Save the ER for a True Emergency
It will save you time and money

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BY BLUE RIDGE HEALTHCARE

FOR THE NEWS HERALD

Upper respiratory infections ranked in the top five reasons for Emergency Department visits in 2004 at Blue Ridge HealthCare’s Emergency Departments at Grace and Valdese Hospitals.

In a lot of these cases, patients could have visited their physician’s office to receive care that could be equally effective, less expensive and more convenient.

According to the National Center for Health Statistics, the average emergency room visit costs $1,049, while the average physician’s office visit cost around $153. Emergency room treatment for non-emergency medical conditions is a major contributor to the rising cost of health care.

“Because we’re here to primarily treat emergencies, we treat the sickest patients first and non-emergencies might have to wait longer,” said David Parker, RN, BSN, MBA, Director of Critical Care Services at Blue Ridge HealthCare. “That said, we will not turn you away. We want to take care of anyone who is sick.”

A true emergency can be your husband having chest pain lasting two minutes or more; your daughter being stung by a bee and suddenly finding it hard to breathe; or you are coughing or vomiting blood.

The emergency department is set up precisely to handle such emergencies. Open 24 hours 7 days a week, it has the equipment and staff to deal with the most serious life-threatening illnesses and injuries.

So it stands to reason that an emergency room is expensive to run.

The law requires that an ER deliver services regardless of whether a patient has health insurance or the money to pay. As a result, many emergency departments serve as safety nets for those who otherwise have no access to health care.

During the 1970s and 1980s, many families got into the habit of using the emergency room for relatively routine matters such as a child’s earache or runny nose. Some insurance plans paid for these ER visits without question, even if physician’s visits were not covered under the plan. During the 1990s, the health care insurance system tried to reverse those incentives, and today you may end up paying more for the visit.

A concerned consumer can help by using the ER for emergencies rather than convenience.

Don’t Think Twice about These

Emergency medical staff know their ABCs - Airways, Breathing and Circulation. The logic is simple: the human body doesn’t survive long without a constant supply of oxygen to every organ, and this requires unobstructed inhalation of air and circulation of blood.

A morsel of food or other object blocking the airways is an obvious emergency. Sudden breathing difficulty can also occur as a result of an allergic reaction to peanuts, an insect sting or medications. Or it can be a sign of a heart attack or a blood clot in the lungs.

Chest pain is a well-recognized sign of a heart attack. It’s a feeling of pressure, crushing, squeezing or tightness in the middle of the chest caused by inadequate blood flow through the coronary arteries. The heart muscle is crying for oxygen, and the obstructed blood vessels are unable to deliver it fast enough.

A stroke is also caused by a breakdown in circulation - in this case to the brain. Rather than pain, symptoms are likely to include confusion, disorientation, sudden memory loss, numbness, partial or complete loss of vision or an inability to handle simple tasks such as speaking or walking.

A less common type of stroke is caused by a hemorrhage or bleeding in the brain; the symptoms are similar although usually more severe.

“Even a bad headache is usually not reason to head for the emergency room,” Parker said. “But a headache unlike one you’ve ever had before or one accompanied by drowsiness, confusion, loss of sensation or muscle strength, nausea, vomiting or unusual sensitivity to bright light should prompt a call to 911.”

Vomiting, seldom a cause for concern, becomes an emergency if it produces blood or dark-colored material like coffee grounds - a sign of bleeding in the stomach or upper bowel. Vomiting accompanied by severe abdominal pain could be caused by appendicitis, an inflamed gall bladder or a perforated or obstructed bowel - all emergency conditions.

Purple spots on the skin along with a temperature higher than 100 degrees could be a sign of meningitis, especially if it’s accompanied by a headache, sensitivity to bright light or pain when the head is leaned forward.

A blow hard enough to cause loss of consciousness or a suspected bone fracture is reason to visit the emergency room or at least an urgent care center, if one is available.

Also requiring emergency or urgent care treatment are gaping wounds or bleeding that cannot be stopped after 15 minutes of direct pressure.

Emergency burns are those that extend through all layers of skin and look white or charred or those that cover an area of the body roughly equal to four hand prints.

Non-Urgent Visits

Unfortunately, more than half of emergency room visits are not for life-threatening illnesses or injuries but for minor medical problems that could be handled more cost efficiently in a doctor’s office or urgent care center.

These include sore throats, colds, ear aches, minor cuts and burns and painful muscle strains. A child who develops a moderately high fever but no other symptoms usually does not need an emergency room visit.

“If you have questions about whether a problem requires emergency treatment, call your primary care physician, who is best able to give advice and follow up care based on your personal health history,” Parker said. “When there’s a possibility that you may be having a stroke, heart attack or other life threatening emergency, you should, of course, never waste time making a decision.”

Unnecessary emergency room visits add $5 billion to $7 billion to national health care costs each year, according to one study.


The second largest employer in Burke County, Blue Ridge HealthCare serves a four-county area and includes Grace and Valdese hospitals, Blue Ridge Home HealthCare, Grace Heights and College Pines Health & Rehabilitation Centers, Grace Ridge Retirement Community, Phifer Wellness Center and a number of physician practices.