Emergency Doctor Explains When to Go to the ER [Dr. Adrian Dreessen]

I'm Dr. Adrian Dreessen. I've been an emergency physician practicing for just over 21 years, and I'm an emergency doctor here at Brookings Health.

What conditions are best handled in the emergency room?

Anything that's on more what we call the acute side, meaning, you know, onset of acute symptoms that happen quickly within, you know, minutes to hours are probably the most important things, whether it be chest pain, shortness of breath. The problem is that we've all seen patients that have minimal things upfront that have something terrible and also have seen patients who have horrible symptoms but have all normal tests. But I think if you feel like there is something worrisome going on, I think you should be evaluated.

When should someone consider urgent care?

There are situations where patients have more minor symptoms and, you know, even though, to the patient, it may feel like, "Oh, my gosh, this sore throat is the worst thing I've ever had," but if you're swallowing okay, you're not having difficulty breathing, you may have time to then either make an appointment with your doctor at the next day clinic appointment or next time the clinic's open, or we have options in town of urgent care. The hard part about that, of course, they're not open 24/7 like the emergency and so the timeframe sometimes doesn't fit into people's schedules. For advice, I think you can always call your doctor on call if you have one or whoever's on call for that provider that potentially can talk to somebody. And then health insurance often has their own nurse advice line or some form of that that maybe could offer some insight.

When should someone dial 911?

That unfortunately is also a judgement call. But I think there's clear things that, you know, somebody who's incapacitated, in so much pain, they can't move, if they're passed out and, you know, or unconscious and need immediate help. I think likely, like, seizures are an important one, and then traumatic injuries or also if you come upon an accident, I think it's always helpful to get the most experienced trained personnel around those sort of patients as quickly as possible.

What is the advantage of a nearby emergency department?

If somebody truly has a medical emergency, the quicker you can get to a trained person who knows what to do next, the better. The hard part, say stroke or heart attack, or trauma, if somebody chooses to drive farther away, if they become unconscious or something terrible happens, such as a respiratory arrest or a cardiac arrest, then you're stuck in a car with nobody to help at that point, and you'll probably be calling 911 at that point anyway. And so I think those are the most important reasons why.

Why are emergency departments important to rural communities?

Would you rather have an ambulance bring you 5 minutes away or 50 minutes away to get that care? Everybody likes to have care in their community as close to home with friends and family or people to help, kind of, take care of either what's happening home or what's happening at the bedside. I think the ability for us to take care of anything that comes in the door helps patients have peace of mind in our community that if something happens, we're here to help take care of them.