The Evolution of Connecticut's Emergency Rooms


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Ralph Miro, director of nursing and EMS coordinator for the Department of Emergency Medicine at Day Kimball Healthcare, which operates Day Kimball Hospital in Putnam, agrees patients should never be discouraged from coming to the emergency department. “Until you’re assessed by health-care professionals, there’s no way to tell if something that may seem minor could be very major,” he says. “Let’s say you have left arm pain or right arm pain or jaw pain—that could be a sign of a heart attack.”

He adds, “Patients who feel that their complaints or their symptoms are serious—what they should not do is ignore them.”

Patients also needn’t worry that their broken ankle will take away needed resources from sicker people, says Miro. Emergency-staff members are trained in triage, or assessing the most critically ill patients to make sure they get priority treatment. This ability to quickly assess need is an area where emergency medicine has advanced significantly, aided by now common life-saving practices such as “point-of-care” testing.

“It’s a procedure that enables us to determine a patient’s condition, or to identify certain disease states, by evaluating the content of a patient’s blood,” Miro says. Blood now can be analyzed at a patient’s bedside thanks to devices like the i-STAT System, a handheld blood analyzer that can provide lab-quality test results on the spot.

“Instead of drawing multiple tubes of blood, all we need is a few drops in an i-STAT,” he says. “Those drops of blood, as little as two, are placed into the unit and rather than having to wait for the results from our lab, the results come within a few minutes.”  

Major advances like this aid in better treating heart attacks and strokes, where time is critical. Using point-of-care treatments like i-STAT, which can test for cardiac markers, staff can assess more quickly what type of heart attack a patient is having and then send him or her to a catheterization lab where they can be treated properly. There are also new medications that slow down the damage caused by a heart attack or a stroke, and innovative techniques such as therapeutic hypothermia, a method by which medical staff can lower the patient’s body temperature to slow down brain damage.

Not all the new technology being used is specific to the health-care industry. Advances in video-conferencing technology have allowed patients at Day Kimball to be examined remotely by specialists at the UMass Memorial Medical Center.

“We can zoom in on the patient and a neurologist all the way over at UMass can assess the pupils and skin color,” Miro says.

In addition to technological advances, another trend in emergency medicine today is in customer service. Dr. Jeffrey A. Finkelstein, chief of emergency medicine and chief medical information officer at the Hospital of Central Connecticut, says the hospital treats visitors like “customers as opposed to patients.” The hospital, which has campuses in Southington and New Britain, features valet parking at

the entrance to the emergency department and people are offered coffee and warm blankets as soon as they come in.

“We’re not the old ER where it was impersonal,” he says. “We really try to make it as easy as possible and as pleasant an experience as possible when you’re in pain or ill, or visiting someone who is in pain or ill.”

A few years ago the hospital began providing estimated emergency department wait times on the hospital’s website, via text message and through smartphone apps. “The number one thing people want is short wait times,” says Finkelstein. “They expect good medical care, they expect people to be nice, but what they really want is to be seen quickly. No one wants to sit in the waiting room for two, three, maybe four hours.”

The Evolution of Connecticut's Emergency Rooms

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