Is it an emergency or not?

HANCOCK – Nobody wants to wind up in the emergency room, but sometimes it’s obviously necessary. Then again, sometimes it’s necessary, but not so obvious. And then there are times it might be best to wait until morning for help from a family doctor, or seek help at an urgent care clinic.

The biggest mistake you can make in these situations, according to Portage Health Chief Medical Officer Dr. Mary Beth Hines, is trying to avoid the ER when you have symptoms of ailments that could threaten your life or lead to permanent disability.

Few people will stay away from the ER when they have broken a bone or serious blood loss, but many try to shrug off symptoms of heart attacks, strokes or serious respiratory ailments.

For each, “there are things we can do, but you must get in right away,” Hines said.

Each of these ailments, she said, has symptoms that should signal an immediate trip to the emergency room.

Stroke symptoms, Hines said, include not being able to move or feel some part of one’s body, or difficulty speaking. Time is critical to stroke treatment – how quickly you get treatment is crucial to long-term recovery, such as whether or not you’ll be able to walk for the rest of your life.

Trouble breathing can be caused by any number of reasons, with allergies just one example. But if a person stops breathing altogether they’ll probably die within minutes or suffer debilitating brain damage.

Chest pain is a key symptom of a heart attack – and one that’s commonly ignored.

“People tend to excuse it because they think it can come from heartburn, especially women because they don’t have as many classic heart attack symptoms,” Hines said.

But when it comes to the heart, “the longer you wait, the more damage you do,” Hines said. When someone gets to the ER quickly “we can get you medication, and if necessary we can get you to Marquette and open anything that’s blocked.”

In other situations, the emergency room isn’t the best option, Hines said. Fast care, urgent care, or express care clinics, all essentially the same thing, are good for coughs, colds, sore throats and some other less serious issues, and can also perform a limited number of urine and blood tests.

Hines said it can be a good idea to call ahead to see if a complaint falls within a clinic’s scope of practice.

A phone call can help you determine your best next step in other situations as well, she said. If you have a family doctor, there should usually be a doctor in their practice on call to deal with urgent questions. The Poison Control Center, (800)222-1222 in Michigan, can offer immediate remedies and tell you whether you should head for the ER.

For mental health complaints, call Dial Help at 482-HELP to talk to a compassionate person immediately and get a referral for counseling. At the ER, “we don’t really have available counseling for someone who’s not suicidal,” Hines said.

Generally, “I suggest not going to the internet,” she added. “There’s a lot of bad information out there.”

While some sites are generally reliable, such as webbed or the Mayo Clinic website, simply running a search on symptoms or a condition could lead to poor advice, she said.

When it comes to chronic conditions, medication refills or changes, or anything that could be considered regular treatment, a family doctor is the best bet, Hines said. The ER may supply enough of a crucial medication to last you until you can phone or see your regular doctor, but they won’t write a prescription.

“If you were out of town and ran out of insulin, we would get you a couple of days worth,” Hines explained. Otherwise, when it comes to medications, “you should be dealing with a family doctor who knows you,” she said.

Of course, not everyone has a family doctor, and “here, at 3 a.m., there’s no where else to go,” Hines acknowledged. She said federal law requires emergency rooms see every patient that comes in, regardless of ability to pay or perceived severity of symptoms.

The first stop at the ER will be a visit to a triage nurse, who will determine the severity of the situation, and with it, the order in which patients will receive treatment. Patients with less critical symptoms go to the back of the line, and could be facing a relatively long wait if the ER is busy, Hines said.

Generally, Hines said, common sense is the best guide on whether or not to go to the ER. “Ask ‘Can this wait until morning so see who knows me best?'” she said. “If not, that’s the time to go to the emergency department.”