severely injured people are best taken to a Level 1 trauma center.

IX. Thou Shalt Not Make Threats or Demands Toward Emergency Staff

Never mention the phrase “lawsuit.” Politely ask and inquire. Keep on top of care for yourself or a loved one. Do not demand and challenge or thou shalt be spurned and ostracized.

X. Avoid Emergency Room Visits for Problems That Have Been Present Three Days or Longer

These non-emergencies should be handled in a doctor’s office or urgent care center. Your doctor will hail an ambulance if your condition warrants the ER. Exception to 3-day rule: if symptoms dramatically worsen on or after that third day then an ER visit is appropriate.

Heed and obey these Ten Commandments or dare suffer the wrath of the emergency room!