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10/06/2015 08:04 am ET Updated Oct 06, 2015

4 Mistakes People Make In The First 24 Hours Of A Medical Emergency

Leslie Michelson, healthcare expert and author of The Patient's Playbook: How to Save Your Life and the Lives of Those You Love, explains how to avoid making a bad situation worse.
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Mistake #1: Not asking questions before calling 911
People fall into two categories when crisis strikes, Michelson says: not dialing 911 soon enough, or calling when it's not necessary. Walking through these questions, whether it's you or someone else who's in trouble, he says, will help you determine the right next step.

- How old is the injured person? If they're very young or very old, it's better to call 911.

- Is the person in poor health in addition to this situation? The more underlying health issues a person has, the more you should err on the side of calling an ambulance.

- What body part seems to be the trouble? "If the problem is in the torso, close to vital organs, or if you suspect a head injury, that should trigger a call to 911," Michelson says. Limb injuries are less likely to be critical, and the same goes for cuts and abrasions, which can generally be handled by an urgent care clinic.

- Is your local ambulance service volunteer or paid? If it's volunteer and you're able to get to the hospital on your own (with a friend or family member driving), that's probably your best option. Volunteer services, where the providers generally aren't based at a firehouse or hospital and have to be called in when a 911 request arrives, are typically slower than paid programs, whose paramedics are ready and waiting.

Mistake #2: Settling for the closest ER
You know that not all emergency rooms are created equal, but it's easier than you may think to pinpoint the best one in your area, and that's something you should do before a crisis comes up. "Hospitals are graded as trauma centers, from level 1 to 5, with 1 being the best," Michelson says. "A level 1 trauma center has top ER expertise plus surgical and intensive care units that can keep treating you once you're out of the ER." If you have a child or infant, you need to know where the nearest ER with pediatric emergency expertise is located. Use this searchable map from the American Trauma Society to find the closest level 1 center and pediatric trauma center near you.

Keep in mind, though, if you call 911 with a heart attack or stroke, the paramedics will take you to the closest ER capable of treating you, as you have a narrow window of time before the odds of death or disability start to climb, says Michelson. When you're dealing with a less time-sensitive issue and the paramedics agree to it, you can have them take you to the hospital of your choice.

Mistake #3: Not using this phrase
Hospitals can be chaotic and frustrating. If you feel like you're not being listened to or treated well, there's one phrase that'll automatically bring in the hospital bigwigs, says Michelson. Ask for the "senior administrator in charge." This is the person who oversees the facility after hours, when you may be more likely to encounter problems. Explain the situation, be clear about what you want changed and consider following up your request with a mention of the patient satisfaction surveys that most hospitals ask you to fill out (hospitals value them more than you might think, says Michelson, and procedures are often changed based on responses). Something along the lines of how you'd really love to be able to give positive feedback, but you won't be able to do that if the issue isn't resolved, should do the trick.

Mistake #4: Forgetting who's actually in charge
Hint: It's you. If you're not sure what a test entails and why it's necessary, ask. If you're at a teaching hospital and you don't want a medical student doing a procedure, say so. If anyone on your care team doesn't seem up to date on your diagnosis, meds or information in your chart, tell them to read it before they see you again. Be respectful, but more importantly, be assertive, says Michelson. Making sure that everyone involved in your treatment is on the same page in terms of tests being run, medications being administered, prior diagnoses and any allergies you have can minimize the chances of preventable medical errors, which kill up to 400,000 Americans each year, according to research in the Journal of Patient Safety.
 

Leslie Michelson is a healthcare expert and author of The Patient's Playbook: How to Save Your Life and the Lives of Those You Love.

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