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ER as the gateway to advanced medical care

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Dr. Michael Hawks (seated), orthopedic trauma surgeon and medical director for AdventHealth and Rothman Orthopaedics in Central Florida, confers with a fellow physician.

Make no bones about it, an emergency room visit is often the first stop for advanced care and proper healing of orthopedic injuries. Accidents and injuries that break or shatter bones should not be ignored and are classic candidates for emergency care.

During the lockdown phase of the COVID-19 global pandemic, many people put off screenings and health care maintenance for a variety of health issues because they were afraid to leave the house. Unfortunately, those delays can result in improper healing for some patients and larger health issues for others.

“Ortho injuries are different than, say, delayed cancer screenings, but putting off any form of health care maintenance can lead to greater health problems down the road,” said Dr. Michael Hawks, orthopedic trauma surgeon and medical director for AdventHealth and Rothman Orthopaedics in Central Florida. “In orthopedics, a fractured arm, for instance, may not heal properly, leading to pain, deformity and reduced function. Unfortunately for these patients, more extensive surgery is needed to correct this improper healing, and the results might be less rewarding than if the injury would have been treated right away. You never want to wait, so it’s important to get these high acuity patients linked directly from ER to a specialist.”

For many patients, the emergency room provides the gateway to advanced medical care. Situations that originate in the ER are often escalated for treatment with specialists in orthopedics, cardiovascular, neurology and digestive health.


“We typically see higher acuity patients in the ER, and that’s where they should be,” said Lorinda Stahley, RN, market director for emergency services in AdventHealth Central Florida. “These are often accident victims and patients suffering cardiac issues, stroke or acute abdominal pains. Chest pains, shortness of breath, injury (broken bones) and other life-threatening issues are commonly treated in the ER and, if necessary, moved into the system for advanced care by our team of specialists.”

Hawks said if you or your child has fallen off a bicycle, if you’ve slipped and fallen at home, or if you have had an unfortunate incident on the ball field, courts or gym, a visit to the ER may be your admission ticket to recovery.


“It’s a seamless approach to whole person care with maximum efficiency and patient comfort,” Hawks said. “Patients can come through the ER and know they’ll be carried through our system with great attention and expertise. The partnerships we’ve put in place keep that consistent, high-quality continuity of care flowing throughout the recovery process. I’ve seen patients for surgery and consultation the very next day after initial ER contact often with x-rays complete and the patient ready for treatment.

"Even though there are several different jerseys we wear, we are all on the same team," Hawks said. "An ER provider may be the initial point of contact, but an ortho surgeon may very quickly get involved in treating a patient in the ER. Having that warm handoff to the next level of care – admission, treatment and discharge – makes a real difference."

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