With hospital emergency departments in Rhode Island experiencing significant crowding and prolonged waiting times, the Rhode Island Department of Health (RIDOH) is reminding people to seek medical care in settings where they will be most appropriately treated. People who do not need emergency care should not go to emergency departments.
Hospital patient volume continues to be high and has been exacerbated by a shortage of clinical staff, especially nurses. These shortages are due to a variety of factors, including health professionals working less or exiting the health sector after working through multiple waves of the COVID-19 pandemic. Patients may experience long wait times in the emergency department for non-urgent symptoms or may board there for a significant period before hospital admission. To prevent this, people should not go to emergency departments for health issues that can be treated more quickly and effectively by a primary care provider or in an urgent care facility. This includes less severe cases of the flu, back pain, minor cuts, sore throats, low-grade fevers, and most cases of norovirus (the "stomach flu").
People should also not go to the emergency department for COVID-19 testing or COVID-19-like illness that does not require emergency care. Most people with COVID-19 have mild illness and are able to recover at home. People with any concerns should check in with their primary care provider (See below for when to seek emergency care for COVID-19).
"Emergency departments are perfect for emergency situations. If someone is experiencing a serious health issue, they should absolutely call 911 or go to an emergency department right away. However, emergency departments treat patients with the most serious health issues first, which means that people with less severe conditions may experience long waits," said Director of Health Nicole Alexander-Scott, MD, MPH. "Keep the phone number for your primary care provider handy and know where your nearest urgent care facility is. An urgent care facility, or other type of express care facility is often a more convenient, less expensive option."
"Our hospitals stand ready to safely treat anyone who needs care regardless of the day or time. If you have a health emergency, call 911. But, if you are not sure whether your health issue is an emergency, call your primary care physician," said Teresa Paiva Weed, President of the Hospital Association of Rhode Island. "If you haven't seen your primary care physician in a while, make an appointment because primary care is the best way to manage existing health conditions and prevent an emergency."
"Hospitals locally and around the country are facing shortages of certain clinical staff, such as nurses, since many front line staff have decided to work less and some have left healthcare after the stresses of over a year of providing care during a global pandemic," said Lifespan Physician-in-Chief of Emergency Medicine Jeremiah Schuur, MD. "As patients return to hospitals for care, we are seeing backups in Emergency Departments, particularly at the busiest times of patient arrival. We remain prepared to care for patients with time-sensitive emergencies such as trauma, heart attack, and stroke, and we urge patients to not delay seeking care for serious illnesses or injuries or concerning symptoms. At the same time, it's important that people who do not need emergency level care be treated by their primary care provider or at an urgent care facility, so that our emergency departments can focus on the critically ill and injured, and all patients can receive the care they need in the most appropriate setting."
"Outside of a perceived medical emergency, a patient should first call their primary care provider, who will assess their need for medical attention at the appropriate level. Primary care providers already understand their patient's unique medical history, and may be able to see them quickly, helping them avoid an unnecessary and costly ED visit. However, if a patient is experiencing an emergency, and feels it is serious, they should immediately call 911," said James E. Fanale, MD, President and CEO, Care New England Health System.
How to know if you should go the emergency department
If someone is not sure if they should go to the emergency department, they should contact their primary care provider or visit an urgent care or community health center. A primary care provider can give you guidance about the next best step, and most offices have a provider on-call after hours. RIDOH has a list of primary care providers online. For people who do not have a primary care provider, RIDOH has information and lists online for urgent care facilities, community health centers, and other express care facilities in the state.
What to do if you have COVID-19
- Stay home (except if emergency care is needed – see below). Do not visit public areas. - Get rest and stay hydrated. Take over-the-counter medicines, such as acetaminophen, for symptom relief. - Avoid public transportation, ridesharing, or taxis. - Separate yourself from other people. As much as possible, stay in a designated room and away from other people. If possible, you should use a separate bathroom. - Tell your close contacts that they may have been exposed to COVID-19. An infected person can spread COVID-19 starting 48 hours before the person has any symptoms or tests positive. - See RIDOH's full guidance on how to isolate safely.
When to seek emergency care for COVID-19 or another health issues
If someone is showing any of these signs, seek emergency medical care immediately:
- Trouble breathing - Persistent chest pain or chest pressure - New weakness in an arm, leg, or face - New difficulty speaking or confusion - Inability to wake or stay awake - Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone
If you are going to an emergency department for COVID-19-like illness, notify the facility that you (or the person you are accompanying) is seeking care for COVID-19. Masks are required in all healthcare facilities.
Steps people can take to help stay healthy and out of the hospital
- Get a COVID-19 vaccine. - Talk to a healthcare provider about treatment for COVID-19, if you test positive. - Get a flu shot when it is available. - Cough or sneeze into your elbow. - Wash your hands carefully with soap and water, especially after using the toilet and changing diapers, and always before eating or preparing food. - Stay home if you are sick and keep children home from school if they are sick. - After an episode of illness that involves vomiting or diarrhea, immediately clean and disinfect contaminated surfaces by using a bleach-based household cleaner.