After a serious crash, get your follow up care and medicines straight
A primary care view of the medical decisions that come next
The emergency department handles urgent problems and decides whether you can safely go home at that moment. It may not answer every question about your injuries. New symptoms can show up. Test results may still be pending. Medicines can be confusing when you’re tired or hurting. In primary care, the next job is turning your discharge papers into a plan someone is really following. [1, 2]
You want to know who to call and what each medicine is for. You also want to know what happens if recovery doesn’t go as expected. Your own discharge instructions come before anything in this general guide.
Decide first whether your concern can wait
If a new emergency warning sign appears, get emergency care instead of waiting for a routine visit. Examples include trouble breathing, severe chest pain or new weakness. Repeated vomiting after a possible head injury and growing confusion count too. For a new symptom that isn’t clearly an emergency, call the team that treated you or a doctor soon. Do the same if pain or function gets worse after discharge. Say what changed and when. [2, 10]
Call emergency services if a medicine might be slowing someone’s breathing or a person can’t be woken up. If you think you took too much medicine, get advice at once from a poison center or emergency service. In the United States, you can reach Poison Help at 1 (800) 222 1222. [9, 12]
Find one home base for your care
If you have a primary care doctor, call the office. Explain that you were in a car crash and have left the emergency department. Ask for a visit or phone advice within the time frame your discharge papers give. Hand the office a copy of those papers. Don’t count on the records showing up on their own. If the time frame isn’t clear, call soon and ask how fast you should be seen. [1, 2, 11]
Without a regular doctor, start with the follow up phone number on your discharge papers. The hospital may have a clinic, a nurse line or a social worker who can help. Your health plan may also be able to find you an open primary care appointment. If you can’t get the appointment you were told to get, tell the team that discharged you or the clinic. Don’t wait in silence. [1, 3]
Specialists treat specific injuries. Your primary care team can help tie everything together. That includes symptoms, medicines, referrals, work limits and how recovery is affecting your daily life. Ask plainly who will review each open issue. Getting a referral is different from having an appointment. A test order is different from someone reviewing the result. [4, 11]
A quick phone call can save you a week
When you call the clinic, you can say something like this: “I was seen after a car crash on [date]. My discharge papers say [follow up instruction]. Since then I have [main symptom or change]. When should I be seen, and do you have my records? Who can answer a question about my medicines?”
Before you hang up, write down who you talked to and the appointment or next step. Note who to call if symptoms get worse before then. Ask for an after hours number if the office has one. If you’re foggy, hurting or feeling swamped, someone you trust can make the call with your OK. [1, 3]
Pack a one page summary for the visit
Your timeline doesn’t have to be perfect. A single page of notes can help you get more out of the visit. It helps most when the crash is hard to recall. Bring these: [1, 2, 3]
- Your discharge papers and any instructions for referrals or imaging tests. Add the names of the hospitals or clinics that treated you.
- Photos of every medicine bottle, or a list of them all. Cover prescriptions, nonprescription products, vitamins and supplements. Include the medicines you were taking before the crash, too. [3, 6]
- Three changes since discharge: one thing that improved, one that got worse and a daily task you can’t do as before. Note sleep, mood, dizziness or focus problems if you have them.
- Your two or three biggest questions, with the most pressing one at the top. If it would help, ask someone who comes with you to take notes.
Talk about what you can and can’t do, along with your pain. Saying “I can’t turn my head far enough to check traffic” tells your doctor more than “My neck is an eight.” Bring up any symptoms that don’t match the first diagnosis. Your doctor needs an accurate picture for your care. A polished story isn’t required.
Pin down the details of your care plan
During the visit, ask your doctor to sort out what is known from what is still uncertain. The emergency department may rule out a dangerous problem without naming the exact cause of each symptom. Ask which symptoms match your current diagnosis and which need another look. Also ask how much improvement to expect with your injury. [2, 3]
- Were any test or imaging results still pending when I left? Who will give me the final results? How will I know someone reviewed them? [4]
- Should I see a specialist, start physical therapy or get another test? Does a wound or broken bone need checking? Who will set that up, and when should I call if I don’t hear back? [11]
- What is safe for me to do right now? Cover driving, work, lifting, exercise and child care. Bring up any equipment or limits that affect your life. [2, 10]
- What kind of change means I should call this office? Which changes mean urgent care, and which mean the emergency department? What number do I call after hours? [1, 2]
Ask for the plan in writing before you leave. Then say it back in your own words: “So this week I’ll do these two things. If this symptom shows up, I’ll call this number. Is that right?” Saying it back checks that the explanation was clear. It isn’t a memory test. [5]
Match up every medicine, old and new
Medicine reconciliation is a check that compares what you really take with your new discharge list. It catches a common source of mistakes. A drug may have been started, stopped or changed in the hospital but look different on a bottle at home. Go over the list with a doctor or pharmacist. [3, 6]
For each medicine, confirm the name, what it’s for, the dose and when to take it. Also confirm how long to take it and its main side effects. Include medicines you take only as needed. [3, 6]
When two sets of instructions don’t agree, don’t guess. For example, the discharge list might leave out a medicine you usually take or list a different dose. Call the doctor who prescribed it or a pharmacist before you change your routine. Mention any allergies and any new medicine from another doctor. If the pharmacy can’t fill a prescription, speak up quickly so the plan can be adjusted. [3, 6]
Watch for these medicine mix ups
- Doubled ingredients: The same ingredient can show up in a prescription pain medicine, a cold remedy and a basic pain reliever. Acetaminophen is one example. Read every label. Check with a pharmacist before you combine products. Taking too much acetaminophen can seriously harm your liver. [7]
- Nonprescription pain relievers: Ibuprofen and naproxen can cause trouble for some people. That includes people with certain kidney or stomach problems. Ask before taking them if you’re on a blood thinner or pregnant. The same goes for any other condition that limits your medicine choices. [8, 13]
- Drowsiness and driving: Opioids and other medicines that make you drowsy can slow your thinking or reactions. Ask whether a new medicine affects driving, drinking alcohol or working with machines. Do not drive if you feel impaired. [9]
- Side effects or injury symptoms: Nausea, constipation, dizziness and sleepiness may come from a medicine or from the injury itself. Tell your doctor or pharmacist what happened and when. Don’t assume the symptom is harmless. Never stop a prescribed medicine without advice, either. [6, 9]
If you were prescribed an opioid, ask how to use it for the shortest time that makes sense. Ask how to manage constipation and whether naloxone is right for you. Find out how to store the tablets and get rid of any you don’t use. A pharmacist, with your full medicine list in hand, is a good person to go over these details. [9]
When the plan stops working
Call back if a referral never got scheduled or no one is named to review a result. Do the same if a medicine isn’t available or the plan no longer fits your symptoms. Be clear about what you need: “I was told to start therapy, but I don’t know who is setting it up.” Ask the team to name the next step and the person responsible for it. [3, 4, 11]
Juggling several injuries, visits and medicines can get hard. If it does, ask whether a nurse care coordinator or social worker is available. You can also ask whether a patient navigator can help. Let the team know about barriers like transportation, child care, language or cost. If you can’t carry out a plan, it needs to change. Hearing it again won’t fix it.
Leave every visit with a plan you can explain
The best follow up visits end with a plan you can put into your own words. By the end, you know what was found and what is still being checked. The medicines to take and the safe activities are clear. So is the person to call if something changes. If any of those answers is missing, ask again. Asking clear questions is part of good care.
Sources and further reading
- 1AHRQ going home guide
- 2MedlinePlus discharge plan
- 3AHRQ follow up calls
- 4AHRQ pending results
- 5AHRQ teach back
- 6MedlinePlus multiple medicines
- 7FDA acetaminophen
- 8FDA pain reliever safety
- 9MedlinePlus opioids
- 10CDC concussion care
- 11AHRQ care coordination
- 12Poison Help
- 13MedlinePlus ibuprofen
This is general health education. Follow your own doctor’s instructions for your care. Outside the United States, contact numbers may be different.
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