New Emergency Center at Beaumont, Troy Offers Private, Personalized, High-Tech Care

Beaumont Hospital, Troy has opened a $58.2 million Emergency Center expansion where board-certified emergency medicine physicians offer leading-edge care in all-private rooms using the most advanced technology available.

The new center will improve efficiency of emergency care and help meet the growing demand for care at Beaumont’s Troy hospital which logged 68,802 emergency visits in 2008.

“Beaumont’s overriding goal has always been to provide the very best care,” says William Anderson, M.D., chief of Emergency Services at Beaumont, Troy. “The new Emergency Center allows us to provide the highest quality care in very comfortable, private rooms, with diagnostic equipment immediately accessible so treatment decisions can be made quickly. It’s very patient-focused and has been designed around the concept of providing the right level of care at the right time. We can handle the most severe illnesses and injuries, as well as the bumps and scrapes that also need medical attention.”

The new Emergency Center uses a color-coded “team” concept, making navigation easier for patients and families and streamlining staff assignments. Patients and families will know which area they are in by color coding on the floors and walls. Outside, the Emergency Center features a separate entrance for ambulances so emergency vehicles do not interfere with private patient drop off or pick up.  

“When you or your loved one is ill or injured, you don’t want to wait a long time for care,” says Heidi Shepard, R.N., vice president of operations for Beaumont, Troy. “Our new Emergency Center offers a faster, more functional patient flow. We now have a total of 88 beds, up from a previous total of 51 beds, separated in areas such as trauma, acute care, minor care and observation. Six of these rooms are designed for pediatric patients, with back-lit ceiling panels, lighted art work and an extra quiet room design to keep younger patients at ease.”

The new trauma care rooms have been organized for maximum efficiency with all of the equipment attached to the ceiling, in easy reach, instead of being connected to the head of the patient’s bed. The acute care area features larger, private rooms, sliding glass doors for easier access and privacy curtains to block the view of hallway activity. Each room also has state-of-the-art physiological patient monitors that continuously feed information to the nurses’ station.

The new observation area also has larger, private rooms, as well as improved nursing stations that allow staff more direct contact with the patient.

Two radiology rooms have been moved closer to the Emergency triage area to allow imaging to be done more quickly, and there is a pharmacy for quicker access to medication.

“When patients come to our Emergency Center, they know they’re getting Beaumont doctors who specialize in emergency medicine. And when the situation calls for it, they’re also getting expedited access to Beaumont specialists in orthopedics, neurosurgery, pediatrics and dozens of other services,” notes Dr. Anderson. “There’s a lot of comfort and reassurance in that.”

Beaumont broke ground for the new Emergency Center in January 2006. Barton Malow/Skanska served as general contractor for the project with Harley Ellis Devereaux providing architectural, engineering and design services.

Hernias: The Working Man’s Condition

By Christine Wideman, RN, with Scott Laker, MD

Moving furniture, shoveling snow, playing sports – everyday activities done without a second thought in our busy lives, until a sudden pull, an awkward twist or a heavy-lift goes wrong , and a hernia is born.

Inguinal hernias are among the most common medical conditions faced by men. According to the National Center for Health Statistics, about 600,000 inguinal hernias are repaired in the United States every year. Nearly 25 % of men and approximately 2% of women will develop inguinal hernias.

“A hernia is essentially a defect in the wall of the abdomen,” said Dr. Scott Laker, M.D., a surgeon at Harper University Hospital in Detroit. “When the abdominal muscle is weakened, the inner lining of the abdomen can slip through, creating a bulge. Depending on the location of the hernia, different structures of the inner abdomen may also protrude.”

There are many types of abdominal hernias, according to Dr. Laker. Hernias may be located around the belly button (umbilical hernia), or near the site of a previous surgical incision (incisional hernia) and in other areas. The most common type of hernia and the one most closely associated with men’s health is the inguinal or groin hernia.

Inguinal or groin hernias make up the majority of all abdominal hernias. They can occur in women, but they are much more common in men. This type of hernia is often associated with heavy lifting, but there can be many other causes.

“People can get a hernia for various reasons,” said Dr. Laker. “Some hernias are congenital and are present at birth. Others develop as a part of the wear and tear process over time.” Basically anything that increases abdominal pressures can help create or worsen a hernia. These would include heavy lifting, coughing or straining during a bowel movement or urination.

Obesity can also be a factor as well as family history. However, Dr, Laker cautions, “hernias can occur to anyone at any time (in their) life.”

Signs of hernia can also vary. “Some people may have a painless lump or protrusion that they can actually push back into place themselves. Others may have pain or aching at the site. Any symptoms suspicious for a hernia should always be evaluated by a physician,” Dr. Laker says.

Treatment of a hernia is very individualized and there are many factors to be considered such as the size, type and location of the hernia as well as the person’s overall health status. Trusses or hernia belts may help support the weakened area for a time, but are not used unless a patient has a medical condition that prevents him from having surgery. Ultimately, according to Dr. Laker, a hernia must be surgically repaired.

“A hernia will not get better by itself and it may get worse. There is always the serious risk of strangulation. If a segment of the intestine slips through the hernia opening and becomes trapped with loss of blood supply to the tissues, there is a danger of developing dead bowel within a few hours time. Strangulation or incarceration of the bowel is considered a surgical emergency and must be treated immediately,” says Dr. Laker.

There are two main surgical options: traditional open repair and laparoscopic repair of inguinal hernias “The traditional open repair has been the gold standard for 100 years,” said Dr. Laker. In the open repair, the surgeon makes an incision long enough to access the hernia site. A synthetic surgical mesh is placed into the defect to help support the repair and then the incision is closed.

In the last ten years, minimally invasive laparoscopic surgery techniques have been developed as an alternative to traditional open repair. In these techniques, smaller incisions are used to insert laparascopes into the site. This enables the surgeon to view and repair the hernia with telescopic cameras. Synthetic surgical mesh is also used in this technique to support the repaired area according to Dr. Laker.

Both procedures are performed on an outpatient basis and recovery time varies from person to person. Generally, because laparascopic procedures have smaller incisions, patients tend to require less pain medication and return to normal activities sooner, according to Dr. Laker.

Which procedure is right for you? Dr. Laker says your surgeon is the best person to make that decision. “Depending on the surgeon’s evaluation of the patient and his overall medical condition, as well as the size and location of the hernia, the surgeon will opt for whichever procedure is most beneficial to the patient. Since laparoscopic repair is fairly new, a lot also depends on the surgeon’s comfort and skill level with the procedure.”

Any surgical procedure carries the risks of bleeding and wound infection. And unfortunately, even if the initial surgery is successful, there is always the possibility that the hernia may come back. According to Dr. Laker, avoiding activities that increase abdominal pressure such as coughing, heavy lifting and straining can help. Obesity is also modifiable a risk factor and Dr. Laker advises anyone who smokes to quit, since the development of chronic lung disease and persistent cough increases hernia risks.

Overall, when it comes to hernias, the best advice is to seek the advice of your health care professional EARLY. If you suspect a hernia, your physician can evaluate your specific needs and recommend a plan of care. A hernia can only grow larger with time, so the time to take care of it is now.

Further information and illustrations of hernias can be found online at WebMD: http://men.webmd.com/guide/understanding-hernia-basics

Christine Wideman, RN, has a degree in nursing and journalism. She continues to work as a nurse and has written on a variety of topics for both local and national publications as a freelance journalist.

Dr. Scott Laker is a native of Southeast Michigan.  He received his medical degree from Boston University and completed his residency in general surgery at New York University.  Dr. Laker’s clinical interests are minimally invasive approaches to obesity, colon and hernia surgery.

10 Ways to Prepare You & Your Child for Surgery

With Nancy Strzyzewski, RN

Surgery can be frightening for almost anyone, let alone a child. So, if the time comes that your child needs surgery, how do you prepare him? Can you prepare him? Are you prepared?

The thought of having surgery can bring on feelings of anxiety, fear, anger, confusion – and that is just for the parents! Now imagine the signals your child is receiving when she sees mom and dad expressing these emotions.

According to Nancy Strzyzewski, RN, a nurse clinician in surgical services education, children pick up on the emotions of their parents during these stressful times. “The better the parent is prepared, the better the child will do. If the parent is anxious and nervous, the child will know that. Your child knows exactly what you’re feeling and you need to be aware as a parent,” says Strzyzewski.

A good starting point to preparing for your child’s surgery is to familiarize yourself with the hospital, facilities and personnel. “I encourage parents to go to the hospital, get familiar with the area; take a test drive. It’s important to know where your going to park, where the entrance is, and where registration is located. If you are anxious, your child will pick up on your anxiety,” says Strzyzewski. “The size of the hospital can be intimidating. Your child will sense you’re more relaxed if you are prepared, and your child will be more relaxed as a result.”

It is also recommended that parents take the time to meet some of the caregivers prior to showing up to the hospital the day of surgery. This way, parents can establish some trust for the people who are going to have direct care of their child pre and post-op. “I’m in awe of the amount of trust that parents put in us,” says Strzyzewski. “Visit the nurses who are taking care of your child.”

So, what else should you know about preparing your child? Here is some advice:

1. The day of surgery bring something of comfort for your child..special toy, blanket

2. Do not allow your child to eat or drink per the physicians instructions the day of, and prior to, surgery. It is so important to the child’s safety.

3. Bring extra underwear. Most kids feel more comfortable in their own underwear (rather than the hospitals paper ones); bring extra pairs in case of any “accidents.”

4. Be flexible for the day. If your child is in the middle of changing habits (bottle to cups; removing pacifier; potty training, etc.), allow your child to regress if they want for the day.

5. Don’t be embarrassed. Your child may throw tantrums the day of surgery. Remember, they are stressed out, afraid and anxious. Tantrums are expected.

6. Talk to your child about the surgery at an age-appropriate time. Do not wait the day of, or the day before, to tell him/her. Recommendations are: preschool, 1-2 days; Adolescents: 7-10 days so they have time to process the information.

7. Ask your child what is their biggest fear/worry. What do they think is going to happen? That will give you a key as to what to talk to your child about beforehand.

8. Give your child some control. Your child does not have control for that day. Give them some reasonable control on what they want to wear to the hospital, items they may want to take, etc. Make your child feel like he/she has some control of the day’s events.

9. Relax. It is going to be a long day, and the best way to calm your child is to be relaxed yourself.

10. Be patient. Remember that everyone involved has your child’s care and safety in mind.

“Children regress when they are stressed out. We know it is the worst day of their life, and we don’t expect them to be perfect. They may have a tantrum or two. We expect that. They are just trying to cope,” says Strzyzewski. “Parents need to look at this as just one day. It is not going to be a reflection on their child for the long run. The goal is to make it work for the child.”