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What to Expect in the ER

As an emergency room doctor, I know that an ER visit can be a scary experience—you don’t feel well, waits can be long and you’re worried about yourself or a loved one. Even worse, it can be confusing; you don’t understand the process and why things happen the way they do. I'll take you behind the scenes and share some of the inner workings of the ER—and answer some of your most common questions.

I was here before that other patient. Why is she being seen before me? I know it can be frustrating to wait and then see someone who arrived after you go ahead. Emergency rooms operate on a triage basis, which classifies patients by how quickly they need to be seen. Someone who is having heart attack, or who arrives with a crushed chest or severed extremity, clearly needs immediate attention. A patient with a sore throat needs medical care, but it’s less urgent. Most people fall somewhere in between. Bottom line: patients are seen in the order of their triage level.

What if I could be getting worse while I’m waiting and no one is paying attention? This is another frequent concern—but know that we haven’t forgotten you. Your wait time is a combination of how busy the ER is and your triage level. Hospitals all have protocols for how often a patient is re-evaluated (even in the waiting room). At some Emergency Departments, we’ll even draw labs and order x-rays for patients as they wait—and we'll be monitoring the results along the way. That said, if you think you’re getting worse, let the ER staff know. You may need to move up the triage ladder.

How long will my tests take? Every hospital is different (and every day is different). Processes that take might 15 to 30 minutes one day can take hours when the waiting room is crowded. Still, here are some averages:

  • Lab results: 45 to 90 minutes after the blood is drawn
  • X-ray: Once the x-ray is completed, 45 to 60 minutes for the radiologist to read the x-ray and add the results to the computer record
  • CT scan: Once the CT is completed, one to two hours for the radiologist to read it and add the results to the computer record

How long will it take for the doctor to share the results with me? It depends. First the doctor has to get the results (waiting as you are), and then needs time to review them. Speaking from my own experience, sometimes I’ll want to consult with another physician, either in person or by phone. I try to do this before coming to discuss the full plan with you. Because of these variables, it’s not as easy to provide an average wait time.

Can I eat while I’m waiting? No! I wish I could make a sign as big as the ER for this. Skip the vending machine. If you’re at home and anticipate a possible ER visit, don’t eat or drink anything. I’ve had so many patients significantly delay their care by doing this. Many procedures (from surgeries to fracture reductions to fixing a bad cut in a child) require us to give patients sedating medications. Since these medications can increase the risk of vomiting and choking, we can’t safely do these procedures on a patient who has had any food or drink in the last few hours. Don’t put anything in your stomach until you have explicit permission from the ER doctor.

Who are all these people?  Emergency rooms are staffed with many employees with different roles. I know it can be confusing to know who’s doing what. Doctors don’t always wear white coats. Other staff members, such as nurses, techs, physician assistants and registration staff, wear various uniforms. How are you to know? Really, the only way is to ask. If you ask and forget, it’s okay to ask again. It's your health and you have a right to know. That's what being a smart patient is all about.

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