Bartlett Regional | HouseCalls | Summer 2017

“Instead of presenting with the flu and getting treatment and antiviral meds early in their illness, they wait and then end up in the critical care unit or may even require a medevac.” Generally speaking, patients are medevaced from Bartlett to another facility to receive services that Bartlett is unable to provide or that are unavailable in Juneau. For example, there are no cardiologists (heart specialists) currently practicing in Juneau. If a patient is having a heart attack (myocardial infarction), he or she would be sent to the closest facility that has a cardiologist. The Bartlett ED is designated as a level 4 trauma center, defined by the American Trauma Society as “demonstrating an ability to provide advanced trauma life support (ATLS) prior to transfer of patients to a higher-level trauma center. It provides evaluation, stabilization and diagnostic capabilities for injured patients.” With the trauma center designation in 2013, Bartlett’s ED received legislative funding to purchase special equipment, including a rapid blood infusion machine, a trauma cart to consolidate supplies, and a Thermoguard to treat hypothermia and cardiac patients. Summer and winter bring influx of patients The Bartlett ED is seeing a steady increase in the number of patient visits. “In 2009, our total volume was 13,600,” Lawhorne says. “Fiscal year 2016 ended with 15,300 patients.” The increase could be due to the growing number of cruise ship visitors to Juneau. Last summer, 1 million people visited our town of just over 30,000. Cruise ship passengers are a daily presence at Bartlett during the summer months. Buses from the ships arrive with passengers and crew members suffering from viral illnesses, like norovirus, and chronic illness flare-ups or fractures resulting from falls. Sometimes the ED sees elderly or frail passengers who were not well enough to travel when they embarked on the cruise. Lawhorne says that visits were also up in the winter. Last winter the number of patients seen in the ED was similar to the number seen in the busiest summer months. She attributes the increase in part to more patients getting influenza (flu) and to a flu vaccine that was less effective that year. The vaccine was estimated to prevent flu in 45 percent of the population compared to an average of 60 to 80 percent prevention in previous years. Coordinating care since 1984 The physicians working in the Bartlett ED are employed by JEMA, or Juneau Emergency Medical Associates. Bartlett has contracted with JEMA to provide 24-hour emergency medical care services since 1984. JEMA funds the ED medical director position, as well as physician extender positions (advanced nurse practitioners and physician assistants), while Bartlett provides the physical space and equipment, as well as the nursing and support personnel. Such a setup is fairly common. “Less than one-third of the entire state of Alaska’s physicians (all specialties) are hospital-employed,” writes JEMA Practice Administrator Cris Waste, RN. “All of Alaska’s emergency departments have independent contracts with physician-owned groups. Juneau is the same as Anchorage, Fairbanks and Soldotona.” How to stay out of the ED It is summer, when some of us may end up in the ED due to hiking, biking or boating accidents. Lawhorne has some advice to limit your possibility of a summer visit to the ED. “Enjoy the outdoors responsibly,” she said during a recent appearance on KINY radio’s Capital Chat. She also encourages outdoor enthusiasts to take a friend with them and, before taking off on an excursion, tell family or friends where they’re going. And in case you do end up in the ED? “Keep a list of your allergies and medications you may be taking on your person,” she says. This ensures that your providers are better equipped to give you the most appropriate care. In any case, the health care providers of the Bartlett ED are ready to take care of you, no matter what. “It takes a special gift to meet people in the worst times of their lives,” observes Lawhorne. “And people remember you.” Rose Lawhorne RN, Assistant Chief Clinical Officer, and Kimberly McDowell, RN, along with the rest of the Bartlett Regional Hospital emergency department, stand ready to help you in a health crisis. TOP-NOTCH EMERGENCY CARE Learn more about our emergency department at www.bartletthospital.org . www.bartletthospital.org 5