Beyond the Emergency Room

Content brought to you by Henry Ford Health System

Chances are that your child will experience at least one visit to the emergency room. With changes to insurance coverage beginning this year, it's important to know when to visit the emergency room, and when to seek other options. An emergency visit may be expensive, time consuming and unnecessary.

The Emergency Room (ER) is the hospital department responsible for providing initial treatment to patients with a wide range of illnesses and injuries, some of which may be life-threatening and require immediate attention.

"The ER is a very expensive entity," says Zahid Sheikh, M.D., Henry Ford Health System Associate Medical Director, Acute Care Walk-In Clinics. In 2011, one in five people on average reported visiting the emergency department at least once in the past year, according to the Centers for Disease Control (CDC). Reported use was higher for children under 6 years of age at 24 percent, or one in four children, and slightly lower for children ages 6-17, with 16 percent reporting at least one visit in the prior year.

Unfortunately, not all visits to the ER are true emergencies. In 2009–2010, 10 percent of all visits by children and 8 percent of all visits by adults were classified as non-urgent.

Dr. Sheikh wants parents to know that there are other, less costly, yet highly effective, ways to receive medical care. For example, he points out that parents might use a same-day appointment with a primary care physician. The co-pay for urgent care or a visit to your physician's office is considerably less than the average $100 co-pay charged by insurance companies for an emergency room visit.  

Researchers have identified several non-emergency conditions including minor infections, strains, some fractures, and minor cuts that can be safely treated in settings other than the ER. Emergency room services are not appropriate for 1) conditions that have been present for a number of days and have not suddenly worsened, and 2) conditions that are neither life-threatening nor permanently damaging.

Walk-in clinics are one smart choice for seeing a health professional quickly instead of going to the ER.

"Physicians can accommodate patients in acute care settings and avoid an unnecessary ER visit," Dr. Sheikh says. He hopes that more doctors will educate their patients on how and when to use walk-in clinics instead of visiting the ER. Colds, sprains and mild cuts are easily treated in walk-in settings. "Of course, we would send more complex cases to the Emergency Room," he says.

Dr. Sheikh adds that Henry Ford also has a Nurse On-Call program, where parents can seek advice from experienced nurses by telephone. These nurses provide expert advice on managing a sick child and make recommendations for appropriate visits to the emergency room. Nurses consult with doctors and use established protocols when advising parents. "The nurse can give advice and let parents know what symptoms can wait until morning or whether to go to the ER," he says. "The idea is to take care of the patient, and not send them off to a crowded ER in the middle of the night."

A trip to the ER is necessary for severe symptoms, which occur suddenly and unexpectedly. The ER is the best place for immediate treatment of serious, life threatening conditions, such as severe broken bones, uncontrolled bleeding, large cuts, serious burns, poisoning, loss of consciousness, extreme difficulty breathing, and high fever in infants less than 6 months of age. 

Dr. Sheikh adds that a high fever in small children can often produce seizures. He notes that any child having a first time seizure should be taken to the ER.

To reach Henry Ford's Nurse On-Call or to make an appointment with a Henry Ford doctor, call 800-HENRYFORD (800-436-7936). Log on to henryford.com/howtogetcare for various care options.

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