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Against the Grain with Dr. Chad Edwards | Tulsa Sports Injury| Podcast 7 – Part 1
Dr. Edwards: This is Dr. Chad Edwards and you’re listening to podcast number 7 of Against the Grain.
Speaker 2: Welcome to Against the Grain podcast with Dr. Chad Edwards, where he challenges the status quo when it comes to medicine. We get into hot topics in the medical field with real stories from real patients, to help you on your way to a healthy lifestyle. Get ready because we’re about to go, Against the Grain.
Brian: This is Brian Wilkes, here with the Dr. Chad Edwards. Dr. Edwards, how are you doing today?
Dr. Edwards: If I were any better, I’d be twins. I’m just so excited to be here.
Brian: Oh man, that is good news. That is good news. I love your dry humor. It’s great.
Dr. Edwards: Is there another kind?
Brian: Hey, speaking of humor, we’ve got a great teaser episode, short episode today, on the emergency room. How to get in, what to do when you get there, all that good stuff. I think it’s going to be great.
Dr. Edwards: It’s awesome. We’ll just get right into, oh, we’ve got a couple of sponsors that we’ve got to talk about.
Brian: Yeah, we’ll talk about a couple of sponsors. Today we’ve got to get through them briefly, but Revolution Health and Wellness Center. Chad.
Dr. Edwards: If you’ve got musculoskeletal pain, athletic injuries, knees, back, neck, any kind of pain, come see us. Prolo therapy, PRP, stem cell, we’re going to fix that stuff right up for you.
Brian: Yep.
Dr. Edwards: Also, functional medicine stuff. Come see us. (918) 935-3636 or revolutionhealth.org.
Brian: Upper Cervical Health Centers is a chiropractic place here in town, in the city of Tulsa, Oklahoma.
Dr. Edwards: T-Town.
Brian: T-town. Chad has a lot of good friends of Chad and highly recommends these guys. Their patients seem overall improvement of over 75% of their health, so I would say that’s a pretty good stat. Their number is (918) 742-2300 or you can visit uppercervicaltulsa.com/new you. Chad, with that, let’s jump right to the ER. I imagine you have some awesome ER stories.
Speaker 2: It’s the Hot Topic.
Brian: Oh yeah, the hot topic, oh yeah.
Dr. Edwards: I am board certified in family medicine, but I’ve spent numerous hours in the emergency room. I used to moonlight in the emergency room, been in some little bitty ones. Been in some rather big ones and it was definitely a growing experience, to say the least.
Brian: When I come to the ER, what can I expect? The average ER.
Dr. Edwards: The first thing I would say is that emergencies are relative. When you get the average patient that has an owie, I don’t know how else to define owie, but fill in the blanks, that’s not going to result in your death …
Brian: Right.
Dr. Edwards: Then, that is probably not a true emergency.
Brian: How many people come to the ER, what percentage would you say, come with non-life threatening ailments?
Dr. Edwards: 80 or 90%.
Brian: Right, so they shouldn’t be there?
Dr. Edwards: They need, understand, they need help. They need something. If you’ve got a broken bone, your bone is sticking through, is that going to result in your death? No. Does that need to be managed? Absolutely.
Brian: Right.
Dr. Edwards: The only reason that I bring that up is because I remember, specifically, a patient that came in that was complaining of knee pain.
Brian: Right.
Dr. Edwards: She wanted to be referred to an orthopedic surgeon for knee evaluation. That was the reason for her coming into the emergency room. She’s had knee pain for years. She comes into the emergency room. This was a relatively small emergency room and this particular night, we were busy. We literally had a 6 hour wait in the waiting room.
Brian: Wow.
Dr. Edwards: This lady was complaining because she was waiting because of her chronic knee pain. Now, it wasn’t that we didn’t care and didn’t want to see her, but when you have patients come in without a pulse or that aren’t breathing, or are unconscious, those patients take precedence.
Brian: How do hospitals manage ER clinics, in the sense of, if you have … At, let’s say, 2 o’clock in the morning, you’re on a rotational shift, right. There’s a car accident involving 10 people. They all come to your ER clinic, right?
Dr. Edwards: Right.
Brian: There’s 10 people waiting that having fairly urgent matters, right? How does the hospital scale up or down accordingly? How does it work?
Dr. Edwards: That gets into what we call triage. It requires a … In the military we did a lot of this because you are in a position where your resources are overwhelmed.
Brian: Right.
Dr. Edwards: You then have to prioritize and you put patients into categories. In the military we would use expectant, urgent, delayed, immediate, these kinds of categories.
Brian: The squeaky wheel gets the grease, right?
Dr. Edwards: That’s exactly right, so when you have something that you can fix and will save their life, immediately you do that and then you go on to the next patient. It’s this cycle. It’s uncommon in America, that you’ll be overwhelmed with 10 patients all at once, all life threatening …
Brian: Because of the resources?
Dr. Edwards: Outside of, when you look at things like Columbine. You look at things like the Boston bombing, what was the one in …
Brian: Major events?
Dr. Edwards: Yeah, where you have multiple severe casualties. The most recent one in France with the terrorist attacks and they implemented their Plight Plan.
Brian: Right.
Dr. Edwards: You’re talking 100s of casualties that all have to be evaluated and there is a process for doing that.
Brian: Right.
Dr. Edwards: Most hospitals have a, all of them should have a …
Brian: Procedure.
Dr. Edwards: An emergency plan.
Brian: Got you.
Dr. Edwards: You activate based on what you have going on. We don’t have to do that everyday. You may be busy and relatively overwhelmed, but the patient with the knee pain is going to wait.
Brian: Yeah.
Dr. Edwards: Until you can get them in. Some hospitals will go on divert, so they’re no longer accepting ambulances because they don’t have the resources to do it.
Brian: They literally divert it to another hospital?
Dr. Edwards: Correct.
Brian: That they have a pre-defined relationships with.
Dr. Edwards: Correct. In Tulsa, you’ve got St. Francis, for example.
Brian: Right.
Dr. Edwards: If all of your ICU beds are full or all of your trauma type ICU related services are full, you may go on divert for trauma. You may go on divert for neurologic.
Brian: Right.
Dr. Edwards: Because you don’t have the neuro ICU. You can’t put them anywhere.
Brian: Right.
Dr. Edwards: It’s better for them to drive an extra few minutes to go some place else where they do have the available resources. Now, you may only go on divert for a few hours. Usually that’s the case, a day or two. If the whole town or the whole city got overwhelmed, then of course, you would take them as you can.
Brian: Right.
Dr. Edwards: In trying to manage, so that takes it to an echellon higher than the hospital itself, so you’re not going to the city resources and go to another hospital. That’s one mechanism by which the system could work. Going back to that, emergency is relative, I think one of the things that we want to discuss in this podcast, is how can we help our patients understand how to utilize the emergency room? How to utilize an urgent care?
