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ER Visit Leaves Many Confused

New research shows most don't understand what was done or what they now need to do

FRIDAY, July 25, 2008 (HealthDay News) -- If you've made a sudden trip to the emergency room and are now heading home, take a moment to think about something besides all that poking and prodding: Are you sure you know what just happened and what comes next?

There are approximately 115 million people who visit ERs annually in the United States, statistics suggest. But new research finds that more than 75 percent of emergency room patients leave the hospital not knowing what's wrong with them or what they should do about it.

While it's not clear why patients are missing important details about their health, the chaotic nature of emergency rooms could have something to do with it, said the study's lead author, Dr. Kirsten Engel, a former University of Michigan emergency medicine fellow who now teaches at Northwestern University.

"It's a difficult, loud, confusing place, and there's a lot of activity going on," Engel said. "It's also a place where people by necessity come in during situations where they're not feeling well, they're anxious and upset."

In 2003 and 2004, researchers from the University of Michigan and Northwestern University interviewed 140 emergency room patients in two Michigan hospitals. The study findings were expected to be published in an upcoming issue of Annals of Emergency Medicine and were released online ahead of print.

The researchers asked the patients about four subjects: their diagnosis, their care in the ER, what would happen next, and when they should return. Then the researchers compared the answers to information in the patients' charts.

Seventy-eight percent of the patients gave incorrect information, and more than half got something wrong in at least two of the four subject areas. More than a third misunderstood what their post-ER care entailed.

Meanwhile, only 20 percent of patients who had incorrect information believed they might not be clear on things.

The study didn't look at why the gaps exist or how they might affect health.

Doctors may be part of the problem, Engel said. "We are pressured by many other issues, and that leads us at times to not necessarily review the information in ways that the patient can understand or we present it in a way that's too rapid at the wrong time for a patient," he said.

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Surviving the ER

Dr. Valerie Norton, an emergency department physician at Scripps Mercy Hospital in San Diego, has tips on how to get through an ER visit:

Bring your medications with you in a bag or write them down.

"It's usually the more healthy people who don't use the ER who don't think of it this," she said.

"A lot of times you'll end up getting prescribed a medication, and it's important that it not duplicate medications you're already on or interact badly with them."

Ask questions.

"It's really important to just be an informed consumer. You should speak up and say, 'What did my tests show, and what did my X-ray show?' "

Consider asking for copies of your lab results and doctor's notes.

"If you want that information to take it back to your doctor, you can say, 'Can I have a printout of my results? Can I have a copy of the notes the doctor wrote?' "

Bring a family member or a friend along.

"A lot of times, they're able to pay better attention. It's really hard to concentrate on what people are telling you. That's where your family member or friend can be your proxy, making sure you're understanding everything that's going on."

SOURCES: Kirsten Engel, M.D., clinical instructor in emergency medicine, Northwestern University, Chicago; Valerie Norton, M.D., emergency department physician, Scripps Mercy Hospital, San Diego; early online release, Annals of Emergency Medicine
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