In the COVID era, a comparative look at two hypothetical visits to the hospital
As the High Desert continues its fight against COVID-19, fears of contracting the virus have led to many instances of delaying care. This is the second installment of a multi-part series highlighting the potential risks of waiting too long to seek medical attention and the precautions St. Mary Medical Center is taking to keep our patients safe. If you or anyone you know is in need of vital emergency care, please call 9-1-1.
APPLE VALLEY (Sept. 24, 2020) – Even under normal circumstances, a visit to the hospital is often accompanied by a tinge of apprehension and dread. In the era of COVID-19, those fears have been amplified.
While the latest research overwhelmingly forecasts grim outcomes for those who delay care — a National Cancer Institute model looking just at breast and colorectal cancers predict there will be 10,000 excess deaths in the U.S. over the next 10 years because of pandemic-related delays in diagnosing and treating these tumors — many people around the country have decided to ride out COVID-19 rather than seek needed medical and surgical treatment out of fear of contracting the virus in clinical settings.
But what does a trip to the hospital really look like in today’s environment and should people be afraid?
From treating those with chest pains to those with broken bones, St. Mary Medical Center has instituted rigorous safety measures and safeguards to protect anyone who walks through our doors. In fact, infection control protocols take effect even before setting foot into the emergency department — they begin the moment 9-1-1 is called.
To help dispel misinformation and misconceived notions, here are two hypothetical scenarios that we believe accurately reflect what an experience coming to the emergency department might look like at St. Mary and other hospitals across the country.
When immediate emergency care is needed, the difference between life and death is often how quickly care can be rendered. In the case of a stroke patient, the time it takes to get to the hospital can also mean the possible loss of function of their limbs, sight and/or speech.
This is because treatment for strokes is time sensitive and most effective within four hours from the onset of symptoms.
“Time is brain,” St. Mary Emergency Department Manager Andrea Davisson, RN, said. “There are many times we can reverse the effects of a stroke, but only if the patient seeks immediate care. The longer your brain is deprived of oxygen, the greater the chance of there being permanent damage, including permanent disabilities.”
As soon as 9-1-1 is called, a dispatcher is trained to ascertain critical information about the patient’s status that can be relayed to paramedics. When paramedics arrive, a second round of screening helps determine the patient’s condition as well as if they might have contracted COVID-19. This multi-level screening process helps the hospital prepare for the patient’s arrival and determine what care pathway is appropriate to protect both that patient and others in the hospital.
“The initial screening from paramedics helps us expedite the process in which we can care for the patient when they arrive,” Davisson said. “Providing care in the quickest and safest manner is critical. Time is everything.”
After hospital staff provides a third round of screening and stabilizes the patient, additional treatment — such as CAT scans and blood thinners — can be initiated and carried out in a timely fashion.
“When we receive a stroke patient, we need to make sure they do not have a brain hemorrhage (bleeding in the brain),” Davisson said. “If we can ensure there’s no bleeding, we’ll immediately begin clot-busting treatment if advised, which helps restore blood flow.”
If the stroke patient is suspected of COVID-19, the patient will be cared for in a separate area of the hospital, staff will always don appropriate personal protective equipment (PPE) in order to reduce the spread of the virus, and common areas (procedure rooms, imaging areas, etc.) will undergo a thorough, terminal cleaning upon the patient leaving that space.
“We don’t want our community to be fearful of seeking care,” Chief Nursing Officer Marilyn Drone, RN, said. “We know the concern is real, but with the precautions that we have put in place, we have greatly minimized the risk of community spread.”
SUSPECTED COVID-19 PATIENT
Unlike patients who arrive at the hospital via ambulance, those who arrive at the doorstep will be screened and triaged outside the emergency department entrance.
This process is crucial in identifying possible COVID-19 patients and determining what level of treatment they require. In addition to being asked a series of screening questions, all patients are masked and required to use hand sanitizer before entering the hospital.
“We have been proactive in directing patient flow in the emergency department to quickly identify which patients are possible COVID-19 patients and those who are not,” Drone said. “Our goal is to provide timely care, no matter what the reason for a visit to the ER.”
Once triaged, any patient suspected of COVID-19 will be escorted to a waiting room separate from all other patients. Chairs in this area, along with other waiting areas throughout the hospital, are separated as much as possible to help with social distancing.
“Cohorting patients with similar symptoms is an effective tool that hospitals use to help combat community spread of COVID-19,” St. Mary Quality Director Mendy Hickey, RN, said. “By separating our patients, we can treat both COVID patients and non-COVID patients in the safest clinical setting possible.”
To help reduce unnecessary movement, suspected COVID-19 patients are examined in a nearby care space where vital signs are charted, symptoms are thoroughly assessed and COVID-19 tests are conducted. Depending on the severity of the symptoms, the patient will either be sent home or admitted to the hospital for additional care. If admitted, the patient will receive care that is in alignment with the latest health and safety regulations as outlined by national, state and local health officials.
Unfortunately, one more layer of safety for patients, family members and staff is critical in containing the spread of the virus. Visiting is very limited, including companions for those who come in for tests and other outpatient procedures.
“We are committed to caring for our community,” Davisson said, “but we can only do that if people trust us to keep them safe and seek our help.
“I know we’re navigating through scary circumstances, but it’s so important to get immediate help from medical professionals if you find yourself in an emergency situation.”
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