All posts tagged the-emergency

The Villages Regional Hospital Emergency Room – Villages-News

To the Editor:

We are relatively new to the Villages and have had to make a few trips to the Villages hospital.The hospital is beautiful and well run, and you can tell that there is a lot of pride that goes into the building, the volunteers, and the staff. The reason that I am writing this letter is because, for the first time, I had to go to the emergency room at the hospital.Even though I had read about negative experiences others had encountered while using the Villages hospital emergency room, I still didnt think it could be that bad.Unfortunately, I was sadly mistaken.The emergency room was understaffed and simply not capable of servicing the needs of the people who came there. While sitting in the waiting room for hours with a blood clot I was amazed at how many others, who were also in need of immediate care, had been waiting. One man came into the waiting room stating that his wife was sitting in the parking lot in the ambulance because they had no beds for her in the emergency room.The staff member in the emergency room, who was clearly overwhelmed, said that the wait time could be up to 20 hours. Some people left to try to find other hospitals and some stayed and hoped for the best. I just found it hard to believe that this was happening. Our short time living in The Villages we had become so accustomed to everything in the Villages being top notch, that this was just so unexpected. I think the higher level administrators need to take a hard look at what is happening.They should strive for having the best emergency room services possible (like the Villages tries to provide in all other aspects of living here), or maybe not have an emergency room at all. Their current situation is just giving the entire hospital a bad reputation.

Pete JacksonSan Pedro Villas

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A View of the Epidemic: At the ER, New Complexities – Valley News

Lebanon Its hard to imagine someone more directly involved in the opioid epidemic through his work than Thomas Trimarco. Hes an emergency medicine physician at Dartmouth-Hitchcock Medical Center, where hes worked since 2012.

Emergency rooms, of course, in some ways serve as one of the front lines in dealing with fallout from the epidemic. Its where opioid users are taken when theyve overdosed. Its also a place where users might go to feign a condition in the hope of securing narcotics.

Dartmouth-Hitchcock officials couldnt readily produce statistics on the number of opioid-related cases it handles in the emergency room, but Trimarco, 37, has no doubt it has increased substantially in the number of people he sees with serious, chronic conditions resulting from intravenous drug use, such as infections of the spine, heart and brain.

Those can lead to significant problems that cant necessarily be taken care of at the smaller, community hospitals, said Trimarco, who also serves as medical director for 27 local emergency medical service agencies. So, weve seen a significant increase in the amount of patients who are being transferred from (other) hospitals that are ending up in our emergency department and in our facility with these more serious, long-term complications.

Such cases were once relatively uncommon, but the amount that were seeing now is very significant. Instead of kind of an interesting, once-in-a-while case, its a pretty common case these days.

While some patients come to the emergency room seeking drugs to feed their habit, Trimarco said DHMC has not seen an increase in such patients recently.

I dont think were known as a candy shop, he said.

Because drug seekers often come in complaining of pain-related conditions, such as those that are commonly treated with opioids, it can sometimes be difficult for providers to determine whether a patient is seeking drugs to feed a habit or is in need of medication to treat an acute medical need, he said.

We like to think the best of patients and surely we will give them the benefit of the doubt, Trimarco said.

His job though is to evaluate a patient to determine what their medical need might be.

Once weve eliminated the acute medical issue that might be going on other than the substance abuse … We try to be upfront and honest about our ability to prescribe (opioids) for chronic pain issues out of the emergency department, he said.

There are times when Trimarco has to speak firmly and bluntly with patients who just want to feed their habit.

Most of the time the overall interaction is reasonable and goes well, he said. But, patients can get upset and angry when they are looking for what they think they need or deserve in coming into the emergency room.

In some cases, patients may become violent, Trimarco said.

Trimarco was assaulted twice while working in an emergency room in Cincinnati, prior to coming to DHMC. In one instance, he was punched in the face, in the other he suffered a broken rib. Though both assaults predated the opioid epidemic, they did involve substance use, he said.

Violence against health-care providers is a problem throughout this system and the nation, he said. Its certainly complicated and, perhaps, increased by the opioid epidemic that were seeing. We are seeing more instances of risk to providers both in the ED as well as in the hospital over the last couple of years.

Health care providers face another danger as a result of the epidemic: toxic substances. Even a trace amount of fentanyl or carfentinal narcotics frequently used by addicts could cause a fatal overdose. Such substances may lurk on patients clothing or belongings when they arrive in the emergency room or when emergency medical personnel arrive on a scene, Trimarco said.

No longer can we just kind of dive in and start treating that patient, he said.

If providers suspect patients may have toxic substances on them, they may need to remove and bag their clothing, or take a shower, Trimarco said.

He and the emergency room staff have to deal with overdoses and medical conditions related to intravenous drug use, but the epidemic has also forced him to question whether the standard emergency-room approach is adequate to the task.

As emergency physicians, were really trained to diagnose and to stabilize the acute medical problem thats in front of us, and once that stabilization is achieved were able to hopefully pass that patient along to another provider that would specialize in the longer term care of whatever the ailment, injury or illness is, Trimarco said.

What weve recognized, though, is the exposure that we have to a patient in the emergency department is sometimes the only chance that the health care system has to access these patients and to offer them this support that they may be in need of.

Aiming to break the cycle of addiction, emergency-room staff have started a peer-recovery coaching program.

We will identify patients who may benefit from this program and well call in a recovery coach to spend some time with that patient and offer some support to that patient, both for their current emergency department visit as well as, hopefully, going forward as they try to deal with the long-term addiction that theyre struggling with, he said.

Shifting to addressing patients longer-term needs, however, has come at a cost. What might previously have been a one- or two-hour visit can sometimes last much longer, which can mean longer waits for other patients, he said.

It does have significant downstream effects for all of the other patients in the community who are coming in for emergency care, but these patients are as important as all of our other patients and we still prioritize them and all of our patients according to severity, said Trimarco.

Providers approach those struggling with substance abuse differently than they did in the past, Trimarco said.

I think we all do a little bit of a better job of recognizing the significant struggle that our patients are having dealing with substance abuse these days, he said. I think the patients are less stigmatized than they have been in the past, perhaps.

In some cases, health-care providers also struggle with substance abuse.

Before coming to D-H, I worked at a hospital and we had a young, tremendously talented nurse in our emergency department that died of an overdose, and so I dont think anybody is immune to this epidemic, he said. You see it in many different ways, both when youre working clinically and … it certainly spills over to our personal side as well.

Its a privilege to be able to see and treat patients in some of the worst times of their (lives), but at the same time that can take a toll on you and you certainly need to find a way to appropriately and positively deal with those stresses to be able to continue to do your job and serve the patients that we try to serve, Trimarco said.

Sometimes you just need a little bit of a breather, he said. A lot of times the issues that we see just constantly remind us of the blessings and the amazing things in our own lives.

Staff Writer Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.

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Medical Monday-When to go to the Emergency Room vs. Your Primary Care Physician – WAGM

When youre sick, its hard enough to function, much less try and decide where to go to see a doctor. Pines Health Services is sending out pamphlets to help with Cary Medical Centers overcrowded emergency room.

“The ER is extremely busy. Every single bed I think even the hallways are full. Patients are in the waiting room that might be able to be seen here so we really can take away the wait time in the ER making it more convenient for the patient,” said RN Practice Manager Libby Gardner.

To help with overcrowding, Pines health services is educating the community on when to see a primary care physician or head to the Emergency room.

“So we sent out five thousand mailers today to community members just stating the differences for where they should seek treatment,” said Gardner.

The pamphlet includes when to see your primary care physician including sprains, sports injuries, and even getting a pregnancy test.

“The reason that were doing this is because weve seen an influx of patients going to the ER seeking treatment there rather than coming here to see a primary care provider. Seeing increase wait times, costs, those kinds of things when were readily available to help here,” said Gardner.

But if youre experiencing a symptom with more severity Gardner says you should be going to the emergency room.

“If someone is experiencing some chest pain, numbness on one side of the body, those are signs of a much more severe condition and they should seek expert advice in the emergency department,” said Gardner.

Gardner also says you could be saving money if you see your primary doctor rather than heading to the ER.

“If you come to your primary care physician depending on the insurance that you have or copay. If you go to the emergency department you might have a copay thats 5 times as high than coming to the office,” said Gardner.

In order to encourage patients to come in to see their primary care physicians Gardner says the staff at pines health does their best to see their patients as soon as possible.

“We strive to be able to get our own patients in the very same day that they are calling with their needs. Although they may not see their own primary care provider we have a team of providers ready to help who have access to a patient’s medical records making it a safe, smoother transition for the patient,” said Gardner.

And when in doubt, call your physician to determine where you should go.

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Hospital evacuated after reports of odor in emergency room – Atlanta Journal Constitution

EXETER, N.H.

Exeter Hospital in New Hampshire was evacuated Friday morning and extra ambulances were called in after reports of an odor in the emergency room, according to the local firefighters’ union.

New Hampshire One reports employees were asked to leave the hospital around 11:30 a.m. when police and other first responders were called.

The Exeter firefighters union tweeted crews were called to the scene for an “unknown odor” in the emergency room.

According to a spokesperson for the hospital, five staff members began showing symptoms like dizziness around 8:30 Friday morning.

The number of patients increased to about 20 as the morning went on and the emergency department and operating room were closed out an “abundance of caution,” Deb Vasapoli told Boston 25 News.

Officials say they have not been able to find the source of what is making people sick at the hospital. Some of the patients were transferred to other hospitals in the area.

According to Vasapoli, the only people affected by the symptoms were staff members and they were all from the operating room.

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Medicaid expansion didn’t lead to overwhelmed emergency rooms … – Baltimore Sun

After the Affordable Care Act expanded access to Medicaid, some worried that newly insured patients would overwhelm emergency rooms, but those concerns appear unfounded, according to new research from Johns Hopkins Medicine.

The study comes as lawmakers in Washington consider legislation to scale back the federal-state health insurance program for low-income people as part of a larger overhaul of the health care reform known as Obamacare.

Through the Medicaid expansion, there were some people who believed more patients would choose to go to primary care providers instead of the emergency department, because now they have health coverage, and there were some people who believed that the expansion would swamp the emergency department, said Eili Klein, assistant professor of emergency medicine in Hopkins School of Medicine. We wanted to look at what actually happened.

Thirty-two states expanded their Medicaid programs. In a paper published this week in the Annals of Emergency Medicine, Hopkins researchers looked at billing data from Maryland during 18 months before and after enrollment in the health program began in 2014.

Marylands Medicaid rolls swelled by about 20 percent, or 160,000 people. About 800,0000 already were enrolled in the program.

Overall, the study found there was a 1 percent decrease in emergency room use over the study period despite an increase in the number of insured people.

Those new to Medicaid did use the emergency room more about 43 percent more than people without insurance, Klein said. But most people dont visit the emergency room much, and the growth in Medicaid enrollees wasnt enough to have much of an effect.

Among those using the emergency room, there was a six percent increase in those with Medicaid coverage and a corresponding decrease in those with no insurance.

Klein said the financial benefits to patients was positive because they werent stuck with bills they couldnt pay, and the hospitals bottom lines were protected from uncompensated care.

meredith.cohn@baltsun.com

twitter.com/mercohn

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Emergency Room Wait Times Getting Longer in North Texas – NBC 5 – NBC 5 Dallas-Fort Worth

The next time you need to visit the emergency room, you might wait longer than usual.

The average wait time to see a medical professional inside a hospital emergency department in Texas is now 26 minutes, according to Centers for Medicare and Medicaid Services.

However, explosive growth in North Texas may keep you from seeing a doctor as fast as possible.

According to W. Stephen Love, president and CEO of the DFW Hospital Council, North Texas is experiencing explosive growth, and federal health care changes will likely lead to more uninsured residents, who he says go to the emergency department for primary care.

Love says right now, Texas leads the nation in uninsured patients.

“Most people who drive themselves to the emergency departments are really people seeking primary care. Primary care will be delivered, but it’s not the best place for primary care. It creates wait times,” he said.

Free-standing ERs affiliated with hospitals can alleviate some of the load, but he says free-standing ERs not owned by hospitals typically don’t treat patients on Medicare or Medicaid.

Love says they have little impact on wait times at the large hospital systems.

Your best bet, he suggests, is to know where to go.

“If you’re going to an emergency room that has trauma built in, like a Level One trauma or a Level Two trauma, sometimes very severe emergencies come in and you’re going to have to wait,” Love said.

Grand Prairie pastor Jordan Tew knows what it’s like to wait in the an emergency room waiting room.

He and his wife recently had to rush their young daughter, Savannah, to the emergency room after she became sick a few days after surgery.

“She had just had surgery to remove an extra digit on her hand and she developed a little stomach illness afterwards,” Tew said.

He says Children’s Health hospital staff had told him if any complication arose, they should return to their hospital.

“We were advised that was the place to go,” Tew said.

He said he didn’t expect to wait four-and-a-half hours to inside the emergency department waiting room.

“This is my number-one priority. It’s my child, but she’s down on a list and that is very frustrating,” he said.

Hospitals now post current wait times on signs and billboards near their facilities.

Many have also launched apps to improve customer service.

Tew says the care his daughter eventually received was excellent, but knowing what he knows now, he would have taken her to an urgent care clinic.

According to Hospital Compare, Parkland Memorial Hospital in Dallas has the longest wait time, from the moment a patient enters the hospital to the time the patient is seen by a medical professional. The average wait time is 83 minutes.

John Peter Smith Hospital in Fort Worth has an average wait time of 35 minutes.

Published at 10:28 PM CDT on Jul 24, 2017 | Updated at 3:58 AM CDT on Jul 25, 2017

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Emergency Room Wait Times Getting Longer in North Texas – NBC 5 – NBC 5 Dallas-Fort Worth

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