Emergency Care Guide: This guide helps you understand emergency department tests, reports, and results. Learn what tests mean and how to interpret urgent medical findings.
Emergency department visits can be overwhelming and frightening. Understanding the tests performed, the results, and what they mean can help you make informed decisions and follow up appropriately after emergency care.
Common Emergency Department Tests
Initial Assessment Tests
Vital Signs
What's measured: Blood pressure, heart rate, temperature, respiratory rate, oxygen saturation
Why it's done: Quick assessment of overall stability and severity of illness
Critical values: Very high/low blood pressure, rapid/slow heart rate, low oxygen levels
Triage Assessment
What it is: Systematic evaluation to prioritize patients by urgency
Categories: Critical, urgent, less urgent, non-urgent
Factors considered: Symptoms, vital signs, pain level, risk factors
Emergency Blood Tests
Complete Blood Count (CBC)
What it shows: Infection, anemia, bleeding disorders
Key values: White blood cells (infection), hemoglobin (anemia), platelets (bleeding)
Normal ranges: WBC: 4,500-11,000, Hemoglobin: 12-16 g/dL, Platelets: 150,000-450,000
Basic Metabolic Panel (BMP)
What it shows: Kidney function, electrolyte balance, blood sugar
Critical values: Very high/low sodium, potassium, or glucose levels
Emergency concerns: Kidney failure, severe dehydration, diabetic crisis
Cardiac Enzymes (Troponin)
What it shows: Heart muscle damage from heart attack
When ordered: Chest pain, suspected heart attack
Results: Elevated levels indicate heart muscle damage
Emergency Imaging Studies
X-rays in the ER
Chest X-ray
What it detects: Pneumonia, collapsed lung, heart problems, rib fractures
Common findings: Infiltrates (pneumonia), pneumothorax (collapsed lung), enlarged heart
Urgent findings: Tension pneumothorax, massive pleural effusion
Abdominal X-ray
What it detects: Bowel obstruction, kidney stones, foreign objects
Limitations: Cannot see soft tissues well, limited for abdominal pain diagnosis
When used: Suspected obstruction, swallowed objects, kidney stones
Bone/Joint X-rays
What it detects: Fractures, dislocations, arthritis
Emergency concerns: Open fractures, joint dislocations, spine injuries
Follow-up needed: Some fractures may not show immediately
CT Scans in Emergency Care
Head CT
What it detects: Stroke, brain bleeding, skull fractures, brain swelling
When ordered: Head injury, severe headache, stroke symptoms, altered mental status
Critical findings: Intracranial hemorrhage, large stroke, increased pressure
Chest CT
What it detects: Pulmonary embolism, aortic dissection, detailed lung problems
Contrast needed: Often requires IV contrast for blood vessel evaluation
Life-threatening findings: Pulmonary embolism, aortic aneurysm rupture
Abdominal/Pelvic CT
What it detects: Appendicitis, kidney stones, internal bleeding, organ injury
Preparation: May require oral or IV contrast
Emergency findings: Internal bleeding, organ rupture, severe infections
Heart-Related Emergency Tests
Electrocardiogram (EKG/ECG)
EKG Critical Findings:
- • ST elevation (STEMI heart attack) - requires immediate intervention
- • ST depression (NSTEMI heart attack) - urgent cardiac care needed
- • Dangerous arrhythmias - may need immediate treatment
- • Heart blocks - may require pacemaker
- • Signs of electrolyte imbalances
Normal EKG vs. Abnormal
Normal: Regular rhythm, normal rate (60-100 bpm), normal wave patterns
Abnormal findings: Irregular rhythms, very fast/slow rates, abnormal wave patterns
Emergency patterns: Heart attack patterns, life-threatening arrhythmias
Serial EKGs
Multiple EKGs may be done to track changes over time, especially if heart attack is suspected.
Understanding Emergency Lab Results
Critical Lab Values
Blood Sugar Emergencies
Hypoglycemia: Less than 70 mg/dL - requires immediate treatment
Severe hyperglycemia: Over 400 mg/dL - risk of diabetic ketoacidosis
Symptoms: Confusion, weakness, rapid breathing, fruity breath odor
Electrolyte Emergencies
Potassium: Very high (>6.0) or low (<2.5) can cause dangerous heart rhythms
Sodium: Severe imbalances can cause seizures or brain swelling
Treatment: IV medications to rapidly correct dangerous levels
Kidney Function
Creatinine: Rapid rise indicates acute kidney injury
BUN: Very high levels may indicate kidney failure or severe dehydration
Emergency dialysis: May be needed for severe kidney failure
Specialized Emergency Tests
Pregnancy-Related Tests
Pregnancy Test
Why done: Any woman of childbearing age with abdominal pain or bleeding
Emergency concerns: Ectopic pregnancy, miscarriage, pregnancy complications
Follow-up: May need pelvic exam, ultrasound, serial hormone levels
Emergency Ultrasound
Uses: Check for ectopic pregnancy, fetal heartbeat, internal bleeding
FAST exam: Focused assessment for trauma to detect internal bleeding
Toxicology Screening
Drug Screens
When ordered: Altered mental status, suspected overdose, unexplained symptoms
What's tested: Common drugs of abuse, alcohol level, specific toxins
Treatment implications: May need specific antidotes or supportive care
Alcohol Level
Legal limit: 0.08% for driving, but medical complications can occur at lower levels
Emergency levels: Very high levels (>300 mg/dL) can be life-threatening
Understanding Your Emergency Discharge Summary
What's Included in Discharge Papers
Diagnosis
Primary diagnosis: Main reason for your visit
Secondary diagnoses: Other conditions found or considered
Rule-out diagnoses: Conditions that were considered but excluded
Treatment Given
Medications: What was given in the ER and prescriptions to fill
Procedures: Any treatments or interventions performed
IV fluids: Hydration or medication delivery
Follow-up Instructions
When to follow up: Specific timeframes for seeing your regular doctor
Specialist referrals: If specialty care is needed
Return precautions: Symptoms that require immediate return to ER
Red Flag Symptoms for Return Visits
Return to ER Immediately If:
- • Difficulty breathing or shortness of breath
- • Chest pain or pressure
- • Severe abdominal pain
- • High fever (>101°F) that doesn't respond to medication
- • Severe headache with neck stiffness
- • Signs of infection getting worse
- • Bleeding that won't stop
- • Confusion or altered mental status
After Your Emergency Visit
Important Follow-up Steps
- Fill prescriptions promptly: Don't delay getting medications
- Schedule follow-up appointments: Within the timeframe specified
- Keep all discharge papers: Important for your medical record
- Share information: Give copies to your regular doctor
- Monitor symptoms: Watch for improvement or worsening
- Take medications as directed: Even if you feel better
Understanding Test Results Timing
Immediate Results
Available quickly: Basic blood tests, X-rays, EKGs, some CT scans
Used for: Immediate treatment decisions, discharge planning
Pending Results
May take longer: Blood cultures, some specialized tests, detailed radiology reads
Follow-up needed: Your doctor will contact you if action is needed
Insurance and Billing After ER Visits
Understanding ER Charges
- Facility fee: Charge for using the emergency department
- Physician fee: Separate charge for doctor's services
- Ancillary charges: Labs, X-rays, medications given in ER
- Specialist fees: If specialists were consulted
Insurance Considerations
Emergency Coverage
Most insurance plans must cover emergency care, even if the hospital is out-of-network.
Documentation
Keep all paperwork for insurance claims and appeals if needed.
Remember: You Have Rights
You have the right to understand your diagnosis, ask questions about your treatment, receive copies of your medical records, and get a clear explanation of follow-up care. Don't hesitate to ask for clarification if anything is unclear.
Emergency department visits can be stressful, but understanding the tests, results, and follow-up care can help you make informed decisions about your health. Always follow discharge instructions and don't hesitate to seek clarification from your healthcare providers.