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emergency department

Alternative Names
ED, emergency room, ER, casualty, A &E department

Definition
The emergency department (ED) or emergency room (ER) is where most people first receive care when they go to a hospital. It is the portion of the hospital that treats people experiencing an emergency.

What is the information for this topic?
People get to the ER by different methods. Many drive themselves or are driven by someone else. Some people arrive by ambulance or even helicopter.

After arriving at an ER, the person will be asked for personal information at the registration desk. The person is then evaluated by a triage nurse. This nurse decides whether the person needs to be taken right away into a treatment room, or if they can stay in the waiting room for awhile. People with conditions that are life threatening will be taken immediately into the ER. Hospital EDs are set up to handle trauma and life-threatening cases. They do not work on a first-come, first-served basis.

The triage nurse will ask what brings the person to the ER, and a medical history will be taken. It is very important to know what medications and dosages the person is presently taking. Vital signs will be taken, including temperature, heart rate, and blood pressure.

The person will be assigned a bed, and asked to change into a hospital gown. The doctor comes into the room at this time. Depending on the situation, blood may be drawn for testing and an intravenous or IV may be started. Both of these procedures involve sticking a needle through the skin and into a vein. Usually, a vein on the hand or forearm is used. Oxygen may be given by facemask or through the nose, if needed. The person may be attached to a monitor, which is used to get a heart tracing, called an ECG.

Initially, family members may not be allowed into the treatment area. Once a person is thought to be stable and has had initial treatment, family and friends can often visit. There may be a limit on the number of people allowed to visit at one time. This limit is meant to ensure that the ER doesn't get too crowded, and to protect the privacy of the other patients. A waiting period is normal in the ER and is not a sign that the staff there don't care about the person awaiting treatment.

It is important to be honest when answering questions. Embarrassing questions may be asked about sexual history, drug and alcohol use, menstruation, and other sensitive issues. These questions can help to determine the cause of an illness.

After the doctor finishes the history and examination, he or she may order further tests, such as X-ray studies. The test results can sometimes take several hours to come back. In the meantime, treatment will be given as needed. Once all the test results are back and any treatment has been given, the person is evaluated again.

A decision is then made on whether the person is well enough to go home or needs to be admitted into the hospital. If the situation is a life-threatening emergency, such as a heart attack, this process will occur very quickly. Otherwise, the process may take several hours. When a person is admitted to the hospital, their primary care physician will be called to assume care of the individual. If a person is going home, it is important that they follow all instructions from the doctors and nurses involved in their care.

Many EDs are now opening urgent care areas to deal with injuries and illnesses such as torn skin and sore throats. This may be separate from the main ER, allowing a person to be treated in a more timely fashion. Healthcare is best provided by a persons' general practitioner. In an emergency, however, the ER is always open.

Author: Adam Brochert, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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