Making sense of ‘urgent’ versus ‘emergency’ care





By Daniel Wolowiczdanielw@theacorn.com

While playing a weekend game

of driveway hoops, you roll your

ankle and a sharp pain rockets up

your leg. In a few moments, your

throbbing ankle has begun to swell

and you figure it’s badly sprained,

possibly broken.

Your family doctor suggests

you go to an emergency room.

Upon arriving, you’re told the wait

may take up to five hours.

With the continual closures of

emergency rooms across the

United States and the increase in

ER visits by people seeking regular care, waiting time in emergency

rooms continues to rise.

According to a report released

earlier this year by the Center for

Disease Control, visits to emergency rooms increased by 26 percent between 1993 and 2003.

More than 113 million people

made trips to the ER in 2003.

In addition, more than 12 percent of the nation’s hospitals

closed their emergency room

doors during those 10 years.

Ventura County saw the closures of both Santa Paula Memorial Hospital and the Westlake Village Medical Center. Los Angeles

County hospitals were hit especially hard, closing 10 of 23 emergency rooms over the past decade.

There are only seven acute care

hospitals in Ventura County with

emergency rooms.

Fortunately, there is an alternative. For most non-life threatening

injuries, an urgent care center can

offer basically the same treatment

as an emergency room, generally

in half the time.

“We can do 85 to 90 percent of

the same things that an emergency

room can do,” said Dr. Razmig

Krumian, a doctor at the Westlake

Village Urgent Care Center, which

serves this area from its L.A. County

location. “If it’s life threatening, it

does not belong here; it belongs in

an emergency room.”

Emergency Rooms

Call 911 if you have chest pain

or difficulty breathing. The two

symptoms may be signs of heart

problems, a severe allergic reaction, asthma or pneumonia. Patients should also call 911 immediately if there are signs of a stroke.

Symptoms may include numbness

in any extremity.

It’s recommended that patients

call an ambulance because immediate medical care while enroute

to the hospital may be necessary.

An ambulance will only take patients to an emergency room, not

an urgent care center.

Serious injuries such as a bad

burn, an amputation, severe head

trauma, a complicated fracture or

electrical shock should be treated

in an emergency room.

ER attention is also required if

someone shows an altered mental

state, seizures or is unconscious.

An ER visit is also recommended

if poison is ingested.

Legally, all emergency rooms

cannot deny anyone care and

emergency room staff cannot ask

for type of payment before medical services are performed.

Most major hospitals staff

emergency rooms with doctors

who are board certified in ER

medicine. All emergency room

doctors at Los Robles and Simi

Valley hospitals are certified in ER

medicine.

According the Los Robles officials, Los Robles is the only hospital in Ventura County with pediatric accreditation.

Los Robles has about 15 physicians in its emergency room rotation, while Simi Valley has

seven. Both hospitals staff 35 ER

nurses.

Los Robles sees about 37,000

patients in its emergency room per

year, and Simi Valley reports

nearly 25,000 ER visits annually.

Diane Freeman, a nurse and

director of the Los Robles ER,

said wait times for the hospital’s

ER can be anywhere from 20 minutes to several hours, with the

most critically injured patients

treated first.

Emergency rooms are open 24

hours a day, seven days a week.

Urgent Care

By law, urgent care facilities must

have oxygen, a defibrillator, and x-ray

and laboratory capabilities.

Urgent care centers can handle

a myriad of non-life threatening

problems such as a cough, fever,

vomiting, sore throat, diarrhea,

earache, insect/snake bites and

minor cuts requiring stitches.

In addition, urgent care centers

treat anything from minor burns and

simple fractures to removing moles

and treating infected toenails.

Most urgent care centers will

also provide drug screening, give

travel immunizations and perform

school and work physicals.

Although urgent care centers,

which are typically privately

owned, aren’t legally required to treat

everyone, Krumian said, doctors are

ethically required to provide help.

Krumian said he’s never heard of anyone being turned away from his urgent care center.

Westlake Village Urgent Care

Center is a privately owned facility

with five physicians on staff. Krumian

said the doctors are primarily general

practitioners, but the center also has a

hand specialist and a plastic surgeon

on call.

Urgent care centers also treat patients on an as-needed basis. Wait

times, however, for urgent care centers are typically shorter.

Westlake Village Urgent Care

Center provides services to nearly

15,000 patients a year, clinic officials

said. Their facilities are open 7 a.m.

to 7 p.m. seven days a week.

Wherever you seek care, bring a

list of all current medications, as well

as list of any medications you’re

allergic to.



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