Posts by zavorag

How to Stay Safe from Double Whammy of Smoke and COVID-19

Posted on Aug 20, 2020 in Safety, Scroll Images

With wildfire smoke settling in every Northern California community, and with COVID-19 still a major health concern, Dr. William Isenberg, Sutter Health’s Chief Quality & Safety Officer, has two words of advice on the best way to avoid the associated health risks: Stay inside.

“With COVID-19, we have sheltered in place and limited our public interactions, and with the smoke in the air, sheltering in place is even more important,” Dr. Isenberg says. “Stay home, close the windows and doors, try not to let the outside air in. Those are the optimal recommendations to keep everyone safe during this unprecedented combination of a deadly pandemic and wildfire smoke, not to mention the heat of summer.”

Especially at risk of lung issues from the smoke are children, the elderly, those with underlying respiratory and heart issues, and pregnant women. “Inhalation of this wildfire smoke can cause premature labor,” he said. But he reiterated that prolonged exposure to all this smoke can cause queasiness and heart attacks to even those who are not high risk.

Dr. Isenberg offers the following precautions during this time of poor air:

  • Stay indoors as much as possible, limiting opening of doors and windows.
  • Use air conditioning in your homes and vehicles, if you have it. Malls, if open, are great places for people without their own air conditioning at home.
  • Do not run fans that move smoky outdoor air inside, such as whole-house fans. If your home is equipped with an automated venting system, make sure you turn it off.
  • Keep wellhydrated. Dr. Isenberg recommends drinking a minimum of 8 ounces of water eight to 10 times daily.  
  • Use your maintenance puffers/inhalers if you have asthma, emphysema or other respiratory diseases, and carry your rescue puffer/inhaler with you if you leave your home.
  • When out in public, make sure you wear your cloth or surgical mask. While these won’t protect you from the small smoke particles, they do help in controlling the coronavirus.

Air Now also has information about how to protect yourself from wildfire smoke, along with a chart that pinpoints the Air Quality Index of your town.

For further information, listen to this podcast from Capital Public Radio, which features an interview with Vanessa Walker, D.O., a Sutter Health pulmonologist.  

How a Rural Hospital Treated a COVID-19 Patient 120 Miles Away

Posted on Jul 2, 2020 in Expanding Access, Innovation, Memorial Hospital, Los Banos, Quality, Safety, Scroll Images, Uncategorized

When Sutter Health’s Memorial Hospital Los Banos had a critically ill patient test positive for COVID-19, there wasn’t an ICU room for her. The small community hospital’s four ICU beds are located in the same large room separated by curtains, and this patient needed to be isolated.

A private room was made available, but there was a problem: It was not equipped with the Sutter eICU telehealth system that allows 24/7 critical-care physician coverage from a central hub 120 miles north in Sacramento. But, as part of its preparations for a COVID-19 patient surge, Sutter Health had just deployed a new system that allowed its eICUs to more than double its capabilities. The patient in Los Banos was the first to be cared for using the new system.

Sutter, a national pioneer in electronic ICU (eICU), has for years ensured critically ill patients in both large cities and small towns have 24/7 access to an expert team of doctors specially trained in their care. From central hubs in Sacramento and San Francisco, these doctors monitor patients in ICUs many miles away using live interactive video and remote diagnostic tools to instantly assess critical changes in a patient’s condition and provide expert critical-care physician support and supervision for the hospitalists, specialists and nurses who provide the hands-on care.

Sutter Health has more than 300 ICU patient rooms at 18 hospitals, each one outfitted with interactive video cameras, but in a matter of a month, Sutter designed and deployed specialized units that enable the eICU’s critical-care physicians to care for upward of 1,000 coronavirus patients without having to travel from hospital to hospital and using in-demand PPE. As part of its COVID-19 surge planning, each hospital set aside other patient rooms that don’t have the eICU video technology installed, and Sutter’s eICU team created and deployed 82 iPad stands across its network to bring these specialized critical care teams to those patients, too. Including the patient in Los Banos.

“The challenge was to come up with a plan for our eICU to provide care for a surge in patients across Northern California,” said Dr. Tom Shaughnessy, medical director of Sutter Health Bay Area eICU. “We are now able to meet the need of a patient surge by giving the same comprehensive, quality care whether a patient is in one of our ICU beds or a converted room.”

With the assistance of the eICU team through the mobile units, the patient in Los Banos recovered from the novel coronavirus. Now rural hospitals throughout the Sutter network are prepared for patients who need to be isolated and still have 24/7 critical-care physician coverage, and Sutter’s larger hospitals are prepared for a future patient surge of any type that requires all-hours critical-care coverage.

“We have nurses and physicians providing some of the best bedside care in the country, and the eICU allows us to come in and provide advanced specialized support as they care for patients,” said Dr. Vanessa Walker, medical director of the Sutter Health Valley Area eICU. “This is critical in the care for those suffering from compromised lung function due to a virus such as COVID-19. Now with these additional mobile units, we are well prepared to meet a surge of patients from this current crisis or any other that may come in the future.”

Vanessa Walker, D.O., cares for a patient through the eICU system in Sacramento

How to Stay Safe with Rising Heat and COVID-19 Cases

Posted on Jun 26, 2020 in Carousel, Pediatric Care, Quality, Safety, Scroll Images, Sutter Medical Center, Sacramento

Temperatures are rising in Northern California, and so are confirmed cases of COVID-19. How do you keep safe from both? Stay home, says an emergency medicine physician with Sutter Medical Center, Sacramento.

“Our recommendation for the heat is stay inside and exercise intelligently; that’s kind of what we would say about COVID-19. They overlap,” said Arthur Jey, M.D. “Because it’s so hot, we’re not going to want to go out anyway, so it’s a good excuse to stay home with your family.”

With communities opening up and more area residents wanting to take advantage of the great outdoors and other opportunities, Dr. Jey pleads for folks to keep their masks on … or at least handy. Popular activities in the region include walking and hiking, which are great ways to get some fresh air and exercise at the same time. Won’t wearing a mask make you even hotter?

“When you’re outside, walking and hiking, and there’s no one around, you don’t need to wear the mask,” he said. “But you don’t know when you’re going to come close to someone, so keep your mask close by. I am always wearing a mask around my neck or it’s in my pocket. As soon as someone approaches, I put it on. … When there are people around, my mask is on all the time.”

During an interview with the media, Dr. Jey gave some other tips on how to avoid heat-related illnesses, from heat rashes and sunburns to heat exhaustion and heat stroke. Those most susceptible to the heat illnesses include toddlers who can’t communicate that they’re suffering, the very old, and those who have to work in the sun, including farm and construction workers.

What and How Much to Drink

If you are out in the sun, Dr. Jey says the best thing to do is drink a lot of fluids. He recommends good, ol’ plain H2O. Not ice-cold water that can cause cramps, but cooled water. He also recommends sugar-free electrolyte drinks, which are good ways to replenish those essential minerals when working out. Avoid alcoholic beverages along with sodas and sports drinks that contain sugar.

“Make sure you’re smart about what you drink,’ he said. “Alcohol is going to dehydrate you. Really heavy sugared water, like Gatorade, is going to dehydrate you. Electrolyte waters with low or no sugar, fantastic. Water, fantastic.”

He also says it’s not important to count how much fluids to take in, but rather to sip consistently and continually, not a lot at one time. “Everyone asks me how much to drink. Many medical professionals say drink eight to 10 glasses a day. But really, just try to drink well.” He said to take sips at least every half an hour while out in the sun. His counsel: “Don’t wait until you’re thirsty to take a drink.”

He also recommends that those going outside wear light, loose clothing and a hat. “I tend to wear baseball caps a lot, but they aren’t the best choice. The ones that you really want are the wide-brimmed ones, like the fishing hats, that cover the back of your neck. We’ve all been sunburned there before.”

What to Do When You’re Feeling the Heat

“There’s a whole continuum of heat-related diseases,” Dr. Jey says, and they progressively worsen as you’re exposed longer to the hot weather.

1.       Heat rashes, which is a reddening of the skin.

2.       Sunburns, which can be very painful.

3.       Heat exhaustion, when you’re still sweating, but you’re feeling a little woozy or nauseous. Your urine at that point is a darker yellow.

4.       Heat stroke.

“This is when it gets scary,” Dr. Jey says. “You stop sweating and your thinking slows down, and you feel horrible. You look like you’re having a stroke; that’s why it’s called heat stroke. I’ve seen people come in completely confused, acting like they’re almost drunk, that’s when you really get scared. The way you prevent that is that you don’t wait until you’re thirsty to start drinking water.”

He says when heat stroke is happening, the first step is to get out of the heat and let someone know you’re not feeling good. That’s why toddlers who aren’t talking yet are very susceptible to heat illness, because they can’t verbalize how they’re feeling.

Next step: “Get some water in you. Don’t chug it, don’t drink a whole gallon of it. Just sit down in the shade or some air conditioning and sip some water. And, if you don’t get better, then come see us at Sutter.”

Dr. Jey said, even during this pandemic, don’t be afraid to go to the emergency room when you are in a medical emergency, whether it’s heat stroke, a real stroke, or any other kind.

“We get concerned that you push things off too far,” he said. “Our nurses and physicians here work really hard to make sure that we keep you safe. … So if you start feeling problems with temperature, problems with the heat, or for that matter, trouble breathing, come see us. Don’t be scared. We have a separate area for those who we think might have COVID-19. Especially now when we’re starting to have another uprising of it. We’re very cautious of it. But I don’t want that to stop people from coming in when they have other illnesses.”

The Sacramento Bee posted one of Dr. Jey’s interviews on heat illnesses. Click here to watch it, and notice his mask is around his neck for when someone comes close!

No Need to Put Off Possible Life-Saving Mammogram Any Longer

Posted on May 19, 2020 in Carousel, Expanding Access, Quality, Safety, Scroll Images, Sutter Medical Foundation, Women's Services

ROSEVILLE, Calif. — Laurie Deuschel of Rocklin received news during the COVID-19 crisis that breast cancer runs in her family, but during the first two months of the pandemic, mammograms were considered elective scans and weren’t being performed. The first week they became available again, Deuschel got an appointment.

“I’m here to have my first mammogram, and I’m a little bit scared,” she said, but she wasn’t scared about catching the novel coronavirus while at the Sutter Imaging center in Roseville Monday, May 18.

Why? “Sutter Imaging knows the cleaning procedures and how to keep me safe,” she said.

Sutter Health is going to great lengths to protect its patients and staff in the COVID-19 era. It has created a “new normal” for its imaging centers, focused on a “safety strategy” that is incorporating guidance from the national Centers for Disease Control, California Department of Public Health and the American College of Radiology. Some of those measures include:

  • Temperature screening of all staff, doctors and patients at the door,
  • Universal masking,
  • Social distancing in waiting rooms (patients can wait in their cars if they prefer),
  • Screening patients at the time of scheduling and arrival for symptoms,
  • Deeper cleaning of equipment after every patient,
  • Regular sanitization of chairs and door handles,
  • Thorough wipe-downs of patient lockers and dressing rooms with a “Cleaned” sign placed for patients and staff to know those areas have been disinfected,
  • Regular audits or “double checks” with staff to ensure that the new procedures are being followed. 

Miyuki Murphy, M.D., the director of breast imaging for Sutter Medical Group, was interviewed for a story on the Sacramento NBC affiliate KCRA, Channel 3. Dr. Murphy explains why not delaying your mammogram is important, and the story includes video of some of the safety measures being taken at Sutter Imaging. Click here for that story on their website.

Dr. Miyuki Murphy on KCRA about the safety of mammograms at Sutter Imaging.

Program Designed to Attract Docs to Rural Areas Receives Accreditation

Posted on May 15, 2020 in Community Benefit, Expanding Access, Scroll Images, Sutter Amador Hospital, Sutter Medical Center, Sacramento, Uncategorized

The Sutter Rural Residency Program received a U.S. grant last year and this week was accredited and is ready to screen applicants. Leaders involved in the program include, from left, Dineen Greer, M.D., program director of the Sutter Family Medicine Residency Program; Sutter Amador Hospital CEO Tom Dickson; HRSA regional administrator Capt. John Moroney, M.D; Jackson Mayor Robert Stimpson; Sutter Valley Area Chief Medical Officer Ash Gokli, M.D.; former Sutter Amador CEO Anne Platt; and Robert Hartmann, M.D., longtime Amador County internal medicine physician and an instructor in the Rural Residency Program.

JACKSON, Calif. – Sutter Amador Hospital’s Rural Residency Program this week received accreditation from ACGME (Accreditation Council for Graduate Medical Education), the organization responsible for accrediting all graduate medical training programs for physicians in the United States. This Sutter Health program is designed to bring more primary-care physicians to rural regions, which have been hampered throughout the country by a shortage of family doctors.

The ACGME accreditation allows the Sutter Health Rural Residency Program to begin screening and selecting residency applicants. Those selected – two each year for six total in the program – will complete core inpatient training in Sacramento during the first year, with their next two years on the campus of Sutter Amador Hospital and in community medical offices.

The goal of the Sutter Health program is to develop a sustainable, accredited rural training track in Amador County and to ultimately expand the area’s rural primary-care workforce. In Amador County, there is a high need for primary-care physicians (PCPs) in the area as the ratio of the population to one PCP is 1,760-to-1; the ratio throughout the state of California is 1,280-to-1, according to the County Health Rankings and Roadmaps website.

“This is welcome news for Amador County, as it will provide an influx of bright, young physicians into our community to care for our families and should give us a steady supply of primary-care physicians for years to come,” said longtime Amador County internal medicine physician Robert Hartmann, M.D., who will be one of the instructors in the Rural Residency Program. “This is a major collaborative accomplishment between Sutter Amador Hospital, Sutter Medical Group physicians and the Sutter Family Medicine Residency Program.”

The Rural Residency Program was made possible through a grant from the U.S. Health Resources and Services Administration (HRSA), which allows not-for-profit Sutter Health to expand its successful Sacramento-based physician residency program to Amador County as part of the federal agency’s efforts to provide better access to quality medical care in rural areas.

Since its inception in 1995, the Sutter Family Medicine Residency Program has graduated 139 physicians, all of whom passed their Board Certification assessments on the first effort. Currently there are 21 residents in the program, and the Amador County program will expand the program to 27 residents.

“We are working to strengthen the physician pipeline throughout our integrated network so our patients receive the same high-quality care no matter where they live,” said Dineen Greer, M.D., program director of the Family Medicine Residency Program. “We have combined a strong, dedicated core faculty, community preceptors, innovative curriculum and access to Sutter hospitals so that our residents develop the skills needed to be outstanding family physicians and leaders in their communities.”

The accreditation was welcome news for the state legislators who serve the Gold Country. State Sen. Andreas Borgeas said: “The physician shortage continues to be a prevalent issue in Amador County and many rural areas of California. I offer my sincere congratulations and gratitude to Sutter Health on the program’s latest achievement, and for its targeted effort to bring much-needed family practice physicians to our community. This is a significant step to help expand access to quality care for our communities in the beautiful, remote areas of our state.”

State Assemblyman Frank Bigelow echoed Sen. Borgeas’ sentiment. “Sutter Health has long supported hospitals in more rural regions of California and they understand how family doctor shortages can have a negative impact on a community’s health,” Bigelow said. “I am so pleased they are pursuing this program and continuing their investment in bringing needed primary care physicians to Amador communities.”

Drs. Greer and Hartmann expect the program to be successful in filling the need for well-trained, community-minded primary-care physicians in Amador County and the greater Mother Lode region.

“The medical students applying for this residency opportunity will enter the program with a strong desire to serve in rural communities,” said Dr. Hartmann, “so their career focus will be the health and well-being of families in our towns and smaller cities. This is great for the future of health care in our community.”

For more on the Sutter Family Medicine Residency Program, go to www.suttermd.com/education/residency/family-medicine