Thursday, December 08, 2005
Be prepared for medical emergencies with packed bag

By Dr. Anthony Policastro
Nanticoke Memorial Hospital,
Medical director

Some Emergency Department (ED) visits are not planned. Patients brought in from the scene of an accident do not anticipate going to an ED. However, most ED visits are planned in some way. A majority of ED patients come to the ED by car. Some drive themselves. Others are too sick to drive. Some patients call 911 for ambulance transport. There is planning time while waiting for an ambulance to arrive. The current issue of Money magazine created a checklist of items related to an ED visit. The primary focus of this magazine is saving money. However, poor health costs us money. Therefore, the checklist made sense from their standpoint. The first suggestion that they had was to create a bag of emergency items to keep at home. If you have this created ahead of time, all you need to do is take it with you. They call it a "Grab -N- Go Bag." This is a good idea for anyone to have. It is almost a necessity for someone who is sickly. It actually is something that we teach in the Pediatric Advanced Life Support Course (PALS). Those children with special care needs should always have one of these bags ready. Once you create the bag, you need to decide what to put in it. The most important thing to keep in it is a list of your current medications. The list should be kept updated. It should change whenever your medications change. It should include over-the-counter medications like vitamins or aspirin. It should include herbal remedies. When you go to an ED, they will likely prescribe medications. They need to know exactly what you are on. This will prevent bad interactions between the drugs. Those interactions could be with over-the-counter drugs or herbal remedies. For that reason everything needs to be included on the list. A second thing needs to be the contact number for your health insurance plan. All plans are different. Some require notification about ED visits within 72 hours. It is best to have that information with the other things you bring to the ED. Another set of items to include is a pen and paper. This will allow you to take notes of the things that happen. The goal is to have a list of procedures and medications when the bill comes. If your insurance company has questions about the bill, you will have the documentation you need to compare to that bill. For that same reason, make sure that you do receive a copy of the detailed bill.

There are other things that the article suggested that are part of the on-scene planning once you arrive in the ED. One of those is related to the fact that EDs see the sickest patients first. When you arrive, you go through a process called triage. Triage is the French word for "sort." This process allows the nurse to decide how quickly you should be seen for your illness. Triage is an ongoing thing. Other patients may come in after you with more severe illnesses. They will be seen before you. However, you may get sicker while you are waiting to be seen. It is important for you to tell that to the triage nurse. You may need to be seen sooner if you get sicker. While you are being seen, make sure that you pay attention to your own safety. Make certain that people who care for you wash their hands before they touch you. This includes the obvious people like physicians and nurses. It also includes people like X-ray technologist and lab personnel. When you receive a medication, make sure that your identification is rechecked. This will ensure that you are getting the correct medication. When you are ready to leave, make sure your discharge instructions are given to you in writing. Make sure you understand them. Ask questions if you do not. The instructions should include medications. They should tell you what to take. They should tell you how often to take it. They should tell you what route to take it. They should tell you what to do with the medications you are already on. The instructions should include details about follow up. They should include when to return to your family physician. They should include referrals to specialists. The referrals should include the specialist's name and phone number. They should include details about what kind of symptoms should prompt you to return to the ED. The last item has to do with after you leave. You should notify your family physician that you had an ED visit. If you were asked to return to your doctor, you should schedule a visit. If you were not asked to return to visit your doctor, you should ask the office if you should come in anyway. You should be able to tell the doctor about what tests were done. That will allow the doctor to get copies for office records. Money magazine certainly had a list of practical suggestions. It even had them in a checklist format to clip out of the magazine and put in your Grab N Go Bag. Your homework assignment for this week is to create your own Grab N Go Bag.