At Hendricks Regional Health, we understand that illness, injury or medical emergencies can happen any day at any time.
That’s why we offer a full-service emergency department as well as two convenient immediate care centers with extended weekday and weekend hours.
When you or your loved one is injured, how do you determine whether to use the ER or the immediate care center.
David Farman, MD, Emergency Medicine Physician at Hendricks Regional Health, is here to help you decide which service is best for your emergency.
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When To Go To The ER
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Learn more about David B. Farman, MD
David B. Farman, MD
David B. Farman, MD, is an Emergency Medicine Physician at Hendricks Regional Health.Learn more about David B. Farman, MD
Transcription:
When To Go To The ER
Melanie Cole (Host): Illness, injury or medical emergencies can happen any day at any time and that’s why Hendricks Regional Health offers a full service emergency department as well as two convenient immediate care centers with extended weekday and weekend hours. My guest today is Dr. David Farman. He is an Emergency Room Physician with Hendricks Regional Health. Welcome to the show, Dr. Farman. How does somebody know whether they should go to an urgent care, call their doctor, or rush off to the emergency room?
Dr. David Farman (Guest): That’s a great question and thanks for asking. There’s a lot of overlap between those three sections of healthcare delivery – between the urgency care, the primary care physician and the emergency department. Sometimes it’s difficult to know where someone should actually end up. I think that there are some good rules of thumb that you can take. One is if it’s significantly after hours and you know your primary care office will be closed, you can certainly look at the urgent care calendar if it’s a minor complaint. But, if it’s one in the morning, there aren’t very many places that are open other than the emergency department. If you’ve got a significant concern and it is one or two in the morning come on in and see me. I just work nights. If you are on the fence and it’s during the day about what your symptoms might be – if it’s something that you’ve had before in the past and it is more of an ongoing issue, certainly I would call the primary care provider first. You have to use your own good judgement on this. If it’s something that you feel is a little bit more minor – something like an upper respiratory tract infection, or perhaps a sprained ankle – certainly, an urgent care would be an appropriate place to seek care. The emergency department is a fantastic place that has the capabilities of taking care of all sorts of critical illness. Certainly, we can take care of the more minor things as well but if you’re having significant chest pain, belly pain, or have a significant injury, we’re probably the place for you.
Melanie: Let’s discuss that. What do you tell patients about the differences? What should they symptom-wise be aware of that would send them right to the emergency room as opposed to seeking out urgent care or calling their doctor first?
Dr. Farman: It is a challenge. There are actually researchers who have looked at this. When people have looked at utilization of the emergency department, what they find is that a lot of the things that come in through their front door at first blush that could very well be a significant emergency. It’s not until after testing has been done do we discover that, in fact, it is something that the patient can probably go home with – whether that be chest pain or belly pain. If you are having chest pain and you have a strong family history of heart disease or if you are someone who has had a history of heart attacks or coronary artery disease before in the past, then certainly the emergency department is the place for you. If you go to the urgent care, I bet they’ll be sending you right over to the E.R. if you have a history such as that. If you’re having significant shortness of breath, I would say that is almost always something that should drive you to the emergency department because that can be a very significant complaint or symptom. If you are losing consciousness or have had an episode where you actually have lost consciousness, hopefully your family, or if you regain consciousness, you yourself would find a way over to see us at the E.R., too. Those are some of the three big ones that I’d say are very rarely treated appropriately at the urgent care or the primary care office.
Melanie: What’s the difference between the urgent care and the emergency room?
Dr. Farman: The emergency department is staffed by folks who are board certified and board trained in emergency medicine which is a specialty in and of itself. What that requires is additional training after medical school in critical procedures and in taking care of the critical patient. In the emergency department, we are driven by an interest in taking care of the critically ill patient. That is something that we do very well. For things that are more chronic in nature, we, frankly, are probably not the best trained to take care of those. Sometimes that is the primary care provider who is the most well-versed in taking care of those. If you come to the emergency department with something that has been going on for some time or has been managed elsewhere, we just may not just be the ones who are as well- versed in the management of those chronic issues. The emergency department also is a building that is attached to the hospital. If you get admitted to the hospital, you have lots of capabilities for fancier imaging, fancier testing than you would have at an urgent care. So, things like CT scans, labs, respiratory therapy--all those things are available in the emergency department. They may not be available at an urgent care.
Melanie: Dr. Farman, parents – you know we’re all kind of nuts – we want to call 9-1-1; we don’t want to ever call 9-1-1. What should we know about emergency rooms and our children? When is it time to call 9-1-1 or when is it time to take our children to the emergency? Parents--maybe if a child is vomiting--worry that’s a time. What do you want parents to know about bringing their children in?
Dr. Farman: First off, I’d say that we’re always open and we’re always available. I tell parents that come into the emergency department that very thing. Sometimes it’s hard to know whether your child is sick and needs to be admitted to the hospital. Being a parent myself, I’ve certainly been in those same situations where you’re looking at your child and you’re wondering, “Oh, is now the time that we go or is now not the time?” It’s a challenging situation. It’s always okay to bring your child in and we’re always happy to take a look. A couple of things that I want to discuss would be fever fear. I would say most emergency room physicians would say that there’s not a number when it comes to a temperature that is necessarily worrisome. There are some that would get our attention but it’s not the height of the fever as much as it is the appearance of the child. Oftentimes, a viral illness can cause a temperature up to 104 or 105 degrees but if the child is running around smiling and playing, I wouldn’t worry as much about the temperature as I would about the countenance of the child. Secondly, when it comes to something like vomiting and diarrhea, you’re more likely to get dehydrated from diarrhea then you are from vomiting. Oftentimes, these things do run their course on their own and pushing just little sips of fluid at home will be enough to get the child over the hump but if the child is acting lethargic or not urinating, or if it hasn’t improved after 12 hours or so, then certainly that would be something to consider coming into the emergency department for. One of the big ones is if the child is ever lethargic or has a decreased level of responsiveness, I don’t care what time of day that is I need to see that child.
Melanie: People are sometimes afraid to come to the emergency room for fear that you docs will yell at them if it’s not something – and you must have heard this before--but if someone is suffering from chest pain, for example, then they’re worried if it’s not a heart attack, that they did the wrong thing by coming to the E.R. Clear that up for us.
Dr. Farman: Hopefully, no one has ever yelled at anyone at our emergency department. I’m sure that’s not true. But, it should be a judgment free zone. As physicians, we have a certain area of expertise that we shouldn’t expect the general patient population to have. If they come in with a concern and complaint, we need treat that complaint with respect. Ultimately, what I tell folks is, “If I don’t find anything, that’s good. You don’t want me to find out something.” You don’t want me to find out that you’re having a heart attack or a blood clot.
Melanie: As an emergency room physician, Dr. Farman, what do you want people to bring with them when they come to the emergency room? What do you think is the most bits of information you need from people?
Dr. Farman: Communication is paramount to having a good experience in the emergency department. If you’re someone who speaks a foreign language or needs an interpreter, if you could bring someone that would be fantastic. Sign language interpreters are very useful. We have the capabilities to get interpreters in the emergency department but occasionally that can take some time and if it’s a time dependent illness, then having an interpreter with you would be fantastic. The other part of communication is that if you have an elderly parent or perhaps or a child, then certainly having someone there with them that can assist with giving history. Past medical history is very, very useful. Also, in that same vein, having a list of medication is very, very helpful. What I tell folks is that I want them to, if they have more than one or two medications and they have a hard time remembering specifically the names of those medicines, I would ask them to write all their medicines and the doses down on a note card and shove it in their purse or shove it in their wallet. That way, when they come to the E.R., they can pull out that piece of paper and we can look at it without having to try to call four or five pharmacies to try to track down their medication list.
Melanie: That’s great advice. In just the last few minutes, doctor, please give your best advice about people considering going to the E.R., when they should do that and why they should come to Hendricks Regional Health for their care.
Dr. Farman: If you’re considering going to the emergency department, take your symptoms seriously. If you’re having significant chest pain and your past medical history is concerning for having coronary disease or if you have a strong family history of coronary disease; if you’re having stroke-like symptoms; if you’re having unusual shortness of breath; if you’ve had a loss of consciousness; if you have a significant injury such as a broken arm or something you think might be broken; or, if it’s after hours and your urgent care or your primary care doctor isn’t open, please do consider coming to the emergency department. I would certainly advice you for those first things to come. Don’t wait. Call 9-1-1 if you need to and come on in and see us. I would say one of the advantages of what we do at Hendricks Regional is that we have a very patient-centered emergency department. We have one of the best door to doctor times in the state. When you come into the emergency department, you don’t typically wait very long in the waiting room. We do a very good job of getting you back to the patient’s room and getting seen by a physician, usually in less than 10 minutes from time of arrival to the physician. We also have excellent lab services and radiographic services where we get those things turned around very quickly. In other parts of the country, it is not unusual to spend four to six hours in an E.R. and our standard time is less than three. We actually do a very good job on our times for getting people into the heart catheterization lab if you’ve got a heart attack or getting clot busting medication on board if you have a stroke. I think that at Hendricks Regional Health, we actually do a very good job. We’ve been able to create an environment in our emergency department that not only treats people with respect but also provides them with excellent top notch medical care. If we can’t provide it to you here, we’ll get you to where you need to be. We’ve got a helicopter on site and we’ve got all the local amenities of tertiary care centers just down the road. If you’re considering an emergency department visit in central Indiana, I hope that you consider our facility and we’ll see you soon.
Melanie: Thank you so much. What great information, Dr. Farman. Thank you so much for being with us. You’re listening to Health Talks with HRH and for more information you can go to Hendricks.org. That’s Hendricks.org. This is Melanie Cole. Thanks so much for listening.
When To Go To The ER
Melanie Cole (Host): Illness, injury or medical emergencies can happen any day at any time and that’s why Hendricks Regional Health offers a full service emergency department as well as two convenient immediate care centers with extended weekday and weekend hours. My guest today is Dr. David Farman. He is an Emergency Room Physician with Hendricks Regional Health. Welcome to the show, Dr. Farman. How does somebody know whether they should go to an urgent care, call their doctor, or rush off to the emergency room?
Dr. David Farman (Guest): That’s a great question and thanks for asking. There’s a lot of overlap between those three sections of healthcare delivery – between the urgency care, the primary care physician and the emergency department. Sometimes it’s difficult to know where someone should actually end up. I think that there are some good rules of thumb that you can take. One is if it’s significantly after hours and you know your primary care office will be closed, you can certainly look at the urgent care calendar if it’s a minor complaint. But, if it’s one in the morning, there aren’t very many places that are open other than the emergency department. If you’ve got a significant concern and it is one or two in the morning come on in and see me. I just work nights. If you are on the fence and it’s during the day about what your symptoms might be – if it’s something that you’ve had before in the past and it is more of an ongoing issue, certainly I would call the primary care provider first. You have to use your own good judgement on this. If it’s something that you feel is a little bit more minor – something like an upper respiratory tract infection, or perhaps a sprained ankle – certainly, an urgent care would be an appropriate place to seek care. The emergency department is a fantastic place that has the capabilities of taking care of all sorts of critical illness. Certainly, we can take care of the more minor things as well but if you’re having significant chest pain, belly pain, or have a significant injury, we’re probably the place for you.
Melanie: Let’s discuss that. What do you tell patients about the differences? What should they symptom-wise be aware of that would send them right to the emergency room as opposed to seeking out urgent care or calling their doctor first?
Dr. Farman: It is a challenge. There are actually researchers who have looked at this. When people have looked at utilization of the emergency department, what they find is that a lot of the things that come in through their front door at first blush that could very well be a significant emergency. It’s not until after testing has been done do we discover that, in fact, it is something that the patient can probably go home with – whether that be chest pain or belly pain. If you are having chest pain and you have a strong family history of heart disease or if you are someone who has had a history of heart attacks or coronary artery disease before in the past, then certainly the emergency department is the place for you. If you go to the urgent care, I bet they’ll be sending you right over to the E.R. if you have a history such as that. If you’re having significant shortness of breath, I would say that is almost always something that should drive you to the emergency department because that can be a very significant complaint or symptom. If you are losing consciousness or have had an episode where you actually have lost consciousness, hopefully your family, or if you regain consciousness, you yourself would find a way over to see us at the E.R., too. Those are some of the three big ones that I’d say are very rarely treated appropriately at the urgent care or the primary care office.
Melanie: What’s the difference between the urgent care and the emergency room?
Dr. Farman: The emergency department is staffed by folks who are board certified and board trained in emergency medicine which is a specialty in and of itself. What that requires is additional training after medical school in critical procedures and in taking care of the critical patient. In the emergency department, we are driven by an interest in taking care of the critically ill patient. That is something that we do very well. For things that are more chronic in nature, we, frankly, are probably not the best trained to take care of those. Sometimes that is the primary care provider who is the most well-versed in taking care of those. If you come to the emergency department with something that has been going on for some time or has been managed elsewhere, we just may not just be the ones who are as well- versed in the management of those chronic issues. The emergency department also is a building that is attached to the hospital. If you get admitted to the hospital, you have lots of capabilities for fancier imaging, fancier testing than you would have at an urgent care. So, things like CT scans, labs, respiratory therapy--all those things are available in the emergency department. They may not be available at an urgent care.
Melanie: Dr. Farman, parents – you know we’re all kind of nuts – we want to call 9-1-1; we don’t want to ever call 9-1-1. What should we know about emergency rooms and our children? When is it time to call 9-1-1 or when is it time to take our children to the emergency? Parents--maybe if a child is vomiting--worry that’s a time. What do you want parents to know about bringing their children in?
Dr. Farman: First off, I’d say that we’re always open and we’re always available. I tell parents that come into the emergency department that very thing. Sometimes it’s hard to know whether your child is sick and needs to be admitted to the hospital. Being a parent myself, I’ve certainly been in those same situations where you’re looking at your child and you’re wondering, “Oh, is now the time that we go or is now not the time?” It’s a challenging situation. It’s always okay to bring your child in and we’re always happy to take a look. A couple of things that I want to discuss would be fever fear. I would say most emergency room physicians would say that there’s not a number when it comes to a temperature that is necessarily worrisome. There are some that would get our attention but it’s not the height of the fever as much as it is the appearance of the child. Oftentimes, a viral illness can cause a temperature up to 104 or 105 degrees but if the child is running around smiling and playing, I wouldn’t worry as much about the temperature as I would about the countenance of the child. Secondly, when it comes to something like vomiting and diarrhea, you’re more likely to get dehydrated from diarrhea then you are from vomiting. Oftentimes, these things do run their course on their own and pushing just little sips of fluid at home will be enough to get the child over the hump but if the child is acting lethargic or not urinating, or if it hasn’t improved after 12 hours or so, then certainly that would be something to consider coming into the emergency department for. One of the big ones is if the child is ever lethargic or has a decreased level of responsiveness, I don’t care what time of day that is I need to see that child.
Melanie: People are sometimes afraid to come to the emergency room for fear that you docs will yell at them if it’s not something – and you must have heard this before--but if someone is suffering from chest pain, for example, then they’re worried if it’s not a heart attack, that they did the wrong thing by coming to the E.R. Clear that up for us.
Dr. Farman: Hopefully, no one has ever yelled at anyone at our emergency department. I’m sure that’s not true. But, it should be a judgment free zone. As physicians, we have a certain area of expertise that we shouldn’t expect the general patient population to have. If they come in with a concern and complaint, we need treat that complaint with respect. Ultimately, what I tell folks is, “If I don’t find anything, that’s good. You don’t want me to find out something.” You don’t want me to find out that you’re having a heart attack or a blood clot.
Melanie: As an emergency room physician, Dr. Farman, what do you want people to bring with them when they come to the emergency room? What do you think is the most bits of information you need from people?
Dr. Farman: Communication is paramount to having a good experience in the emergency department. If you’re someone who speaks a foreign language or needs an interpreter, if you could bring someone that would be fantastic. Sign language interpreters are very useful. We have the capabilities to get interpreters in the emergency department but occasionally that can take some time and if it’s a time dependent illness, then having an interpreter with you would be fantastic. The other part of communication is that if you have an elderly parent or perhaps or a child, then certainly having someone there with them that can assist with giving history. Past medical history is very, very useful. Also, in that same vein, having a list of medication is very, very helpful. What I tell folks is that I want them to, if they have more than one or two medications and they have a hard time remembering specifically the names of those medicines, I would ask them to write all their medicines and the doses down on a note card and shove it in their purse or shove it in their wallet. That way, when they come to the E.R., they can pull out that piece of paper and we can look at it without having to try to call four or five pharmacies to try to track down their medication list.
Melanie: That’s great advice. In just the last few minutes, doctor, please give your best advice about people considering going to the E.R., when they should do that and why they should come to Hendricks Regional Health for their care.
Dr. Farman: If you’re considering going to the emergency department, take your symptoms seriously. If you’re having significant chest pain and your past medical history is concerning for having coronary disease or if you have a strong family history of coronary disease; if you’re having stroke-like symptoms; if you’re having unusual shortness of breath; if you’ve had a loss of consciousness; if you have a significant injury such as a broken arm or something you think might be broken; or, if it’s after hours and your urgent care or your primary care doctor isn’t open, please do consider coming to the emergency department. I would certainly advice you for those first things to come. Don’t wait. Call 9-1-1 if you need to and come on in and see us. I would say one of the advantages of what we do at Hendricks Regional is that we have a very patient-centered emergency department. We have one of the best door to doctor times in the state. When you come into the emergency department, you don’t typically wait very long in the waiting room. We do a very good job of getting you back to the patient’s room and getting seen by a physician, usually in less than 10 minutes from time of arrival to the physician. We also have excellent lab services and radiographic services where we get those things turned around very quickly. In other parts of the country, it is not unusual to spend four to six hours in an E.R. and our standard time is less than three. We actually do a very good job on our times for getting people into the heart catheterization lab if you’ve got a heart attack or getting clot busting medication on board if you have a stroke. I think that at Hendricks Regional Health, we actually do a very good job. We’ve been able to create an environment in our emergency department that not only treats people with respect but also provides them with excellent top notch medical care. If we can’t provide it to you here, we’ll get you to where you need to be. We’ve got a helicopter on site and we’ve got all the local amenities of tertiary care centers just down the road. If you’re considering an emergency department visit in central Indiana, I hope that you consider our facility and we’ll see you soon.
Melanie: Thank you so much. What great information, Dr. Farman. Thank you so much for being with us. You’re listening to Health Talks with HRH and for more information you can go to Hendricks.org. That’s Hendricks.org. This is Melanie Cole. Thanks so much for listening.