Emergency department ramps up for increases in winter patients | SteamboatToday.com

Emergency department ramps up for increases in winter patients

Steamboat Springs Fire Rescue firefighter/EMT Julie Wernig reloads a gurney into an ambulance after transporting a patient in late December to the emergency department at UCHealth Yampa Valley Medical Center.
UCHealth/Courtesy photo

One December day, within a span of 20 minutes, local ambulance crews responded to four calls for slips and falls that resulted in fractures to patients who ended up in the emergency department.

Every winter from the weekend before Christmas through early April, the emergency department at UCHealth Yampa Valley Medical Center increases staffing to accommodate for the annual anticipated increase in patients, including adding two full-time nurses on duty each week, said Dr. Laura Sehnert, a YVMC emergency medicine physician since 2007.

The volume of patients in the department can increase 50% during the busy winter season compared to slower times of the year such as in May, said Maureen Taylor, ED nurse manager at YVMC.

Much of the increased patient visits comes from the nearby Steamboat Ski Resort, but the fact that the emergency department is less than one mile from the ski area base can be a benefit to patients. If a skier is going to have a heart attack at any ski area in Colorado, Steamboat could be a good place for that, Sehnert said.

This winter season, locals and visitors also are at increased risk of COVID-19, influenza and respiratory syncytial virus in addition to the usual long list of winter injuries.

“We see anything and everything that you can imagine could occur with an increase of snow, ice, cold temperatures and recreating outdoors – snowmobile accidents, skier traumas, motor vehicle accidents, frostbite and hypothermia,” Taylor said.

Precondition and stay sober on the slopes

“We do see more injuries in those who are not conditioned. If you’ve been preparing to be at altitude and exert yourself, that certainly plays a hand in preventing injuries. Any use of alcohol and marijuana significantly increases your chances of injury as your decision making and reflex response time is often impacted.” — Maureen Taylor, Emergency Department nurse manager

Since the staff of nine board-certified emergency medicine physicians serving in the department are active and enjoy skiing too, Sehnert said, they realize how important it is to learn how to balance risk with fun.

“There is story after story after story, from ski poles to chair lift injuries, to falling from chair lifts. It’s incredible how many different ways there are to hurt yourself on the mountain — trees, tree wells, restaurant stairs, collision with significant others,” said Sehnert, also YVMC chief medical officer.

Winter recreationists should remember these key recommendations: engage in preconditioning exercise, stay hydrated and know your body’s limitations so you can quit before you become too tired.

“Listen to your body. When you are tired, it’s time to be done. We hear so often, ‘It was the last run of the day, and I was tired, and then…,’” Sehnert explained.

Vaccinations for the coronavirus and flu are at the top of the doctor’s precaution list, along with wearing good winter shoes with traction, recreating within personal ability levels, giving space to other skiers or boarders, using proper and tuned equipment, and always wearing helmets. Sehnert said if skiers from lower elevations have one to two extra days to acclimate to Steamboat elevations before going skiing, that is best.

Typically, 1 p.m. to 5 p.m. daily is the busiest time in the emergency department, with a condensed influx of patients, Sehnert said. Frequent winter injuries include ACL tears, fractures, upper extremity injuries to shoulder or clavicle, and head injuries from slipping on ice.

The department staff includes more than 30 employees with emergency medical technicians and registered nurses, many of whom have additional training in trauma, Sehnert said.

“For being a small community, we really have an incredible group of providers,” Sehnert said.

The YVMC Emergency Department medical team

The staff at the Yampa Valley Medical Center Emergency Department includes eight full-time doctors, five of those with more than 20 years of experience in the local emergency department.

Those five are: David Wilkinson at 38 years; David Cionni at 27 years; Nathan Anderson and Laila Powers, both at 21 years; and Jeanne Fitzsimmons at 20 years.

The latest addition in full-time doctors include Jim Cotter two years ago and David Richter in September, both of whom joined the department with significant emergency medicine experience, Sehnert said.

Working alongside doctors with so many years of emergency experience is an “honor,” Sehnert said.

The emergency team strongly emphasizes that lack of fitness conditioning, as well as drinking alcohol or smoking marijuana, lead to more injuries as reflex response time is often impacted.

“We see alcohol and skiing under the influence significantly impact the numbers and the severity,” Sehnert said. “People take more risks when they are under the influence and don’t make the best decisions keeping themselves safe. Refrain and wait until après ski.”

Working through the Christmas holiday, Sehnert noticed a somewhat reduced number of emergency department patients, which she attributed to the lower number of acres of terrain open this holiday season at Steamboat Ski Area. Taylor and Sehnert also complimented the Steamboat Ski Patrol staff, who maintain a close working relationship and coordinated team effort with the department staff to help patients.

The level of winter accidents sending patients to the emergency department usually increases when winter conditions are tricky, for example, during wet snowfalls that freeze causing slippery mornings.

Although patients through the past six months in the department have seen a doctor within an average of six minutes, the COVID-19 pandemic still is challenging the staff, who are treating an increase in respiratory illnesses on top of typical skier and winter injury patients. The staff continues to change out personal protective equipment between the busy flow of patients.

Tricky conditions, crowds add to injuries

“Snow conditions and crowds play a factor in wintertime injuries. Every condition can present a different injury potential. Thin snow cover can leave rocks barely covered, whereas heavy, wet snow can be sticky and cause different injuries. Icy spots on the mountain and on sidewalks and roads can wreak havoc.” — Maureen Taylor, Emergency Department nurse manager

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