DEMAND FOR SERVICES GROWS; ABOUT THIRD OF AMERICANS WILL VISIT EMERGENCY ROOM THIS YEAR

Nearly one out of three Americans will visit a hospital emergency room this year, a figure that experts say will likely continue to rise.

As a result, the availability of emergency care is a major concern of health care workers. Emergency Medical Services Week is recognized each May.

According to the American Hospital Association, the number of emergency room visits has increased by one-third in the last 20 years.

Locally, both Cape Girardeau hospitals report a steady increase in emergency room visits during the past decade.

Dr. Charles Pancost is the medical director of the St. Francis Medical Center Emergency Room, and the medical director for the Cape County Private Ambulance Service and Bollinger County Ambulance Service.

He said medical techniques practiced by military forces in the 1960s and 1970s laid the foundation for today's emergency medical procedures.

"The air ambulance helicopter was born during the Vietnam War," he said. "We needed a way to treat the wounded soldiers at the scene, then evacuate them as fast as possible back to a field hospital for more extensive care."

Pancost said the emergency medical services given to the wounded in Vietnam led to the discovery of the "golden hour," the one-hour period from the time the injury occurs until the patient is treated at the scene and transported to the emergency room.

A spokesman for St. Francis Medical Center said over 16,000 patients were treated last year in their emergency department. This year, the number is projected to be about 18,000 patients.

At Southeast Missouri Hospital, about 25,000 people were treated in the emergency room in 1991. Hospital officials say the number of people treated emergency department at Southeast has risen about 12 percent each year for the past decade.

At St. Francis, the emergency room staff consists of six trauma-trained physicians, and 19 nurses.

The Southeast Hospital emergency department is staffed by six trauma-trained physicians, assisted by 15 nurses and eight emergency room technicians.

Medical experts say reasons for the increasing number of emergency room patients at local hospitals are the fact there are more people without adequate medical insurance who visit the emergency room for basic medical care. For people who don't have a personal physician, the hospital emergency room has become an alternative method of medical care.

According to the American College of Emergency Physicians, the growth of the emergency medical services both in the hospital and in the field, is the result of public demand.

The ACEP says on-the-scene emergency care given by emergency medical technicians didn't surface as a national concern until the 1960s. Prior to that, the victim of a medical emergency didn't receive much medical assistance other than transportation.

In 1966, a report was published that more than 50,000 Americans died in traffic accidents. This report established emergency care as a national priority.

The U.S. Department of Transportation was charged with developing national standards for training of EMTs which became the nucleus for forming EMS systems nationwide.

In 1973, the Emergency Medical Services System (EMSS) Act designated federal dollars for the development of regional EMS systems and trauma centers, including requirements on training and certification, inter-agency cooperation, equipment development, communications and public education. All of these have led to our present-day nationwide network of EMS systems.

Pancost says it's important to call an ambulance for a major medical emergency, and not a minor problem.

To determine what constitutes a major emergency, he advises, it's best to talk to your regular doctor before you have an emergency.

"Ask what you should do if you think someone in your family needs emergency care. Ask if they should come to his office first, or go straight to the emergency room," he said.

He also advised: "When you call for help, speak calmly and clearly. Give your name, address, phone number, location of the victim, and nature of the medical problem.

"Above all, do not hang up the phone until the 911 dispatcher or ambulance service dispatcher tells you to. They may need additional information, or need to give you instructions that may help save the patient's life until the ambulance arrives."

Pancost says the time will come when the Cape Girardeau area will have a two-tiered EMS system as the population in the rural area of the county continues to increase.

"Right now, we have a one-tiered system with EMTs and paramedics responding in the ambulances," he said. "In the not-too-distant future, we're going to see the First Responders, such as rural firefighters or other EMTs responding to the scene of an accident or injury and treat and stabilize the patient. Later, the ambulance with paramedics will arrive and transport the patient to the hospital.

"As the number of people in the rural areas of the county continue to increase, the role of the rural First Responder firefighter EMTs is going to become even more important," he said.