When should I seek emergency care?

It’s vital that you know what to do when you or someone you love needs urgent care before they need it. In an emergency, time is precious. Where should you go to seek help? LMH Health has the answers.

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, a headache worse than you’ve ever had before 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
• 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 Elizabeth Guastello, MD, 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 don’t always come with cuts and bruises. Seek emergency medical care if you experience any of the following:

• Excessive drowsiness
• Changes in speech
• Confusion
• Loss of consciousness

Severe broken bones

Broken bones can be painful but not all require a trip to the emergency department. When it comes to broken bones, there are a few common types of fractures:

• Non-displaced fracture: The broken ends of the bone line up and are barely out of place.
• Open (compound) fracture: The skin may be pierced by the bone or a blow that breaks the skin at the time of fracture.
• Complete fracture: The bone is broken in two or more pieces.
• Partial fracture: The bone is cracked but not totally broken.
• Stress fracture: The bone contains a hairline fracture.

“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 Adam Goodyear, MD, an orthopedic physician with OrthoKansas. “You should also be seen immediately if you have an open or non-displaced fracture.”

If the break is in the spine, skull or in a weight-bearing bone, you may also need emergent care. Other types of breaks can generally be cared for at a walk-in or primary care clinic.

Severe/persistent vomiting or diarrhea with symptoms including confusion, difficulty breathing, high fever (greater than 101ͦ F), severe headache, 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 reactions. Seek immediate medical care.

Emergency doesn’t mean immediate

Seeking care in the emergency department is vital when you’re experiencing a life-threatening illness or injury. When you arrive at LMH Health, 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. “

The triage nurse will take 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) acuity. ESI is an evidence-based tool and the standard in hospitals across 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. “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,” she explained. “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.”

Why are so many people waiting?

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.”

So what does this mean? 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 patient 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 explained.

What if I don’t need emergency care? Where do I go?

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:

• Abdominal pain (mild)
• Asthma (minor/moderate)
• Back injuries
• Cold and flu (cough, congestion, fever, sore throat)
• Earache
• Eye irritation/redness
• Immunizations
• Minor cuts, scrapes and bumps
• Minor sprains or strains
• Rashes
• Sexually transmitted disease (STD) screening and testing
• Urinary tract infection (UTI)

“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. “If you’re in doubt, trust your gut. LMH Health is here 24/7 and ready to care for you.”