What really goes on in a hospital emergency department

Medicine has changed in the two decades that Dr. Fred Voon has been a physician. The questions from his patients in the emergency department have remained the same.

“Why is the wait so long?”

“Why did that person get seen ahead of me?”

“Why do I have to tell you the same story I told the last person?”

Dr. Voon, a clinical assistant professor with UBC’s department of emergency medicine, tackles these questions and more in his new book, Your Inside Guide to the Emergency Department—And How to Prevent Having to Go!

Drawing on his experiences across Canada and New Zealand—most recently Victoria—Dr. Voon takes readers behind the scenes and helps demystify the emergency room visit.

What motivated you to write this book?

Over the past 20 years, I’ve kept hearing the same questions from angry or confused people in the waiting room. I looked around for pamphlets or brochures that might help in our emergency departments, and there really wasn’t anything good out there.

I got lots of feedback from nurses and the rest of the team about what they would want someone to know while they’re sitting in the waiting room for four hours. The more I worked on the book, the more the information kept growing.

I realized it wasn’t the public’s fault for not knowing this stuff. It’s our fault as a medical system that we haven’t educated the public about what to expect from the emergency department.

Can you give me an example of a takeaway for readers?

The book explains why you shouldn’t call the hospital’s emergency department with medical questions or ask about whether to come in or not. It’s usually a non-medical clerk who is answering the phone. They are vital to the operation of the department. They’re like air traffic control—everything flows through them. So, it’s a bit like calling the airport control tower to ask what time your flight is supposed to leave.

How can people benefit from the smaller tips you highlight throughout the book?

Some conditions aren’t an emergency and it could save a person an emergency visit altogether if they knew that. On the other hand, I also tried to include some dangerous things that people might not know about, such as aortic emergencies, and what to watch out for.

There are lots of pearls of wisdom that I’ve picked up along the way such as using over-the-counter medications effectively, how to administer eyedrops easily and how to calm anxiety and distress. These are things I use or share every shift, so I think it’s important information to get out there.

Why shouldn’t patients get too hung up on wait times?

It doesn’t really help to know what the wait time is before you come in.

Even if we think it’s going to be a two-hour wait, it changes quickly. For instance, if somebody suddenly deteriorates in the ER or an ambulance arrives with a critical patient, one particularly sick patient can tie up the department for a lot longer, and then people who are less sick get pushed down the list.

If the wait time is going to determine whether you come in or not, then maybe it’s not really an emergency. Does the length of the airport security line-up stop you from going on a flight?

If somebody has to call 9-1-1, will they even have time to read this book?

I hope they have time to read the book because that means it’s not imminently life-threatening! Some people might want to just keep it available on their shelf so they could take it with them if they ever did have to call the ambulance or end up in the emergency department.

Your Inside Guide to the Emergency Department—And How to Prevent Having to Go! is available at drvoon.ca. News media can contact Erik Rolfsen at erik.rolfsen@ubc.ca to receive a review copy.