Week: 527.2 Guest: Dr. John Wogan, M.D. Greater Baltimore Medical Center Topic: Emergency Room procedure and questions - One Part Host: Steve Girard Producer: Ed Graham

NEMA: Today, a visit to a real emergency room...our guide is attending physician Dr. John Wogan....at Greater Baltimore Medical Center....

WOGAN: Most emergency departments are gonna run exactly the same way...there will be a nurse, who will perform the immediate, initial evaluation, the triage, to sort out the life threatening from the non-life threatening problems, and then to have those patients who require immediate diagnostics and treatment brought back to the emergency department. And the folks who don't have an immediately life threatening problem, or something that requires immediate attention will usually, then be registered and brought back in the order of arrival. It's a good question to ask the nurse how long of a wait you're going to have...cause usually they do know and they usually can, in addition, tell you what to expect in terms of what tests are going to be ordered, how long they're going to take and other issues regarding insurance and payment are put off until later, appropriately so, I think.

NEMA: What questions should, say a parent bringing a child to the ER ask of the attending physician...perhaps, is there a pediatrician also on duty?

WOGAN: There are various levels of care that are to be delivered by different hospitals , and different emergency departments ...level one, level two....based on the skill and training of the practitioners available...on the ancillary tests, x-rays, the kinds of surgery that can be performed...you would want to know if the personnel in the emergency department are trained to handle pediatric emergencies... most emergency departments have their staff trained in pediatric life support, pediatric resuscitation standard training that's available. It would be good to know if your emergency department personnel are qualified in that..it would be good to know if that emergency department has a pediatrician in the hospital on duty, 24 hours should a pediatric specialist be urgently required.

NEMA: How do you tell if you have to go to the Emergency room with a condition, or an injury...

WOGAN: Anybody who has an injury which could possibly compromise their breathing, respiration....or where they believe they could be hemorrhaging or losing blood to a significant degree that they wouldn't be able to sustain their blood pressure. For lacerations, there's a critical period after which you cannot repair lacerations. ..for example, on the face...anywhere from 12 to 24 hours after the laceration has occurred we typically won't repair them. For the extremities, the hands, feet, arms and legs...a shorter period of time...so, those we like to see as soon as possible. I guess a good, general rule of thumb is that if you think something is broken, you're going to come right away. because you really cannot tell whether a bone is broken by the standard, common sense things....can you move it? Can you walk on an extremity with a broken bone? Well, very often you can...so using those sorts of guidelines is not a reliable way to know if something is broken.

NEMA: Dr. John Wogan of Greater Baltimore Medical Center says parents should ask their emergency room questions before an emergency occurs. Feel free to call your local hospitals, they'll be happy to help. I'm Steve Girard.