Transcription:

This Healthy Takeout COVID-19 podcast was recorded on August 4, 2020.

Prakash Chandran (Host):  In the state of the pandemic, many are avoiding emergency care due to the anxiety and fear of contracting COVID-19. However, there are plenty of ways that medical professionals are ensuring clean and safe environments for all patients and visitors. We’re going to talk about it today with Dr. Peter Antkowiak, Medical Director of Emergency Medicine, Tricia Leach, the Director of Emergency Services and Heather LaFlamme, the Nurse Educator for Emergency Department; all at Harrington Hospital.

This is Healthy Takeout, the podcast from Harrington Hospital. I’m Prakash Chandran. So, Dr. Antkowiak, we’ll start with you. I’m just curious as to what the state of the Emergency Department is during this time.

Peter Antkowiak, MD (Guest):  Sure. The Emergency Department is a very safe place. I think that is something we want to stress to everyone. Our regular services have not really shifted dramatically during COVID. There certainly was a massive change in March and April of this year. And once all those policies were put in place, and those changes were made; we now have sort of a regular Emergency Department that has always been the way we’ve functioned and provided services. So, any patient that comes to the Emergency Room is immediately screened for COVID symptoms and they are automatically separated into sort of a separate pathway in the Emergency Department.

So, I think the main thing that we want to stress is that the Emergency Room has not really changed dramatically because of COVID. And it’s still just as safe as it always was before.

Host:  So, Tricia, I want to expand on that a little bit more and direct this question at you. Dr. Antkowiak mentioned that everyone is being screened but I’d love to learn a little bit more about the other precautions that the hospital is taking to prevent visitors from contracting COVID-19.

Tricia Leach, BSN, RN, CEN (Guest):  So, we developed a process here, it’s called curbside triage where all our services are outside the main ED and our triage nurse is outside and when patients first present to the Emergency Room; that triage nurse screens the patient initially for any COVID type symptoms and they are either screened green or red, red meaning that they screen in for COVID symptoms, green means that they have no symptoms. And then they are treated accordingly to those two colors. If they are screened in red, the nurse comes out fully in protective gear to bring the patient into our isolated room where they are then treated and seen. If the patient screens in green, they are treated normally, and the patient would have to wear a normal surgical mask upon arrival into the ER. We do keep separation from all patients so that everyone is socially distanced, and they are protected as best as possible.

Heather LaFlamme, MSN, RN, CEN (Guest):  I would add to that. We’ve also limited our visitors to try to prevent unnecessary people coming into the Emergency Department that don’t need the exposure to any potential COVID patients. We allow visitors for minors and for patients who require some assistance from their family. And we always allow visitors when there are more critical situations or end of life situations. So, we’ve really made an effort to try to minimize the traffic and the number of people that are in the Emergency Department.

Host:  Heather, I want to stick with you for a moment here. I know you’ve mentioned that you try to minimize the traffic in the Emergency Department, but I know that people who might consider coming in, they may not know whether they should or not. So, do you have any best tips or a process or a procedure they can follow to assess themselves and really figure out whether they should be coming into the Emergency Department?

Heather:  Well I think we did a really good job when as a healthcare community of trying to not try to educate people about when they should come into the Emergency Department. But I think we also kind of scared people away and people who would normally come in to the Emergency Department were staying away because they were afraid of COVID. We’re starting to see patients come back which is nice. We’re seeing patients come back for things that they should be coming back for. I would just encourage them if they feel they need emergency services to come to the Emergency Department and we’ll do our best to keep them safe and take care of them and minimize their exposure and get them in and out as quickly as we can and as safely as we can.

Tricia:  I have something to add to that, this is Tricia. We do everything that we possibly can to keep everyone protected and we do high standards of precautions here and we’re very cognizant of the fact that patients are concerned about contracting COVID when they are here. And thus far, we’ve done an excellent job of protecting our patients when they are here.

Host:  Yeah, that makes a lot of sense. I know so many people have been avoiding the Emergency Department but as you mentioned, a lot of those people, they need that support and care and it sounds like you’ve put in a lot of processes and procedures to make sure that everyone is safe. I did have a question and we’ll direct this at Dr. Antkowiak around being transported to the hospital. Let’s say something happens and I call 9-1-1, is it safe to travel in an ambulance at this time? What are some of the processes and procedures that transportation is following in order to make sure that it’s happening in a safe way?

Dr. Antkowiak:  The short answer is yes; it is very safe. Every EMS organization has standardized protocol for cleaning ambulances in between transports, ensuring that all the ambulance staff is wearing proper protective gear as well in order to prevent any transmission from prior patients or from staff. I can’t speak specifically to the individual protocols that each of the organizations across our catchment area, but I can say that all of the organizations have safety protocols in place, have cleaning protocols in place and so the transportation process really has not changed. Anyone that has an emergency that they feel they need to be seen for in the Emergency Department should feel very comfortable calling 9-1-1 and should know that they will get proper services that they always have from police, fire and EMS as appropriate for that given call. And one thing we want to stress too while I’m sort of on the point is that we don’t want folks to be afraid of coming in because it certainly can cause more harm too. If you have chest pain and you wait two days and you’re having an active heart attack and don’t realize it; coming in two days later could be significantly more dangerous than coming in in the first hour. Or if you have numbness or tingling and those may be early signs of a stroke or a transient ischemic attack. If you are waiting, those can advance very rapidly and it’s very important to seek care as soon as you feel symptoms. So, to go back to the question of transportation, I would say that it’s very safe and there are protocols in place. Anyone should feel comfortable calling their local EMS services.

Heather:  I would add to that also that when we know that an ambulance is coming in, they call ahead of time and they let us know what their screening is. So, if they are concerned that a patient might be screening positive for COVID; then we have time to prepare and get a room ready and get out staff ready. So, there’s a seamless transition between EMS and the ER.

Host:  Tricia, I’d like to direct this question at you. I’d love for you to expand a little bit more on the screening process, specifically just around how you screen the visitors that you are letting in. One of the things that I’ve heard is sometimes because they want to provide support and be with their loved ones, they might not necessarily be as honest as we would like in terms of who they’ve come in contact with. So, expand a little bit more on screening and how you can really ensure that everyone is safe that enters the hospital.

Tricia:  So, when a patient does present to the Emergency Department outside at curbside, we ask some basic questions to each individual. Have they been in contact with anyone that has been positive for COVID? Have they bee quarantined due to possibility of COVID exposure? Have they been running a fever? Do they have taste? Have they lost the sense of taste? What are their other symptoms? All these things are categorized and then determine if any of these are positive, that then flips them into either that category of a red card or a green card, then we know how to then move forward treating the patient.

Heather:  I would add to that as far as if a visitor wants to come in with a loved one say they are presenting with a family member who is a minor. We would ask the same questions to the visitor and we ask that all visitors wear masks, anybody that comes into the department we ask that they wear masks to protect themselves and to protect others.

Host:  And Dr. Antkowiak, just as we wrap up here. I know that even despite everything that we’ve talked about today there’s still going to be some apprehension and uncertainty about coming into the Emergency Room. So, is there any last piece of advice that you might give to alleviate their concerns?

Dr. Antkowiak:  My piece of advice is really that the state of the world has certainly changed. And the way we practice medicine and screen patients has certainly changed. We – I think certainly at Harrington have gone above and beyond in terms of our screening protocols, our protective equipment, our ability to keep patients and visitors safe and so even though the world feels like a very different place than it might have six or seven months ago; we really want to reiterate that us in the healthcare community and at Harrington, the world is not that much different. I mean we certainly are very careful. We are thinking very thoughtfully about how we screen patients. But it’s just really important that folks know that they can always get the same quality care that they had been able to get in the past. And I don’t want folks to feel any different about coming to the Emergency Room at Harrington.

Host:  Tricia are there any final words from you?

Tricia:  The only thing I would add to any of this is that I would like the community to know that it’s a safe place to come. We’ll treat you appropriately, we’ll take good care of you and we always have you, the patient, at the foremost of importance to all of us. So, everyday we come in here to do the best for every patient that walks in through the door.

Host:  And finally, Heather, is there anything else that you’d like to add?

Heather:  Just that we’re a community hospital and our job is to take care of our community and we strive to do the best we can to take care of our patients and our community in a safe way.

Dr. Antkowiak:  Oh, I just wanted to add one more thing. I think we mentioned briefly the curbside triage. I think we’ve also gone above and beyond and many protocols to help folks feel like they can come in and let the Emergency Room still feels like a very safe place but that includes a lot of our split flow, it includes again, getting masks on arrival and so we want to really encourage folks to come in because as I said previously, it’s so important to seek care when you feel like you need it. And that’s what we’re here for and as Heather and Tricia have mentioned, we’re here for the community and we just want folks to feel like they can come and see us anytime they need to.

Host:  Well I think that is a perfect place to end. Thank you so much for your time today. That’s Dr. Peter Antkowiak, Medical Director of Emergency Medicine, Tricia Leach the Director of Emergency Services and Heather LaFlamme, the Nurse Educator for the Emergency Department, al at Harrington Hospital. Thanks for checking out this episode of Healthy Takeout. Head to www.harringtonhospital.org to get connected with a provider. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we’ll talk next time.