By Tim Sheehan
The Fresno Bee
FRESNO, Calif. — Hospital emergency rooms throughout the Fresno region have become clogged with patients confronting respiratory illnesses, prompting health leaders to install an “assess and refer” policy for ambulance crews to deny transport for patients whose cases are not true emergencies.
Dan Lynch, Fresno County’s director of emergency medical services, said the surge in patients with COVID-19, respiratory syncytial virus (RSV) and influenza in recent weeks triggered the policy, in which ambulance crews in Fresno, Kings, Madera and Tulare counties respond to emergency calls and then determine whether the patient’s condition represents an actual threat to life or limb. If not, paramedics or emergency medical technicians will recommend alternatives not take the person to a hospital.
Alternatives for patients may include seeking treatment at urgent-care centers, walk-in clinics, their own personal doctor, or telehealth services through their medical insurance carrier.
In scenes reminiscent of peak demand during the COVID-19 pandemic, health officials said waiting times in hospital emergency departments can run 10 hours or longer for non-emergency patients. Additionally, when an ambulance arrives at a hospital, it is often a one- to two-hour wait before that patient can be turned over to the hospital emergency staff.
Lynch reported that hospitals are operating at least 20% over their maximum capacity, and sometimes up to 40% over capacity. When patients are admitted for treatment, some hospitals are having to hold them in the emergency room for up to four days, as well as holding patients in conference rooms and other non-patient areas until a bed opens up for them.
“We need everyone’s help to slow down the number of people using the emergency room for non-emergency medical issues,” Lynch said in a statement issued this week by the Fresno County Department of Public Health .
In a table illustrating the types of cases for which people should go to an emergency room, Fresno County includes patients who are experiencing difficulty breathing or pain in their chest, arm or jaw; a severe burn or electric shock; seizures or a head injury with fainting or confusion; deep wounds with heavy bleeding; severe allergic reactions; possible poisoning; or severe abdominal pain associated with trauma or pain/pressure in the chest.
People with less severe or more routine conditions such as common illnesses including cold or flu, earache, migraine, minor cuts, sprains, or rashes are encouraged to turn to urgent-care centers or health clinics for walk-in care, make an appointment with their regular personal doctor, or use telehealth services available through most health insurance carriers.
To keep from getting sick in the first place, health officials encourage people to get the latest available version of COVID-19 vaccine, flu vaccine, and to check with their doctor about their suitability to get a vaccine for RSV.
Many of the same precautions that were part of the regimen during the peak of the COVID-19 pandemic are also recommended by local health officials, including:
- Getting tested for COVID-19 or flu if a fever or cough arise. Those who test positive for COVID-19 should seek treatment.
- Staying home when sick.
- Wearing a mask in crowded indoor pubic spaces.
- Washing hands frequently with soap and warm water for at least 20 seconds.
- Covering a cough or sneezing into the crook of your elbow, your arm or a disposable tissue.
Information about vaccine appointments is available at myturn.ca.gov. Other information about testing and treatment locations, or other resources on COVID-19 or flu, can be found online through the Fresno County Department of Public Health at fcdph.org.
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