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Healthy Living Blog

Behind the Scenes of the Emergency Department

March 25, 2019 | John Winter, BSN, RN


Most people will experience visiting the emergency room at least once in their lives. While none of us plan to visit an ER, it’s helpful to understand when to go to the ER and how it works.

How the emergency room works
Since the ER serves a variety of patients not always with urgent conditions, it does not operate on a first-come first-served basis. Patients are seen based on the severity of injury or illness. In fact, the ER is divided into two areas to provide the appropriate level of resources for the patient’s condition: The main side is for more serious or life-threatening conditions, and the split flow area is used for simpler procedures such as suturing, splint placement or minor illness.
When patients arrive at the ER, there is a general process they usually go through.

Here is an overview:

  • Registration staff obtains information necessary to check the patient in. This includes basic information about their condition to help determine the severity of their condition and how soon they need to be seen.
  • A triage nurse gathers in-depth information including vital signs, more information about their specific complaint, and medical history. They assign a level of severity based on a five-tier triage system so each patient receives the best care possible based on his/her unique situation.
  • Depending on the patient’s condition, she/he may be taken back quickly to a room or have to wait a bit longer in the waiting room.

How long will I be there?
Patients often get frustrated when they are in the ER for a long time. Several factors can contribute to this, including the types of tests and procedures required for treatment, and the volume of patients and the severity of their conditions, including those arriving via ambulance. Our top priority is to treat the most critically ill patients first, but to see all patients as quickly as possible.

When to go to the ER
When you’re sick or injured, you often have to decide quickly whether or not to visit the ER. If you are considering going, you probably should. If it’s a serious emergency, don’t hesitate to call 9-1-1.

Here are some reasons you should go to an ER:

  • Difficult breathing or shortness of breath
  • Serious head, neck, or back injury
  • Broken bones
  • Chest pain or pressure
  • Severe bleeding or burns
  • Poisoning or overdose
  • Sudden blurred vision
  • Coughing or vomiting blood
  • Severe abdominal pain
  • Sudden dizziness, weakness or loss of consciousness, coordination, or balance
  • Numbness in face, arm or leg
  • Sudden severe headache
  • High fever
  • Pregnancy complications
  • Flu symptoms that include difficulty breathing, shortness of breath, chest pain or severe abdominal pain, confusion, sudden dizziness, severe vomiting or vomiting that won’t stop, dehydration

ER visits are usually costlier than office visits and can take more time. So when it’s not an emergency but an urgent need, check to see if your primary care provider can work you in or advise if you should go to the ER. If your regular physician is not available, or on evenings and weekends, you can go to Convenient Care for minor illness and injury as well. The emergency room is open 24/7 and we are more than happy to help.

John Winter, BSN, RN, is the emergency department manager at Fisher-Titus. Fisher-Titus is a Level 3 trauma center, has a trauma partnership with MetroHealth in Cleveland, and is a Primary Stroke Center.