Pub. 1 2019 Issue 4

Occupational Health vs. the Emergency Room MARTA SILAKKA, RN, BSN, AND CCM NURSE CASE MANAGER W hen someone is injured at work, there can be some confusion about medical treatment. The NHADA – WCT team offers members education and guidance about what to do when an employee is injured, including treatment options within the managed care network … but we still have many instances where a better choice could have been made by the member and the injured worker. When in doubt, please call me and I can perform a mini triage and determine what level of care is necessary. The Emergency Room has its place. It should be used for life threatening injuries. In most cases, these are obvious enough that someone will call 911. It is not appropriate for minor injuries. Of course, there are some cases when the emergency room is appropriate even though the medical problem is not life threatening; some examples are head injuries with loss of consciousness and when bleeding from an injury cannot be controlled. What happens when an injured worker walks into an ER and asks to be treated medically for a minor injury? • You are not a priority. Essen- tially you go to the back of the line; those in more urgent need of care will always be seen first, no matter how long you have been there. • Time will pass. Wait times in busy emergency rooms can be very long when your injury is minor. This means time away from work and home; and honestly, the magazines in the waiting room aren’t that good. Going to an emergency room when that isn’t the right choice can be considered selfish. Why? If someone is treated in an emergency room for a minor injury, they are taking up a bed that could be used for someone with a true emergency. The person having the heart attack needs that bed more than the person with minor lacerations that don’t even need sutures. • There is a loss of productiv- ity. The injured worker will be gone from work for hours. Typically, an employer usually sends another employee with the injured worker, so now you have two employees who are gone for the day. • Paperwork is often skipped. When an injured worker is treated in the emergency room, there is a very good chance you will not see the paperwork you are accus- tomed to seeing when there is treatment at an occupational health center. The NH Work- ers Comp Medical Form is often not completed, and a “work note” is written instead. This makes it very difficult to determine the work status of the injured worker and if any accommodations are needed to their job. • There is confusion about follow up care. Emergency rooms notoriously refer to a patient’s primary care provider for follow-up care. As we all know, the PCP is there for our personal medical care, but D R I V E 18