Emergency Medicine: Expert Care When You Need It Most

Emergencies happen when you least expect them. At UPMC Passavant, the experts you need are ready to help. Day or night, highly trained Emergency Department doctors, nurses, and other professionals are prepared to deliver the best possible emergency care to patients of all ages.

“Emergency care is about being prepared for the unexpected at all times,” says Jonathan Landis, MD, chief of Emergency Medicine Services at UPMC Passavant. “We are ready and able to handle any type of emergency, at any hour.”


Each year, the UPMC Passavant–McCandless and UPMC Passavant–Cranberry Emergency Department (ED) staff provide care to nearly 60,000 adults and children from throughout the greater Pittsburgh area, including northern Allegheny, Butler, and Beaver counties. Patients are cared for by board-certified emergency medicine doctors, physician assistants, emergency-trained critical care nurses, and advanced patient care technicians.


As a tertiary care center, UPMC Passavant is fully equipped to provide advanced care and treatment for emergencies like heart attacks and strokes. ED doctors have access to leading medical and surgical specialists, including the ability to consult via telemedicine with experts at the UPMC Stroke Institute and UPMC Children’s Hospital of Pittsburgh.


“We are part of a network with the top UPMC specialists available,” says Susan Hoolahan, RN, MSN, president of UPMC Passavant. “And we’re adding new services like our advanced response unit and affiliations, such as our pediatric emergency medicine partnership with UPMC Children’s Hospital of Pittsburgh, to ensure our already excellent emergency departments in McCandless and Cranberry provide patients with the right care, in the right way, at the right time, every time.”


ON THE ROAD: UPMC’S ADVANCED RESPONSE UNIT

UPMC Passavant Emergency Services extend beyond the ED doors. The hospital recently launched a mobile advanced response unit (ARU) to provide crucial support to local Emergency Medical Services (EMS) agencies and advanced care for patients.


“We’re providing an extra set of hands and an extra level of care,” says Alan Shapiro, DO, medical director of Pre-Hospital Care for UPMC Passavant.


Dr. Shapiro, a former paramedic, says UPMC Passavant worked in collaboration with local EMS leaders in the northern region to address a critical need for additional support in covering a large service area.


Unlike other programs in the region, the ARU is staffed by certified advanced care providers, including experienced paramedics, pre-hospital registered nurses with intensive care and emergency experience, and STAT MedEvac flight nurses and paramedics. The ARU, which is stationed at UPMC Passavant–Cranberry, is a sport utility vehicle equipped with special medical equipment to respond to emergency situations requiring extra support.


“Calls requiring multiple ambulance responses can strain EMS resources. The ARU provides extra support for critical patients without taxing EMS systems and possibly delaying care to other patients in the community,” says Dr. Shapiro.


Because the ARU is stationed at UPMC Passavant–Cranberry, team members are available to assist in the ED there. In the field, they can help treat patients and even accompany them to the UPMC Passavant ED.


“We are helping to free up other EMS crews and provide a higher level of care to patients, stabilizing them in the field, and delivering them to the appropriate ED for care,” adds Dr. Shapiro. “It’s a win-win for everyone.”


UPMC Passavant’s ARU will serve the communities of:


• Cranberry

• Eastern Beaver County

• Harmony

• Mars

• McCandless

• Northern Allegheny County

• Seven Fields

• Zelienople


PEDIATRIC EMERGENCY CARE

At UPMC Passavant, every emergency doctor is trained to take care of patients of all ages, including children. But a pediatric emergency program that rolled out in the summer at UPMC Passavant has added another level of expertise by linking them to pediatric emergency specialists at UPMC Children’s Hospital. UPMC Passavant is the first hospital in western Pennsylvania to launch this affiliation.


Betsy Tedesco, DNP, director of UPMC Passavant Emergency Services, says board-certified pediatric emergency specialists at UPMC Children’s are on call 24/7 to collaborate via telemedicine with UPMC Passavant emergency doctors and families. They can offer advice on a complex or unusual condition or provide an expert second opinion for infants, children, and adolescents up to age 18.


“What could be more reassuring for parents? UPMC Children’s emergency specialists bring extra expertise to our care,” she says. “We’re very excited to offer this added level of service to our families. It supports our efforts to provide world-class care for our pediatric patients.”

There’s an added benefit for families: if follow-up care is needed with a UPMC Children’s pediatric specialist, an appointment will be made before they leave the hospital.


A DESIGNATED STROKE CENTER

When a patient is having a stroke—or brain attack—every minute counts. UPMC Passavant is designated as a Primary Stroke Center by the Joint Commission, which means a specially trained team is available 24/7 to assess and treat patients. Established protocols based on best practices of care streamline and accelerate treatment.


At UPMC Passavant, suspected stroke patients are quickly taken for a CT scan of the brain to rule out a hemorrhagic stroke and undergo a neurologic examination. If diagnosed in time, patients experiencing an ischemic stroke—when a vessel supplying blood to the brain is obstructed—can be treated with a drug to dissolve the clot.


Dr. Landis says a new software application has made the system even faster, enabling ED doctors to consult with a neurologist at the UPMC Stroke Institute “almost immediately.” Using telemedicine, the stroke expert can examine and talk directly to the patient and discuss treatment with the ED doctor.


“It’s a game-changer,” says Dr. Landis. “It allows us to treat patients who meet the criteria in half the time. Time is brain—so the faster we can restore blood flow, the better off the patient is going to be.”


24/7 CARDIAC CATHETERIZATION LAB

An ST-segment Elevation Myocardial Infarction (STEMI) is a serious heart attack in which a coronary artery is completely blocked, preventing blood from flowing to a large area of the heart. Cardiac muscle will die if blood flow is not restored quickly.


At UPMC Passavant, a team of interventional cardiologists, nurses, and technologists is on call 24/7 to treat emergency heart conditions. Team members, who are required to live near the hospital, must arrive at the hospital’s state-of-the-art catheterization (cath) lab within 30 minutes. There, doctors diagnose and treat heart problems using specialized imaging equipment to visualize the heart’s arteries and chambers.


National guidelines call for hospitals to perform an angioplasty within 90 minutes—starting from the first medical contact, whether by the EMS provider in the field or by the emergency department team of providers, until the balloon is inflated, and blood flow is restored. At UPMC Passavant, the hospital averages an impressive “door-to-balloon” time of 57 minutes, says Saleem Ahmed, MD, an interventional cardiologist and director of the Cardiac Catheterization Lab.


“Time is critical. The faster we restore blood flow through the arteries, the less damage there is,” says Dr. Ahmed.


That’s why responding EMS workers play such a vital role in this lifesaving effort, says Dr. Ahmed. Not only can they start treatment when they arrive on the scene, they also can use an electrocardiogram (EKG) in the field to quickly diagnose a STEMI and activate the cath lab—up to an hour sooner than if a patient arrives at the hospital by car.


“It takes a coordinated effort by EMS personnel, nurses, technicians, and doctors to get a patient into the lab as quickly as possible. We work as a team to open that blocked artery as fast as we can,” adds Dr. Ahmed.


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