What should you expect in the emergency room?

Zajchowski Enlargephoto


No one wakes up in the morning anticipating that a trip to the hospital emergency department will become the feature event of their day, but when such a visit becomes necessary, it’s comforting to know the service is available. Southwest Memorial Hospital’s Emergency Services Medical Director, Joseph Zajchowski, MD, moved to the area earlier this year and says he and his team are prepared 24/7 to deal with any and all patients who arrive in the ER. “The ER is here to provide our community with emergency medical care. We consider ourselves to be an adjunct to what is an excellent primary care health system in Montezuma County,” said Zajchowski.

Patients who go to any emergency room anywhere in the country are treated by a qualified physician, regardless of their insurance status or ability to pay. It’s the law, plain and simple. That said, the ER is an expensive place to receive care, which is why patients are encouraged to seek medical attention for non-emergent conditions from their primary care physicians or at the walk-in clinic. “We’re experts in emergency conditions,” said Zajchowski. “Just as you wouldn’t go to a cardiologist for an eye problem, it’s best for patients to have routine health matters dealt with by their primary care provider.”

So the question becomes, “What’s an emergency?” According to Zajchowski, urgent conditions include anything that is life-threatening or limb-threatening. “Chest pain, symptoms of a stroke, lacerations that are actively bleeding, broken bones, gunshot or stab wounds, poisonings, snakebites, seizures, serious infections ... these are true emergencies,” said Zajchowski. The rule of thumb is that if you think you might be experiencing a medical emergency, go the nearest ER or dial 911. It’s always better to err on the side of safety.

“Sometimes we have people call the ER and explain their symptoms and want to know if they should come in,” said Zajchowski. “This is always a challenge. Our philosophy is that if someone is questioning whether or not they should be seen, then they should come in. If you’re uncertain, we’re here for you.”

Patients who have local primary care physicians may consider trying to contact their provider, even after hours, to get advice as well. “If a condition is something that a patient’s doctor already knows about they may be able to take care of them and help the person to avoid a trip to the ER,” said Zajchowski.

Another issue patients sometimes question is whether to drive themselves (or be driven) to the ER, or dial 911 for an ambulance. “Again, this is sometimes a tough call,” said Zajchowski. In certain instances, a patient might be able to get themselves to the ER more quickly than they would if they called 911 and waited to be transported. However, certain conditions such a chest pain, stroke symptoms, and debilitating injuries may require immediate attention by emergency medical personnel that is initially administered in the home and/or on the way to the hospital. “It’s a judgment call,” said Zajchowski, “and it helps when people have some basic, general medical knowledge.”

When a patient arrives in the emergency department, they are immediately “triaged” by a qualified nurse who determines the severity of the situation and makes plans for the patient to be seen by a doctor according to that determination. “If someone comes in with a semi-urgent condition and has to wait for a few minutes to be seen, they can rest assured it’s because the doctor on duty is with a patient who is experiencing a true emergency,” said Zajchowski.

Depending on the situation, a patient who receives attention in the ER may be treated and released (and probably instructed to follow up with their primary care physician), admitted to the hospital for observation or treatment, or transferred to another facility if services or specialists are required that are not available locally. A patient who is admitted will then have their care taken over by either their own primary care physician, specialty physicians such as surgeons, or by in-house hospitalists (doctors who specialize in caring for patients in the hospital).

How can you avoid having to pay a visit to the ER? “Good personal care is always the best medicine,” said Zajchowski. “A proper diet, regular exercise, routine check-ups, and preventive care with a primary care physician ... this is how to avoid the ER both in the short-term and over the long-term.”

In addition to leading a healthy lifestyle, common sense measures come into play for anyone who would rather not see the inside of an ER. Wearing seatbelts, never drinking and driving, being careful around the home, farm, or ranch when doing repairs and using power tools, and being conscious of the potential for injuries in the workplace are all smart moves on the part of individuals.

Southwest Health Notes is a public service feature provided by Southwest Memorial Hospital in Cortez, Colorado. The information provided herein is not intended as patient-specific medical advice or as a substitute for consultation with your personal healthcare provider.

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