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Rice Memorial taking new approach to better serve its patients in the ER

A hospital emergency room is one of the most stressful places there is for people.

But in recent years, the stress level at emergency room facilities has been magnified due to an outbreak of substance-abuse emergencies.

At Rice Memorial Hospital, emergency medicine, level-three trauma care, laboratory and other services are available 24 hours a day, 365 days a year. Contributed photo

Rice Memorial Hospital in Willmar has begun a philanthropy campaign in order to make physical changes in its emergency room that will better serve those in need of emergency services.

“This is a nationwide problem, not just at Rice Memorial Hospital” insisted Dr. Ken Flowe, chief medical officer and emergency department medical director at Rice Memorial Hospital in Willmar. “All hospitals have to adapt to the effects of these new types of drugs.”

Thirteen percent of all patients seen in the emergency room at Rice Memorial Hospital last year involved mental illness or substance abuse. When a patient uses illegal drugs, the effects can be unpredictable; even more so with these new drugs, and especially for those with pre-existing mental illness.

“This is not a mental illness problem, although those with mental illness are more susceptible to these drugs and have a worse reaction. Mental illness can even become unmasked because of these drugs, and permanent personality changes can occur.”

Rice Memorial Hospital is now accepting tax-deductible donations to help pay for the physical changes now being proposed to the ER , all designed to help with patient care. Contributed photo

The types of drugs Dr. Flowe refers to are synthetic cannabinoids, which are a growing number of man-made mind-altering chemicals that are either sprayed on dried, shredded plant material so they can be smoked (herbal incense) or sold as liquids to be vaporized and inhaled in e-cigarettes and other devices (liquid incense).

These chemicals are called cannabinoids because they are related to chemicals found in the marijuana plant. Because of this similarity, synthetic cannabinoids are sometimes called “synthetic marijuana” or “fake weed,” and they are often misleadingly marketed as “safe,” legal alternatives to that drug. In fact, they may affect the brain much more powerfully than marijuana; their actual effects can be unpredictable and in some cases, severe or even life-threatening. And they are, in fact, not legal in Minnesota, according to a state law passed in 2012.

“Patients that are coming in that have these types of drugs in their system often are aggressive and violent,” said Dr. Flowe.

Thirteen percent of all patients seen in the ER at Rice Memorial Hospital involve mental illness or substance abuse. Contributed photo

Synthetic cannabinoid users can expect the following effects:

· elevated mood

· altered perception

· symptoms of psychosis (delusional or disordered thinking detached from reality)

· extreme anxiety

· confusion

· paranoia and hallucinations

· rapid heart rate

· vomiting

· violent behavior

· depression and/or suicidal thoughts

Synthetic cannabinoids can also raise blood pressure and reduce blood supply to the heart, as well as cause kidney damage and seizures. The use of these types of drugs is also associated with a rising number of deaths.

Because many of those entering the emergency room with these types of drugs in their system become a threat to others, medical personnel spend additional time on them, taking away valuable time needed for other emergencies.

Dr. Ken Flowe, chief medical officer and emergency department medical director at Rice Memorial Hospital in Willmar.

“These are unscheduled and unanticipated types of emergencies,” said Dr. Flowe. “It takes all our resources for 10 minutes or so to get these patients under control so everyone can feel safe. These types of patients are acutely psychotic and delirious and have to be controlled immediately before we can serve our other patients. This is not the way we want to provide care.”

Last year, Rice Memorial Hospital’s emergency room served 13,351 patients of all ages from Kandiyohi County and 16 surrounding counties. One in every five persons seen there is admitted or transferred to a larger medical facility.

At Rice Memorial Hospital, emergency medicine, level-three trauma care, laboratory and other services are available 24/7/365 to anyone, including emergency responders and hospitals in the region.

There are four major areas of concern in the emergency room at Rice Memorial Hospital that the staff feels would mitigate the safety risk to patients, visitors and staff.

• increasing staff ability to more clearly observe patients and visitors in the waiting area. Currently, there is no clear line of sight due to walls and other physical barriers.

• improving patient flow to minimize contact between discharged patients and patients seeking care. Currently, all patients enter and leave the emergency room treatment area at Rice Hospital through the same door, which results in congestion and risk from avoidable contact.

• relocating security staff in the vicinity of the emergency room. Currently, the security office is located on the opposite side of the hospital campus.

• renovating a secured space for the medication dispensing machine, so patients can fill their home prescriptions and get necessary instructions in private. The medication dispenser is currently located in the waiting area.

“In 2012, one in 500 patients we saw was acutely psychotic, usually related to drug abuse,” said Dr. Flowe. “Today, it is one in every 75, or 13 percent of all the patients that come in. By year end, we will be seeing one such high-risk emergency every two days. And it’s just going to get worse.”

A nurse checks the heartbeat of a patient in the emergency room at Rice Memorial Hospital. Contributed photo

A community investment of $550,000 will help fund the four aforementioned physical changes needed to Rice Memorial Hospital’s emergency room in order to better respond to the public’s emergency needs. Community support will allow Rice Memorial Hospital to remain proactive in preventing violence in the emergency room, as well as throughout the hospital.

For 80 years, Rice Memorial Hospital has met the health care needs of people in the region.

“We need the community’s help to make this project happen, because we’ve allocated resources for other projects and can’t fund it from our capital budget, which is prepared years in advance.” said Dr. Flowe. “Because this problem has come up so quickly, we can’t delay this.

“The popularity of these drugs have steadily been rising in our area over the last two years. Years ago we couldn’t have predicted seeing the increasing numbers of these high-risk, psychotic patients. We would like to start making these improvements to our emergency room as soon as possible.”

Anyone who shares this concern or passion and would like to make a tax-deductible gift toward these necessary improvements to the emergency room, can contact Shirley Carter at Rice Health Foundation 320-231-4141 or visit

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