ER: What to Expect

1. Triage Nurse

 

Your condition will be assessed by a triage nurse who has special training to help gather information about your illness or injury by asking you to describe your symptoms and/or the circumstances that brought you to the ER. 

 

The triage nurse will ask you questions about your symptoms, measure your pulse, blood pressure, temperature and breathing, and ask about any allergies you may have or any medications you are taking, including over-the-counter medications and/or supplements. This information will be recorded and given to the health-care team in charge of your care.

 

If your illness is non-urgent, you may qualify for our new Emergency Room Community Redirect Program. If your illness is non-urgent and you haven't been approached by the triage nurse about a redirect, please feel free to ask the triage nurse if your medical condition can safely be redirected to another health-care facility in the community for treatment.

 

 

IMPORTANT - Please bring: your Medicare card; an up-to-date list of your medication(s), including how much, how often and why you are taking each one, as well as any allergies; a family member or friend who can provide you with support and assist you if necessary. 

 

  

When you arrive at the ER, the triage nurse will assess your health condition based on your symptoms. The triage nurse will then categorize your care as being one of the following:

 

  • Severe – having a potentially life-threatening condition requiring emergency medical care;

  • Urgent – having a health condition that has the potential to become serious; or

  • Non-Urgent – having a non-life-threatening condition.

 

All Canadian health-care facilities use the Canadian Triage and Acuity Scale (CTAS) tool to determine the seriousness of a person’s illness or injury, and care for them appropriately. In the ER, the most critical are cared for first.

 

Please do not leave without being seen by a physician or nurse practitioner. Should you decide to leave without being treated, please let the triage nurse know. 

2. Registration Area

 

If you need to see a doctor or nurse practitioner, you will be sent to the registration desk to provide your Medicare number, as well as your address and other contact information. Using this information, an ER chart is made. Your chart is a permanent record of the tests and treatments the doctors and nurses perform while you are in the ER.

                                                                                       

Once you finish registering with the registration clerk, you will be directed either to the waiting room, non-acute care or acute care areas.

3. Main Waiting Room

 

For less serious illnesses or injuries, you will be asked to sit in the main waiting room and wait to see a doctor or nurse practitioner. Some examples of these illnesses or injuries might include (but are not limited to) a sore throat, twisted ankle, muscle strain, cough or the flu. Once you have been assessed by a doctor or nurse practitioner, you may be asked to return to the main waiting room to await test results (such as blood work or X-rays) so we can continue to assess other patients – reducing overall wait times.

 

While in the main waiting room, the triage nurse will see to your care by providing support, offering additional comfort measures such as ice packs or blankets, and will reassess your condition. You should return to the triage nurse if there is any change in your condition or for any questions you may have. Once in the main waiting room, you should listen for your name to be called to see the doctor or nurse practitioner.

 

If you need to leave the waiting area for any reason, please advise the triage nurse.

4. Non-Acute Care 

 

There are 12 exam rooms in non-acute care in which you may be seen by a doctor or nurse practitioner. Most of the rooms are set up to take care of specific types of injuries. There is an eye room where there is special equipment designed to look at your eyes; an ears, nose and throat (ENT) room with special equipment for any type of injury that involves those parts of your body; two suture rooms in case you need stitches; two gynecology rooms; and, a cast room where splints and casts are applied to sprains and breaks. 

 

Once you are placed in an exam room, a member of the health-care team will do a more thorough assessment of your condition. Remember, there are a lot of other patients in this area of the department, so there may be a wait for the doctor or nurse practitioner to see you. 

 

After examination by the doctor or nurse practitioner, you may undergo testing, such as blood work or have an intravenous started. You may be given medication by a non-acute nurse that the doctor or nurse practitioner has ordered. It is also possible that you will be given directions to the X-ray department to have an X-ray taken. After your testing is done, depending on your illness or injury, you may be asked to return to the waiting room to await test results. This will allow another patient to be seen and assessed by the health-care team.

5. Acute Care  

 

 

Acute care is a 19-bed area where you will be seen by a doctor. Some examples of why you may be placed in the acute care area include severe abdominal pain, recent but not ongoing chest pain, or a recent but not ongoing seizure.

  

Your acute care nurse will be responsible for the nursing care you receive while in this area of the ER. He or she will ask you further questions, and give you an opportunity to ask questions or provide any additional information that you would like to share about your illness or condition. If you have had recent chest pain, or any other symptoms that may relate to your heart, the nurse may place you on a heart monitor which displays a waveform of your heart beat. You may also be placed on oxygen if you are short of breath. After the nurse has completed their assessment, the doctor will come to see you.  There may be a wait, as the doctor is responsible for all patients in this area of the ER.

 

The doctor may order tests, intravenous fluids, and/or pain medications for you that will help him or her determine the cause of your discomfort or concern. Your acute care nurse will carry out these orders and may draw blood work, perform an electrocardiogram (ECG) or send you to the X-ray department for X-rays.

 

When all of your test results are back from the lab, the doctor will visit you again to explain the results to you. Results from the lab can take a while and the waiting can be difficult, but your acute care nurse will be there to assist you and make you as comfortable as possible during the wait. You should also feel free to ask any questions you might have about the tests you are having, the medications you are being given or any other concerns you may have.

 

Meals will be provided by the hospital food service at scheduled meal times for patients remaining in the department, either for further testing or admission, unless your doctor has asked that you not eat. This may happen if your tests are not complete or should you require further treatment, such as an operation or special procedure. If you are able to eat, make sure that your nurse knows of any allergies or special meal considerations you may have.

 

After all testing is complete and the doctor has reviewed the results with you, you may be sent for additional testing, admitted to the hospital or discharged home. If you are discharged, you will be given instructions on any follow-up appointments you may need to make and keep, and/or be given a prescription for medications that you will need to take at home.

About Nurse Practitioners

Nurse practitioners work in various health-care settings, such as family doctors’ offices and Emergency Rooms, so you may be seen by one, depending on your medical condition. A nurse practitioner is a registered nurse with advanced training and work experience. He or she can work independently or as part of a team, with responsibilities somewhat similar to those of physicians. Your nurse practitioner will treat many medical issues, diagnose health conditions, order and interpret screening and diagnostic tests, perform procedures, prescribe medications, refer you to other health-care professionals, including specialists, and meet with you/your family on a regular basis to discuss your overall health. 

 

For more information about nurse practitioners, please visit:

6. Trauma/Resuscitation Area  

 

If your condition is serious or critical, you will be taken to the trauma area. The trauma/resuscitation area of the ER is where the sickest patients are seen by a doctor. You may be having a heart attack, stroke, or experiencing severe bleeding as the result of an accident. 

 

The trauma area is a 6-stretcher critical care area where you will be cared for by doctors and trauma nurses who will also ask you more about your condition. Medical specialists may also be consulted to see you in the trauma room.

 

In the trauma area, the trauma nurse will connect you to a heart monitor so that your vital signs can be continuously monitored. The cardiac monitor (heart monitor) displays waveforms on the screen that tell us how well and how fast your heart is beating. It also has a waveform that shows us your oxygen saturation. There are a lot of alarms on the cardiac monitor. These alarms are very sensitive and may make a loud noise. If you hear an alarm, it does not mean that you are in danger. Often these alarms sound with movement alone. The staff in the trauma room can explain these alarms and reassure you.

 

During your stay in the trauma area, you may have an X-ray with a portable X-ray machine, have an electrocardiogram (ECG), which records the electrical activity of your heart through wires attached to stickers on your chest, or be sent for further testing (such as a CT scan) in the Medical Imaging Department.

7. Family Room

 

The family room is a small area near the trauma area, which is designed for families of our most critically injured patients to be together and wait while their loved one is being cared for.

 

Periodically, a doctor or a nurse will come to update your family on your condition and allow your family member(s) to visit you. We also offer support from spiritual and religious care or social workers if you or your family are interested in speaking with them.

Important Privacy Information:

When visiting the ER, you should be prepared to be asked who you are visiting. As we work under strict privacy legislation, it is always up to the patient as to how much information we share and with whom. We never give out information over the phone for confidentiality reasons. The taking of pictures or recording of video is not permitted, for both privacy and security reasons.

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