Emergency Department attending physician provides virtual visit to Valencia hospital’s state-of-the-art ER, where the action is
By Stephen K. Peeples 
Ask anyone who works at a hospital like Henry Mayo Newhall Memorial that serves an area as large as the Santa Clarita Valley: They’ll tell you the emergency department or ED and its emergency room or ER are where the action is.
“One of the beautiful things about emergency medicine is that every day you go to work, it's definitely something different, something new,” said Dr. Tracy “Bud” Lawrence, an attending physician for the past 10 years at the Henry Mayo  emergency department in Valencia, a Level II Trauma Center. “That variability keeps it fresh, which is what I love about it.”
From the SCV resident’s viewpoint, knowing our community hospital has a staff that shares Lawrence’s passion, uses the latest equipment, and is ready to help people 24/7 make the Henry Mayo ER the place to go if struck by sudden illness or traumatic injury.
“We've done a complete reorganization of our patient flow,” said Lawrence, a board-certified emergency medicine specialist. “We re-engineered the way our patients move through our emergency department to decrease wait times to less than 30 minutes from door to doctor. We're completely focused on customer satisfaction.”
A Closer Look Behind the Scenes at the Henry Mayo ED
Lawrence (pictured) said he and his fellow Henry Mayo ED doctors treat around 50,000 patients a year in the ER.
“We see 4,000-4,400 patients per month, or even more at times. Personally, I see anywhere from 350 to 450 patients per month,” he figured.
Reflecting the national trend, Henry Mayo’s ER patient numbers fluctuate by season, with more people treated during summer (biking, hiking and boating injuries) and winter (viral infections). Flu season “happens in the spring,” Lawrence said.
Most trauma patients including traffic collision victims arrive at the ER by helicopter or ambulance, he said, but others arrive in vehicles driven by family or friends, often after an accident at home or outdoors in some remote location where ambulance service would have taken too long.
Symptoms that may prompt a trip to the ER include sudden pain and/or dizziness, acute headache or a change in vision, weakness or fainting, difficulty breathing or shortness of breath, repeated vomiting or persistent diarrhea, and suicidal or even homicidal tendencies.
Every incoming patient sees a triage registered nurse, who checks the patient in, helps stabilize him or her, determines the nature and priority of the injury, takes vital signs, and establishes identification and insurance coverage.
If a patient has no medical insurance but still needs emergency medical treatment, California law requires hospital ERs to treat patients anyway as the humane thing to do in an emergency.
Henry Mayo Provides Level II Trauma Center to L.A. County Health Care Grid
Henry Mayo’s ED is now an integral part of Los Angeles County’s overall health care system.
"L.A. County as well as most of the country now has set up a dedicated trauma center program where the ambulances or helicopters will divert the patient to a trauma center, as opposed to an emergency department or hospital that is not a designated trauma center," Lawrence said.
"As a designated Level II trauma center, we are very well-equipped to handle essentially any kind of traumatic injury," he said. "The only thing above us is Level I trauma centers, a designation reserved for teaching hospitals like UCLA or County-USC.”
Henry Mayo recently expanded and upgraded its ED, which now features a state-of-the-art trauma room, cardiac-monitored beds, a larger more efficient nursing station, and more privacy for patients.
All the attending physicians follow guidelines set by the American Heart Association for emergency cardiac care.
The ED staff has also taken special training to treat pediatric patients, and the county Emergency Medical Services Agency has certified Henry Mayo’s ED as an Emergency Department Approved for Pediatrics (or, EDAP, for acronym fans).
County health officials have designated Henry Mayo as a paramedic base station as well, equipped with a helipad atop one of the hospital’s parking structures.
High-Quality ER Doctors and Staff are Passionate about Emergency Medicine
Dr. Bud Lawrence is as enthusiastic about what he does today as he was more than two decades ago, when he decided emergency medicine was his passion.
A UCLA graduate, he went on to medical school at USC. He then completed his four-year residency at County-USC Medical Center near downtown Los Angeles before arriving at Henry Mayo in 2003.
Attending Physician Dr. Darrin Privett and a nurse tend to a child in Henry Mayo's ER.
“County-USC is one of the biggest trauma centers in the country, and it was an amazing experience,” Lawrence said. “At that facility, you see absolutely anything and everything possible. It really prepared me well for life in a community emergency department. There's really nothing that can come in that will throw me off, or will make me nervous or concerned, because I've pretty much seen it already, been there and dealt with it.”
Lawrence said Henry Mayo’s ED seeks out doctors with similar backgrounds and experience.
“The majority of physicians at Henry Mayo were tops of their residency class from either UCLA or USC, so we really have high-quality physicians in our emergency department,” he said. “That makes us, in my opinion, one of the best emergency medicine groups in Southern California.”
Seven Shifts of Attending Physicians a Day on Duty at Henry Mayo ED
Staffing Henry Mayo’s ED and ER at all times takes seven shifts of attending physicians per day.
“Generally, we have three physicians on during the day,” Lawrence said. “It drops down to single coverage from 4 a.m. to 8 a.m., our lowest-volume hours. We consider ourselves over-staffed, but prefer to have more physicians present to meet the needs of the community.”
The ED orchestrates the schedules of the doctors, nurses and support staff so the transitions are seamless from shift to shift.
"We all work variable shifts, so my shift could be anything from coming in at six in the morning to coming in at 10 o'clock at night, and our shifts average 10 hours," said Lawrence, who works between 40-50 hours a week.
Arriving at the ER, Lawrence first logs onto his computer, finds out what patients are waiting to be seen and for what, and gets right to work.
"You pick up the next patient, whether that's a trauma, a child with a fever — you can never tell," he said. "Again, our goal is the least amount of wait time as possible.”
Henry Mayo of New ‘A Spectacular Place’
During his decade on duty in Henry Mayo’s ED, Lawrence has seen the not-for-profit hospital as a whole make “amazing progress. I think the Henry Mayo of new is a spectacular place, a huge improvement in the last 10-15 years over the Henry Mayo of old,” he said.
Lawrence, who also serves as Henry Mayo's director of risk management, takes part in much of the information technology work at Henry Mayo. "Our emergency department is completely electronic,” he said. “We use electronic charting and electronic ordering for patient safety.”
The improvements never stop. “Soon we’ll have 24-hour-a-day cardiac catheterization at Henry Mayo to treat all of our acute heart attacks or cardiovascular infarctions,” he said. “We’re making amazing pushes forward to help make Henry Mayo one of the leaders in the Los Angeles area for health care.”
“A lot of hard work has been done — physicians and administration — and it's really showing,” Lawrence observed. “It's very impressive.”
For more information, call 661-253-8000 or visit http://www.henrymayo.com .
Photos: Courtesy Henry Mayo Newhall Memorial Hospital.
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Henry Mayo Emergency Department: Behind The Scenes With An ER Doctor
Article: Henry Mayo Emergency Department: Behind The Scenes With An ER Doctor 
Source: Santa Clarita News
Author: Stephen Peeples