Patients now wait about 40 percent longer before receiving care in emergency rooms than they did in 1997. And nearly a quarter of heart-attack patients wait at least 50 minutes before seeing a doctor. Those delays can not only deprive you of needed care but also increase your exposure to the germs that often breed in E.R.s, including antibiotic-resistant bacteria.

Some of the delays stem from fewer emergency rooms as hospitals close or consolidate and more uninsured patients resort to E.R.s for basic care. Here’s how to make your trip to an E.R. go more smoothly.

Recognize real emergencies. Get to an E.R. fast if you have severe blood loss or physical trauma, including a possible broken limb, or if you experience sudden chest pain, difficulty breathing, the inability to use a limb, vision loss, or an "explosive" headache.

Don’t go if you don’t have to. Conditions that don’t warrant emergency care include mild respiratory infections, minor aches and sprains, scrapes and bruises, and prescription refills. If your doctor isn’t available, go to an urgent- or immediate-care center.

Don’t drive yourself. Dial 911 for an ambulance. You can ask to be taken to a hospital of your choice. But for true emergencies it's generally best to let the paramedics take you to the nearest E.R. that is accepting patients. You can transfer to a different facility later.