Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, March 6, 1994 TAG: 9403040113
SECTION: ROANOKE MEMORIAL HOSPITAL PAGE: RMH-4 EDITION: METRO
SOURCE: By JOANNE ANDERSON
DATELINE: LENGTH: Medium
One decade later in 1992, emergency departments saw 92 million people across the country for medical conditions and injuries of varying severity. Close to 50 percent of the 19,003 admissions to Roanoke Memorial in 1992 were through the emergency department, and 34,622 total came to the emergency department, from as far away as West Virginia.
Originally developed to provide life-saving care for persons with critical medical conditions or trauma injuries, the popularity of emergency departments has forced an evaluation and redefinition of their mission. Most, including Roanoke Memorial's, have expanded services to serve non-urgent and urgent needs.
In some cases, the department serves as a primary physician, and a new 12-bed fast track area has been set up in the new South Pavilion to handle ambulatory and non-acute conditions or injuries. This service functions more as a doctor call than an acute emergency.
The emergency department at Roanoke Memorial is a Level One trauma center, only one of five in the state. This designation means, among other things, that a trauma team is in place at all times. The center has its own mission and budget and must have advanced procedures and capabilities in the trauma area of the emergency department.
"Our trauma department has been specifically designed for our region," said Dr. Carol Gilbert, a trauma surgeon and director of the hospital's trauma program. "For example, we see more car accident victims and people with injuries from tractor rollovers that gunshot wounds. Therefore, our diagnostic equipment is part of the emergency department, whereas a big city hospital might arrange their capabilities differently to meet their needs."
The new South Pavilion's emergency department is four times the size of the old one and encompasses the latest in both medical technology and health care delivery techniques.
There are also improvements in patient-delivery techniques. A 90-foot diameter helicopter touchpad is located on the roof on the ninth floor. A new oversized elevator, which can be dedicated on a moment's notice, has been installed with the other new patient- and staff-only elevators. The large one has a stainless steel interior and can accommodate a patient, medical team and life support equipment.
There are two entrances for ambulance arrivals and one for injured and ill people coming by private vehicle. Admission into the department has been streamlined to include a triage determination upon arrival. From there, patients are directed to either a waiting room, private examination room or trauma area.
A decontamination room with a private outside entrance has been built to handle hazardous materials (often referred to as hazmat) incidents. The room is completely tiled with its own shower and a drain system that collects all the wash for proper disposal.
The greater square footage means minimal patient movement. With the computerized tomography (CT) scan equipment in a room next to the trauma rooms, the medical team can quickly evaluate the extent of injuries.
Also, the new X-ray equipment is mounted overhead on sliders so it can be positioned over the patient, eliminating more transport and movement. "Time is valuable in every trauma case," added Gilbert.
A small laboratory is located in the emergency department, and patients really don't need to leave the floor at all during initial evaluation. In fact, according to Dr. Richard Surrusco, medical director of emergency services, a patient doesn't even have to leave the stretcher.
"We've switched to using a versatile stretcher that can carry an emergency room patient from the helicopter or ambulance through all the diagnostics. A patient does not have to move until a bed is assigned."
The entire department has been organized as a multi-functional area in terms of space allocation. That is, the different rooms can accommodate all types of incoming patients.
"We wanted to be able to do everything in every room," explained Surrusco. This way, the facility is not limited in what types of injuries can be treated in which rooms. Everything can be treated anywhere, except for pediatrics and pregnancy.
Surrusco, who oversees emergency services for both Roanoke Memorial and Roanoke Community hospitals, emphasizes that the new South Pavilion emergency department has not been designed for pediatric or obstetrics and gynecological (ob/gyn) emergencies. All children and babies-on-the-way should go to Community Hospital's emergency department.
Whatever the time of day, whatever the injury or medical condition, the emergency department and its Level One trauma center at Roanoke Memorial Hospitals are ready and capable to meet your health care needs.
by CNB