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Dublin: 5 °C Sunday 15 December, 2019

8 things to know if you need to go to the emergency department over Christmas

Or if one of your loved ones has a health emergency – you’ll be better off having read this.

Image: Unsplash

WHILE OTHERS ARE elsewhere eating turkey sandwiches, assembling toys and watching reruns of Home Alone, unfortunately some of us may have an unexpected health emergency.

In case those people might include you or one of your loved ones, we spoke to Dr Gerry McCarthy, Consultant in Emergency Medicine at Cork University Hospital, to find out how to ensure your visit is as efficient as possible.

According to the Health Service Executive, three-quarters of people get to go home after having tests or treatment in the emergency department. So here’s what you should know.

1. Take a picture of your prescriptions

If you are taking medication and can never remember the dosage or name of it, think about taking a picture of your prescription so you have it if a doctor asks, says Dr McCarthy:

The list of medications you’re taking is really important. Sometimes people would say, ‘I’m on a little white tablet’ and it’s hard to know which one it is. Increasingly elderly people are on a lot of medication, sometimes it’s very useful in that case.

The importance of this is two-fold:

Firstly, it can affect the medication that we give patients and secondly, it gives a clue as to their longtime diagnosis. Obviously don’t delay if it’s an emergency but even a picture of a recent prescription can do. We can find out ourselves but it will slow things down.

2. Try to keep your doctor’s letters safe (and your glasses)

rawpixel-com-472352 Source: Unsplash

Similarly, if you have an emergency and need to go to the ED it’s a good idea to bring any recent doctor’s letters relating to your condition:

If you do have a letter from your GP, that can take us a lot further down the diagnostic route. Sometimes patients will leave it in the car and while it’s not essential, it is a huge help.

Although you can obviously arrive in a bit of a fluster to the emergency department, do try to get someone to follow with your glasses or your hearing aid if you have left them behind, says Dr McCarthy:

When patients are already distressed, they can be even more frightened if they can’t see and can’t hear. For a small number of people who don’t speak English, try to bring a friend or family member who can translate. We can get an interpreter but it’s faster and reduces stress for them if they have someone to speak in their language.

3. Come in if your health takes a dramatic turn

Not entirely sure whether you need to go to hospital or just the GP? The answer often lies in how quickly your condition changed, says Dr McCarthy:

The kind of people who should come in are people who were quite well yesterday and feel very unwell today. If they have sudden severe chest or abdominal pains, or any sudden dramatic, negative change in health conditions, they should make their way to the Emergency Department.

What else needs immediate medical assistance? Any symptoms that are associated with heart attack or stroke, says Dr McCarthy:

People tend to know the symptoms of a stroke – things like face twisting, difficulty speaking and a loss of power in one arm or leg. These are time-critical conditions and the faster you get into us the better.

4. Hurt yourself? The emergency department might not be your best bet

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Obviously, if it’s an injury stemming from a car accident or where you are losing blood, do go to the emergency department – but for sprains and breaks think about going to an injury unit instead, says Dr McCarthy:

If it is something like you’ve fallen over and damaged your wrist, ankle or shoulder, they will be seen in the emergency department but the injury department can see them in less time. The one in North Cork handles 17,000 patients a year. We try to keep as much healthcare as local as it is safe to do so.

These units in areas like Loughlinstown, Ennis, Nenagh, Roscommon, Monaghan, Dundalk, Limerick, Cork, Smithfield/the Mater have been open for five or six years, which can take the pressure off Emergency Departments.

Each is linked to an emergency department hub so patients can be admitted there if needed. This doesn’t affect the number of patients on trolleys but it enables people to get the service they need closer to home in a lot less time. Emergency Departments always treat the sickest people first, so patients with less serious injuries tend to wait longer for treatment.

Find the injury unit closest to you here.

5. The flu generally doesn’t warrant the emergency department

Have a serious dose of the flu? Hospital is actually not the best source of help, says Dr McCarthy:

The most common thing in winter is flu-like viral illness and we can’t really help with that in hospital. HSE now has a number of resources like undertheweather.ie which contains information about self care, along with advice for pharmacist or GP services.

Obviously if you have collapsed as a result of it or are in a high-risk category (more of that below), do seek help from the emergency department but flu infections can put a lot of strain on hospitals, shares Dr McCarthy:

If someone does come in with the flu, we isolate them and there is only so many people we can do this for. In practice, it means we lose the function of the space in which we isolate them – in the emergency department, we can isolate a few but if there are 20 people you are looking at closing the department down if you can’t get a ward.

6. If you’re likely to be infectious, try to steer clear

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If you have a loved one in hospital and come down with a respiratory illness, gastroenteritis or flu, do them (and other vulnerable patients) a favour and delay your visit, warns Dr McCarthy:

Things like gastroenteritis are highly contagious and are caught by things like not washing your hands after using the toilet, while respiratory illnesses are spread by the person infected breathing out germs, so both can put patients at risk.

7. If you’re sick, keep as hydrated as you can

If you are suffering from a tummy bug like gastroenteritis, do take the proper precautions at home if you can, to avoid a visit to hospital (along with washing your hands properly to stop it spreading):

With gastroenteritis the main thing to do is rest and take loads of fluids and take some Dioralyte if you can. With diarrhoea and vomiting, you are losing minerals you would usually have so they’re very important to replace. You may collapse if you lose too much so it’s essential to keep up with your fluid intake.

8. But if you’re in a high-risk category… do take extra care

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McCarthy’s final advice is to take extra care if you are in a high-risk category, or have a loved one who is and gets quite sick over Christmas:

The very elderly tolerate infections less well than the young and fit, as do very young babies who can get a very high temperature and have difficulty letting people know how sick they are. So if you do have an infectious condition and can go to your pharmacist or doctor for advice, please do if you can rather than coming into hospital.

And the good news?

Most people are well able to shake off the bugs they pick up at Christmas.

Just like in previous years, our Emergency Departments (EDs) expect to see more patients attending this winter. Many of these patients will have complicated illnesses and complex care-needs. While this is likely to increase the waiting times, we can assure the public that all patients attending an ED will be seen and the sickest patients and those requiring urgent treatment will be prioritised. In the meantime, take a look at what you can do to keep common winter illnesses under control here.

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