Crash Course: Caregiving in the Emergency Department

Here's the quick and dirty for those who’ve only got a few minutes in the midst of a crisis.

Your loved one has just been taken to the emergency department (ED) at a nearby hospital. Here are your first steps:

1. Allow time for the transfer of your loved one to the hospital and initial admission to the emergency department.
2. Call the hospital and ask to be transferred to the ED to talk to a nurse (better yet, show up at the hospital).
3. Report conditions your loved one may have if the care team doesn’t have access to the records or hasn’t read them.
4. Inform them of any medications your loved one takes, including dosage and frequency.
5. Ask for a summary of your loved one’s vitals and what assessments they are doing.
6. Request that they call you once their assessment is complete or when your loved one is discharged from the ED, admitted to the hospital, or transferred to another hospital.

Emergency Department.

Source: Pixabay/Pexels

Unpacking the Steps

If an ambulance arrives at your loved one’s home after a call to emergency services, the first responders will have a few questions.

They’ll want to know what event(s) preceded the call as well as any health conditions that are present. They’ll ask for a list of medications (keeping a printed list handy is helpful because you may not remember under stress). They’ll ask if your loved one takes blood thinners. They’ll ask if they’re diabetic.

They’ll check blood pressure, oxygen saturation levels, and blood sugar. They’ll ask if they’ve taken their medications that day. (You may know or you may not. And they may or may not have taken the medications correctly. Accidental overdoses and confusion do happen.)

The paramedics may ask your loved one what year it is, where they are, or who the president is. Don’t answer for them, even if you want to be helpful.

Before they leave with your loved one, they’ll tell you to which hospital they’re taking them. If you’re in a city, there may be more hospitals so getting this detail is key.

If you’re in a more rural area, they likely will be mandated to take them to the nearest hospital, not necessarily the one best suited for complex needs. Once they’ve done an assessment there, they may transfer them by ambulance—land or air—to a bigger and better-equipped hospital.

This knowledge may be useful later. If you know your loved one’s needs well, you may choose to call the ambulance for help transferring your loved one to your own car and taking them to the better-equipped hospital yourself in order to avoid losing time on an additional assessment. (At least that’s what I did on two occasions.)

It takes time to transfer someone to an emergency department. If you are able to get there separately, then you can advocate for your loved one in person.

If not, you can also call to speak with a nurse in the emergency department. Be ready to share critical information with them and know what kind of updates you would like.

Do not assume they know your loved one’s conditions or medications, even if you gave the information to the paramedics. Information can get lost at each transfer, whether it’s from the first responders to the emergency department, the emergency department to the hospital, the night shift to the morning shift, and so on. Even accessing health data through shared medical records can be cumbersome. Never assume the care team has as much information as you do.

The emergency department will need your name and number on file to share information. They may not be able to share information if your loved one has not signed a consent to release health data or prepared a health care directive with you named. When feasible, have these forms signed at their main clinics and hospitals before a crisis occurs, so advocacy can be seamless.

Now, take a deep breath and drink a tall glass of water while the professional care team does their assessment of your loved one.