Queens Doc Offers Survival Kit To Boroughs Emergency Rooms

"The great secret known to internists, but still hidden from the general public…is that most things get better by themselves. Most things, in fact, are better by morning." Dr. Lewis Thomas.
The young emergency room physician gritted his teeth and shouted, "this is like a Marx Brothers movie!"
He was trying to close the curtain around his heart attack patient gasping on a gurney. But half the screen was missing, making a private examination in the crowded ER impossible.
This episode in a Queens emergency room is typical of the frustrations borough residents will encounter if they are unlucky enough to need urgent care for anything from a fractured hip to a major stroke.
In another Queens hospital, a patient with a potentially dangerous potassium level waited 28 hours in the ER before a bed opened up for him.
In a nearby bed, one angry patient ripped the IV off his arm and began dressing after waiting for almost two days for a bed to open up. He ran through the ER with nurses and doctors pursuing him.
"I must get out of here. Ive had enough," he shouted as he ran down the corridor.
He was eventually returned to his ER gurney soon after a precious bed opened up.
In yet another borough facility, portable EKG (electrocardiograph machines) were often in disrepair. No one knows how many adverse health complications result from lack of working EKGs. But officials of the 1199 hospital union have long complained about the shortage in vital equipment. In the same hospital, desperate ER nurses swiped thermometers from other departments to complete their examinations.
One patient told The Queens Courier that hospital "transporters," workers who move patients from their rooms to other floors for surgery, lab tests or X-rays, are overwhelmed by the proliferating number of patients they must move.
"I was pushed at a frightening rate of speed down crowded hospital corridors filled with medical personnel and visitors," he said. "Then the worker began cursing when the hospitals overwhelmed elevator banks became temporarily stalled."
The patient, who asked to remain anonymous, said the transporter told him he was frustrated because he had a backlog of several patients who needed to get to the operating room.
Queens over-utilized hospitals are struggling to manage the boroughs growing patient loada phenomenon that can be traced to the large elderly population and ethnic groups that settle here carrying diseases contracted in their homeland. Their ailments include tuberculosis, asthma and hepatitis C.
Flushing political leaders held a news conference with Local 1199 officials over two years ago to call attention to the critical hospital-bed shortage in eastern Queens. The charges came from Assemblyman Brian McLaughlin and the late State Senator Leonard Stavisky. But little has been done to address the problem of overcrowded and understaffed hospitals.
A startling new look at emergency room woes has just been published by a Bayside emergency room physician, Dr. Joel Cohen, who practices at First Med, an urgent care facility on Northern Boulevard. His book, "Enter at Your Own Risk: Dangers Inside Your Emergency Room," provides readers with a survival guide to the ER.
"With nearly 100 million annual emergency room visits in this country nobody is immune to unexpected illness or injury. Sooner or later you or a loved one will end up prone and vulnerable on a hard stretcher," Cohen writes.
The Bayside author said that the ER crisis has been worsened by the introduction of managed care, a shortage of doctors, overcrowding and severe financial restraints on hospitals. This results in tough going for patients who urgently need medical care.
"Emergency care just isnt profitable to hospitals," Cohen said. "There are an estimated 40 million Americans who lack medical insurance and hospitals must often pick up costs of their care."
He advises patients to think of the emergency room as a "jungle" and explains how to sidestep dangers. These measures will see you through safely.
The books main message is "avoid ERs if at all possible!"
The author cites five rules for getting quality emergency care, including:
Plan ahead. On a day you feel perfectly well, call all nearby hospitals. Find the closest hospital that is a regional trauma center and that offers pediatric intensive care and invasive heart procedures such as emergency angioplasty. This is the emergency room you should use for serious heart disease, severe injury such as a major car accident, and for a seriously ill or injured child. A community hospital is fine for an illness that is likely to be less serious but cannot wait for an office visit.
With the help of your family doctor, stock your medicine chest wisely. Be prepared to treat pain, fever, cough, diarrhea and other common ailments. If your child has an earache during the night, for instance, proper doses of ibuprofen should help you wait until the pediatrician has office hours.
Learn who is treating you at the emergency room. Not all doctors have equal experience and training qualifications. Not everyone who dons a white coat is a doctor. Is your treating caretaker a doctor-in-training? A nurse practitioner? A moonlighting doctor who is only working the ER to earn extra money? Be sure the physician in charge speaks to you and examines you before less experienced workers make key decisions. Have ER workers discuss your illness with your family doctor too.
Ask questions. Take an active part in your own care (if possible). Do not wait for quality medical care to happen to you. It might not. Discuss risks versus benefits of performing risky tests and treatments. Assume tests and treatments are unnecessary until your doctor explains them and convinces you they are needed.
Get the expert specialist to treat you. If you require a cast or a procedure such as surgery or repair of a serious gash on the face, be sure your specialist is both skilled and experienced. Ask emergency staff which specialist they would use for their own mother. Do not let ER staff automatically contact the on-call specialist. There is a wide range of skill among specialists ranging from inept to expert. If a specialist does not respond within a reasonable amount of time, ask ER staff to call another.
"Enter at Your Own Risk" was published by Writers Club Press and sells for $11.95. It is available at Barnes & Noble stores in Queens.