Holiday rush

Jace Radke

Friday, Dec. 10, 1999 | 11:48 a.m.

What's an emergency:

Severe bleeding, difficulty breathing, chest pain, broken bones, head injuries, partial or total amputation of a limb, severe abdominal pain or sudden dizziness.

What's not:

Lacerations, sprains, infections, flus and colds can usually be treated by a private physician or an urgent care center.

The holiday season has arrived in Las Vegas, signaling area hospitals and paramedics that it's time for the annual game of emergency room hot potato.

The game is played by rotating incoming patients to the hospitals around the area to deal with the increased demand on emergency room facilities in the Las Vegas Valley every winter.

The rotation kicks into effect when a hospital runs out of beds and goes into what's called emergency divert status.

"It's really a situation where you get too many in the chute and the chute gets clogged," said Dr. Donald Kwalick, chief health officer for the Clark County Health District. "It's something we deal with every year, and nobody's really to blame. It's not the hospitals or the ambulance company's fault, but a combination of many factors that force us into divert status."

Divert status means that at various times during the day and night a hospital's emergency room reaches capacity, and ambulance drivers are directed by their dispatchers to take patients to hospitals that have available ER beds. Other hospital divisions such as critical care, routine care and CAT scan also top out at sporadic periods each day during the winter months.

Among the causes of the overcrowding are colder weather, flu season, rapid population growth and people who go to the emergency room when their medical problem could be treated by a private physician, Kwalick said.

Ann Lynch, spokeswoman for Sunrise Medical Center, says that divert status is something that is hard to understand and frustrating to the public.

"People see that maybe our ER beds are full, but some of our other beds aren't and wonder why they are still waiting," Lynch said. "People don't understand that you can't put an 80-year-old man in a room with a teenaged girl, or put an emergency room patient into neurology.

"We're not running a hotel. The right person has to go to the right place."

When an American Medical Response ambulance picks up a patient they are told by dispatch which hospital can take their patient, AMR spokeswoman Kathi Rice said.

"We rotate patients around, but all traumatic injuries go to University Medical Center, which operates a trauma center," Rice said. "No matter the divert status all trauma patients will go to UMC. For the most part the rotation works well."

AMR usually runs between 32 and 37 ambulances at one time, but during divert season they run a minimum of 35 and sometimes 40, Rice said. AMR paramedics stay with the patients until they can be handed over to medical personnel at a hospital.

One way residents can help to lighten the load at the hospitals in the winter months is to only use emergency rooms for critical situations and not for a cold or flu, Kwalick said.

"Its not a situation where people aren't going to get taken care of," Lynch said. "Nobody goes without treatment, because we'll get you in somewhere. At the same time people have to understand if we're on super divert and someone walks in with a sore throat, they may have to wait a long time."

To avoid long waits the county has put out a list of guidelines on what types of problems require emergency room care. Severe bleeding, difficulty breathing, chest pain, broken bones, head injuries, partial or total amputation of a limb, severe abdominal pain, or sudden dizziness are all problems that require emergency room attention, Kwalick said.

Lacerations, sprains, infections, flus and colds can usually be treated by a private physician or an urgent care center.

Both UMC and Sunrise are expanding their emergency rooms, with Sunrise adding two new floors and nearly tripling its emergency room to 35,000 square feet.

Lynch is hopeful that the new space will help lessen the impact of winter overcrowding, but believes the growing population will eventually call for new hospitals.

"It's a lot like the school district," Lynch said. "They build a new school and two years later they are putting up portables. Everyone is doing their level best to try to meet the demand.

Even if new hospitals are built, keeping up with the booming population may still be difficult.

"It's tough to tell just how many beds are needed," Lynch said. "When Mountain View and Summerlin (hospitals) were built a few years ago we thought that would slow down this situation, but it hasn't."