GIMC_ED_Description.pdf

GALLUP INDIAN MEDICAL CENTER EMERGENCY DEPARTMENT

Gallup Indian Medical Center sees 30,000 pts/year. We are a level 3 trauma center for the McKinley area. We see from 80 to 100 pts/day. Our ED is busy and our acuity is high. Our physicians are ED trained and boarded. Occasionally, we will take ED providers who have a lot of emergency medicine experience (more than 10 years of ED in high volume EDs). We prefer EM boarded but can work with providers that showed appropriate experience. We take care of severely ill patients and our most common procedures are intubation, giving lytics, central line placement, U/S, paracentesis, etc. Our shifts are 10 hours shifts with midlevel support. We have needs in the day, evenings and nights. Our highest volumes are between 4p to midnight. Our shifts hours are as follows for MDs/DOs 7am to 5p, 11a to 9p, 4p to 2a and 9p to 7am. Midlevel coverage is 9a to 7p and 8p to 6am. Physicians can work initially a maximum of 5 shifts then rest then work some more shifts. Our ED is busy therefore, allowing a day of rest provides a rest for providers. Our adult patients compromise 70% of our volume and our pediatric is 30%. We have an area that is part of the ED that is called the Fast Track for lower acuity patients. This is run by mid-levels mostly. ED providers do not admit patients to the hospital as we have other services that take care of admissions. We have hospitalist, pediatrics, ob/gyn, orthopedics, surgery, optometry, behavioral health, podiatry, anesthesia and ENT. We have X ray and CT 24 hours a day, 7 days a week. We have U/S every day from 8am to 4pm and on call after 4pm when available.

Most of our transfers are to Albuquerque for Neurosurgical cases, significant polytrauma, STEMIs, Stroke that receives thrombolytics, urological cases, and pediatric ICU cases. We have a good support system from other services. Triage is done mostly by nurses with a medical screening exam done mostly by mid-levels during the day while UCC is open.