When To Skip The ER

Dear Rich Lifer,

All around the country, ERs and ICUs are filled to the brim due to coronavirus, meaning a trip to the hospital can result in greater pandemic related risks.

According to the Covid Tracking Project, currently 119,927 people are hospitalized due to coronavirus. Most states are reporting record numbers of cases.

This affects more than just the emergency department, with staffing and space compromised throughout entire hospitals due to the influx of patients coming in with Covid-19.

This has resulted in a more complicated process when deciding whether or not a trip to the hospital is absolutely necessary.

Today we get some advice from doctors and other medical professionals about what to do if you are sick or injured and trying to decide the best course of action.

Make The Most Of Urgent Care

Andra Blomkalns, chair of the emergency medicine department at Stanford University, advises that if you aren’t facing a serious medical emergency like a heart attack or a stroke, consider going to your local urgent care instead of a hospital.

This is incredibly important to keep in mind, especially if your hospital is near capacity. “If you have a sprained ankle, it’s probably not the time to go to the hospital,” Blomkalns said. Many urgent cares will actually post waiting times and can do sutures, X-rays and other diagnostic testing.

Charleen Hsuan, professor of health policy and administration at Pennsylvania State University, also wanted to point out that studies show humans are not always able to judge whether they are experiencing a health emergency. He adds, “in general, patients aren’t necessarily good at telling when something is a real emergency or not.”

So if you have even a small bit of doubt if your ailment requires a hospital visit, check out your local urgent care first instead.

Be Proactive About Your Visit

With such a large rush of Covid-19 patients pouring into hospitals, it’s becoming more and more difficult to separate infected patients from others.

Sarah Nafziger, vice president for clinical support services at the University of Alabama at Birmingham Hospital, says that her hospital — like many others — has created separate entrances and waiting areas for non coronavirus patients. However, with so many patients it’s often very difficult to keep everyone separated.

She notes, “They don’t come in wearing a label: ‘I have Covid’ or ‘I don’t.’” So by coming into a hospital if it isn’t necessary you could be putting yourself at more risk interacting with possibly infected patients. If you do have to enter a hospital and you know for sure you do not have Covid, make sure you use the proper entrances and exits.

Additionally, if your doctor has admitting rights in a particular hospital, you should call and ask if it is appropriate to come in and if the hospital is over-crowded.

If you are sure you will need intensive care, see if you can be admitted to a larger hospital. According to Eugene Litvak, president of the Institute for Healthcare Optimization, a nonprofit in Newton, Massachusetts, “Larger hospitals have better resources and typically smaller hospitals have much fewer ICU beds that are critical nowadays.”

Prepping For A Surgery

If you have to go into a hospital for a surgery, there are a few things you can do ahead of time to make sure you are taking the proper coronavirus precautions.

In general, get a sense of the current staffing levels as well as resources after surgery. Mr. Litvak notes that a nurse-to-patient ratio of 1:5 or 1:4 can result in better care for the patient, according to pre-pandemic research.

Because Covid patients are staying in hospitals longer, they are drawing resources away from other departments. He urges patients to remember that nurses can no longer move back and forth, tending to Covid and then non-Covid patients.

In this case, consider asking your doctor whether surgeries are scheduled evenly throughout the week or concentrated on certain days. Concentrated surgeries can mean limited space in some recovery areas on certain days.

Dr. Hsuan adds that it’s always a good idea to check the hospital’s website before a procedure for the most up to date information and any pandemic-related changes. She also warns that quality ratings for hospitals haven’t been updated to reflect operations during the pandemic, so doing your own due diligence is key.

Unfortunately, besides tracking hospital rates, there is no easy way to tell if a particular medical provider feels overworked. Additionally, hospitals don’t release information on when they rotate staff to provide time off between shifts.

“To some degree you have to have some faith in the system,” Dr. Blomkalns said, providing some reassurance. “Physicians are used to staying up nights, studying hard and being challenged on the job—and this is what we all trained to do.”

Once You’re At the Hospital

If you have decided a trip to the hospital is absolutely necessary or have done your research and scheduled a procedure, there are a few key measures you can take to keep yourself and others safe.

The most important are social distancing, masking wearing, and hand washing. Most hospitals do not allow cloth masks and will ask patients to wear surgical masks during their day.

We know everyone is hopeful about the vaccine and with medical professionals receiving the doses first, we may be lulled into a false sense of security about the safety of hospitals. However, Dr. Nafziger notes that although some health-care workers have been vaccinated, the shots haven’t yet had an effect on the hospital population overall.

She cautions, “It doesn’t mean that hospitals are any safer right this minute.”

This information is not meant to scare you, it is only meant to help keep you informed sp you can make the best and safest decisions when it comes to your health and the health of those around you.

We all hope that this year will be a healthier and happier one!

To a Richer Life,

The Rich Life Roadmap Team

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