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Anthem asks Missourians to think twice before going to the … – St. Louis Public Radio

Anthem Blue Cross Blue Shield, one of Missouris largest insurers, no longer covers emergency room visits that it deems unnecessary.

The policy aims to save costs and direct low-risk patients to primary care physicians and urgent care clinics. But doctors say patients may avoid going to a hospital when they really need it, if they fear a large bill.

Theyre forcing the lay public to make a medical determination, said Dr. Doug Char, a Washington University emergency physician. Theyre basically telling people you have to decide if this chest pain youre having is indigestion or a heart attack.

An emergency room is the most expensive place to see a doctor, and insurers are balking at the cost. Between 15 percent and 30 percent of emergency room visits in the St. Louis region are avoidable, according to a study by the nonprofit Midwest Health Initiative. Missouri hospitals charge an average of $372 for emergency room visits for minor issues, but some charge as much as $1,300, according to data compiled by the Missouri Hospital Association.

“Most non-emergent medical conditions can be easily treated at retail clinics, urgent care clinics or 24/7 telehealth services,” Anthem’s Missouri spokesperson, Scott Golden, wrote in an email. “The review by an Anthem medical director will take into consideration the presenting symptoms that brought the member to the emergency room as well as the diagnosis.”

In mid-May, Anthem sent letters to Missouri enrollees to alert them that from June 1, it would no longer cover emergency room services for non-emergencies. In such cases, people who have health insurance could still be stuck with the full cost of their visit, if the insurer determines that their symptoms did not reach the level of requiring emergency care.

Anthem enforces the same guidelines in Kentucky, and put the rule in place for Georgia policyholders this month. Its officials say there are several exceptions, such as if a patient is under 14, the visit occurs on a Sunday or there are no urgent-care centers within 15 miles.

The American College of Emergency Physicians raised a red flag when Anthem sent out a spreadsheet of 1,908 conditions that it may not deem worthy of coverage in an emergency room. Some of the listed symptoms could indicate a life-threatening emergency, said Dr. Jonathan Heidt, president of Missouris ACEP chapter.

To have them under that threat of not having their bills paid if theyre wrong about what their diagnosis is, its really going to harm patients in the long run, Heidt said. Our patients have a right to seek emergency care.

The doctors argue that Anthems policy, and similar rules set up by state Medicaid programs, violate the federal Affordable Care Acts prudent layperson standard. The rule asserts that a person with average knowledge of health and medicine should be able to anticipate serious impairment to his or her health in an emergency, and that laws should not assume that a person will know more than that. Anthem contends that it reviews claims using this standard already.

Though Anthem began enforcing the Missouri rule at the beginning of June, patients who visit the emergency room for non-emergencies likely will receive bills in the coming months. Heidt said that if Anthem does not reconsider its policy, ACEP may weigh legal action against the insurer.

Were still a little bit early for that,” Heidt said. “But at this time, all of our options are on the table.

According to the Missouri Department of Insurance, Financial Institutions & Professional Registration, the rule is based on previously filed language that was approved by the regulator. Other plans have similar provisions.

“If a consumer believes a claim has been improperly denied, or has questions about how a claim has been handled by their insurer, they can contact the Department’s Consumer Affairs Hotline at 800-726-7390 or they can file a complaint online,” said Grady Martin, the agency’s director of administration.

Follow Durrie on Twitter: @durrieB

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Anthem asks Missourians to think twice before going to the … – St. Louis Public Radio

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Anthem asks Missourians to think twice before going to the emergency room – St. Louis American

(St. Louis Public Radio) – Anthem Blue Cross Blue Shield, one of Missouris largest insurers, no longer covers emergency room visits that it deems unnecessary.

The policy aims to save costs and direct low-risk patients to primary care physicians and urgent care clinics. But doctors say patients may avoid going to a hospital when they really need it, if they fear a large bill.

Theyre forcing the lay public to make a medical determination, said Dr. Doug Char, a Washington University emergency physician. Theyre basically telling people you have to decide if this chest pain youre having is indigestion or a heart attack.

An emergency room is the most expensive place to see a doctor, and insurers are balking at the cost. Between 15 percent and 30 percent of emergency room visits in the St. Louis region are avoidable, according to a study by the nonprofit Midwest Health Initiative. Missouri hospitals charge an average of $372 for emergency room visits for minor issues, but some charge as much as $1,300, according to data compiled by the Missouri Hospital Association.

“Most non-emergent medical conditions can be easily treated at retail clinics, urgent care clinics of 24/7 telehealth services,” Anthem’s Missouri spokesperson, Scott Golden, wrote in an email. “The review by an Anthem medical director will take into consideration the presenting symptoms that brought the member to the emergency room as well as the diagnosis.”

In mid-May, Anthem sent letters to Missouri enrollees to alert them that from June 1, it would no longer cover emergency room services for non-emergencies. In such cases, people who have health insurance could still be stuck with the full cost of their visit, if the insurer determines that their symptoms did not reach the level of requiring emergency care.

Anthem enforces the same guidelines in Kentucky, and put the rule in place for Georgia policyholders this month. Its officials say there are several exceptions, such as if a patient is under 14, the visit occurs on a Sunday or there are no urgent-care centers within 15 miles.

The American College of Emergency Physicians raised a red flag when Anthem sent out a spreadsheet of 1,908 conditions that it may not deem not worthy of coverage in an emergency room. Some of the listed symptoms could indicate a life-threatening emergency, said Dr. Jonathan Heidt, president of Missouris ACEP chapter.

To have them under that threat of not having their bills paid if theyre wrong about what their diagnosis is, its really going to harm patients in the long run, Heidt said. Our patients have a right to seek emergency care.

The doctors argue that Anthems policy, and similar rules set up by state Medicaid programs, violate the federal Affordable Care Acts prudent layperson standard. The rule asserts that a person with average knowledge of health and medicine should be able to anticipate serious impairment to his or her health in an emergency, and that laws should not assume that a person will know more than that. Anthem contends that it reviews claims using this standard already.

Though Anthem began enforcing the Missouri rule at the beginning of June, patients who visit the emergency room for non-emergencies likely will receive bills in the coming months. Heidt said that if Anthem does not reconsider its policy, ACEP may weigh legal action against the insurer.

Were still a little bit early for that,” Heidt said. “But at this time, all of our options are on the table.

According to the Missouri Department of Insurance, Financial Institutions & Professional Registration, the rule is based on previously filed language that was approved by the regulator. Other plans have similar provisions.

“If a consumer believes a claim has been improperly denied, or has questions about how a claim has been handled by their insurer, they can contact the Department’s Consumer Affairs Hotline at 800-726-7390 or they can file a complaint online,” said Grady Martin, the agency’s director of administration.

Republished with permission of St. Louis Public Radio: http://news.stlpublicradio.org/post/anthem-asks-missourians-think-twice-going-emergency-room

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Summer months bring rise in emergency room visits – Florida Times-Union

Summertime in Florida brings warm weather, beach trips and outdoor activities as children are out of school and families enjoy vacations.

All can be fun, but also have inherent risks and increases in injuries.

Close to 20 percent of adults and more than 17 percent of children every year visit an emergency room.

About 27 percent of visits are in the summer months, according to the Centers for Disease Control and Prevention.

In Florida, we are faced with a unique set of problems that can result in drownings from rip currents in the ocean to heat-related illnesses and dangerous sunburns.

Some other common injuries and illnesses seen in emergency rooms in the summer include motor vehicle accidents, watersports-related injuries, snake bites, shark bites, bug bites, spinal injuries and other traumatic injuries.

But there are many ways to stay safe while enjoying all the fun summer has to offer.

Wear sunscreen that is SPF 30 or higher and reapply frequently

Limit your time in the extreme heat and direct sun and wear sun protective clothing

The suns rays are most harmful between 10 a.m. and 4 p.m. If youre out during these times, seek shade under a tree, shelter or an umbrella.

Stay hydrated throughout the day

Learn CPR and other life-saving techniques

Be sure to wear your seatbelt at all times

In the summer, the temperature inside a parked car can reach 140 degrees. Never leave a child or a pet inside a parked car even if the windows are cracked or the car is parked in the shade.

Water safety is also essential. The CDC reports that from 2005 to 2014 there were an average of 3,536 fatal unintentional drownings (non-boating related) annually in the United States about ten deaths per day. An additional 332 people died each year from drowning in boating-related incidents.

Drowning is the leading cause of death among children between 1 and 4 and the second leading injury-related cause of death in older children, with nearly 800 children drowning each year nationally, according to Safe Kids Northeast Florida, led by THE PLAYERS Center for Child Health at Wolfson Childrens Hospital. More than half are under age 5.

More than 5,000 children nationally are seen in emergency rooms for injuries from near-drowning incidents.

According to Safe Kids Northeast Florida, studies show that although 90 percent of parents say they supervise their children while swimming, many acknowledge that they engage in other distracting activities at the same time like talking, eating, reading or taking care of another child. Even a near-drowning can have lifelong consequences.

With all the water activities in Florida, its important to also know that Floridas drowning death rate of children ages 1 to 4 has historically been the highest in the nation.

Children need to be watched carefully and at a close distance while also avoiding any distractions. Use life jackets when boating and ensure that yourself and children know basic swimming skills. If you have a pool, be sure it is fenced off and safeguards are in place to protect children from getting inside unsupervised.

When it comes to the outdoors, children and adults also need to be careful where they walk and play because they may come face-to-face with critters, including snakes.

Summer is snake season and Florida is especially dangerous with several poisonous snakes commonly roaming the area.

Avoid high-brush areas and if you see a snake, do not approach or pick it up.

If you are bitten, seek help immediately. Do not apply a tourniquet and do not attempt to suck venom from the wound. Often times, people try to capture and bring in the snake when they go to the emergency room. But that is actually more dangerous and does not help with treatment. Instead, remember the snakes color and shape to describe to medical personnel.

The key to summer fun is to just be cautious and take necessary precautions to keep you and your family safe.

Brandi Gilchrist, MD, is board-certified as an emergency medical specialist. She is medical director of Baptist Emergency at Town Center and assistant medical director of the emergency department at Baptist Medical Center Beaches, 1350 13th Avenue South, Jacksonville Beach, FL 32250.

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Avoid a 4th of July emergency room trip – KRISTV.com | Continuous … – KRIS Corpus Christi News

CORPUS CHRISTI –

For many Americans, the 4th of July is a day of patriotism, family celebration, barbecue, and, of course, fireworks. However, each year the fun ends with a trip to the emergency room for those who aren’t careful.

Last year fireworks accidents sent more than 11,000 Americans to emergency rooms.

The 4thof July holiday has earned a reputation as the most dangerous holiday in the U.S. Jennifer Carr, theTrauma Program Managerat the Corpus Christi Medical Center says 4th of July related activities and fireworks bring a lot of people into the ER.

It is actually more common than you think. We see a lot of injuries with adults, and we also see injuries with children. We see injuries due to fireworks. We see burns to faces, hands, and eyes due to fireworks,said Corpus Christi Medical Center Trauma Program Manager Jennifer Carr.

According to the Consumer Product Safety Commission (CPSC). The injuries skyrocket around this time of year. More than 230 people on average end up in the ER with fireworks-related injuries every day in the month around July 4th.

If somebody gets injured from a firework, you definitely want to get them to the closest emergency department. Call 911, especially if it is an injury to the face or eye. Typically a burn such as a sunburn is a first-degree burn. Anything that is more than a first-degree burn needs to beevaluated by a physician. Anything that causes the skin to open up or not stay intact anymore needs to be evaluated. Burns can scar and require lots of treatments infollow-up phases, said Carr.

Even with seemingly harmless sparklers, parents should use great caution and think twice before handing them to children.

Take it seriously. Realize that fireworks can cause injuries, and always have adult supervision even with sparklers. Children need to be supervised. Sparklers can reach a temperature of 2000 degrees, and so we see lots of injuries of children with fireworks. A lot of those is because of lack of adult supervision, said Carr.

Before use:

During use:

After use:

While following these tips will help, sometime injuries happen. The most common areas of the body that are injured tend to be the hands, fingers, eyes, head and face, mostly with burns. If your child gets inured, considering the following:

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Avoid a 4th of July emergency room trip – KRISTV.com | Continuous … – KRIS Corpus Christi News

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Emergency rooms and urgent cares expect busy holiday week – KY3

Branson, Mo. — Many emergency rooms and urgent cares in the Ozarks are all hands on deck this holiday weekend.

But even with the extra staffing, some medical centers are backed up

With it being a busy weekend, CoxHealth in Branson said they are at capacity.

The hospital has all of its backup staff working in the ER to treat a lot of patients coming in.

At noon today, the ER waiting room was so crowded it was standing room only and its Urgent care, next door, was also backed up with a two-hour wait time.

Tourists and locals celebrating independence day have flooded the Branson area and with this being the most popular holiday for fireworks, many of the patients are coming in with burns.

“The injuries we see a lot this time of year are injuries to the hands,” CoxHealth, Branson, Communications Coordinator Brandei Clifton said. “A lot of folks even though fireworks don’t always work the way they’re supposed to, so you’ll see a lot, you’ve might even done this yourself holding roaming candles in your hands we’ve had folks hold the artileryshell canisters in their hand and if they malfunction that’s a pretty severe burn right there,” CoxHealth, Branson, Communications Coordinator Brandei Clifton said.

Even the smallest of fireworks can end badly.

“Even a little firework can cause a big burn,” Clifton said. “Make sure your kiddos… it seems like common sense, but like I said, when you’re in the fun… of the moment you don’t always have safety on the mind, so make sure those kiddos have adult supervision if they’re out their shooting off those fireworks… Even a smoke bomb, if a little hand grabs a smoke bomb at the wrong place which they don’t always know to do, or a sparkler, you know want to grab the sparkly pretty part of it and there’s a bad injury to the hand right now, so take care of those little ones and take care of yourself.”

The medical staff reminds people to keep a bucket of water close by to put out any remaining firework flames, in order to protect accidentally stepping or holding anything that could burn you.

“When fireworks don’t perform as they’re supposed to you, get a dud every once in a while, a lot of the times folks will try to reset or relight a dud firework and when that happens, sometimes, it can light back up and an injury to the face can happen that way, and more injuries to the hands,” Clifton said. “So important when you have a dead firework just leave it alone and after about 20 minutes if it still hasn’t fired go ahead and throw it back in that bucket of water.”

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Fourth of July tales from the emergency room – ABC News – ABC News

Summer is in full force by the time Fourth of July weekend rolls around every year — and so are the opportunities to injure oneself.

Doctors who have worked in the emergency room during the holiday weekend told ABC News that they often see the same types of incidents every Independence Day, including sunburns, poison ivy rashes, underage drinking and fireworks injuries.

But that doesn’t mean they haven’t treated some out-of-the-ordinary cases as well.

Here are some Fourth of July tales from the emergency room:

Jamie Coleman, a trauma surgeon at Indiana University Health Methodist Hospital in Indianapolis, said the bomb squad had to be called in for one of the “craziest” cases she’s ever seen, which happened on a Fourth of July weekend.

The incident involved fireworks that were the largest consumers in Indiana could buy without needing a license, Coleman said.

While the firework was being lit at a backyard party, one of the explosive mechanisms — a metal ball about four inches in diameter — misfired, Coleman said. Instead of launching the firework into the air, the metal ball came out of the side of the firework and became lodged inside the patient, she said.

Since the explosive did not detonate, it still had the potential to explode, and the bomb squad had to be present during the man’s emergency surgery to remove it, Coleman said.

“They’re there to protect it and ensure that it doesn’t go off once they’ve removed it, ensuring the safety of everyone in the operating room,” Coleman said of the bomb squad’s role.

As soon as the explosive device was removed from the man’s body, doctors “very carefully” handed it to the bomb squad, who then disposed of it safely, Coleman said.

“This stuff is so crazy sometimes — what we do and see,” Coleman said. “You just can’t even make it up.”

A couple of years ago, a Fourth of July prank lead to a trip to the emergency room for a group of teenagers in New York City, said Robert Glatter, an emergency physician at Lenox Hill Hospital on the Upper East Side.

During a party, the teens adorned a cake — which was decorated festively for Independence Day — with sparklers. But, one of the sparklers was actually a firecracker, Glatter said.

After the blast, the group took an Uber to the emergency room, where they were treated for minor injuries such as facial abrasions and a ruptured eardrum, Glatter said.

When the teens arrived at the hospital, they were covered in cake and red, white and blue icing, because they didn’t think to stop and wipe it off before they left, Glatter said.

None of the teens suffered eye injuries, since they were already wearing goggles so they could spray champagne on each other, Glatter said. Eye injuries are typical in accidents involving firecrackers, Glatter said.

The blast effect from the firecracker was probably lessened since it was lit outdoors, Glatter said. Had it exploded inside, the pressure from the blast effect could have led to more serious injuries such as ruptured bowels or a collapsed lung, he said.

Last year, a teen about 14 years old had to be medically evacuated from northern Michigan to Helen DeVos Children’s Hospital in Grant Rapids after he fell into a campfire, said Erica Michiels, associate director for the hospital’s pediatric emergency department.

First responders had initially reported to doctors that the teen was “burned black” and sustained surface burns to more than 30 percent of his body, causing his family and emergency physicians to fear the worst, Michiels said.

When the boy arrived, “he had soot all the way up to his waist,” Michiels said. Hospital staff got him to the emergency room to wash him off and to better see the burns, but they weren’t there.

The teen merely had one burn the size of the palm of his hand near his ankle, Michiels said.

“The rest was just soot from falling into the fire,” she said.

The boy’s parents may have over-inflated the sense of danger because he was “screaming and yelling and floundering around” after he fell into the campfire, Michiels said.

“I think his anxiety was contagious and made everyone think … he must be really, really injured,” she said.

The boy’s family and the healthcare professionals looking after him were all “relieved” when they realized his injuries weren’t so serious, Michiels said, adding that the medical staff “learned a lesson” that day to not get too carried away before they have a full understanding of the patient’s injuries.

Michiels saw another incident last year in which parents panicked a bit too prematurely.

A “terrified” mother brought her infant into the emergency room the day after Independence Day because she thought the baby had contracted “some sort of horrible infection,” Michiels said.

The cause for concern: bright blue poop.

The mother brought doctors the baby’s diaper in a Ziploc bag, and when they opened it, the “sweet, fruity smell” was “overwhelming,” Michiels said.

The family had been at a picnic the day before, where someone had brought a big bowl of blueberries, which the baby had never had before, she said. The infant “loved” the fruit and ended up eating a handful.

“When babies eat fruit, it passes through their system fairly quickly,” Michiels said. “You wind up with this sweet-smelling, dark-colored poop.”

Michiels said parents should only be worried if poop is white, black or red.

“All other shades of poop are usually OK,” she said.

Fireworks are best left to professionals, Coleman said, adding that every year she amputates fingers due to fireworks accidents.

Even the most seemingly innocuous items, such as sparklers, are a cause for concern, Coleman said. Sparklers can reach up to 1,200 degrees Fahrenheit, and physicians see sparkler burns almost every Fourth of July, Michiels said.

“Just the quickest touch to a child’s hand will give them a pretty significant burn,” Michiels said.

Glatter advised that people celebrating watch the amount of alcohol they imbibe, which, combined with setting fireworks off or swimming, could be a “perfect recipe for disaster,” he said.

Another safety concern to keep in mind is monitoring children near water at all times, Michiels said, adding that every Fourth of July, she tends to see at least one patient who has drowned.

During a pool party or beach outing, there are usually several adults around but not one particular person who is looking after the kids, she said.

“We often see a drowning event of a child where there were many, many adults right in the vicinity who could have rescued that child had they known the child was in trouble,” she said.

Michiels said a common misconception is that if you don’t hear anyone yelling for help, everything is fine.

“In truth, drowning is almost always a silent event,” she said. “You can’t hear someone calling for help because the person who is floundering is doing everything they can to get that breath in. They don’t have that extra energy to call out for help.”

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Heavy Rains Put Everglades in ‘Emergency Room’, Force Wildlife Officials to Make Tough Choices – The Weather Channel

The Everglades are in the midst of a catastrophic flood event.

So says Ron Bergeron, a 10-year commissioner with the Florida Fish and Wildlife Conservation Commission, who has watched heavy rains in South Florida over the past month push water levels in the conservation areas of the swamp to historic heights.

All but a few of the tree islands in the Everglades, which are used by white-tailed deer and other wildlife, are under water, Bergeron told the Florida Sun-Sentinel.

We have the highest water level ever since records were kept going into the rainy season, he said. This event, if its not addressed properly, will have the greatest impact to our wildlife, the environment, the habitat and the plant life that weve ever seen.

Bergeron told the Sun-Sentinel he had been in contact with Gov. Rick Scott, who issued an emergency order Friday to move water out of the Everglades water conservation areas, as well as the U.S. Department of the Interior, the U.S. Fish and Wildlife Service (USFWS), the South Florida Water Management District, and the U.S. Army Corps of Engineers.

While Scotts decree has helped some, its not enough, Bergeron says.

Its very scary, inflows that are three times greater than the outflows, he told the Sun-Sentinel. The level of the water conservation areas will rise close to one inch a day with those kinds of inflows and no rain. The water is so high above [where it should be at this time of the year] that if the inflows matched the outflows, and there was hardly any rain, it would take until December to get back to regulation.

Not everyone is on board with pumping water out of the conservation areas.

The USFWS is proposing to keep those spillways closed until July 15 to protect the endangered Cape Sable seaside sparrow, whose nesting areas would be in the path of the releases.

Larry Williams, state supervisor for USFWS, told the Palm Beach Post he agrees the Everglades animals are in a crisis and that some will die, but that the Cape Sable sparrow is the only species that could be wiped out forever.

Willaims told the Post there are between 2,000 and 3,000 Cape Sable seaside sparrows left in the Everglades, but if their population drops much below 300, they will likely go extinct.

The sparrows are close to extinction and if something goes extinct, it doesnt come back, Williams told the paper. The other populations will come back. We dont want to seem callous, but extinction, you dont recover from it.

On Friday, the South Florida Water Management District was granted emergency permission to back pump clean water into Lake Okeechobee to alleviate overflow in the conservation areas, the Post reports.

But Williams told the Post that even with the water pumping at maximum capacity, Williams said it will drain only a quarter-inch per week, and Bergeron told the Sun-Sentinel that if the water isnt moved quickly, there might not be an Everglades to restore.

When you have a 100-year Act of God, the weak may die and the strong survive and thats nature, Bergeron told the Post, but when you extend the duration and compound it with flood control, you put the Everglades in the emergency room.

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Orange hospital builds new kind of emergency room for growing mentally ill population – OCRegister

Theres a new model for hospital emergency rooms and given the pressures on the health care system it appears to have arrived just in time.

Most hospital emergency care centers are ordered chaos a kid with a broken leg and a worried parent in one room, a mountain biker with a concussion in another, a muttering and bleeding homeless man in a third.

Glenn Raup, right, Executive Director of Emergency Nursing Services at St Joseph Hospital in Orange, chats with psychiatrist Ernest Rasyidi and nurse practitioner Cindy Illescas in the hospitals psychiatric strategy room. This is where the patients course of treatment is planned.(Photo by Mindy Schauer, Orange County Register/SCNG)

Nurses David Barone and Kearylyn Stanton work inside the temporary Emergency Clinical Decision Unit at St Joseph Hospital in Orange, where psychiatric patients are treated. (Photo by Mindy Schauer, Orange County Register/SCNG)

Glenn Raup, center, Executive Director of Emergency Nursing Services at St Joseph Hospital in Orange, chats with nurse Kearylyn Stayton, psychiatrist Ernest Rasyidi and a psychiatric patient. The hospital will get a new Emergency Clinical Decision Unit in one-to two-years.(Photo by Mindy Schauer, Orange County Register/SCNG)

Glenn Raup, Executive Director of Emergency Nursing Services at St Joseph Hospital in Orange, is reflected in a mirror outside what will be the temporary Emergency Clinical Decision Unit for psychiatric patients.. (Photo by Mindy Schauer, Orange County Register/SCNG)

Security officer Anthony Davila works inside the Emergency Clinical Decision Unit at St Joseph Hospital in Orange, where psychiatric patients are treated. (Photo by Mindy Schauer, Orange County Register/SCNG)

Glenn Raup, Executive Director of Emergency Nursing Services at St Joseph Hospital in Orange, outside the hospital where psychiatric patients are usually brought in for treatment. St Joseph, the busiest ER in OC and the second busiest in the State, is completely revamping the way it triages patients to help reduce wait times and is building a new and completely different model of care.(Photo by Mindy Schauer, Orange County Register/SCNG)

But at St. Joseph Hospital in Orange one of the busiest ERs in Orange County there now are two separate emergency areas that administrators say allows all patients to receive faster triage while providing mentally ill patients with tailored, comprehensive treatment.

When a patient is admitted, a mental health assessment is made. Those with mental illness are treated for their physical condition, but also are seen by a special team that includes a social worker, nurse practitioner, a psychologist and a psychiatrist.

Emergency and behavioral health treatment at St. Joseph is expected to improve even more with a combined $13 million-plus fundraising effort to expand facilities for mentally ill ER patients.

The needs of the mentally ill are different, explains Glenn Raup, executive director of emergency nursing and behavioral health services at St. Joseph. Yet few if any other hospitals in California, he reports, offer a separate ER for mentally ill people.

In regular emergency care centers, bright lights help doctors and nurses make fast diagnoses, orderlies move swiftly, people confer in hallways, machines beep and blink.

But for many mentally ill patients, noise, lighting and movement can be frightening.

St. Josephs new ER facility for mentally ill patients is like no other. Lighting is low, machines work in a whisper, caregivers speak in hushed tones, visitors are limited.

Theres also a very sturdy guard.

But transforming hospital care doesnt come easy or cheap. If St. Joe was a retail store, creating an ER for the mentally ill would be called a loss leader.

Instead of being a money maker, the move took morality and moxie. It also took vision.

Raup is either obsessed with degrees or he loves learning. Spend some time with this man who recently rappelled off a 16-story building to raise funds to fight addiction and its clear its the latter.

The director also loves serving and, yes, challenges.

Hes been on the front lines as well as behind a desk. Hes performed an emergency tracheotomy with a pen. The patient lived. And hes massaged a heart that stopped beating during surgery. The patient died.

Still, the experiences, however painful, informed both his thinking and his confidence. The registered nurse realized, I can do this.

He admits to two masters degrees and a Ph.D. Before becoming an administrator at St. Joe, he was a police officer in Kansas, a registered nurse, a SWAT paramedic in Houston and a college dean in Colorado.

Raup and his wife announced their move to Denver with relatives by Skyping from the front porch of the house where his relatives lived.

But the reason for the move was serious. Raups brother, Greg, was diagnosed with severe multiple sclerosis. He died two years later at age 40.

Now 50, Raup spends much of his time thinking about the larger issues of treating people. We take people from a death situation, to a life situation, he says. But the bigger question is why are these people coming into my ER?

ER is an example of the total failure of the whole system. All social ills end in ER.

Pause for a moment and ponder his points.

Raup isnt saying ERs are a failure. Rather, he is saying that if things were designed better perfectly, really health care wouldnt be handling so many emergencies.

Consider cellphones. Yes, cellphones.

The inventors and designers of cellphones dont consider the spiritual and mental health impacts of people texting rather than talking, Raup says. They dont take into account the physical hazards of texting while driving.

If cellphones were designed differently, there could be fewer patients in emergency rooms.

We need to look upstream, Raup explains, to where all these failures occur.

Stay with me here because it is this kind of thinking that led to St. Joseph Hospital agreeing to revamp triage.

When a typical patient arrives in the ER with chest pains, the job is to treat the problem. Raup says, Hes one and done.

But diagnosis and treatment for a mentally ill patient often is more complicated. Theres a psychiatric component, he says. Some have anger, others are bipolar, others have eating disorders.

Before the new ER facility was built, regular physicians treated all patients. Now, mentally ill people homeless as well as people with homes are treated by a special team.

Administrators say this allows physicians in the main ER to focus on the stream of strokes, heart attacks and trauma.

Raup walks through the area for mentally ill patients. There are eight beds with another three-dozen beds elsewhere in the hospital for longer-term mentally ill.

Four beds are empty on this day an example of swift, efficient care, Raup offers. Staff, he says, are rocking it.

Raup also points out it is mid-morning, a typically quiet time of day. ERs heat up in the afternoon and peak hours usually run from about 8 at night to early morning.

About 5 percent of ER admissions involve mentally ill patients, and an estimated 80 percent to 90 percent are treated and released. Yetthe numbers are staggering.

Raup reports that St. Joe averaged 330 mentally ill patients a month before the new facility was built. Since it opened, that number has jumped to 420 patients a month because of the shift in function.

Im still band-aiding, the director admits.

Getting the facility up and running hasnt been easy. Along with grants and the fundraising campaign, there also had to be a cultural change for separating out mentally ill patients.

In some places theres a philosophy of, Build it and they will come, Raup allows. I say, Build it because they are already here.

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Orange hospital builds new kind of emergency room for growing mentally ill population – OCRegister

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Report: Opioid use continues to swamp Virginia emergency rooms – Daily Press

In one year, Riverside Regional Medical Center saw an increase of more than 47 percent in emergency room visits related to opioid use.

The Newport News hospital had 26 cases in 2016, compared with 16 in 2015. There were 23 in 2014, hospital spokeswoman Wendy Hetman said in an email.

A national report shows the local hospital is not alone opioid treatment in emergency rooms have surged 99 percent since 2005. There were 1.3 million opioid-related emergency room visits or hospital stays in 2014, the latest year for which complete figures were available.. With the country in the midst of an opioid epidemic, experts expect the numbers to continue to rise, according to the Agency for Healthcare Research and Quality, which released the report.

“Our data tell us what is going on. They tell us what the facts are. But they don’t give us the underlying reasons for what we’re seeing here,” report co-author Anne Elixhauser, a senior research scientist with the agency, told The Washington Post.

The 2014 numbers, the latest available for every state and the District of Columbia, reflect a 64 percent increase for inpatient care and the jump for emergency room treatment compared with figures from 2005, the Post reported.

The sharpest increase in hospitalization and emergency room treatment for opioids was among people ages 25 to 44. The data also show that women are now as likely as men to be admitted to a hospital for inpatient treatment for opioid-related problems.

At least 1,420 people died in Virginia last year from drug overdoses, the fourth year that drugs have outpaced motor vehicle accidents and gun-related incidents as the leading cause of unnatural death, the Virginia Department of Health reports. On Tuesday, the state agency hosted more than 300 health officials, community agencies and law enforcement officers at an opioid summit in Hampton to discuss a drug crisis decades after the “War on Drugs” was declared.

The crowd listened to a series of speakers who talked about coordinating continuous care for drug addicts.

Fred Brason II of the North Carolina-based Project Lazarus, which worked with officials there to create an opioid overdose prevention program, talked about successes the state had with its opioid problems. And he encouraged local officials not to try to copy North Carolina’s program.

“You have to create a program that will work for your communities,” Brason said. “You know your communities and what they need. You have to own it to make it a success.”

Several local agency leaders expressed a need for an agency to coordinate care for people and not just leave them to their own devices to find counseling on their own after facing a crisis. Brason told the crowd if a person is ready and wants treatment, the community has to have services in place to help him or her succeed.

In 2014, fatal overdoses overtook motor vehicle crashes as the most common cause of accidental death in Virginia. Last year, Gov. Terry McAuliffe and state health officials declared the opioid epidemic a public-health emergency in the state.

By this time last year, more than 300 people in Hampton Roads had overdosed on drugs, local police and health officials reported. Sixty-five of those overdoses many of them pertaining to heroin and prescription painkillers were fatal.

When the health department planned the opioid summit, organizers worried they wouldn’t have enough people who wanted to participate, said Dr. Heidi Kulburg, director of the Virginia Beach health department and the Hampton Roads Opioid Working Group.

They were encouraged to see so many people interested in helping, she said.

The Washington Post contributed to this story. Canty can be reached by phone at 757-247-4832.

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Report: Opioid use continues to swamp Virginia emergency rooms – Daily Press

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Suspect tries to escape by running out of local hospital emergency … – KBTX

COLLEGE STATON, Tex. (KBTX)- A Bryan man is facing escape charges after he tried to run from a police officer while in custody at the College Station Medical Center, according to a police report.

On Friday, College Station Police Officer William Anderson was with the suspect at the hospital who was being examined for chest pains.

The suspect, Phillip Lee Martinez, was in custody for 5 warrants including a felony warrants for Evading Arrest with a Previous Conviction.

While he was at the hospital, Martinez, 32, was placed in handcuffs which were double-locked. The handcuffs were moved to the front of his body so that the doctors could do their examinations.

During this time, Officer Anderson was notified by a nurse of another nearby patient in the hospital who was unruly. While attending to that situation, according to the police report, Martinez was able to remove the medical equipment from his body and took off running out of the examination room.

Witnesses said they saw Martinez, still in handcuffs, running out of the emergency room doors.

Officer Anderson was able to catch up to him, and detained him in the hospital’s parking lot.

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Suspect tries to escape by running out of local hospital emergency … – KBTX

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