Triage on Paul Nystrom

I don't know your doctor

Fri, 27 Feb 2026 00:00:00 +0000

Very frequently, when asking patients about their medical problems, they will tell me the name of their specific provider. Sometimes this is a primary care provider; sometimes it’s a specialist. Their tone suggests that they assume I know who they’re talking about.

Me: What other medical problems do you have?

Patient: I see Dr. Johnson—you know, across the street—for my heart stuff. He did my angiogram last year.

Me outloud: OK.

EKGs in the ER

Sat, 13 Dec 2025 00:00:00 +0000

When you go to the ER with chest pain, you enter a generally well-functioning system that prioritizes you. You will almost always have an EKG done within 10 minutes. This is not a guarantee, but it’s a standard metric that most emergency departments strive to meet.

So, when you present at triage, you’ll likely be escorted to a private-enough area where a nurse or technician will perform the EKG. If the department is busy, you may then be sent back to the waiting room until a provider can speak with you or an actual treatment room becomes available. If you’re fortunate enough to be placed directly into a room, you might still wait a while for the EKG results or for a provider to discuss them with you.

Be Upfront

Tue, 12 Aug 2025 00:00:00 +0000

It’s a good idea to be upfront about the specific condition you’re most concerned about when you come to the ER. I’ve had many conversations with patients who undergo an extensive workup in the ER for a condition I’m concerned about based on their symptoms. At the end of the visit, the patient or their family may ask a question that seems out of left field to me. I recall evaluating a patient with neurologic symptoms that suggested a possible stroke or other neurologic condition. At the end of the visit, the patient’s wife asked if I had checked the patient’s heart. I hadn’t done any cardiac evaluation because the symptoms they described didn’t raise any concerns about a heart condition. If we had discussed this at the beginning of the visit, we could have tailored the discussion and workup, and I could have addressed their concerns much sooner.

Eating in the ER

Tue, 12 Aug 2025 00:00:00 +0000

When you arrive at the ER, it’s standard practice to prohibit eating or drinking until a doctor has evaluated you. This rule likely exists because sedation for a procedure or surgery is considered higher risk if you have a full stomach. However, this policy is not always practical, as the vast majority of ER patients do not require acute surgery, procedures, or sedation. It’s reasonable to ask the nurse checking you in if you can have something to eat or drink. Their answer will likely be no, but it’s also reasonable to politely ask if they can consult the doctor rather than provide a blanket response. Depending on whom you’re speaking with, this request may meet resistance. There may be reluctance to allow eating or drinking because, at the start of your visit, the only information available is your vitals and a triage note from the nurse.