Don't Delay Care: Emergency Room Trends During COVID-19
Dr. Pete Mikkelsen discusses emergency room trends during COVID-19 and what hospitals are doing to adapt to treating emergency room patients during this time.
Featuring:
Pete Mikkelsen, MD
Pete Mikklesen, MD, joined Pullman Regional Hospital in 2003. He has been Medical Director of the Emergency Department since 2011. His professional interests are compassionate emergency medical care and healthcare leadership. Transcription:
Deborah Howell (Host): We've all been to the emergency room at some point in our lives. But in these difficult times of COVID-19, we might be reluctant to go there now. So, what are hospitals doing to adapt to treating emergency patients during a pandemic? To talk about emergency room trends during COVID-19 and why you shouldn't delay getting care there, today we're joined by Dr. Pete Mikkelsen, Medical Director of the Emergency Department here at Pullman. Dr Mikkelsen, how has COVID-19 affected emergency department visits? And what trends have you seen nationwide and locally?
Pete Mikkelsen, MD (Guest): Well, thanks for this opportunity. I really appreciate it. As almost everything has been affected by this worldwide pandemic, so has emergency care in the country and around the world. In Pullman, we have adapted to changing conditions, changing complaints and problems for patients and also to some of the needs in the community around testing. As far as emergency patients themselves, if folks can remember back early on even back in March, February when we were hearing those terrible stories that were happening in North Italy, North of Italy and other places in Europe, and then of course in New York, New Jersey; we were very frightened and preparing for the worst. During that time, what was interesting for us and for a lot of emergency departments around the country is that we actually, people were afraid to come into the emergency department.
And they were afraid to come in for all sorts of problems, but even heart attacks and strokes. We found that in New York state, there was a 20 plus percent decrease in the number of visits to emergency departments for both strokes and heart attacks during that time shortly after the shutdown in the early pandemic.
Host: So, why is it so important not to delay getting care when you need it?
Dr. Mikkelsen: Well, for unscheduled problems, that could get worse if you delay care, we really want to see folks in the emergency department and especially some of the things that I already mentioned, strokes and the heart attacks. If you have chest pain, if you have some sign or symptom of stroke, such as loss of motor function, those are things that we really need to see you for. Call 9-1-1 come to the emergency department.
I know a lot of people are afraid to go out during this time. There's good advice to social distance and to not have unnecessary contact physically with people. But what we've found is that, the risk of coming to the emergency department and contracting COVID really isn't there. We've been very fortunate at Pullman Regional Hospital to not have any cases of COVID-19 transmitted from either a patient to another patient or a staff member to a patient. And I know a lot of people are worried to come into the emergency department because of fears of contracting COVID. But I really want to stress that if you need to be seen in the ED, if you have, symptoms that could be something serious to your health, we really want to see you.
Host: Absolutely. Now with emergency visits so low and people delaying care, are you noticing that when people do come in to get care, they're more sick and maybe harder to treat than if they were to come in at the start of their sickness.
Dr. Mikkelsen: We have. We've seen people further into their illness, whether it be appendicitis where the appendix has ruptured by the time we see the patient or it's someone who stayed at home while they were having a stroke or a smaller heart attack. Those are the things that really impact people's lives that we want to encourage folks to get care and, and to get care because they feel like they need the care, not out of fear for accessing care to emergency departments.
Host: Now you touched on this before Dr. Mikkelsen, but is it safe for people to come into the emergency department at PRH?
Dr. Mikkelsen: Yeah. So, at Pullman Regional Hospital, very early on, we started some measures to try to separate, both the patients and families from each other. Also, personal protective equipment for staff and for patients. We emphasized that early on. We started having folks, with more minor complaints, even wait in their cars and we'd call them in. But one thing we also do in the emergency department is when you come in and you present to the front desk, we don't have you wait in the waiting room. If we have a room available in the emergency department, we bring you right back there. And we start asking you about more specifics about what brought you in today in your own room, in the emergency department, instead of being in the waiting room. So, we've really, for the most part eliminated the waiting room.
Host: That's amazing. Yeah. I had a mammogram yesterday as a matter of fact, and they had me park on the street and they used their garage as sort of the reception area. And then you get your temperature taken there in the garage. And then if you were approved, then you went up to your appointment.
Dr. Mikkelsen: That's great. I think that all organizations have really adapted and come up with some creative ways to keep patients safe.
Host: Right. So, if you have a need, for sure, go to the emergency department, don't take a chance because literally everything is at risk, correct?
Dr. Mikkelsen: Well, I think a lot of these disease processes they don't stop because you have a COVID pandemic. And so you mentioned, screening, health maintenance. Those are things that doctors have been talking about now, since this pandemic began as concerns that people aren't going to get the care that they need to keep them healthy.
Host: Is there anything else that you want people to know about this topic at this time?
Dr. Mikkelsen: I think the main message is that it's safe to get care. If you have serious concerning symptoms, you should trust yourself to get care. There's something called a prudent layperson, where if you, if you feel like you need emergency care, then as a lay person, then you need emergency care. And so, we want to encourage people to come in. If they might have something that's a serious problem that we may be able to impact their lives by diagnosing and treating and intervening early on in the course of that problem.
Host: Well, Dr. Mikkelsen, as the daughter of an emergency physician, some of the best people on earth and definitely somebody you want to put your life in your hands. So, thanks for everything you do. And for being with us today.
Dr. Mikkelsen: Oh, I really appreciate the time and the opportunity to talk about this.
Host: Please come back soon. And for more information, as well as more podcast episodes, visit Pullmanregional.org. This has been the Health Podcast from Pullman Regional. I'm your host Debra Howell. Thanks for listening and have yourself a terrific day.
Deborah Howell (Host): We've all been to the emergency room at some point in our lives. But in these difficult times of COVID-19, we might be reluctant to go there now. So, what are hospitals doing to adapt to treating emergency patients during a pandemic? To talk about emergency room trends during COVID-19 and why you shouldn't delay getting care there, today we're joined by Dr. Pete Mikkelsen, Medical Director of the Emergency Department here at Pullman. Dr Mikkelsen, how has COVID-19 affected emergency department visits? And what trends have you seen nationwide and locally?
Pete Mikkelsen, MD (Guest): Well, thanks for this opportunity. I really appreciate it. As almost everything has been affected by this worldwide pandemic, so has emergency care in the country and around the world. In Pullman, we have adapted to changing conditions, changing complaints and problems for patients and also to some of the needs in the community around testing. As far as emergency patients themselves, if folks can remember back early on even back in March, February when we were hearing those terrible stories that were happening in North Italy, North of Italy and other places in Europe, and then of course in New York, New Jersey; we were very frightened and preparing for the worst. During that time, what was interesting for us and for a lot of emergency departments around the country is that we actually, people were afraid to come into the emergency department.
And they were afraid to come in for all sorts of problems, but even heart attacks and strokes. We found that in New York state, there was a 20 plus percent decrease in the number of visits to emergency departments for both strokes and heart attacks during that time shortly after the shutdown in the early pandemic.
Host: So, why is it so important not to delay getting care when you need it?
Dr. Mikkelsen: Well, for unscheduled problems, that could get worse if you delay care, we really want to see folks in the emergency department and especially some of the things that I already mentioned, strokes and the heart attacks. If you have chest pain, if you have some sign or symptom of stroke, such as loss of motor function, those are things that we really need to see you for. Call 9-1-1 come to the emergency department.
I know a lot of people are afraid to go out during this time. There's good advice to social distance and to not have unnecessary contact physically with people. But what we've found is that, the risk of coming to the emergency department and contracting COVID really isn't there. We've been very fortunate at Pullman Regional Hospital to not have any cases of COVID-19 transmitted from either a patient to another patient or a staff member to a patient. And I know a lot of people are worried to come into the emergency department because of fears of contracting COVID. But I really want to stress that if you need to be seen in the ED, if you have, symptoms that could be something serious to your health, we really want to see you.
Host: Absolutely. Now with emergency visits so low and people delaying care, are you noticing that when people do come in to get care, they're more sick and maybe harder to treat than if they were to come in at the start of their sickness.
Dr. Mikkelsen: We have. We've seen people further into their illness, whether it be appendicitis where the appendix has ruptured by the time we see the patient or it's someone who stayed at home while they were having a stroke or a smaller heart attack. Those are the things that really impact people's lives that we want to encourage folks to get care and, and to get care because they feel like they need the care, not out of fear for accessing care to emergency departments.
Host: Now you touched on this before Dr. Mikkelsen, but is it safe for people to come into the emergency department at PRH?
Dr. Mikkelsen: Yeah. So, at Pullman Regional Hospital, very early on, we started some measures to try to separate, both the patients and families from each other. Also, personal protective equipment for staff and for patients. We emphasized that early on. We started having folks, with more minor complaints, even wait in their cars and we'd call them in. But one thing we also do in the emergency department is when you come in and you present to the front desk, we don't have you wait in the waiting room. If we have a room available in the emergency department, we bring you right back there. And we start asking you about more specifics about what brought you in today in your own room, in the emergency department, instead of being in the waiting room. So, we've really, for the most part eliminated the waiting room.
Host: That's amazing. Yeah. I had a mammogram yesterday as a matter of fact, and they had me park on the street and they used their garage as sort of the reception area. And then you get your temperature taken there in the garage. And then if you were approved, then you went up to your appointment.
Dr. Mikkelsen: That's great. I think that all organizations have really adapted and come up with some creative ways to keep patients safe.
Host: Right. So, if you have a need, for sure, go to the emergency department, don't take a chance because literally everything is at risk, correct?
Dr. Mikkelsen: Well, I think a lot of these disease processes they don't stop because you have a COVID pandemic. And so you mentioned, screening, health maintenance. Those are things that doctors have been talking about now, since this pandemic began as concerns that people aren't going to get the care that they need to keep them healthy.
Host: Is there anything else that you want people to know about this topic at this time?
Dr. Mikkelsen: I think the main message is that it's safe to get care. If you have serious concerning symptoms, you should trust yourself to get care. There's something called a prudent layperson, where if you, if you feel like you need emergency care, then as a lay person, then you need emergency care. And so, we want to encourage people to come in. If they might have something that's a serious problem that we may be able to impact their lives by diagnosing and treating and intervening early on in the course of that problem.
Host: Well, Dr. Mikkelsen, as the daughter of an emergency physician, some of the best people on earth and definitely somebody you want to put your life in your hands. So, thanks for everything you do. And for being with us today.
Dr. Mikkelsen: Oh, I really appreciate the time and the opportunity to talk about this.
Host: Please come back soon. And for more information, as well as more podcast episodes, visit Pullmanregional.org. This has been the Health Podcast from Pullman Regional. I'm your host Debra Howell. Thanks for listening and have yourself a terrific day.