Healthy Living

Preparing Ahead for Medical Emergencies

Emergency situations can catch you off guard. Here
are some tips on what you can do now to get ready.
Page 4
First aid courses offered by American Red Cross year round!
To learn more or sign up for classes, visit their website at
http://www.redcross.org/ma/boston/take-a-class
directly from the field to you
Between 1997 and 2007, ED
visits increased 37.8% (from
352.8 to 390.5 per 1000
persons). This is double what
would be expected with the
given population growth.
According to the CDC, only
13% of 114 million ED
visitors were considered non-
urgent.
The average wait time to see
a health professional in MA
is 37 minutes (up to 3 hours).
The average time patients
spend in the ER before being
sent home is 154 minutes.
ER Trends in the US
Should I Go to the
Emergency Room?
The arrival of summer brings along increase in outdoor activities,
which means there is an increase in accidents. When emergency
strikes, you know you need medical care fast. Going to the emergency
room (ER) has become a common trend in the United States. People
are choosing emergency care over urgent care or general physician
visits. It is important to know when to use the ER, call your primary
care physician (PCP), or find an alternative option.
ERs utilize triage, meaning patients are prioritized from most urgent
to least urgent. Patients who have life threatening injuries or illnesses
are treated first, while others who have minor injuries or illnesses have
to wait. About 30% of patients who go to the emergency room could
have gone to an urgent care center. It is important to make the right
choice for your own health and the safety of others. This issue of
Healthy Living will show you the many options available and help you
pick the one that best suits your needs.
Massachusetts General Hospital Summer 2014

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Alternatives to Emergency Care
Urgent Care Centers: UCCs are a good choice when your condition needs immediate attention
but is beyond the availability or scope of your PCP or not severe enough to warrant a trip to the
emergency room. Visit http://www.urgentcarecenter.org/ to find an accredited UCC near you.
Who you will see: Physicians, nurse practitioners, medical students.
Wait time: Walk-in appointments accepted and extended hour access for adults and children with
non-life threatening illness and injury. Most visits take about an hour.
Common reasons to visit: Minor injuries, minor fractures, lacerations, eye/ear infections, allergic
reactions
Additional services: Diagnostic and preventative services such as X-rays, lab work, vaccinations,
and physicals.
Insurance: Accepts most health insurance. Most insurers do not require patients to get a referral
from their doctor for urgent care.

Walk-in doctors office: This is a good choice for simple medical
care in a hurry.
Who you will see: Physicians
Wait time: No appointment necessary, not required to be
existing patient. More urgent cases will be prioritized.
Common reasons to visit: Mild asthma, minor allergic reactions,
infections, rashes, vomiting, diarrhea, insect and animal bites
Additional services: minor dressing changes, blood pressure
checks, pregnancy tests, TB testing, immunizations, lab tests
Insurance: Insurance accepted with lower co-pays than an ER

Convenient Care Clinics: CCCs are ideal for routine care. The
main focus is on convenience. They are located in drug store chains,
major retailers (Target, Wal-Mart) and even hospitals.
Who you will see: nurse practitioner, physicians assistant,
sometimes a physician.
Wait time: shorter wait times, weekend/evening hours, no appointments. Most consultations take
less than 15 minutes
Common reasons to visit: simple acute conditions like strep throat, ringworm, and bronchitis. For
chronic conditions, it is recommended to visit your PCP.
Additional services: Preventative care including blood tests and immunizations
Insurance: Accepts most health insurance. If you do not have health insurance, studies have shown
that the cost for basic care is lower than charges incurred at an urgent care center or ER.

Be sure to familiarize yourself with local options. Services offered at each location may vary. All three
options can refer you to an appropriate specialist if the situation warrants.

The MGH Medical Walk in Unit in
Boston offers urgent care services for
anyone unable to see their PCP, without
a PCP, or visiting Boston.

Wang Ambulatory Care Center
15 Parkman Street Boston, MA 02114
Phone: (617) 726-207
MGH Medical Walk-In Unit
Massachusetts General Hospital ~ Wang
Building on Left by Steven James

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Retail
Health
Clinic
Walk-In
Doctors
Office
Urgent
Care
Center

Emergency Room
Animal, Insect Bites

!
Heart attack symptoms:
sudden/severe chest and right arm
pain, pressure
Stroke symptoms: numbness on one
side of the body, lethargy, sudden
loss of vision
Loss of consciousness
Possible head-neck-back injury
Severe shortness of breath
High fever (above 102F)
Coughing up or vomiting blood
Profuse or continuous bleeding
Possible broken bones
Partial/total amputation of a limb
Poisoning (consult local Poison
Control center)
Injuries resulting from violence
(gunshot or stab wounds)
Major allergic reaction with or
without use of an Epi-Pen
Suicidal/ homicidal thoughts
Major complications of previously
diagnosed chronic illness or surgery
X-ray

!
Back Pain

! !
Mild Asthma

! !
Minor Headache

! !
Sprain, strain

! !
Nausea, vomiting,
diarrhea

! !
Bumps, cuts, scrapes ! ! !
Burning with
urination
! ! !
Cough, sore throat ! ! !
Ear or sinus pain ! ! !
Eye swelling,
irritation, pain
! ! !
Minor allergic
reaction
! ! !
Minor fever, colds ! ! !
Rash, minor bumps

! !
Vaccination ! ! !

MGHs Chelsea HealthCare Center provides personalized
primary care for people of all ages with extended hours and
on-care physician 24 hours a day. Many services are offered:
regular office visits, routine exams, and lab tests as well as
access to specialists in cardiology, geriatrics, mental health,
neurology, hematology, obstetrics/gynecology, occupational
health, oncology and rehabilitation medicine.
Hours of Operation: M-Th 8:30am 8:00pm | F 8:30am
5:00pm | Sat 8:30am noon
Chelsea HealthCare Center urgent care services offer high-
quality medical care for children and adults unable to see their
regular physician or who do not have a PCP. Patients are seen
on a first come, first serve basis for non-life threatening
illnesses and injuries and routine medical services.
Urgent care is open everyday from 8:00am 8:00pm except
Thanksgiving and Christmas.
Chelsea HealthCare Center
151 Everett Avenue
Chelsea, MA 02150
Phone: 617-884-8300
Chelsea HealthCare Center, Massachusetts General Hospital
This chart can be cut out and taped to your fridge for a quick reference. Emergency rooms are for
sudden and severe injuries or illnesses. If you are ever in doubt, call 911 or go to the nearest ER.

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How Prepare for an ER Visit
1
Be Prepared
Have a Primary Care Physician (PCP): Have
a doctor who keeps your medical history and
who is available to see you in an emergency.
Consider filing a consent form: If your child
has a medical emergency while you are out of
town or unreachable, a consent form will allow
doctors to get to work without having to deal
with a social worker or getting court approval
for medical assistance.
Check your insurance coverage: Make sure
you know which emergency services are
covered and what instructions you need to
follow in urgent situations. Some plans may
require that you notify them within a few hours
of being admitted or treatment may not be
covered.
Organize family medical information: It is a
very good idea to carry a card with the name
and number of your regular doctor, any
allergies or chronic medical ailments you may
have, any medications you may be taking with
the dosage, and whether or not you are
pregnant. This will save precious time when
doctors diagnose and treat your condition,
especially if you are unconscious.
Locate the best emergency rooms near your
home and work: Not all hospitals have
emergency care departments or are equipped to
handle every emergency situation. Talk with
your doctor about what to do and which ER
to go to before you're in a situation where
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you might need to visit one. The doctor
may direct you to an ER that's close to you
or one in a hospital where he or she
regularly sees patients.
First aid: Keep well-stocked medical kits
at home, work, and in the car. Make sure
you and your family knows basic first aid.
Contact your local Red Cross office for
courses and certifications in CPR and First
Aid for adults and children.
Recognize emergency warning signs:
Consider an ER visit if someones life is in
danger and they need immediate medical
or psychiatric care to avoid drastic
consequences.

When an Emergency Happens
Care for the patient first: First, call 911 or
your local emergency number and follow
the operators instructions. If trained in
CPR or First Aid, initiate after contacting
emergency services. Never leave the
patient unattended. Do not move a
traumatically injured or unconscious
patient unless in immediate danger or at
risk for further injury.
Children: Medical emergencies for
children differ from those of adults.
Children may not be able to communicate
their symptoms, so adults must pay close
attention to sick or injured children.
Always get medical attention if you suspect
your child is having a medical emergency.

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Call the ER: Notifying the ER that you are on
your way will cut down on waiting
time as the medical staff can prepare
for it. You will likely talk to a
triage nurse who will ask you for
symptoms of the person in
question and tell you if you need to
come in; whether to call Emergency
Medical Services (EMS); what
information you need to bring to
the hospital; and if another ER may
be a better option.
Alert your PCP: If possible, call
your primary care physician ahead
of time so they can order lab work
if needed or alert ER staff about
your condition.
Call a family member: If you have healthy
children accompanying you to the emergency
room, consider calling a relative to take care of
them during your stay. Hospitals are not only
scary for young children; the waiting rooms
contain bacteria and viruses of sick children
that have been treated earlier in the day.
Remain calm: Although it is difficult to remain
composed if you or a loved one has been
badly injured, a calm attitude can help
improve communication with the
doctors and nurses who are caring for
you.

What to Bring
A list of medications and
allergies: What's the name of the
medication you are taking? How often
do you take it and for how long?
Even vitamins can interact with
certain treatments. A list of
allergies is important, especially if there
are many of them. Be sure to include
4
medications, foods, insects or any other
product that may cause an allergic
reaction.
Your medical history: A list of chronic
illnesses, invasive procedures, the date of
operation, and the name of the physician
or surgeon who treated you can be very
useful.
Your immunizations: This will likely be
a long list for children; for adults, this
mainly consists of tetanus, flu and
Hepatitis B.
Comfort items: You also may want to
bring something to read and money for
snacks or a soft drink. Try to remain calm
so you are better able to communicate
with the doctors and nurses who are there
to care for you or a loved one.
Overnight items: If you think there is
chance of being admitted into hospital
overnight, you might want to grab a
change of clothes and toothbrush.

Waiting in the ER
Pay attention to any changes: There can
be long waits in the ER but be sure to
alert a nurse of doctor of any changes in
your condition.
Food and drink: First, ask the
medical staff if it is okay to eat or drink
anything. In some situations, your doctor
may prefer if nothing is ingested for an
amount of time, or need you to ingest
something specific.
Write down important information: An
ER can be scary and stressful so
important details can sometimes be hard
to remember. Take note of the names of
doctors, the diagnosis, medications or
treatments administered, and instructions
for follow up or care at home.
(continued)


References
1
About Urgent Care. (n.d.). Urgent Care Association of America. Retrieved on June 15, 2014 from,
http://www.ucaoa.org/patients_about.php
Alternatives to Emergency Room Care. (n.d.). Alternatives to Emergency Room Care. Retrieved June 12,
2014, from, http://www.bcbs.com/why-bcbs/immediate-medical-care/alternatives-to-emergency.html
Before You Go to the Emergency Room, Read This. (n.d.). Health Topics The Voice of the Health Care
Consumer RSS. Retrieved June 12, 2014, from, http://www.editorsweb.org/wellness/emergency-
room.htm
Chelsea HealthCare Center [Photograph]. (N.d.) Retrieved June 15, 2014, from:
http://www.massgeneral.org/chelsea/
Chelsea HealthCare Center. (n.d.). Chelsea HealthCare Center. Retrieved June 14, 2014, from,
http://www.massgeneral.org/chelsea
Durani, Y. (2011, May 1). Going to the Emergency Room. The Nemours Foundtaion. Retrieved June 15,
2014, from http://kidshealth.org/parent/general/aches/emergency_room.html

Groeger, Lena, Mike Tigas, and Sisi Wei. (2013, December 19). ER Wait Watcher. ProPublica. Retrieved
June 12, 2014, from, http://projects.propublica.org/emergency

James, Steven (Photographer). (2010). Massachusetts General Hospital ~ Wang Building on Left (Photograph).
Retrieved June 15, 2014, from: http://www.panoramio.com/photo/43422334
Kowalczyk, Liz. (14 February 2014). Urgent Care Centers in Mass. Fill a Gap. Boston Globe. Retrieved
June 15, 2014 from, http://www.bostonglobe.com/lifestyle/health-wellness/2014/02/17/urgent-care-
centers-expanding-mass-after-insurers-lift-restrictions/3iBZSOA4lKpdZ5uTto66pN/story.html
Retail Clinics: What's in Store for Health Care. (n.d.). Center for Advancing Health. Retrieved June 15, 2014,
from, http://www.cfah.org/prepared-patient/prepared-patient-articles/retail-clinics-whats-in-store-for-
health-care
Retail Health Care Clinics. (n.d.). The RAND Corporation. Retrieved June 14, 2014 from,
http://www.rand.org/topics/retail-health-care-clinics.html
Should You Go to the Emergency Room or Urgent Care?. (2012, June 12). Scripps Health. Retrieved June
15, 2014, from http://www.scripps.org/news_items/4231-should-you-go-to-the-emergency-room-or-
urgent-care
Urgent Care Center. (n.d.). Urgent Care Center. Retrieved on June 14, 2014 from,
http://www.urgentcarecenter.org/
Urgent Care. (n.d.). Massachusetts General Hospital. Retrieved June 14, 2014 from,
<http://www.massgeneral.org/appointments/walkinunit/>.
Walk-In Clinic vs. Emergency Room. (n.d.). The Everett Clinic. Retrieved June 15, 2014 from,
http://www.everettclinic.com/Walk_In_Clinic/when-to-use-walk-in-clinic.ashx?p=4425>
When Should I Go to the Emergency Department?. (n.d.). American College of Emergency Physicians.
Retrieved June 15, 2014 from,
http://www.emergencycareforyou.org/yourhealth/aboutemergencies/default.aspx?id=26018


2
When Should I Go to the Emergency Room? (n.d.). University of Colorado. Retrieved June 12, 2014 from,
https://www.uchealth.org/Pages/Services/Emergency-Services/When-Should-I-Go-to-the-Emergency-
Room.aspx
When to go to the ER. (n.d.). Californians for Patient Care. Retrieved June 12, 2014, from,
http://www.calpatientcare.org/post/when-go-er
When to Use the Emergency Room. (n.d.). U.S National Library of Medicine. Retrieved June 12, 2014
from, http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000594.htm
When Should You Go to the ER?. (n.d.). St. Marys Medical Center-West Palm Beach, FL. Retrieved June
16, 2014, from http://www.stmarysmc.com/en-
us/ourservices/medicalservices/pages/whenshouldyougototheer.aspx
























3
Reflection
My original topic started off with exploring triage. I explored how it functioned in emergency rooms its
efficiency, and how it affected patient care. The biggest complaint from patients is waiting time. Research
suggests emergency room overcrowding is in part due to misuse of the ER. The public is not aware of the
many options available for urgent medical attention and that the emergency room is dedicated to life
threatening conditions. Patients - often uninsured or lacking adequate access to primary-care services -
end up there for non-urgent care or for serious conditions that could have been prevented or treated
elsewhere in quicker times. For hospitals, overcrowding can cause in ambulance diversions resulting
delayed care and poorer health outcomes, even death, for patients in emergency situations.
The purpose of this medical newsletter is to draw attention to the various forms of care available for
people in need of medical care as well as highlighting important points to remember in emergency
situations. It is in a persons best interest to receive healthcare as quickly and efficiently as possible.
Going to an emergency room for a sprain or minor allergic reaction will only result in a longer wait time
for the patient and possible deterioration of his/her condition.
This newsletter is designed to be family friendly. I used brightly colored headers and footers to catch
peoples attention. The first page used various graphics and formats to draw readers in. The idea behind
Healthy Living is that medical professionals will write to the readers. As such, the content and vocabulary
is tailored for the general public. It will be distributed in print form all over Massachusetts General
Hospital, particularly in waiting areas. In addition, it will be posted online and available for the public to
read.
I find that myself skimming articles when I am looking for specific details, often using photos or other
graphics that may stand out on the page to find my place. This was my goal when designing the
newsletter. In the section entitled Alternatives to Emergency Care I chose to bold certain phrases such
as Urgent Care Centers and immediate attention to create a connection between them. I also chose to
place a description of the MGH Medical Walk in Unit next to the description of walk-in doctors office
because this example of alternative urgent care is the least well known. Providing an example can help
clear up the differences between a UCC and a walk-in office for those who may want more information.
Though there is a lot of text, the information I chose to keep is very important to families. Large blocks of
text are broke up with pictures, different colored fonts, and bullet points. By keeping the Alternatives to
Emergency Care section uniform, readers know where to look for specific information, such as
insurance, when reading through the article. The chart on page 4 was designed to allow for quick
scanning. If printed, this portion could be torn out for future reference. This way, readers would be able
to physically take away the main point. In How to Prepare for an ER Visit, I summarized each of my
points with a short phrase. Again, from my own experience, I find bolded words or summaries helpful
when trying to recall details.
Note: I would definitely like to include this in my professional portfolio.