average er visit time

What to expect at the ER: A guide to navigating the emergency room

Your ER experience and wait time will depend on the severity of your condition.
Reasons to go to the ER might be excessive bleeding, a high fever, a seizure, or chest pains.
If you need to see a doctor immediately, but it's not an emergency, urgent-care is another option.

When you or a loved one arrives at an emergency room (ER) in the US, you should expect to have a nurse briefly assess you shortly after arrival. The nurse will determine the severity of your condition, which will determine your wait time. If you're in serious condition, you may be brought by paramedics or EMTs and be taken directly to a trauma ward, or seen by a doctor immediately depending on your condition.

People in the ER are treated in order of how sick they are, says Eric Chu , MD, an emergency medicine physician at the University of Connecticut School of Medicine.

"For example, if you are brought in after having a cardiac arrest, you will be taken to the resuscitation bay where you will be seen immediately. In other cases, you may walk into the waiting room, be assessed by a nurse, and then depending on your acuity, have to wait until a room is open for you," says Chu.

Average wait times in the ER can range from 25 to 50 minutes , depending on how busy the hospital is. "I think the biggest factor on how long it'll take to be seen in the ER is where you live and which hospital you go to. I have seen patients wait six hours just to be put into a room. It also depends on what time and which day you go. Mondays are notorious for being the busiest day of the week and the weekends are usually the least," says Chu.

Here are some instances when you might need to go to an ER, and what you can expect once you're there.

What to expect at the ER

When you arrive at the ER, a trained emergency nurse will assess your condition and determine the urgency of your situation; this process is referred to as " triage ."

While you're waiting to see a doctor, you may be x-rayed, given medications for your symptoms, or be asked to provide blood or other samples, according to Chu.

"You will be seen by a doctor, physician assistant, or nurse practitioner when you are moved to a room. Treatment or further tests may be done at this time. Consultants, including cardiologists, nephrologists, or neurologists, may also be involved in your care, if required. Then, depending on how sick you are, you may be discharged or admitted to the hospital," says Chu.

When should you go to the ER?

As the name suggests, an ER is essentially for emergencies that could be fatal or cause permanent disability.

You may also need to go to the ER if you or a loved one have been in an accident or have experienced trauma and require immediate attention.

On the other hand, if you're feeling unwell and need to see a doctor immediately, but it's not an emergency, you can go to your primary care doctor if they have a same-day opening or go to an urgent-care clinic .

Many urgent care clinics are open every day, and you can get treated faster and for a substantially lower cost than at an ER. If your symptoms are mild and you can wait a day, you can also visit your primary care physician during clinic hours.

What to bring to the ER

If possible, you should try to gather some essentials before you go to the ER, to help the ER physicians understand your medical history and any allergies you might have.

"Things that are helpful to bring to the ER include your home medication list, the names of your doctors, any paperwork from recent hospital or doctors' visits, and your insurance information (if you have insurance). For example, if you had a recent heart attack, it may be helpful to bring the paperwork from that admission and what medications you have been taking," says Chu.

You should also try and take a trusted family member or friend along with you to help with paperwork and answer any of the physician's questions, if you are too ill to do so yourself.

If you're not going to the ER under acute circumstances, Chu recommends bringing a book or a phone charger, since you could be waiting a long time.

What is the cost of an ER visit?

The cost of your ER visit will depend on the tests conducted, medication and treatment provided, and your health insurance coverage, says Chu. This can vary from hospital to hospital. "One hospital may charge you $30 for a medicine while another may charge you $300," he says. This variation in cost can be due to several factors . For example, larger hospitals, teaching hospitals, or hospitals that provide highly specialized services may charge considerably higher fees.

The average cost of an ER visit is around $1,500 . Sprains, which are among the top causes for ER visits, could cost around $1,100, whereas treating a kidney stone could cost around $3,500. If you have insurance, it may help cover some of this cost, depending on your insurance plan.

Whether your ER visit is covered by insurance can depend on several factors, including whether the hospital or provider are included in the insurance provider's network, says Chu.

"It can also depend on whether your insurance covers certain costs, like an ambulance ride, for example. An ambulance ride that is not covered by insurance can be quite expensive," says Chu. Ambulance rides can range between $224 and $2,204 per transport.

Insider's takeaway

You may need to visit the ER for life-threatening situations. The course of your visit can vary quite a bit depending on your condition. While ERs provide necessary and oftentimes lifesaving services, they can involve long wait times and expensive bills, making urgent care or your primary care provider a better option if the situation isn't an emergency.

ER wait times, by state

Maryland is the state where patients spend the longest time in the emergency department before leaving the hospital, according to research by IT service automation company SysAid .

The research examined CMS data to see which states had the shortest average (median) time patients spend in the emergency department before leaving, in minutes. The data covered Jan. 7, 2020, to March 31, 2021.

While Maryland has the longest hospital waiting time, North Dakota has the shortest.

Here are the waiting times by state, from shortest to longest:

Note: The list includes ties.

1. North Dakota: 104 minutes

2. South Dakota: 113 minutes

3. Nebraska: 114 minutes

4. Oklahoma: 115 minutes

5. Hawaii: 117 minutes

5. Kansas: 117 minutes

7. Iowa: 123 minutes

8. Mississippi: 124 minutes

9. Arkansas: 127 minutes

9. Montana: 127 minutes

11. Louisiana: 128 minutes

12. Minnesota: 129 minutes

13. Utah: 130 minutes

13. Vermont: 130 minutes

15. Idaho: 131 minutes

16. Indiana: 133 minutes

17. Wisconsin: 136 minutes

18. Wyoming: 137 minutes

19. Alaska: 138 minutes

19. Washington: 138 minutes

21. Alabama: 139 minutes

21. Texas: 139 minutes

23. Colorado: 140 minutes

24. West Virginia: 141 minutes

25. Ohio: 143 minutes

26. Missouri: 144 minutes

27. Nevada: 145 minutes

27. Tennessee: 145 minutes

29. Georgia: 146 minutes

30. Maine: 147 minutes

31. New Mexico: 150 minutes

32. Kentucky: 151 minutes

32. South Carolina: 151 minutes

34. Michigan: 153 minutes

35. New Hampshire: 154 minutes

35. Virginia: 154 minutes

37. Florida: 155 minutes

38. Illinois: 157 minutes

38. North Carolina: 157 minutes

38. Oregon : 157 minutes

38. Pennsylvania: 157 minutes

42. California: 164 minutes

43. Connecticut: 166 minutes

44. New Jersey: 173 minutes

45. Arizona: 176 minutes

46. New York: 184 minutes

47. Rhode Island: 185 minutes

48. Massachusetts: 189 minutes

49. Delaware: 195 minutes

50. Maryland: 228 minutes

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Study reveals average ER wait times in all 50 states

A trip to the emergency room is often means waiting hours before getting medical attention.

A new study reveals the wait in some states is much longer than others.

North Dakota tops the list of the states with the shortest ER wait times, at one hour and 48 minutes.

Oklahoma and Iowa tied for 4th shortest wait times, at one hour and 59 minutes.

According to US News, St. Francis Hospital in Tulsa is ranked as the best in the state and is high performing in 12 procedures and conditions.

Maryland is on the other end of the end of the spectrum.

The average ER wait time in Maryland: 4 hours and two minutes.

Personal injury attorney’s InjuredinFlorida.com analyzed hospital data from all 50 states.

Kevin Samuels, who described himself as an “image consultant” who shared controversial relationship advice on social media platforms, has died, his mother confirmed to NBC News.

10 States With the Longest Emergency Room Waits

The median wait time far exceeds two hours in some states.

ER Waits by State

Getty Images | Tetra images RF

A number of states have a median wait time that exceeds 150 minutes, according to a recent study.

The rate of emergency room visits has increased significantly over recent decades in the U.S., rising from 360 visits per 1,000 residents in 1995 to 445 in 2017, according to a report released recently by Autoinsurance.org .

The report, which analyses data from the Centers for Disease Control and Prevention and the Kaiser Family Foundation, found that Washington, D.C., has the longest median wait time in the nation for admitted patients waiting for an inpatient room after seeing a doctor in the emergency department.

According to the report, admitted patients in the nation's capital wait a median of 286 minutes for their room in the hospital.

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Nationally, admitted patients spend a median of 103 minutes waiting for a hospital room, according to the report. The initial screening is far shorter, with more than 40% of patients seeing a physician, nurse of physicians assistant within 15 minutes of checking into the emergency department.

Delaware , New York , Maryland and Connecticut joined Washington, D.C., with median waiting times above 150 minutes.

These 10 states have the longest median wait times for admitted patients:

1. District of Columbia: 286 minutes
2. Delaware: 153 minutes
3. New York: 153 minutes
4. Maryland: 152 minutes
5. Connecticut: 152 minutes
6. New Jersey: 150 minutes
7. California: 150 minutes
8. Rhode Island: 147 minutes
9. Massachusetts: 131 minutes
10. Hawaii: 131 minutes

If two states had the same median wait time for admitted patients, the tie was broken by considering their median wait time for patients who were ultimately discharged, meaning that they are not admitted to the hospital and are sent home.

With a median wait time of 46 minutes for admitted patients, South Dakota boasts the shortest emergency department wait.

These 10 states have the shortest wait times:

South Dakota: 46 minutes
Kansas: 55 minutes
Wyoming: 58 minutes
Iowa: 60 minutes
Wisconsin: 61 minutes
Nebraska: 62 minutes
Utah: 62 minutes
Montana: 63 minutes
Mississippi: 67 minutes
North Dakota: 68 minutes

According to the report, most visits don't require immediate attention. In order of increased severity, visits are categorized as nonurgent, semiurgent, urgent, emergent, emergent and immediate, and only 9% of emergency department visits are categorized as "emergent," while 1% require immediate attention. The majority of cases are considered "urgent."

Among the authors' other notable findings:

More than 25% of emergency room department visits are for patients below the poverty line
Painkillers are the most common drugs prescribed during emergency room visits.

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Tags: Washington, D.C. , hospitals , doctors

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# 2 New Hampshire
# 3 Nebraska
# 4 Minnesota

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When to Visit the ER

Unsure when to visit the ER? Learn about common signs and symptoms that indicate you should seek emergency care.

This article is based on reporting that features expert sources.

Patients sitting in waiting room. Confident doctor and nurse are walking in corridor. They are in hospital.

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It's 2 a.m., and you wake up with a terrible pain in your lower back . It's 5 p.m. on a Sunday afternoon, and you suddenly feel extremely nauseous. It's 9 a.m. on a Wednesday morning, and the cough that's been bothering you suddenly seems to take a turn for the worse. What should you do?

Depending on the severity of the problem and your overall health, the answer to that question may be to head to the emergency room – a unit within your local hospital that handles all manner of emergent medical issues.

“ER providers are able to very quickly assess and treat sudden, serious and often life-threatening health issues,” explains Dr. Sameer Amin, chief medical officer with L.A. Care Health Plan, the largest publicly operated health plan in the country that serves nearly 2.9 million members.

The ER, also known as the emergency department, is open 24/7 and can handle a wide range of illnesses, including physical and psychiatric issues, adds Patrick Cassell, patient care administration, emergency services, with Orlando Health in Florida.

Some ERs are Level 1 trauma centers that can handle “very high-level stuff,” he explains, while others, such as those in a community hospital or more rural settings, might need to transfer patients to a larger facility. These transfers happen when the acuity (severity) of the need exceeds the hospital's capacity to care for the patient on-site.

Common Reasons to Visit the ER

So, what constitutes an emergency?

“For us, an emergency is what the patient thinks is an emergency,” Cassell says. “It’s something that we don’t get judge-y about.”

According to a report from the Healthcare Cost and Utilization Project at the Agency for Healthcare Research and Quality, in 2018 (the most recent year data was available), U.S. residents made 143.5 million emergency room visits. Circulatory and digestive system conditions were the most common reasons for an emergency room visit, and 14% of those seen in the ER were admitted to the hospital .

Some common reasons to visit the ER include:

Chest pains .
Shortness of breath or difficulty breathing.
Abdominal pain, which may be a sign of appendicitis , bowel obstruction, food poisoning or ulcers .
Uncontrollable nausea or vomiting.
COVID-19, influenza and other respiratory infections .
Severe headaches .
Weakness or numbness.
Complications during pregnancy .
Injuries, such as broken bones, sprains, cuts or open wounds.
Urinary tract infections .
Dizziness, hallucinations and fainting .
Mental health disorders or suicide attempts.
Substance use disorders.
Back pain .
Skin infections, rashes or lesions on the skin.
Foreign object stuck inside the body.
Tooth aches .

When to Seek Urgent Care Instead of the ER

If you're questioning where to seek care, you should opt for the emergency room if you might have a potentially serious condition or are in severe pain, advises Dr. Brian Lee, medical director of the Emergency Care Center at Providence St. Joseph Hospital in Orange, California.

However, if you’re having a medical issue that’s not a full-blown emergency, but your primary care provider can’t get you in for an appointment, that’s a good time to head to an urgent care provider.

“Urgent care clinics are best equipped for a less dire level of care,” Amin explains. “They fill the gaps when the health concern will not require a hospital stay but still needs immediate treatment.”

Deciding between the ER and urgent care also depends on your medical history, notes Dr. Christopher E. San Miguel, clinical assistant professor of emergency medicine with the Ohio State University Wexner Medical Center in Columbus. For example, most people with a cough and a low-grade fever can be treated at an urgent care clinic without difficulty.

“If, however, you have a history of a lung transplant, you should probably be seen for your cough and fever at an ED,” he recommends.

Because urgent care centers typically offer less robust interventions than what you’d find at the emergency room, they can’t help in all situations. They can, however, refer you to a local ER if you do require more intensive care. They also tend to have a lower deductible than the ER, “and if you’re paying out of pocket, urgent cares can be cheaper than an emergency department typically,” Cassell says.

Cost of Urgent Care vs. ER

On the cost front, San Miguel says there are a few factors to be aware of, particularly if funds are an issue.

“Urgent cares are like any other outpatient health care office – they can require payment up front and decline to see patients who are unable to pay,” San Miguel explains.

Emergency departments, however, are compelled by federal law – the Emergency Medical Treatment & Labor Act, which was enacted in 1986 – to see patients and assess them for “life- or limb-threatening illness and injuries regardless of their ability to pay,” he says.

While this means that the ER must see you, they can “decline to treat non-life-threatening problems once they determine that they are non-life-threatening,” San Miguel adds.

You won’t be charged a fee upfront to be seen in the emergency room, but the hospital can and will bill you after you’ve been discharged.

When you accept treatment at the emergency department, “you’re still ultimately accepting responsibility for the bill ,” San Miguel points out. “And because of the nature of providing a 24-hour service that is prepared to handle any emergency, the cost of care in the ED is much higher than the cost in an urgent care.”

If you find yourself in a situation where you’ve received emergency care but are unable to pay, you should call the billing office as soon as possible to talk about your options.

“Often the bill will be reduced and you’ll be placed on a reasonable payment plan,” San Miguel says.

For any non-urgent or ongoing health concerns, visit with your primary care provider, Amin adds.

“It’s always better to have longstanding issues taken care of in a calm and collected manner during normal business hours,” he explains.

How Long Is the Wait at an ER?

Before you arrive, consider that you could be in for a long wait, depending on the type of problem you’re having and the situation inside the ER.

“We don’t operate on a first-come, first-served basis. It’s based on how sick you are,” Cassell explains.

For instance, he says, patients with more severe illnesses, such as a suspected heart attack or stroke , will take precedence over less severe problems, such as a sprain or an earache .

Even though you may walk in and find an empty waiting room and assume you’ll be seen quickly, there could be all sorts of activity going on behind the scenes. Especially in larger ERs, ambulances may be arriving with sick patients or the ER may already be very busy with sicker patients. You will get the same triage if you come by ambulance or walk in to the ER.

So rest assured that if you are very sick, you will get brought back immediately if you walk into ER. Similarly, if you take an ambulance for broken toe, it wont get you in sooner. You will likely be placed in waiting room if ER full.

San Miguel adds, “The best thing you can do is to let the triage/registration team know if there has been a change in your symptoms while you are waiting. For instance, if your chest pain is getting worse or if you are now having trouble breathing, this should prompt the team to reassess you and make sure you are triaged appropriately.”

What Should You Do While You're Waiting to Be Seen?

While you’re waiting, Amin recommends considering what the provider will ask you, such as:

When did symptoms start?
How long have they been going on for? Have they changed in severity or frequency?
Are symptoms related to a health issue you’re being treated for?
What triggered your visit to the ER today?

You should also bring a list of your medications, health conditions and history, such as chronic conditions and previous surgeries. It's also a good idea to have the names of the providers on your care team, including your primary care doctor and any specialist. Having this information at the ready is especially helpful if you’re headed to an ER that’s outside of the health system you typically use.

“It’s immensely valuable if patients are able to provide us with an accurate history of their medical problems and current medications,” San Miguel notes. “Unfortunately, not all electronic health systems communicate with each other, and in the middle of the night, it can be impossible to request records from another hospital.”

What Happens When You See an ER Provider

When you are brought in to see a provider, the initial aim of the interaction is to assess what’s going on and make sure you’re stabilized.

For some patients, a "big point of frustration is the need to tell their symptoms to more than one person," San Miguel says. "It seems like we’re quite unorganized and not communicating with each other, but in reality, we just know that the patients themselves are the best source of information about their own symptoms.”

As the physician, San Miguel always reads the notes that come from the initial intake, “but I want to confirm the details directly with you.”

While you will receive some care on the spot, most of your treatment will take place elsewhere, Cassel adds.

“With the exception of putting in stitches to fix a cut, the emergency department is not in and of itself a definitive care spot. Definitive care takes place outside of the ED,” he says.

This means that once the care team determines what’s going on and what care you need, you’ll either be admitted to the hospital for more intensive treatment or sent home with care instructions and a plan for additional follow-up if necessary.

For example, if you are having a heart attack , you’ll be admitted to an inpatient unit in the hospital for more testing and stabilization. If you’ve come in for an earache, you’ll probably be given a prescription and sent home. You'll then use those medications and recover with instructions to follow up with your primary care provider as soon as they can see you.

Lee underscores that “emergency and urgent care is not complete care. It is an acute intervention that addresses specific issues that often require further attention in the ambulatory office setting.”

Lastly, remember that the providers you’re working with are doing their best to look after you in a timely, helpful fashion. The ER staff understand you have been waiting, but they have no control over how many patients show up at once. If a surge of patients show up in an hour, the ER doesn't have the ability to suddenly bring on more staff. This happens more frequently than people realize.

Cassell says that the people who staff the emergency department are there “because we love it. We are task-focused, and we’re often very busy going from place to place, but we really do care.”

Keep in mind that the ER is not generally a calm place and the patient experience will be different from what you might get if you’re admitted in the hospital.

What to Pack in Your Hospital Bag

Senior woman packing her luggage in bedroom.

The U.S. News Health team delivers accurate information about health, nutrition and fitness, as well as in-depth medical condition guides. All of our stories rely on multiple, independent sources and experts in the field, such as medical doctors and licensed nutritionists. To learn more about how we keep our content accurate and trustworthy, read our editorial guidelines .

Amin is chief medical officer of L.A. Care Health Plan, the largest publicly operated health plan in the U.S.

Cassell is patient care administrator, emergency services, with Orlando Health in Florida.

Lee is medical director of the Emergency Care Center at Providence St. Joseph Hospital in Orange, California.

San Miguel is clinical assistant professor of emergency medicine with the Ohio State University Wexner Medical Center in Columbus.

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