Top reasons for ER visits and how to avoid them
By Meghann Finn Sepulveda
Millions of older adults end up in the emergency department (ED) each year, often as a result of a fall-related injury, illness or adverse medication interaction. While some accidents are unavoidable, there are safety measures you can take to lower your risk of ending up in the ED.
We spoke with Hites Patel, M.D., medical director of Emergency Services at Banner Boswell Medical Center, who shared the top reasons for ED visits at Banner Boswell and how they sometimes can be prevented.
Unintentional falls are the leading injury-related reason for why people seek emergency care, resulting in 9 million ED visits annually, according to the Centers for Disease Control and Prevention.
Falls can cause deep cuts, bruises and broken bones.
“Falls can also cause trauma to the head,” Dr. Patel says. “This can be especially concerning for seniors who may be on blood thinners or other types of medication because it could exacerbate an injury.”
Patients who fall are evaluated, treated and observed before being discharged or admitted for further care. In more severe cases, patients with a head injury may be transported to a Level I Trauma Center to control bleeding.
“It’s important to recognize that symptoms from a head injury like headache, confusion and nausea or vomiting, may not show up until days or weeks later,” Dr. Patel says. “That’s why it’s critical to follow up with your primary care doctor after an ED visit.”
Not all falls can be prevented, but staying physically active, getting regular vision and hearing screenings, understanding the side effects of medication, using an assistive device, wearing proper shoes and eliminating tripping hazards around your home can reduce your chances of falling.
People who feel sick, from abdominal pain to flu-like symptoms, often come to the ED.
Dr. Patel says it’s important that older adults, especially those with weakened immune systems, stay current on vaccinations for pneumonia and the flu.
Chest discomfort and shortness of breath are additional reasons older adults seek care. Knowing the signs of heart attack and stroke are key to obtaining effective treatment and the best possible outcome.
“Most people are aware of heart attack symptoms like chest pain or pressure, and pain or numbness in the shoulder, arms, jaw or neck,” Dr. Patel says. “Other symptoms may include nausea, vomiting and a general feeling of doom or malaise.”
The signs of a stroke, however, can be subtler and more atypical, including acute onset of dizziness, one-sided weakness, balance issues, vision problems and trouble coordinating simple tasks like writing.
“A stroke that occurs in the back of the brain does not affect speech and is often overlooked,” Dr. Patel says.
If symptoms of a possible heart attack or stroke occur, it is critical that the person gets to an ED immediately.
Dr. Patel explains, “Waiting to see if symptoms resolve is often the worst thing someone can do because heart or brain tissue can be permanently damaged if the underlying cause is not treated in a timely manner.”
Adverse medication interactions
According to the National Institutes of Health, nearly 25 percent of all older adults who wind up in the ED are there because of adverse medication side effects or interactions.
“These patients often have a combination of issues like dehydration and medication interactions, which can lead to the improper metabolization of medications,” Dr. Patel says. “This can cause pain, confusion and weakness. A urinary tract infection can further exacerbate these symptoms.”
Staying hydrated is especially important for older adults, even during the cooler months. Experts recommend drinking at least five to eight, 8-ounce glasses of water per day, unless directed otherwise by their physician.
The side effects of some medications could also put older adults at risk of bleeding and cause kidney damage.
“Be sure to review all current and new medications with your primary care physician or pharmacist,” Dr. Patel says. “This can help you remain knowledgeable and aware of any potential interactions or warning signs you should look for.” He also recommends carrying an updated medication list so that it’s available in the event of a health emergency.
Above photo (L-R): Physician assistants Samantha Kline and Lori Petroff confer with Dr. Patel.
Banner Boswell Medical Center is expanding its Emergency Department with the community’s philanthropic support through Sun Health Foundation’s Generosity for Generations Campaign. To learn more, please email Joyce Wilt at Joyce.Wilt@sunhealth.org or call (623) 832-5330.