When you or someone you love needs urgent care, time is precious. To be sure you’re ready when an emergency strikes, you should learn what steps to take and where you should go to seek help.
Emergency care
Life-threatening injuries or illnesses require immediate attention. If you experience any of the following symptoms, immediately call 911. Acting quickly could save your life.
• Changes in speech, confusion, loss of coordination, numbness, weakness. Feeling confused, experiencing numbness or weakness on one side of your face or body, blurred vision, an extremely painful headache or sudden changes in speech might be symptoms of a stroke. Seconds matter. Be fast and call 911 if you experience these symptoms or notice them in a friend or loved one.
• Chest pain. Call 911 immediately if you experience sudden or persistent chest pain or pressure. You could be having a heart attack.
The most common symptoms include chest pain or discomfort; feeling weak, lightheaded or faint; pain in the jaw, neck or back; pain or discomfort in one or both arms or shoulders; shortness of breath; and/or a sudden onset of nausea.
“If you feel like you’ve got an elephant sitting on your chest, pain radiating down your arm or jaw pain, it’s vital that you get checked out immediately,” said Dr. Elizabeth Guastello, a cardiologist with Cardiovascular Specialists of Lawrence. “Call 911 and get to the emergency room. Time is heart muscle.”
• Head injuries. Symptoms of a serious head injury can be more subtle than cuts and bruises. A person with a head injury should get emergency medical care if they experience excessive drowsiness, changes in speech, confusion or loss of consciousness.
• Severe broken bones. Broken bones can be painful, but not all require a trip to the emergency department. How do you tell when a broken bone is an emergency?
“If you have an obvious deformity, pain that isn’t controlled with medication, inability to bear weight or you’re unable to move the joint, head straight to the emergency room,” said Dr. Adam Goodyear, an orthopedic physician with OrthoKansas. He also metioned two types of broken bones that should be treated immediately: an open or compound fracture, where the skin is pierced by the bone or by an impact that broke the skin at the time of the fracture; and a nondisplaced fracture, where the broken ends of the bone line up and are barely out of place.
If the break is in the spine, the skull or a weight-bearing bone, you may also need emergent care. Other types of fractures can generally be cared for at a walk-in or primary care clinic.
• Severe or persistent vomiting or diarrhea, along with symptoms such as confusion, difficulty breathing, fever greater than 101 degrees, severe headache and/or stiff neck. Influenza, norovirus or food poisoning can cause vomiting and diarrhea. If you experience additional symptoms including a high fever, severe headache or stiff neck, call 911 or head to the emergency department.
• Shortness of breath or difficulty breathing. When you’re having trouble breathing, it can induce panic. Shortness of breath can be caused by a number of things, including a heart attack, stroke, blood clot, asthma attack or allergic reaction. Seek immediate medical care.
Patients may need to wait
Seeking care in the emergency department is vital when you’re experiencing a life-threatening illness or injury. When you arrive at the emergency department, you’ll meet with a triage nurse who will assess your condition and determine what order you’re seen in.
“Triage is the process for identifying those patients who need immediate intervention versus those who are able to wait a bit longer,” said Jan Wiebe, emergency department director at LMH Health.
The triage nurse will measure your vital signs and ask you questions about your illness or injury so they can understand what’s going on when you arrive. Based on that interaction, the triage nurse will assign you an Emergency Severity Index (ESI), a type of patient rating system used in hospitals around the country.
“We assign the ESI based on the acuity of your illness and the resources that we anticipate it will take,” said Jen Lemus, clinical nursing manager for the emergency department at LMH Health. “ESI is a five-level system, with ESI 1 being the highest level for the most ill patients and ESI 5 as the lowest.”
LMH Health also uses an artificial intelligence program called KATE during the triage process. Wiebe said that KATE helps supplement the decision-making process to ensure the proper ESI is assigned to a patient.
“As the nurse is triaging the patient, KATE is working in the background to analyze what’s being documented in real time and also reviewing the entire available medical record to calculate the ESI level,” Wiebe said. “If KATE disagrees and assigns a higher level, the triage nurse gets a notification from KATE stating the level it recommends and the reason why.”
Once you’ve been seen by the triage nurse, you may still have to wait longer than you’d like to receive care. The volume of patients seeking care at LMH Health, both at the hospital and in the emergency department, has increased over the past year. When inpatient beds aren’t available for those who need to be admitted, it leads to patients being boarded in the ED.
“When we board patients in the ED, we’re holding patients who have been admitted to the hospital in our department until an inpatient bed becomes available,” Wiebe said. “We start all the orders and care for them, just as if they’d been admitted to an inpatient unit. It becomes difficult because those rooms are no longer available to care for patients in the ED.”
The LMH Health emergency department has rooms to care for 29 patients. If ten patients are being boarded in the department, that reduces the number of available rooms and leaves staff with only 19 rooms to provide emergency care. In turn, that will increase the time that patients in the waiting area wait to be seen.
“Boarding isn’t a new challenge in emergency departments, as many across the country have been doing this for years. It’s definitely something new at LMH Health over the past year or two,” Wiebe said.
Not all problems are emergencies
Fortunately, not all illnesses or injuries require you to visit the emergency department for care. Less serious conditions can be treated at a walk-in clinic or by your primary care provider. These include:
• Mild abdominal pain
• Mild to moderate asthma
• Back injuries
• Cold and flu symptoms like cough, congestion, fever or sore throat
• Earache
• Eye irritation/redness
• Minor cuts, scrapes and bumps
• Minor sprains or strains
• Rashes
• Sexually transmitted disease screening and testing
• Urinary tract infection
“You might feel awful due to a cold or sinus infection, but those conditions can often be managed at a lower level of care,” Lemus said.
But, if you have a nagging feeling that something is seriously wrong, don’t wait: “If you’re in doubt, trust your gut,” Lemus said.
— Autumn Bishop is the marketing manager and content strategist at LMH Health, which is a major sponsor of the Journal-World’s Health section.
When should you go to the emergency department? - Lawrence Journal-World
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