UC HEALTH LINE: What You Should Know About Emergency Departments

CINCINNATI—Most people will visit an emergency department at some point in their lives, as a patient or in support of one. Although you can’t anticipate an emergency, there are some things that are helpful to know when you do visit an emergency department.

What Is an Emergency?

“If people feel they have a problem that needs to be fixed now, they should come and see us,” says John Deledda, MD, assistant professor and director of clinical operations for emergency medicine at the University of Cincinnati.

Common emergencies include:

• Severe chest pain with shortness of breath, sweating, nausea, vomiting, dizziness or a fast or irregular heartbeat

• Severe bleeding that doesn’t stop after applying 15 minutes of direct pressure

• Sudden or severe joint pain or swelling

• Fainting

• Choking

• Broken bones

• Swallowing poison

• Not being able to move or speak

• A gaping wound

“It’s a misconception that what we mostly see at University Hospital are violent injuries like gunshot wounds and stabbings,” says Arthur Pancioli, MD, associate professor and vice chair of emergency medicine. “In fact, our most common source of significant trauma is car accidents. In terms of total visits, we see a tremendous number of heart and respiratory problems, broken bones and sprains, and infections such as abscesses.”

Common nonemergencies include:

• Earache

• Cold symptoms

• Skin rash

• Muscle sprain

• Fever without convulsions or shaking

• Sunburn

• Minor burns

• Minor cuts if the bleeding is under control

“If these are symptoms you’ve had for a while, or you have simply run out of medication,” says Deledda, “it’s best to see your primary care doctor, who can provide long-term management.”

Managing Your Expectations

“We see nearly 80,000 patients a year in the emergency department at University Hospital. People know they can always come here and receive care regardless of the time of day or whether they have insurance,” says Deledda.

Medical dramas and ads for various medications and treatments may affect a patient’s expectation of care versus what really happens.

“A good example is that a patient who has a headache may expect to receive an MRI and treatment from a neurologist,” Deledda says. “Depending on the patient’s symptoms and condition, what may actually be needed is simply rest and medication to help relieve the headache.”

When patients arrive in the University Hospital emergency department, whether they walk in or come by ambulance, a triage nurse takes their vital signs and assesses their condition. The most critical patients are seen first.

“One thing that will never change in an emergency department is that we have to see the sickest patients first,” says Pancioli. “If someone comes in who is truly unstable and could possibly die, we have to focus on them, so patients with less serious symptoms, unfortunately, have to wait.”

To help decrease patient wait times, University Hospital has implemented an extended triage area. When a patient requires lab work or tests like X-rays for conditions such as a hand or ankle injury, nurses can save time by ordering the tests themselves before a physician sees the patient.

According to Deledda, patients who are diagnosed, treated and released spend an average of four to five hours in the department.

“People don’t realize that this is actually a quick turnaround. It’s not uncommon to spend up to 24 hours in the emergency department at some inner-city academic hospitals,” says Deledda.

What You Can Do to Help Physicians Provide the Best Care

“Tell us what medications you’re taking, and the doses, and the name of your primary care doctor,” Deledda says, “so we can collaborate to develop a better treatment plan.”