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8 | Health Matters: Providence St. Mary Medical Center "The advantage of this," says Dr. Lopez, "is if a time comes when you have an emergency medical condition that requires immediate attention, our team of experts in specialized acute care management will prioritize you." The ER at Providence St. Mary 's strives to provide excellent care, and part of the equation is to improve wait times. In recent years, the ER has transitioned to the Rapid Medical Evaluation (RME) system, whereby a patient is seen by a physician or advanced provider within minutes of arrival. After undergoing the RME process, the patient will be directed either to another treatment area or to a bed for immediate care, depending on their medical condition. The process is part of the overall goal of serving the High Desert community with compassion and timeliness, allowing for an average wait time to see a medical provider of fewer than 10 minutes—regardless of triage acuity. A HOLISTIC APPROACH TO HEALING Two of the more serious reasons people come to the ER are heart attacks and strokes. A STEMI, or ST-elevation myocardial infarction, is a more serious type of heart attack that involves a greater risk of complications and possibly death. Providence St. Mary was honored to be designated a STEMI receiving center in 2008, and is the only primary stroke center in the High Desert accredited by the Joint Commission. The STEMI designation means that when an ambulance has a patient who's exhibiting signs of a heart attack, paramedics will transport the patient to the most appropriate setting—in many instances a STEMI center. Dr. Lopez explains, "That's why it's critical, if a patient thinks they 're having a heart attack or stroke, that they call 911 and not drive themselves. Because care starts in the ambulance. Paramedics notify our ER team, and we immediately prepare for a patient's arrival along with our excellent group of cardiologists and neurologists." While ERs are known for being busy places, Providence St. Mary 's staff always takes the time to provide comprehensive care to each patient. It's part of what could be described as a holistic approach, in that the ER is interconnected with many specialties and resources. "This means that our work involves not just what people are seeing in the ER, but also leveraging resources both in and outside the hospital to meet a patient's emergency needs," says Dr. Lopez. If you walk into the waiting room of an ER, some patients may not look as though they need emergent care, but much more often the opposite is true. In many cases, patients who initially thought they didn't need to come in, or who delayed care, find themselves in the ER for conditions that do warrant a visit. At that point, dedicated staff will be ready to assist and connect them with appropriate treatment plans. Dr. Lopez says many patients ask him, "Are you specialized in anything?" He says, "I tell them yes, emergency medicine is a specialty in itself." Unlike other specialties that focus on a specific population or discipline, emergency physicians treat everyone and almost anything requiring acute intervention. For example, one patient may be suffering from a life-threatening illness and the next patient from a broken bone. WE WANT YOU TO LEAVE INFORMED AND REASSURED "One of the most difficult things about being an ER doctor," says Dr. Lopez, "is that we have to make critical decisions with very limited information and in a limited amount of time. During an ER visit, tests are directed at diagnosing, as well as identifying and stabilizing, the most urgent of possible diagnoses. What's sometimes unsettling for the patient is they think, 'I came in with a complaint, and I still don't have an exact explanation for my symptoms.' While not every visit will result in a definitive diagnosis, rest assured that our emergency providers have considered your condition stable enough to transition to outpatient management before discharge." This is why it is important that patients understand their aftercare discharge instructions, what possible diagnoses were ruled out and all follow-up information. Under certain circumstances, it might be necessary to return to our ER, and that's OK. Conditions often evolve, for better or worse, which is why—despite reassuring tests—if symptoms abruptly worsen, it is important to return to the ER and never wait to see your doctor, according to Dr. Lopez. "Being an emergency physician and taking care of patients is a humbling and fulfilling experience. I love what I do yet understand the stress that an ER visit can create for patients and their loved ones. Our hope at Providence St. Mary is that understanding the inner workings of the ER will help ease your concerns should you ever need our care. And if that time comes, rest assured we are here for you 24/7," he says. OUR WORK INVOLVES NOT JUST WHAT PEOPLE ARE SEEING IN THE ER, BUT ALSO LEVERAGING RESOURCES BOTH IN AND OUTSIDE THE HOSPITAL TO MEET A PATIENT'S EMERGENCY NEEDS.

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