Good for me: from urgent care to ER - Cape Cod Healthcare

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Published on June 30, 2017

Good for me: from urgent care to ER

Good for me: from urgent care to ER

I woke up on a recent Sunday morning to the room seemingly spinning around my head. It scared me because of the sudden onset and I didn’t know what to make of it.

As I managed to get out of bed, while hoping that it wouldn’t happen again, I realized I was pretty nauseous and I was feeling off balance. It was all very unnerving and while I didn’t feel the need to go to the Emergency Department, I did want someone to tell me why this was happening.

I decided to go to the Falmouth Urgent Care Center. Because I am a nurse, I thought I probably had an inner ear infection or inflammation causing the symptoms. My plan was to be evaluated, get some medication to take care of the problem to relieve my symptoms and go home.

When I checked in, I was greeted by a sympathetic receptionist who commented that she has vertigo at times and that somehow made it all feel more “normal” to me, since I wasn’t the only one having these spinning sensations.

I waited only a couple of minutes before I was brought into an exam room and within 10 minutes, Christina Bruni, PA and Brittany Taylor, RN, BSN were assessing me and checking my vital signs.

To my surprise, Bruni recommended I go to the Emergency Department (ED) at Falmouth Hospital. She said I needed further testing including blood work and a possible head CT scan that they couldn’t do at the Urgent Care Center. I decided it would be best to go.

Bruni said she would call ahead to the ED and let them know I would be coming and what she had noted during her exam, which was very reassuring to me.

“Depending on the chief complaint, the provider at Urgent Care will speak to the ED triage nurse, the charge nurse or the conversation will be doctor-to-doctor, if it’s indicated,” said Robert Davis MD, Director of Emergency Services at Falmouth Hospital.

Sometimes it’s hard to make the decision whether to go to Urgent Care or the ED. The following is a list of some of the illnesses that can be adequately evaluated at Urgent Care, according to Dr. Davis.

  1. Upper respiratory infections, such as coughs and colds
  2. Orthopedic injuries
  3. Sore throat
  4. Flu
  5. Urinary tract infections
  6. Rashes
  7. Tick bites

“If it’s something that is life-threatening or going to require a lot of diagnostic tests, it’s probably better to go to the emergency room,” said Dr. Davis. “Both Urgent Cares have X-ray capabilities and we do have some rapid tests, but we don’t draw blood.”

And if you are unsure whether your situation can best be taken care of at an Urgent Care Center or the ED, call and ask,, said Dr. Davis.

Upon my arrival in the ED, I was initially seen by a triage nurse.

Tomas Giardino RN, the emergency room nurse assigned to take care of me, took my vital signs, started an IV and explained the steps that would be taken to further assess my symptoms. A personal care technician (PCT) drew some blood for further testing.

I admit that my anxiety level was pretty high because I was conjuring up all kinds of medical scenarios that could be the cause of my symptoms. But warm blankets, a familiar hello from a former nurse co-worker and the reassurance of Giardino helped to ease my nervousness.

After an evaluation and some head movement tests by Justin Popso, DO, a Falmouth Hospital emergency room physician, he told me I had peripheral vertigo. This is usually caused by an inner ear problem. He offered further testing, but I told him I felt comfortable with his diagnosis and I would follow-up with my primary care physician. I was given discharge instructions, a prescription and a dose of medication to relieve my symptoms until the prescription could be filled.

The entire process was very reassuring to me especially knowing that the if an Urgent Care physician has a concern about a diagnosis or the need for further evaluation, there is a smooth transition to the ED. All of the staff at Urgent Care and the ED were calm and confident, which in turn made me more comfortable.

“About 4 to 4.5 percent of the patients are transferred from Urgent Care to the emergency department,” according to Dr. Davis.

“One of the things that makes the transition easy is that it’s really the same team,” said Dr. Davis. “It is the same group of emergency room physicians, physician assistants and nurse practitioners who rotate through the emergency department and the Falmouth Urgent Care and Stoneman Urgent Care in Sandwich.”