• November 28, 2014

Know when to visit the emergency room

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Posted: Wednesday, September 11, 2013 4:30 am

Learning when to make use of the Carl R. Darnall Army Medical Center’s Emergency Department not only helps providers, but also all of the beneficiaries who receive care there, said Col. Patricia Darnauer, Darnall commander.

“(Emergency Department) visits cost the U.S. Army approximately three times more than PCM (primary care manager) visits for the same complaint. We are already in a time of budgetary constraint,” she said. “If PCM visit volume goes down, our budget for staffing is cut, and fewer services are available.”

In short, mismanaged care could end up cutting services, which means even less routine care availability when beneficiaries need it.

This also can be hurting others, said Maj. Michael Simpson, chief of Darnall’s Emergency Department.

“Every nonemergent patient who comes (in) prolongs the wait for those who truly require our care,” he said.

The key to knowing when to use emergency services is to know the difference between emergent, urgent and routine care.

Emergent care is medical care that directly addresses threats to life, limb or eyesight, such as heart attack, stroke, gunshot wounds, major motor vehicle accidents, open fractures, appendicitis, severe allergic reactions that make it difficult to breath, bleeding that does not stop with 10 minutes of direct pressure, wounds requiring stitches, poisoning, a major injury such as head trauma, persistent vomiting, or suicidal or homicidal feelings, Simpson said.

A condition is considered urgent when it is not life threatening, but requires care in a timely manner (within 24 hours). Examples include conditions that could deteriorate or are not bearable due to discomfort. Routine is care for stable patients whose condition will not deteriorate over time and/or will typically resolve on its own. Examples include seasonal allergies, pregnancy tests, sports or school physicals, or any complaint for a problem chronic in nature.

“Access to care standards for routine care can vary, but for most situations it is seven calendar days. Wellness and health promotion services, physical exams, well woman exams and referrals for specialty care may take up to 28 days,” Darnauer said.

“Patients should ask themselves: ‘Is my condition so grave that I cannot wait to see my PCM?’” Simpson said.

Conditions that frequently show up at the Emergency Department that should be handled by a PCM include cold, cough, sore throat, flu, ear ache, sexually transmitted diseases, fever controlled with over-the-counter medicines, rashes, minor insect bites or stings, sprains, minor cuts with controlled bleeding, suspected new pregnancy, nonemergent subspecialty referrals (dermatology, chiropractic, etc.), medical second opinions, medication refills, profiles/workman’s compensation/line of duty/insurance paperwork/school excuses, school or sports physicals, vaccinations, insomnia and other chronic problems such as hemorrhoids, back pain, fibromyalgia or shin splints.

For help determining medical emergencies, contact the Darnall Nurse Advice Line at 254-553-3695. It’s a free 24/7 service for all military health care beneficiaries living in the Fort Hood area, and it provides guidance from registered nurses on urgent or non-urgent situations. Beneficiaries also may also seek information on self-care for injuries or illnesses.

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