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I know emergency physicians are trained to treat every type of medical emergency, including falls, cuts and sprains; heart attacks; strokes; and car accidents with multiple victims. They spend a lot of time treating complications and are well aware of what needs to be done to prevent emergencies.
I wondered what patterns they see in hospital emergency departments. Are there situations that the average person could take to prevent having to rush suddenly to the emergency room?
I turned to CNN wellness expert Dr. Leana Wen, who is a board-certified emergency physician and has seen everything I could think of in the ER — and more. She is an adjunct associate professor at George Washington University and was previously Baltimore’s health commissioner.
CNN: What are the most obvious ways to keep healthy and avoid seeing you in the ER?
Dr. Leana Wen: Go to your doctor every year for preventive care visits. Many people skip these visits because they feel well. They have the mistaken idea that they should go to the doctor only when they are sick.
That’s a bad idea. If you are ill, the doctor will, understandably, address that specific problem. There probably won’t be time to discuss prevention. Let’s say that you have a high fever and cough. The doctor may want to be sure you don’t have pneumonia or may test you for flu and Covid-19.
There may not be time to make sure you are up to date on vaccines and cancer screenings and discuss other issues that might not be bothering you but are still important to bring up.
Even if you got a clean bill of health last year and even if you feel totally fine, you should go. In fact, when you are feeling well is the best time to visit your provider for a preventive care visit.
You will also have your blood pressure checked, and your doctor may order additional tests to screen for diabetes, high cholesterol, anemia, hypothyroidism, sexually transmitted infections and other health conditions.
This is also a good time to bring up questions about sexual and reproductive health, sleep, nutrition and other aspects of your life. Making sure that you are in optimal health is the best way to avoid having to go to the ER when these undiagnosed and untreated problems present themselves.
And yes, it’s also a fine time to discuss any mental health concerns with your primary care provider. Stress and depression can have physical effects on the body, and your doctor is a good place to start asking for help.
CNN: What about people with chronic conditions?
Wen: My second piece of advice for keeping healthy is to be sure to treat high blood pressure, diabetes, high cholesterol and other chronic conditions. It’s natural for people to become complacent and forget to take care of their chronic medical problems. People may forget to take their blood pressure pills, for example. Or they may be told for years that they are developing diabetes and high cholesterol and they need to exercise more and eat better. But life becomes busy, and these things get pushed aside because they aren’t top of mind.
This is totally understandable, but it’s also a major problem. Take hypertension, which is often called the “silent killer” because people may have no symptoms even when their blood pressure is very high. Prolonged high blood pressure can damage blood vessels and the heart. Someone can have a heart attack or stroke as a result, which can have very serious complications including permanent disability and death.
It’s crucial for people to know if they develop chronic conditions and to treat them.
CNN: What if someone doesn’t have a primary care provider?
Wen: If you don’t have a primary care provider, you need one. Many people have insurance but just haven’t identified a primary care provider. Now is the time to make an appointment before you become ill. Those who are uninsured should look for community health centers in their area and establish a relationship. Local and state health departments could also be good resources to connect you to providers who can treat uninsured patients at low or no cost.
CNN: What are other advantages to having a primary care provider?
Wen: This brings me to my third piece of advice. Everyone should have a plan with their physician about where to seek care.
A lot of providers will have same-day visits, whether in person or virtual via telemedicine. Knowing how to access this care will save you time and money. If your provider doesn’t have this option, find out where you would go for what type of emergency. Does your provider have admitting privileges to a hospital? In which case, you might wish to go to that hospital’s ER if you got sick. Does your insurance differentiate between visits to urgent care or ER? If so, perhaps it’s more economical to visit urgent care for minor issues.
When you are feeling ill, you may not be in the best state of mind to decide where to go. Have a plan and make sure that family members know it, too.
CNN: What other steps can we take to avoid the ER?
Wen: My fourth recommendation is to lock up your medicines, including over-the-counter pills. This is especially important if you have children living with you or who may visit you. Every year in the US, there are approximately 35,000 ER visits due to unintentional medication overdoses among children under 5 years old. Over 90% of these visits are due to young kids getting into medicines without caregiver oversight. Locking your medicines up also keeps them away from people looking to steal your medications (such as narcotics).
People have long discussed locking up their liquor cabinet and firearms because these can pose dangers to others. These are best practices, as is locking up medicines — both prescription medications as well as over-the-counter treatments.
CNN: When should we to go to the ER?
Wen: This brings me to the fifth piece of advice, which is that people should go to the ER if they have symptoms of heart attack or stroke. If you have these symptoms, do not try to get a same day visit with your doctor. Do not go to urgent care. Call 911 and go straight to the ER.
Warning signs of a heart attack include chest pain, shortness of breath and sudden pain in the arm, back, neck or jaw. For stroke, remember the acronym BE FAST. B is for balance, or having trouble staying on your feet. E is for eyes — experiencing sudden vision problems like blurry vision or double vision. F is for face, or having facial droop. A is for arm — having one arm suddenly weaker than the other. S is for speech, or experiencing slurred speech. T is for time, which is noting the time the person was last seen as their “normal” self.
The goal is not to never go to the ER. There are very good reasons to seek care, and emergency providers are there to help if you need care. You shouldn’t delay going to the ER if you need it. But there are things you can do to reduce the likelihood of becoming severely ill and requiring emergency care.