Emergency Medicine | St. Louis Public Radio

Emergency Medicine

Dr. Robert Poirier works in the Barnes-Jewish Hospital emergency department. He says patients are dying because they're waiting too long to seek care in the region's ERs.
Erin Jones | Barnes-Jewish Hospital

People in the St. Louis region are dying from preventable causes such as strokes or heart attacks because they’re afraid of contracting COVID-19 in emergency rooms, doctors said this week.

Patient volume in the region’s emergency rooms is down by as much as 50%, according to hospital officials at Barnes-Jewish, SSM Health and Mercy hospitals. Doctors want to ensure patients that they won't contract the coronavirus in the ER and should seek care if they need it.

health officials are expecting the peak on/around April 25. But another, potentially worse, peak could come if businesses/etc try to go back to normal before wide-spread testing becomes available.
Nat Thomas | St. Louis Public Radio

In mid-April, the incident commander of the St. Louis Metropolitan Pandemic Task Force, Dr. Alex Garza, predicted that hospitalizations of COVID-19 cases in the region would peak around April 25. It’s impossible to say whether the city has hit the peak until time has passed and the overall trend becomes clear, but it could be the case that recent days have been as bad for local hospitals as it will get.

According to Dr. Kristen Mueller, an emergency medicine physician at Barnes-Jewish Hospital, St. Louis Children’s Hospital and Barnes-Jewish West County Hospital, the overall volume of patients coming to the emergency room is actually down.

"Fires don't chase firemen home," said Dr. Howie Mell, an emergency physician. "But this bug chases lots of folks home, and that's a new reality."
Nat Thomas | St. Louis Public Radio

As an emergency room physician at Barnes-Jewish Hospital, Evan Schwarz is used to working under pressure. 

But when he and his team connect a COVID-19 patient to a ventilator, it’s hard not to worry.

To connect a patient to the equipment, the team must first insert a tube down a person’s trachea — one of the riskiest procedures for medical workers when treating a coronavirus patient. As the tube is inserted, potentially deadly virus droplets spray into the air. 

The rate of emergency room admissions for child sex abuse in the U.S. nearly doubled between 2010 and 2016, according to research from Saint Louis University.
Maria Fabrizio | NPR

Children who have suffered sexual abuse are now going to the ER at much higher rates compared to a decade ago, according to research from St. Louis University. 

The national rate of ER admissions for child sex abuse nearly doubled between 2010 and 2016. At the same time, cases of confirmed child sex abuse in the U.S. have been declining since the 1990s, according to data from the National Data Archive on Child Abuse and Neglect. 

Dr. Laurie Punch plunged her gloved hands into Sidney Taylor's open chest in a St. Louis hospital's operating room, pushing on his heart to make it pump again, though a bullet had torn through his flesh, collarbone and lung. His pulse had faded to nothing. She needed to get his heart beating.

She couldn't let the bullet win.

Captain Garon Mosby of the St. Louis Fire Department (at left) and Helen Sandkuhl of SSM Health Saint Louis University Hospital joined Monday's talk show.
Evie Hemphill | St. Louis Public Radio

Last week, St. Louis Fire Department Chief Dennis Jenkerson said that paramedics see the impact of so much violence that they're quitting faster than he can hire replacements.

“Two to three paramedics a month are leaving the job,” said Captain Garon Mosby of the St. Louis Fire Department on Monday’s St. Louis on the Air. “If you can leave the St. Louis City Fire Department and go to another department where there’s less trauma, or get into a completely different field, that’s what we’re seeing our people do.”

For sickle cell patients, opioids are often the only pain relief. But growing rates of addiction among the general public mean emergency room doctors are more cautious than ever in prescribing those powerful medications, causing challenges.
File photo | Carolina Hidalgo | St. Louis Public Radio

A growing number of people in the St. Louis region are seeking mental health treatment in hospital emergency rooms, according to a recent report from the St. Louis and St. Louis County health departments.

The report’s authors found the rate of people seeking mental health care in emergency rooms increased more than 40% in both the city and the county between 2010 and 2016, indicating people can’t get access to long-term care for chronic issues, health officials say.

Some patients seek treatment in the emergency room because they do not have health insurance. Others go to the ER because they cannot find psychiatrists, social workers or counselors. For many, the only available option is the emergency room — not an ideal setting for mental health treatment, doctors say.

Cenya Davis puffs on her inhaler earlier this month. The 8-year-old student at Gateway Elementary School in St. Louis has been to the hospital three times for breathing trouble starting in December. She now regularly uses the inhaler.
Ryan Delaney | St. Louis Public Radio

The vast majority of St. Louis emergency room visits for asthma are from black children, according to report from Mayor Lyda Krewson’s office.

The Equity Indicators report found black children are 10 times as likely as white children to visit the emergency room for asthma-related health problems, making it the lowest-scoring indicator of the 72 measures studied by the city.

The report is part of the city’s larger Equity Indicators Project, which measures racial disparities in health care, education, employment and other areas.

When the hospital closed in rural Ellington, Missouri, a town of about 1,000, the community lost its only emergency room, too. 

That was 2016. That same year, a local farmer had a heart attack.

For sickle cell patients, opioids are often the only pain relief. But growing rates of addiction among the general public mean emergency room doctors are more cautious than ever in prescribing those powerful medications, causing challenges.
File photo | Carolina Hidalgo | St. Louis Public Radio

It took too long for blood supplies to get to Baghdad, so Dr. Philip Spinella and his Army colleagues gave their own blood. To their surprise, it worked better.

“We started to use whole blood, out of our arms into the casualties,” said Spinella, who served as an Army doctor between 1995 and 2007. “Their shock would resolve, their bleeding would resolve a lot quicker than just using plasma and red cells that we had shipped from home.”

This article first appeared in the St. Louis Beacon, April 12, 2012 - In a few years, baby boomers who get care in hospital emergency rooms might find the experience more pleasant than expected. That's the goal of Dr. Christopher Carpenter, assistant professor of emergency medicine at Washington University and president-elect of the geriatric section of the American College of Emergency Physicians. He's part of a movement to encourage hospitals to create "geriatric friendly" ERs that offer both comfort and expertise for health problems unique to an increasingly aging population.

Scheduling a visit to the emergency room

Jan 16, 2012

This article first appeared in the St. Louis Beacon, Jan. 16, 2012 - Patients expecting relatively long waits for emergency room care are said to be surprised by what happens when they use a new program at some hospitals in the SSM system. Instead of showing up at the ER unannounced and taking a number, the patients have the option of contacting the hospital to hold their place in line and generally getting faster service when they walk in the door.

This article first appeared in the St. Louis Beacon, May 7, 2009 - (Note: Some names were changed to protect the privacy of those who did not know they were under the observation of a reporter).

10:35 a.m.: I arrive at the ER with Bennie Ford, my 72-year-old brother-in-law who is in the ninth day of suffering stomach pains. He is diabetic with a pending toe removal, has had several heart attacks, has a broken but inoperable hip (because of his fragile health) and is on dialysis. But today he is seeking help for this new problem.