Don’t let COVID-19 keep you from the Emergency Department

Naval Medical Center San Diego’s (NMCSD) tent stands erected in front of the hospital’s emergency room to treat possible, future COVID-19 patients Mar. 10. NMCSD’s mission is to prepare service members to deploy in support of operational forces, deliver high quality healthcare services and shape the future of military medicine through education, training, and research. NMCSD employs more than 6,000 active duty military personnel, civilians, and contractors in Southern California to provide patients with world-class care anytime, anywhere. (U.S. Navy photo by Mass Communication Specialist 3rd Class Jake Greenberg)
April 16, 2020

Got a medical emergency? Then you should go to the emergency room, even during a pandemic. That’s what the Director of Emergency Medical Services for Naval Medical Forces Pacific (NMFP), Capt. Ben Walrath, wants people to know.

As concerns rise about the spread of coronavirus disease 2019 (COVID-19) and people are encouraged to stay home to stop the spread of the virus, Walrath and his fellow emergency medicine providers want to let patients know that emergency departments across the military health system remain open and ready to provide emergent care.

“We want people to stay home right now to help stop the spread of COVID-19, even if they’re mildly ill, but if someone is experiencing a medical emergency, such as choking or difficulty breathing, a head injury with passing out, or chest pain or pressure, please don’t delay care” said Walrath. “They should absolutely call 911 or seek treatment in the nearest emergency department immediately.”

Acknowledging that people have concerns about contracting COVID-19 by visiting a hospital, Lt. Cmdr. Robert Fowler, a clinical nurse specialist who works at Naval Medical Center San Diego’s (NMCSD) emergency department, said staff are taking every precaution to protect patients from COVID-19.

“Upon arrival to our emergency department, all patients are being screened for COVID-19 symptoms and risk factors,” Fowler said. “This screening process helps us to quickly isolate any patients suspected of having COVID-19 away from the rest our general patient population. We have increased patient safety and our critical care capability by dedicating specific COVID-19 patient care areas and, at NMCSD, through expansion of negative-pressure isolation areas.”

NMCSD’s emergency department is not unique in taking extra measures to reduce the risk of transmitting the virus to patients and staff alike. Across the region, every emergency department is leveraging their resources and maximizing their spaces to implement rigorous patient safety and infection control precautions, such as conducting COVID-19 patient screenings to isolate suspected cases to designated areas.

But when should you go to the emergency room? What constitutes a medical emergency? Aside from the more well-known indications like difficulty breathing and chest pain, Fowler said with any illness or injury, patients may find it difficult to determine when to seek care from their primary health care provider or go to the emergency department. If that happens, he encourages patients to visit for web and video chat, or dial 1-800-TRICARE (874-2273), option number 1, and a registered nurse can provide advice.

While patients with minor symptoms, particularly symptoms of COVID-19, should stay home to limit the spread of the virus, patients should not hesitate to come to the emergency department if they develop more severe symptoms like trouble breathing, pain or pressure in the chest, confusion, or a bluish discoloration of the face or lips.

Recently, Walrath and his colleagues have seen patients who have delayed medical care for potentially life-threatening conditions due to fear of getting exposed to COVID-19 by going to the hospital. These patients, he said, are often quite sick and require many more interventions.

“We’ve seen patients with appendicitis not coming until their appendix has ruptured,” said Walrath. “Patients having chest pain but ignoring it until their heart is failing and they are struggling to breathe because their lungs are full of fluid. There are very few areas left untouched by COVID-19 but this risk does not outweigh the potential risk of delayed medical treatment,” said Walrath.

Another way emergency departments throughout the NMFP region are reducing the risk of spreading COVID-19 is through modified visitor policies.

“To protect our staff, patients, and community, routine visitation has been suspended in the emergency department,” said Cmdr. Travis Deaton, department head and academic chair for the emergency department. “Visitors will only be allowed for patients who are under the age of 18, have developmental delays, or an altered mental status. Patients meeting these criteria may still have one visitor, parent, or guardian present; however, they must be screened for COVID-19 and stay in the patient’s room for the duration of the visit.”

Right now, hospitals everywhere are reducing services and delaying elective procedures while leveraging telehealth and virtual appointments for routine care to encourage patients to stay home, because the best way to beat COVID-19 is through social distancing.

But if you are having a medical emergency, the best thing you can do is call 911 or head to the nearest emergency department. Not only will Navy Medicine providers do everything they can to treat your illness or injury, they will do everything they can to protect you and the community from COVID-19.