The following are answers to common questions concerning our Emergency Department
What will happen when I arrive in the Emergency Department?
First, you will see the triage nurse... When you arrive at the Emergency Department, triage personnel will evaluate your condition and determine the first step in your care. Please be prepared to give the following information:
- Reason for your visit
- When you had your last tetanus shot
- Names and doses of medications you are taking
- If you are allergic to any medications
- If you think you may be pregnant
- Previous medical history
The triage nurse has special training to assess how quickly you need treatment and in which room your care needs to take place. The triage nurse will ask you questions about the reason for your visit to the Emergency Department and about your general health. He/she will take your pulse, blood pressure, temperature, and breathing rate, and take note of any allergies you may have and current medications you are taking. If you feel you need to speak to someone privately, please ask. We know that the Emergency Department can be noisy and crowded. Check with your nurse before eating or drinking. Some tests require you to have an empty stomach. Leave your personal belongings and valuables with a friend or a relative.
Next, you will be registered...
The triage nurse gives your information to a registration clerk. The clerk will ask you for your name and address, insurance card and photo identification, your family doctor’s name, and an emergency contact number. It is important that we have accurate contact information from you in case we need to reach you to discuss test results that return after you are sent home. The clerk will make up your chart and give you an identification band. If the triage nurse feels you need to be seen immediately by a physician, a family member can register for you. You will be seen at triage and registration on a first-come, first-served basis. Patients remain in that order unless their chief complaint or the severity of their condition requires a more urgent response. Then a patient may be taken out of order and seen ahead of those who may have come before them. If your condition worsens while you are waiting to be seen, you should immediately tell the triage nurse so you can be re-assessed.
After registration, you will receive treatment...
Depending on your medical condition as assessed by the triage nurse, you may be sent to the appropriate area of the Emergency Department to be seen by a physician or you may be asked to stay in the waiting room until an examination room is available. In the treatment area, a primary nurse will assess your condition and be responsible for your care while you are in the Emergency Department. Tests or procedures will be ordered as needed. Test results and diagnostic procedures can take time to be completed and for the results to be available. If you are able to go home, it is important to follow through with the plan of care outlined in our aftercare instructions. This includes follow-up with your primary doctor and other specialists. If you do not have a primary physician, referrals may be provided to doctors or clinics in the local area. Occasionally, you may be asked to return to the emergency department for a re-check or ongoing testing. Your emergency team will discuss this with you and provide you an opportunity to ask questions.
Why is the wait so long?
We do our best to let you know when you will be seen. Things can change quickly in the Emergency Department and delay your care. Patients requiring the most urgent care must be treated first. There may also be delays while we wait for your test results from the laboratory or x-ray departments.
Please understand that our aim is to provide you with the most efficient service possible. If you do have to wait, a nurse will be nearby to answer your questions and monitor your condition. Your patience is appreciated.
Emergency Department’s Stroke Prevention Clinic
A transient ischemic attack (TIA) can be a warning sign that someone is in danger of having a full stroke, and occurs when the blood supply to the brain is blocked for a short time. The brain malfunctions temporarily and then usually returns to normal with no permanent damage. Sometimes, however, permanent damage to brain functions, such as short term memory loss, can occur.
“When a patient comes to the Stroke Prevention Clinic, a nurse reviews their health history to suggest lifestyle changes that could help prevent a full stroke in the future. A neurological exam is performed and the neurologist reviews any tests the patient may have had done recently, such as a CT scan, carotid ultrasound, or MRI. The patient does all this at MGH&FC’s Stroke Prevention Clinic, where the neurologist and patient talk face-to-face via tele-robot. The neurologist then gives follow-up orders and information. The stroke clinic visit is then followed up by the patient visiting their primary care provider,” said Nelson, adding that “helping to ward off a full stroke is the Clinic’s main goal, as well as providing services that patients once had to travel to Olympia to receive”.
Nelson explained that a patient will receive follow-up phone calls at one month, three months, six months, and one year following their first visit to the Stroke Prevention Clinic, to see if they’ve had additional TIAs or strokes, and to make sure they are following their plan to reduce the risk of another stroke. It is also a check to see if they need further support or resources to help accomplish their goals.
“So far, we’ve received really great patient feedback for the program because of the one-on-one care and personal education we provide for the patients,” Nelson added. A Stroke Prevention Clinic appointment lasts about an hour and includes a lifestyle assessment.
“We start with small lifestyle changes, choosing one thing to work on so the patient doesn’t get overwhelmed. They decide what to work on and we help them with it,” Nelson said. Suggestions for change may include to stop smoking, lose weight, or to add daily exercise to their routine – all of which help decrease stroke risk.
“I think the biggest advantage of our stroke clinic is that people are getting in for care much faster. It’s also cost effective having all of their tests done at once, and in one place. A patient can have their MRI, ultrasound, CT scans, and lab tests all here at Mason General, and usually in one visit instead of having to make multiple appointments. You’re not likely to get that kind of patient-centered care at any other area hospital,” Nelson concluded.
With an emphasis on ‘prevention,’ MGH&FC’s TIA Clinic was recently re-named the Stroke Prevention Clinic.
The typical symptoms of TIA and Stroke: F.A.S.T.
▪ FACE Drooping – Does one side of the face droop, or is it numb? Ask the person to smile. Is their smile uneven?
▪ ARM Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
▪ SPEECH Difficulty – Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue”. Is the sentence repeated correctly?
Time to call 9-1-1 – If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital immediately. Check the time so you remember when the first symptoms appeared.
How to Help Prevent a Stroke:
- If your blood pressure is high, lower it. For people over age 18, high blood pressure is a measurement of 140/90 or higher.
- Find out if you have atrial fibrillation (Afib). Atrial fibrillation is an irregular heartbeat that can cause blood to pool in parts of your heart. Pooling blood can cause clots which can break away and cause a stroke.
- If you smoke, stop. Smoking doubles the risk of stroke.
- If you drink, drink in moderation. Heavy drinking can increase the risk of stroke.
- Keep your cholesterol at a normal level. Your total cholesterol should be under 200, and your LDL or “bad” cholesterol should be between 50 and 70.
- If you are diabetic, follow your doctor’s instructions carefully and keep your blood sugar levels under control. Diabetes increases stroke risk.
- Include daily exercise in your routine, which decreases the risk stroke.
- Cut down on sodium and fat. Eating less salt and fat can lower your blood pressure and risk of stroke.
[Source: National Stroke Association]
Mason General and St. Peter Neurology Partner in New Stroke Technology
If you suffer a stroke in Mason County it is important that you get medical help as soon as possible ‒ and go immediately to Mason General Hospital ‒ as time loss is brain loss.
MGH is staffed 24/7 by board-certified emergency medicine physicians who are trained in stroke diagnosis and treatment. And now, thanks to Providence St. Peter Hospital, Olympia, there will be a neurologist in the room via two-way video camera and a remote telehealth robot. Mason General Hospital & Family of Clinics has joined the Telestroke Network, a southwestern Washington hospital partnership set up by St. Peter that allows access to neurologists, 24-hours-a-day, through advanced video technology.
“This technology puts the neurologist right in the room with the patient and emergency medicine physician,” said Dean Gushee, M.D., director of emergency services for MGH & FC. “When needed, this new technology will allow the neurologist to be present when the patient arrives at MGH’s emergency room. Faster diagnosis and immediate treatment can often reduce or eliminate the debilitating results of a stroke. It is critical that people know the symptoms of a stroke, and get to MGH as quickly as possible.” The new technology allows the neurologist to see and talk with the patient and family as well as MGH emergency medicine physicians by way of remote video conferencing.
With two-way video cameras and remote maneuvering, this technology allows a neurologist from the certified Stroke Center at Providence St. Peter Hospital, Olympia, to work remotely with board certified physicians and patients in MGH’s emergency department to quickly provide stroke treatment. In addition to emergency bedside consultation, physicians will be able to electronically share brain scans and discuss treatment options.
“When it comes to stroke, every minute is critical,” says James McDowell, M.D., medical director of Providence St. Peter Hospital’s Stroke Program. “Being able to share our expertise in ‘real time’ will help patients receive a more favorable diagnosis and treatment.”
The diagnosis and treatment protocols for stroke patients have been a two-year long cooperative endeavor between MGH &FC physicians and staff, St. Peter staff, and emergency medical services personnel, aiming to perfect techniques and protocols that will speed up diagnoses and treatment. The use of video conferencing enhances that team effort ‒ to minimize the effects of a stroke and increase the likelihood for a good patient recovery.
Mason General Hospital Wins “T-System National Award for Emergency Department Excellence in 2011
Mason General Hospital & Family of Clinics was recently chosen from more than 1,700 hospitals nationwide to receive the 2011 T-System Client Excellence Award. T-System, Inc., an industry leader in clinical, business and IT solutions for emergency medicine, annually recognizes hospitals that have most effectively used its solutions to improve the quality of patient care, operational processes and financial results in the emergency department (ED).
“We are thrilled to receive this prestigious award as a result of the hard work and progress made over the past year to improve our emergency department and the professional lives of our dedicated emergency medical staff,” said Dean Gushee, MD, medical director at Mason General Hospital & Family of Clinics. “Using T-System solutions has helped our physicians, nurses and staff to increase our efficiency, reduce length of stay, and improve patient contact and coordinate care between providers.”
In addition, Tom Hornburg, chief information officer at MGH & FC added, “The T-system solution highlights our continuing effort to provide exceptional medical care while taking advantage of the latest technologies.”
The Emergency Department of Mason General Hospital is known for high quality and efficient care. The hospital has leveraged the experience of T-EV in deploying technologies to the rest of the facility. T-System provides a best of breed model to compare with enterprise documentation solutions.
“Congratulations to Mason General Hospital & Family of Clinics for being chosen as a 2011 T-System Client Excellence Award recipient in demonstrating superior patient care and financial improvements in attaining their goals,” said Sunny Sanyal, T-System chief executive officer. “Their commitment to the use of technology to enhance the practice of emergency medicine is an inspiration to all hospitals. Mason General Hospital & Family of Clinics’ deployment, use of our solutions and outstanding collaboration with T-System employees is both exemplary and a best practice in emergency medicine.”
In recognition of Mason General Hospital & Family of Clinic’s accomplishments, T-System will make a donation to Mason General Hospital & Family of Clinic. MGH & FC will also receive a commemorative plaque and special recognition at the 2012 T-System user conference.