Emergency Rooms are Swamped with Seriously ill Patients but not Covid-19

https://www.npr.org/sections/health-shots/2021/10/26/1046432435/ers-are-now-swamped-with-seriously-ill-patients-but-most-dont-even-have-covid


An ambulance crew weaves a gurney through the halls of Sparrow Hospital's emergency department in Lansing, Michigan. Overcrowding has forced the staff to triage patients, putting some in the waiting rooms and treating others on stretchers and chairs in the halls.

"ED crowding is not an issue of inconvenience," the authors wrote. "There is incontrovertible evidence that ED crowding leads to significant patient harm, including morbidity and mortality related to consequential delays of treatment for both high- and low-acuity patients."

Did you know that many people die from conditions that could have been treated every day with just one doctor's visit? We can't do anything about those who have already died, but maybe we can save some if we start by educating ourselves on how to avoid an emergency room visit best.


This blog post will walk you through the current state of healthcare delay, staff shortages and emergency room chaos and crowding that is not only dangerous for the patient but extremely stressful on the healthcare providers, patient privacy and risk.

You'll also learn what to do when faced with a serious injury or illness and be guided towards the best place to receive care based on the severity of your illness/accident

The article attached from NPR discusses the critical and serious problems with #emergencyroom overcrowding before Covid-19. Some patients that go to the ER for a non-serious or urgent illness should be treated at a clinic, standard general practitioner, or pediatricians office visit. Going to the ER for pink eye or even the flu puts both you as the patient at more risk as the ER is full of germs and taking up doctor and nurse time with non-life-threatening or emergencies creates a more stressful atmosphere, more room for #error, #misdiagnosis and even #death.


It's not a new phenomenon, but the number of people visiting our emergency room for illnesses their general practitioner can treat is rising. There are many reasons why this is happening. Some are simple and others more complex as it relates to patient care and what I call "Covid 19 hangover." Because the pandemic has delayed a lot of #pre-screening, #wellness visits, and what has been labeled #elective surgeries and/or treatments, patients are showing up to the ER sicker than they were before the pandemic, their diseases are more advanced, and they need more complicated care. This is not just in areas that still may be considered Covid-19 hot spots but in contrast in small towns and low Covid-19 positive areas throughout the United States.


Even though it seems like we are on a slow crawl out of this #pandemic, and thankfully each week, we seem to be getting better news about how many cases of Covids-19 are reported; it is still affecting #healthcare overall because now you have significant waitlists to get appointments and particularly #specialist appointments. I myself have been told some of my personal doctors were three months out to get appointments. It can be very frustrating, especially if you are not well or need care quicker than your ability to get an appointment.


Testing particularly #Radiology is also seeing big delays, which can be incredibly dangerous. For example, recently, I needed an MRI, and I could not get an appointment until January locally, so I went into NYC. Thankfully, with good insurance, I waited one day, which is unheard of.


Covid-19 restrictions and proximity rules also cause some delay. For example, when are the last time you went to an appointment and at least in New York, many of the waiting rooms have chairs that were once filled with patients are either removed or blocked off to try and keep people away from each other to try and #slowthespread of #Covid-19.


Another issue negatively impacting access to healthcare and appointment delay is staff burnout, #vaccine #mandates, employee layoffs, and terminations. The Biden Administration has created an executive order requiring vaccination of any private company with greater than 100 employees, federal workers, government contractors, and our military. The details are in this link: https://www.whitehouse.gov/briefing-room/presidential-actions/2021/09/09/executive-order-on-requiring-coronavirus-disease-2019-vaccination-for-federal-employees/


There are also additional state #vaccine mandates that vary. For example, in #healthcare, the state of Florida has a governor that is not allowing vaccine mandates to any of its private sectors and making it the individual choice vs. my state of New York requires its #healthcare staff to be vaccinated or terminated, its police force, EMT, and fireman to be vaccinated or be put on leave without pay. Currently, 12 states are banning Covid-19 vaccine mandates. As of October 12th, they are Arizona, Arkansas, Florida, Georgia, Indiana, Montana, New Hampshire, North Dakota, Oklahoma, Tennesee, Texas, and Utah. All of their rules differ. See the attached link. https://www.beckershospitalreview.com/workforce/11-states-banning-covid-19-vaccine-mandates-how-it-affects-healthcare-workers.html


As you can imagine, it is currently a litigation football and changes by the day. There are many that feel that the state or government does not have the right to impose such mandates on anyone. For example, in Texas, the order states that "no entity in Texas" can enforce vaccination against anyone, including an employee or consumer, who objects "for any reason of personal conscience, based on a religious belief, or for medical reasons, including prior recovery from COVID-19." It is my feeling that we are in the infant stages of ongoing tort on this subject and employee practice liability and possible workers compensation suits for the near and long future.


Nobody can make the decision for your need to be seen and how urgent it is except you. Here are some guidelines to consider:

When to use the Emergency Room - Adult

Whenever an illness or injury occurs, you need to decide how serious it is and how soon to get medical care. This will help you choose whether it is best to:

Call your health care provider

Go to an urgent care clinic

Go to an emergency department right away

It pays to think about the right place to go. Treatment in an emergency department can cost 2 to 3 times more than the same care in your provider's office. Think about this and the other issues listed below when deciding.

Signs of an Emergency How quickly do you need care?


If a person or unborn baby could die or be permanently disabled, it is an emergency. Call 911 or the local emergency number to have the emergency team come to you right away if you cannot wait, such as for:

Choking

Stopped breathing

Head injury with passing out, fainting, or confusion

Injury to neck or spine, particularly if there is loss of feeling or inability to move

Electric shock or lightning strike

Severe burn

Severe chest pain or pressure

Seizure that lasted 3 to 5 minutes


Go to an emergency department or call 911 or the local emergency number for help for problems such as:

Trouble breathing

Passing out, fainting

Pain in the arm or jaw

Unusual or bad headache, particularly if it started suddenly

Suddenly not able to speak, see, walk, or move

Suddenly weak or drooping on one side of the body

Dizziness or weakness that does not go away

Inhaled smoke or poisonous fumes

Sudden confusion

Heavy bleeding

A possible broken bone, loss of movement, particularly if the bone is pushing through the skin.

Deep wound

Serious burn

Coughing or throwing up blood

Severe pain anywhere on the body

Severe allergic reaction with trouble breathing, swelling, hives

High fever with headache and stiff neck

High fever that does not get better with medicine

Throwing up or loose stools that do not stop

Poisoning or overdose of drug or alcohol

Suicidal thoughts

Seizures


When to go to an Urgent Care Clinic When you have a problem, do not wait too long to get medical care. If your problem is not life-threatening or risking disability, but you are concerned and cannot see your provider soon enough, go to an urgent care clinic. The kinds of problems an urgent care clinic can deal with include:

Common illnesses, such as colds, the flu, earaches, sore throats, migraines, low-grade fevers, and limited rashes

Minor injuries, such as sprains, back pain, minor cuts and burns, minor broken bones, or minor eye injuries


Remember, the list above is meant to give you direction. There are some circumstances that can't wait or you need to be the judge if it is a true emergency. Sometimes we push care off because we don't want to wait or be bothered and what may start as what you think is minor can get major quick so if you don't know, it is safer to go than not. You know your body. You know your loved one's circumstances. For example, recently a family member had a medical emergency and did not want to go to the emergency room He was stubborn and needed to go as he was in acute congestive heart failure. I'm confident that if he did not go when he did, as he was filling up with fluids he would have died at home. Trust your gut and always err on the side of caution. If insurance is a problem, Emergency Rooms can't reject you because of your healthcare coverage. It can be scary and stressful if you don't have coverage but it can be worked out after you get the care you need. No amount of money or bills can bring back a life.

If you are not Sure, Talk to Someone.

Call your provider if you are unsure, what you should do, and/or if you don't have one of the serious conditions listed above. If the office is not open, your phone call may be forwarded to someone. Describe your symptoms to the provider who answers your call, and find out what you should do. Your provider or health insurance company may also offer a nurse telephone advice hotline. Call this number and tell the nurse your symptoms for advice on what to do.


Prepare now Before you have a medical problem, learn what your choices are. Check the website of your health insurance company. Put these telephone numbers in the memory of your phone:

Your provider

The closest emergency department

Nurse telephone advice line

Urgent care clinic

Walk-in clinic


aaucm.org/what-is-urgent-care-medicine/.



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