When faced with illness or accidents, the immediate focus is on treatment. However, different conditions are more or less urgent than others.
Dr. Olivia Andrade, Emergency Department physician, discusses what situations are best for hospital treatment, urgent care or the emergency room.
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Learn more about Olivia M. Andrade, MD
Olivia M. Andrade, MD
Olivia M. Andrade, MD is a practicing Hospitalist in Syracuse, NY. Dr. Andrade graduated from St George's University School of Medicine in 2003 and has been in practice for 15 years. She completed a residency at St Josephs Hospital Health Center. She currently practices at St Josephs Hospital Health Center and is affiliated with St Joseph's Hospital Health Center.Learn more about Olivia M. Andrade, MD
Transcription:
Prakash Chandran (Host): When illness strikes, or an accident happens, it’s rarely convenient. It might be three a.m. and your only option is the ER. But when you do have a choice for treatment; how do you determine the best place to go? Here with us to discuss is Dr. Olivia Andrade, a Medical Director at the Emergency Department at St. Joseph’s Health. Dr. Andrade, thanks so much for being here today.
Prakash: So, let’s start by hearing the differences between what urgent care handles versus the emergency department or ER.
Dr. Andrade: Thank you. If I could just say, I think it’s best for the patient always go to their regular doctor if they are available, their primary care provider. That being said, if the urgent care versus the emergency department; the urgent care is convenient, it provides extended hours so a patient should go there if they have a medical issue that occurs outside of their doctor’s normal hours, if they are unable to get into their doctor’s office and they feel like they have an urgent situation that cannot wait and something not life-threatening. The emergency department really should be reserved for those serious life or limb threatening issues.
Prakash: Is there a rule of thumb to follow to determine whether urgent care is a good option versus what an emergency room is? Are there kind of cases that you put in each bucket? Can you give us some examples?
Dr. Andrade: Sure. Some examples could be for the urgent care in particular, evaluation of the minor strains or sprains, if there is a concern for a fracture, only if there is no bone sticking out of course, that’s certainly something that can be assessed in the urgent care setting with an x-ray. Simple cuts that can be stitched up also the urgent care area. Cold, flulike symptoms and those kind of injuries or things can be assessed in the urgent care setting. For the emergency department I would say more of the life and limb threatening conditions, severe chest pain, sudden onset of slurred speech, weakness, numbness, severe head injuries, eye injuries are those that I would consider for the emergency department.
Prakash: So, if I have like for example, last week I had what I consider a pretty severe flu, high chills, fever, nausea, you’d say that the urgent care is probably a better department for me to go to, to handle that?
Dr. Andrade: I would, certainly. Certainly, the urgent care and ideally your primary doctor because they know you best. But yes, the urgent care would probably be the best option to go if your primary doctor is not available as they would be able to assess you and evaluate you there.
Prakash: So, I feel like there’s been a rising trend of young people substituting their urgent care – or an urgent care clinic instead of a primary care physician just because of the wait times. Maybe they moved to a city and they just feel that urgent care is easier. Do you think that that’s an issue?
Dr. Andrade: I do appreciate the patient considering the urgent cares for these kinds of things especially if they don’t have a regular doctor to go to and they have busy lives, as the urgent care does afford the patient convenient and extended hours, that they may not be able to see their regular doctors during their business hours. So, the urgent care does provide them this convenience if you will and they can get their concerns taken care of there.
Prakash: Okay. And in true emergencies, I know how important efficiency is. Is there anything that a patient can do to help the doctor, like having a list of medical information on hand?
Dr. Andrade: I always encourage patients even when they come to the emergency department to please always have your medication list with you. It’s important to know the dosages so that we can address your issues accordingly and make sure that we have the right medications, the right dosages. A lot of the times, patients will come with a list of their medical history and we do appreciate that as it does help us to hone in and focus on what the presenting concern may be.
Prakash: So, maybe talk a little bit about the most common things that you see in the emergency department or the emergency room. What are you seeing the most often?
Dr. Andrade: We see – St. Joseph’s Health is known for their cardiac care so certainly, we do see a lot of chest pain presentation here. And we see patients that present with chest pain that then end up having a heart attack or they are further admitted for stress tests and such to ensure that they are not having an acute coronary issue. We see significant abdominal pain presentation as well. And this can be from anywhere from just like a gastritis to something more severe like a diverticulitis or perforation even that requires surgical intervention. So, there really is a wide array and each patient is different in terms of their presentation and so we do see a wide variety of presentations of chest pain, abdominal pain, shortness of breath, what have you.
Prakash: So, my father actually suffers from a heart condition and I feel like there’s a wide range of the chest pain that you are talking about. When is it a good idea for someone with a chest pain or that abdominal pain that you are talking about to say you know what, it’s time for me to really go do something about this and either call someone or take myself to the emergency department? Is there a certain pain threshold that you look for that you wish that patients would stick to when they come in?
Dr. Andrade: I think patients do know their bodies best and if they feel like this is something out of the norm for them, something that is very different from what they are used to and cannot handle or what they would assess as severe pain; they really should be calling 9-1-1 first or if they have someone that’s available to bring them in to please have that person bring them in to the emergency department. Ideally, I would suggest that they call 9-1-1 as chest pain can be very severe and life threatening.
Prakash: And I’m sure you get this a lot, but we talked about preparedness and efficiency; as for example a loved one is taking someone to the emergency department; is there prep work that they can do besides the medical history for example calling in advance, getting information ready for the hospital? Is there anything that is available to them there?
Dr. Andrade: Probably not to the patient directly. Certainly, if they are in urgent care that then requires a higher level of care and an evaluation in the emergency department; usually we do have a prior report that is given from provider to provider. If they are coming from their primary care setting certainly, again, we will have another doc to doc kind of a report that is given. Because the emergency room is and emergency service provider; a lot of the times we are unable to have this information given to us ahead of time from the patient and so upon their arrival, they are quickly assessed and triaged and then sent to the appropriate area of the emergency department for their care.
Prakash: Alright, well this is great Dr. Andrade. I really feel like we have a much better sense for when we should pursue these treatment options. I really appreciate your time today. For more information, please visit www.sjhsyr.org/emergency, that’s www.sjhsyr.org/emergency. This is St. Joseph’s Health MedCast from St. Joseph’s Health. I’m Prakash Chandran. Thank you for listening.
Prakash Chandran (Host): When illness strikes, or an accident happens, it’s rarely convenient. It might be three a.m. and your only option is the ER. But when you do have a choice for treatment; how do you determine the best place to go? Here with us to discuss is Dr. Olivia Andrade, a Medical Director at the Emergency Department at St. Joseph’s Health. Dr. Andrade, thanks so much for being here today.
Prakash: So, let’s start by hearing the differences between what urgent care handles versus the emergency department or ER.
Dr. Andrade: Thank you. If I could just say, I think it’s best for the patient always go to their regular doctor if they are available, their primary care provider. That being said, if the urgent care versus the emergency department; the urgent care is convenient, it provides extended hours so a patient should go there if they have a medical issue that occurs outside of their doctor’s normal hours, if they are unable to get into their doctor’s office and they feel like they have an urgent situation that cannot wait and something not life-threatening. The emergency department really should be reserved for those serious life or limb threatening issues.
Prakash: Is there a rule of thumb to follow to determine whether urgent care is a good option versus what an emergency room is? Are there kind of cases that you put in each bucket? Can you give us some examples?
Dr. Andrade: Sure. Some examples could be for the urgent care in particular, evaluation of the minor strains or sprains, if there is a concern for a fracture, only if there is no bone sticking out of course, that’s certainly something that can be assessed in the urgent care setting with an x-ray. Simple cuts that can be stitched up also the urgent care area. Cold, flulike symptoms and those kind of injuries or things can be assessed in the urgent care setting. For the emergency department I would say more of the life and limb threatening conditions, severe chest pain, sudden onset of slurred speech, weakness, numbness, severe head injuries, eye injuries are those that I would consider for the emergency department.
Prakash: So, if I have like for example, last week I had what I consider a pretty severe flu, high chills, fever, nausea, you’d say that the urgent care is probably a better department for me to go to, to handle that?
Dr. Andrade: I would, certainly. Certainly, the urgent care and ideally your primary doctor because they know you best. But yes, the urgent care would probably be the best option to go if your primary doctor is not available as they would be able to assess you and evaluate you there.
Prakash: So, I feel like there’s been a rising trend of young people substituting their urgent care – or an urgent care clinic instead of a primary care physician just because of the wait times. Maybe they moved to a city and they just feel that urgent care is easier. Do you think that that’s an issue?
Dr. Andrade: I do appreciate the patient considering the urgent cares for these kinds of things especially if they don’t have a regular doctor to go to and they have busy lives, as the urgent care does afford the patient convenient and extended hours, that they may not be able to see their regular doctors during their business hours. So, the urgent care does provide them this convenience if you will and they can get their concerns taken care of there.
Prakash: Okay. And in true emergencies, I know how important efficiency is. Is there anything that a patient can do to help the doctor, like having a list of medical information on hand?
Dr. Andrade: I always encourage patients even when they come to the emergency department to please always have your medication list with you. It’s important to know the dosages so that we can address your issues accordingly and make sure that we have the right medications, the right dosages. A lot of the times, patients will come with a list of their medical history and we do appreciate that as it does help us to hone in and focus on what the presenting concern may be.
Prakash: So, maybe talk a little bit about the most common things that you see in the emergency department or the emergency room. What are you seeing the most often?
Dr. Andrade: We see – St. Joseph’s Health is known for their cardiac care so certainly, we do see a lot of chest pain presentation here. And we see patients that present with chest pain that then end up having a heart attack or they are further admitted for stress tests and such to ensure that they are not having an acute coronary issue. We see significant abdominal pain presentation as well. And this can be from anywhere from just like a gastritis to something more severe like a diverticulitis or perforation even that requires surgical intervention. So, there really is a wide array and each patient is different in terms of their presentation and so we do see a wide variety of presentations of chest pain, abdominal pain, shortness of breath, what have you.
Prakash: So, my father actually suffers from a heart condition and I feel like there’s a wide range of the chest pain that you are talking about. When is it a good idea for someone with a chest pain or that abdominal pain that you are talking about to say you know what, it’s time for me to really go do something about this and either call someone or take myself to the emergency department? Is there a certain pain threshold that you look for that you wish that patients would stick to when they come in?
Dr. Andrade: I think patients do know their bodies best and if they feel like this is something out of the norm for them, something that is very different from what they are used to and cannot handle or what they would assess as severe pain; they really should be calling 9-1-1 first or if they have someone that’s available to bring them in to please have that person bring them in to the emergency department. Ideally, I would suggest that they call 9-1-1 as chest pain can be very severe and life threatening.
Prakash: And I’m sure you get this a lot, but we talked about preparedness and efficiency; as for example a loved one is taking someone to the emergency department; is there prep work that they can do besides the medical history for example calling in advance, getting information ready for the hospital? Is there anything that is available to them there?
Dr. Andrade: Probably not to the patient directly. Certainly, if they are in urgent care that then requires a higher level of care and an evaluation in the emergency department; usually we do have a prior report that is given from provider to provider. If they are coming from their primary care setting certainly, again, we will have another doc to doc kind of a report that is given. Because the emergency room is and emergency service provider; a lot of the times we are unable to have this information given to us ahead of time from the patient and so upon their arrival, they are quickly assessed and triaged and then sent to the appropriate area of the emergency department for their care.
Prakash: Alright, well this is great Dr. Andrade. I really feel like we have a much better sense for when we should pursue these treatment options. I really appreciate your time today. For more information, please visit www.sjhsyr.org/emergency, that’s www.sjhsyr.org/emergency. This is St. Joseph’s Health MedCast from St. Joseph’s Health. I’m Prakash Chandran. Thank you for listening.