You have a hacking cough and a pounding headache that’s getting worse by the minute. You checked your temperature and you are certain you have a fever. You make the decision to go the ER, only to be told to go back home and rest. Unfortunately, this scenario has been the topic of discussion in many headlines amid the coronavirus pandemic. Getting turned away from the hospital happens far too frequently and in worse cases, some are sent home to take their final breath. How can this be prevented? How can you be sure to get the care that you need when you go to the hospital?
- Know the Law!
Since 1986, you’ve had the right to receive treatment at a hospital, even if you don’t have insurance or can’t afford to pay. The Emergency Medical Treatment and Labor Act (EMTALA) was created to prevent hospitals from patient dumping, which is refusing to treat patients who do not have insurance or are unable to pay.
EMTALA applies to any hospital that has an emergency room and accepts payments from Medicare. Even if you are lying in the grass near the hospital entrance, the law requires that emergency treatment be provided to patients up to 250 yards from the hospital’s entrance.
- Know Your Vital Signs!
A triage nurse will check your vital signs to access the severity of your condition and determine if you will be seen first or last by the doctor. Your vital signs include blood pressure, heart rate, temperature and blood oxygen levels. All vital signs are associated with a number or measurement. Knowing the numbers that constitute an emergency can make the difference in you being admitted or sent home.
When the triage nurse wraps your arm with the cuff, she is checking your blood pressure. An urgent crisis is a blood pressure reading of 180/110 and an emergency is a blood pressure 180/120 with other symptoms of like headache, back pain, visual changes, shortness of breath, and nausea. If your blood pressure reading is low (a reading of less than 90/60) and you have symptoms like confusion, dizziness, nausea, or fatigue, this can be cause for further evaluation and a hospital admission.
Heart rate will usually be screened at the same time your blood pressure is. This will detect if you have an arrythmia (abnormal heartbeat). An abnormal heart rate is above 100 beats per min (bpm) or less 60 bpm. This coupled with pre-existing conditions or other symptoms is an emergency.
A temperature of over 103 degrees Fahrenheit in an adult, along with other symptoms like a rash or vomiting, is an emergency. For children, a temperature of 102.2 is considered an emergency. If body temperatures fall below 95 degrees Fahrenheit, this is abnormally low and could warrant a medical emergency.
Blood Oxygen Levels
The nurse will clamp a pulse oximeter, usually on the tip of your finger, to measure your blood oxygen levels (SpO2). A reading of 95 percent is considered low and can be life-threatening if below 88 percent.
- Know Your Rights!
EMTALA states that you have the right to have a medical screening examination (MSE) when you present to the hospital with a complaint. I’m not talking about when the triage nurse, calls you into a small room and takes your vitals. The purpose of triage is to determine how severe your complaints are so that the nurse can decide if you will be the first or last person to be examined.