Emergency Services

Visits to emergency departments can be stressful and confusing.

We are here to help you and your loved ones in this time of discomfort.

We are guided by faith and dedicated to healing.

Call Us - Ask for ER Front Desk      951-290-4000

Is This An Emergency?

If you are experiencing one or more of these symptoms, seek medical help right away.

  • Difficulty breathing, shortness of breath
  • Chest pain
  • Abdominal pain and/or pressure
  • Fainting, sudden dizziness, weakness
  • Changes in vision
  • Confusion or changes in mental status
  • Any sudden or severe pain
  • Uncontrolled bleeding
  • Severe or persistent vomiting or diarrhea
  • Coughing or vomiting blood
  • Suicidal thoughts and feelings
  • Difficulty speaking
  • Any strange or unusual pain

*Guidelines from the American College of Emergency Physicians

Cold / Flu Symptoms: Please check with your Primary Care Physician

When should I go the the Emergency Department?

Knowing when you or someone else needs emergency attention can be critical. An emergency is defined as a serious medical condition or symptom caused by an injury or sickness, or mental illness, which arises suddenly and requires immediate care and treatment to avoid death or disability.

An emergency may include:

  • A suspected stroke
  • A suspected heart attack
  • Bone fractures
  • Poisoning
  • Deep Wounds
  • Vomiting/coughing up blood
  • Head injury
  • Allergic reactions
  • Difficulty breathing
  • Burns

What to Expect During Your ED Visit

All ER visits begin with a process called triage. During this process we evaluate the critical nature of our patient’s needs. Each person is treated in order of the critical nature of their symptoms and immediacy of their medical needs.

“How long will I have to wait before I am triaged?”

We will take you back as quickly as possible. Please keep in mind that when the ER is full, or if there is a very critical patient, the wait might be longer.

“Why are some patients who arrived after me seen before me?”

The care provided in the Emergency Department is designed to make sure that patients with the most critical health needs get cared for first. If you are waiting and you start to feel worse, please let the triage nurse know.

Clinical Assessment and Care

We have ER technicians, nurses, physician assistants and physicians who will work together to provide your care. Please let us know at any time how we can help make your visit more comfortable.

“How long will it take to get treated?”

We see patients according to the seriousness of your medical condition. Critically ill or injured patients are seen first. Patients with conditions that require no tests are usually discharged shortly after seeing a physician but in other cases, the physician may have to wait for test results in order to make a proper diagnosis and render treatment. Diagnostic testing can take time to complete and you may be called from the waiting area to start some tests.

Registration

After you are in a treatment area, a registration staff member will assist you with registration. They will ask you for insurance/billing information and provide consent(s) for medical treatment. Circumstances may vary depending on your condition.

Going Home

When you are treated and ready to go home you will be given instructions about our diagnosis and treatment. It is important for you to share this information with your primary care physician. If you don’t have a physician, please let us know and we can assist you. We offer a free physician referral service by calling 1-800-867-7011.

Being Admitted

If you need specialized care and are admitted to the hospital, our goal is to move you to a hospital room as quickly as possible so that you are more comfortable.

What To Bring to the Emergency Department

Family & Friends / Privacy & Confidentiality

Family and Friends

We will work closely with you to include family and friends in your care. We may need to limit the number of visitors in the exam room based on your condition and the size of the room.

Patient Privacy and Confidentiality

We value your right to privacy. All of our staff are trained to follow privacy regulations in both formal and informal settings. These regulations called the “Health Insurance Portability and Accountability Act (HIPPA)” insure that without your authorization and unless directly related to your diagnosis and treatment, your physicians and other medical personnel may not share information about your condition.

Heart Attack / Arrest

Heart Attack

If you think you or a loved one is suffering from a heart attack or cardiac arrest, call 911 immediately.

Signs of Heart Attack

(Source: American Heart Association)

Cardiac Arrest

Cardiac Arrest, when the heart stops beating, strikes without warning. If you are with someone who collapses and becomes unresponsive call 911 immediately.

Signs of Cardiac Arrest:

  • List of all current medications including“over the counter” drugs, herbal remedies and supplements
  • List of dosages, when they are taken and the last dose taken
  • Primary care physician’s name
  • List of known allergies and medication
  • reactions
  • List of surgeries
  • List of medical conditions
  • Telephone numbers of family, friends or next of kin
  • Chest discomfort – Most heart attacks involve discomfort in the center of the chest that last for more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
  • Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck jaw or stomach.
  • Shortness of breath is a common symptom of heart attack and may occur with or without chest discomfort.
  • Other signs: These can include breaking into a cold sweat, nausea, lightheadedness, extreme fatigue or weakness
  • Women & Heart Attacks: Women sometimes experience heart attack differently than men. Commen symptoms for women include:
  • Shortness of breath
  • Nausea/vomiting
  • Pain in back or jaw
  • Extreme fatigue and weakness
  • Chest pain, pressure or discomfort
  • Sudden loss of responsiveness (the victim does not respond to any stimulus)
  • No normal breathing (the victim does not take a normal breath when you tilt the head up and check them, for at least 5 seconds)

If these signs are present:

  • Call 911 Immediately
  • Start CPR
  • Use an AED – Automated external defibrillator if one is available

Stroke Symptoms

If you think you or a loved one is suffering from a stroke, call 911 immediately.

Stroke Symptoms

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble walking, dizziness, loss of balance or coordination

Spot A Stroke

F - Face Drooping

A - Arm Weakness

S - Speech Difficulty

T - Time to Call 9-1-1

(Source: American Stroke Association)

CPR - Adult

Definition CPR is a lifesaving procedure that is performed when someone's breathing or heartbeat has stopped, as in cases of electric shock, drowning, or heart attack. CPR is a combination of:

  • Rescue breathing, which provides oxygen to a person's lungs.
  • Chest compressions, which keep the person's blood circulating.

Permanent brain damage or death can occur within minutes if a person's blood flow stops. Therefore, you must continue these procedures until the person's heartbeat and breathing return, or trained medical help arrives.

Considerations

CPR can be lifesaving, but it is best performed by those who have been trained in an accredited CPR course. The procedures described here are not a substitute for CPR training. (See www.americanheart.org for classes near you.)

Time is very important when dealing with an unconscious person who is not breathing. Permanent brain damage begins after only 4 minutes without oxygen, and death can occur as soon as 4 - 6 minutes later.

When a bystander starts CPR before emergency support arrives, the person has a much greater chance of surviving. Nevertheless, when most emergency workers arrive at a cardiac arrest, they usually find no one giving CPR.

Machines called automated external defibrillators (AEDs) can be found in many public places, and are available for home use. These machines have pads or paddles to place on the chest during a life-threatening emergency. They use computers to automatically check the heart rhythm and give a sudden shock if, and only if, that shock is needed to get the heart back into the right rhythm.

When using an AED, follow the instructions exactly.

Causes

In adults, major reasons that heartbeat and breathing stop include:

  • Drug overdose
  • Excessive bleeding
  • Heart disease (heart attack or abnormal heart rhythm)
  • Infection in the bloodstream (sepsis)
  • Injuries and accidents

Symptoms

  • No breathing or difficulty breathing (gasping)
  • No pulse
  • Unconsciousness

First Aid

The following steps are based on instructions from the American Heart Association.

Check for responsiveness. Shake or tap the person gently. See if the person moves or makes a noise. Shout, "Are you OK?"

Call 911 if there is no response. Shout for help and send someone to call 911. If you are alone, call 911 and retrieve an AED (if available), even if you have to leave the person.

Carefully place the person on their back. If there is a chance the person has a spinal injury, two people should move the person to prevent the head and neck from twisting.

Open the airway. Lift up the chin with two fingers. At the same time, tilt the head by pushing down on the forehead with the other hand.

Look, listen, and feel for breathing. Place your ear close to the person's mouth and nose. Watch for chest movement. Feel for breath on your cheek.

If the person is not breathing or has trouble breathing:

Cover their mouth tightly with your mouth.

Pinch the nose closed.

Keep the chin lifted and head tilted.

Give two rescue breaths.

Each breath should take about a second and make the chest rise.

Perform chest compressions:

Place the heel of one hand on the breastbone -- right between the nipples.

Place the heel of your other hand on top of the first hand.

Position your body directly over your hands.

Give 30 chest compressions. These compressions should be FAST and hard. Press down about 2 inches into the chest. Each time, let the chest rise completely. Count the 30 compressions quickly: "1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30, off."

Give the person 2 more breaths. The chest should rise.

Continue CPR (30 chest compressions followed by 2 breaths, then repeat) until the person recovers or help arrives. If an AED for adults is available, use it as soon as possible.

If the person starts breathing again, place them in the recovery position. Periodically re-check for breathing until help arrives.

DO NOT

  • If the person has normal breathing, coughing, or movement, DO NOT begin chest compressions. Doing so may cause the heart to stop beating.
  • Unless you are a health professional, DO NOT check for a pulse.Only a health care professional is properly trained to check for a pulse.

When to Contact a Medical Professional

If you have help, tell one person to call 911 while another person begins CPR.

If you are alone, as soon as you determine that the person is unresponsive, call 911 immediately. Then begin CPR.

Prevention

  • To avoid injuries and heart problems that can lead to cardiac arrest:
  • Eliminate or reduce risk factors that contribute to heart disease, such as cigarette smoking, high cholesterol, high blood pressure, obesity, and stress.
  • Get plenty of exercise.
  • See your doctor regularly.
  • Always use seat belts and drive safely.
  • Avoid using illegal drugs.

References

Emergency Cardiovascular Care Committee, Subcommittees, and Task Forces of the American Heart Association. 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2005;112(24 Suppl):IV1-203.

Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th Ed. St. Louis, MO: Mosby; 2002;64-82

CPR - Child 1-8 years of age

Definition

CPR is a lifesaving procedure that is performed when a child's breathing or heartbeat has stopped, as in cases of drowning, suffocation, choking, or injuries. CPR is a combination of:

  • Rescue breathing, which provides oxygen to a child's lungs
  • Chest compressions, which keep the child's blood circulating

Permanent brain damage or death can occur within minutes if a child's blood flow stops. Therefore, you must continue these procedures until the child's heartbeat and breathing return, or trained medical help arrives.

Considerations

CPR can be lifesaving, but it is best performed by those who have been trained in an accredited CPR course. The procedures described here are not a substitute for CPR training.

All parents and those who take care of children should learn infant and child CPR if they haven't already. This jewel of knowledge is something no parent should be without. (See www.americanheart.org for classes near you.)

Time is very important when dealing with an unconscious child who is not breathing. Permanent brain damage begins after only 4 minutes without oxygen, and death can occur as soon as 4 - 6 minutes later.

Machines called automated external defibrillators (AEDs) can be found in many public places, and are available for home use. These machines have pads or paddles to place on the chest during a life-threatening emergency. They use computers to automatically check the heart rhythm and give a sudden shock if, and only if, that shock is needed to get the heart back into the right rhythm.

When using an AED, follow the instructions exactly.

Causes

In children, major reasons that heartbeat and breathing stop include:

  • Choking
  • Drowning
  • Electrical shock
  • Excessive bleeding Head trauma or serious injury
  • Lung disease
  • Poisoning
  • Suffocation

Symptoms

  • No breathing
  • No pulse
  • Unconsciousness

First Aid

The following steps are based on instructions from the American Heart Association.

  • Check for responsiveness. Shake or tap the child gently. See if the child moves or makes a noise. Shout, "Are you OK?"
  • If there is no response, shout for help. Send someone to call 911 and retrieve an AED (if available). Do not leave the child alone to call 911 and retrieve an AED until you have performed CPR for about 2 minutes.
  • Carefully place the child on his or her back. If there is a chance the child has a spinal injury, two people should move the child to prevent the head and neck from twisting.
  • Open the airway. Lift up the chin with one hand. At the same time, tilt the head by pushing down on the forehead with the other hand.
  • Look, listen, and feel for breathing. Place your ear close to the child's mouth and nose. Watch for chest movement. Feel for breath on your cheek.
  • If the child is not breathing:
  • Cover the child's mouth tightly with your mouth.
  • Pinch the nose closed.
  • Keep the chin lifted and head tilted.
  • Give 2 rescue breaths.
  • Each breath should take about a second and make the chest rise.
  • Perform chest compressions:
  • Place the heel of one hand on the breastbone -- just below the nipples. Make sure your heel is not at the very end of the breastbone.
  • Keep your other hand on the child's forehead, keeping the head tilted back.
  • Press down on the child's chest so that it compresses about 1/3 to 1/2 the depth of the chest.
  • Give 30 chest compressions. Each time, let the chest rise completely. These compressions should be FAST and hard with no pausing. Count the 30 compressions quickly: "1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30, off."
  • Give the child 2 more breaths. The chest should rise.
  • Continue CPR (30 chest compressions, followed by 2 breaths, then repeat) for about 2 minutes.
  • After about 2 minutes of CPR, if the child still does not have normal breathing, coughing, or any movement, leave the child if you are alone and call 911. If an AED for children is available, use it now.
  • Repeat rescue breathing and chest compressions until the child recovers or help arrives.
  • If the child starts breathing again, place him or her in the recovery position. Periodically recheck for breathing until help arrives.

DO NOT

Lift the child's chin while tilting the head back to move the tongue away from the windpipe. If a spinal injury is suspected, pull the jaw forward without moving the head or neck. Don't let the mouth close.

If the child has signs of normal breathing, coughing, or movement, do NOT begin chest compressions. Doing so may cause the heart to stop beating.

Unless you are a health professional, do NOT check for a pulse. Only a health care professional is properly trained to check for a pulse.

When to Contact a Medical Professional

If you have help, tell one person to call 911 while another person begins CPR.

If you are alone, shout loudly for help and begin CPR. After doing CPR for about 2 minutes, if no help has arrived, call 911. You may carry the child with you to the nearest phone (unless you suspect spinal injury).

Prevention

  • Unlike adults, who may have a heart attack, most children need CPR because of a preventable accident. With this in mind, remember these simple measures:
  • Teach your children the basic principles of family safety.
  • Teach your child to swim.
  • Teach your child to watch for cars and ride bikes safely.
  • Make sure you follow the guidelines for using children's car seats.
  • Teach your child firearm safety.
  • Teach your child the meaning of "don't touch."
  • Never underestimate what a child can do. Play it safe, and assume the child is more mobile and more dexterous than you thought possible. Think ahead to what the child may get into next, and be ready. Climbing and squirming are to be expected. Always use safety straps on high chairs and strollers.
  • Choose age-appropriate toys. Do not give small children toys that are heavy or fragile. Inspect toys for small or loose parts, sharp edges, points, loose batteries, and other hazards. Keep toxic chemicals and cleaning solutions safely stored in childproof cabinets.
  • Create a safe environment and supervise children carefully, particularly around water and near furniture. Dangers such as electrical outlets, stove tops, and medicine cabinets are attractive to small children.

References

Emergency Cardiovascular Care Committee, Subcommittees, and Task Forces of the American Heart Association. 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2005;112(24 Suppl):IV1-IV203.

Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002:83.

Hauda WE II. Pediatric cardiopulmonary resuscitation. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004:chap 14.