Emergency Department at UCSF Parnassus: What to Expect

General info

If you need a professional medical interpreter, we will do our best to provide one. This is a free service that helps you and us better understand each other. You can request an interpreter from a nurse, doctor or other staff member.

To make you comfortable during your time with us, we also offer:

• Breast pumps and privacy screens for nursing women
• Free Wi-Fi (use UCSF Guest)
• Assistive devices for people with hearing loss or impaired vision (request help from one of our medical interpreters)
• Charging towers to charge your cell phone

If you feel unsafe at any point for any reason, please let us know immediately.

If you need help to escape an abusive situation, please tell us or consider contacting one of these hotlines (available 24 hours a day, seven hours a week):

• National Domestic Violence Hotline: Call 1-800-799-7233
• Human Trafficking Hotline: Call 1-888-373-7888 or text 233733

1. Getting started

You will start at the front desk with the sign that says "PATIENTS START HERE." A registration clerk will ask you to provide your name and date of birth, so they can create your medical record for your visit.

You will also be asked for 2 forms of identification (ID).

Forms of ID with your photo:

• Driver's license
• Debit or credit card
• Passport
• State ID card
• An ID card from a public, government, or private employer, or a college/university (student ID)

Forms of ID without your photo:

• Debit or credit card
• Health insurance card
• Firearms ID
• Social security card
• Student ID

At some point, you will be asked to confirm your:

• Address
• Primary care doctor
• Preferred pharmacy
• Health insurance (your ability to pay will not affect your care)

Please be ready to share information about any allergies you have and any medications you take.

When we are ready to see you, we will call your name. Please stay in the waiting area so you do not miss our call. If you need to leave the area to use the bathroom or for any other reason, please let us know. If you have been provided with a pager, it will vibrate when we are ready to see you.

Emergency Department Staff

This is a teaching hospital. A teaching hospital provides medical education and training to medical students, resident doctors, and fellows. As a result, your care team will include them, as well as doctors and nurses.

During your visit, you may meet with a variety of health care providers, including:

• Doctors specializing in emergency care and other areas of medicine, like cardiology (cardiologists) and surgery (surgeons)
• Nurses, including "triage" nurses who evaluate the severity of your illness or injury
• Resident doctors, also called "residents." Residents are doctors who have completed medical school and are continuing their education to become specialists.
• Fellows are doctors who have completed their residency training and are getting additional specialized training.
• Advanced Practice Providers (APPs), including nurse practitioners (NPs) and physician assistants (PAs). APPs are not doctors but perform medical activities typically performed by a doctor.
• Medical interpreters professionally trained in medical terminology. They help support good communication between patients and their families and our doctors, nurses and other health care providers.
• Patient transport staff, who help move our patients safely from one location to another.

2. Assessment

When we are ready to see you, a "triage" nurse will meet with you and review your symptoms. They will take your vital signs, such as your body temperature, heart rate, blood pressure, and blood oxygen saturation. The nurse may recommend tests to understand what is going on in your body. Sometimes, you will have blood work or X-rays taken before you are taken to an examination area.

Based on the information you provide and your vital signs, the nurse will assess the severity of your condition. This helps us make sure critically ill patients are seen first. It's also why a doctor may see another patient before you, even if you got to the hospital first.

Please be patient. You may wait a long time (sometimes several hours) to be seen by a provider (a doctor, NP, or PA). This is not unusual because we are a busy ED, and we need to prioritize the people who are most severely sick or injured. We cannot see patients based on who came to the hospital first.

If your condition worsens while you are in the waiting room, please ask for help at the PATIENTS START HERE window.

3. Treatment

When a treatment area is available, a doctor and nurse will be assigned to you. They work together to provide care and give you updates throughout your visit. If needed, they will also work with a medical interpreter (in person, by phone or by video). Please feel free to ask questions at any time.

Because of how busy we can be, your treatment area may be on a chair or a gurney in the hallway. If you are moved to a hallway or chair, you may request a privacy screen. When possible, one visitor can stay with you.

Your care team may recommend additional tests to diagnose your condition. These tests help us understand if you are well enough to go home or if you should stay in the hospital.

Types of tests that may be performed:

• Blood work (drawing blood): We use a needle to take blood from a vein in your arm. The results can tell us if you have an infection or other medical problems, like diabetes.
• Electrocardiogram (EKG): We use an EKG machine to take an electrical image of your heart. This test helps us understand how well your heart is working and if it is beating normally.
• Urine test: We use a urine sample to check for signs of health problems, like infections and kidney issues.
• Oxygen saturation testing: We clip a small device on your finger to measure how much oxygen is in your blood. This can tell us how well your lungs are working or how well your body is absorbing oxygen.

Your care team may also order other types of imaging tests, like an X-ray, ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI) scan. X-rays take pictures of the tissues, bones and organs inside your body. Ultrasound takes a moving image of what is happening in the body. CT and MRI scans give us a more detailed view of the body than X-rays and ultrasounds.

As we wait for your test results, you may be asked to return to the waiting room. When your results are ready, your ED provider will review them with you and explain the next steps in your care. These may include medication, or being seen by a specialist, such as a cardiologist or surgeon.

4. Leaving the ED

What happens if I don't need to be admitted to the hospital (stay overnight)?

If you are well enough to be sent home, we will ask you to follow up with your primary care doctor. If you do not have one, we will give you information on how to request one.

We will give you paperwork that summarizes your ED visit. This is called an After Visit Summary (AVS). Your AVS offers guidance for your care after the hospital. This may include medication, visits with specialists, and home care. If your provider recommends medication, we will electronically send your prescriptions to the pharmacy of your choice.

If needed, a medical interpreter will review your AVS with you. We will also make every effort to provide you with a copy of your AVS in your preferred language. Before you leave, we encourage you to ask us any questions you may have about your care and our recommendations.

Please let us know if you need help getting home or finding a pharmacy or other resources.

What happens if I do need to be admitted to the hospital?

If you are admitted to the hospital, your family will be allowed to visit you once you settle into your hospital room. Our hospital staff will let your family know when they can visit you.

UCSF doctors work at other hospitals in San Francisco, such as UCSF Health Mount Zion, UCSF Health Mission Bay, UCSF Health St. Mary's Hospital, and UCSF Health Saint Francis Hospital. You may be transferred to one of these hospitals to continue your care. If you need to be transferred, our hospital will arrange your transport. Your health care plan may request that you be transferred to a non-UCSF hospital. Your care team will discuss this with you.