Pediatric Emergency now within TMC for Children

The Tucson Medical Center Pediatric Emergency Department has relocated within TMC for Children.

Patients and loved ones will gain entry to the Pediatric ED by going through the main TMC for Children entrance on the hospital’s south side.

The layout and design of the 14-bed Pediatric ED is structured in a horseshoe shape to enable staff to monitor patients more easily, spend more time with patients and promote better teamwork.

In addition, the new location is in close proximity to other TMC for Children services, which allows TMC to better integrate comprehensive children’s services.

“With all services in the same area, it will allow for more timely collaboration with pediatric specialists and better coordination of care for our youngest community members,” said Dr. Moira Richards, the medical director of TMC for Children.

The Pediatric ED also offers online appointment scheduling. Visit our home page to find out more.

You’ve got the flu: Is the Emergency Department for you?

when to come to the ed with flu and when to stay awayThe flu outbreak across the state is hitting much earlier – and far harder – than expected.*

If you’ve come down with influenza, how do you know when you should see your primary care provider or if you should go to the emergency room?

The Centers for Disease Control and Prevention (CDC) has a flu guidance page on its website to help you determine whether you should head to the emergency room or your doctor. In short, the emergency room should only be used by those who are very sick and are exhibiting emergency warning signs, including:

In adults

  • Difficulty breathing or shortness of breath
  • Pain or pressure in the chest or abdomen
  • Sudden dizziness
  • Confusion
  • Severe or persistent vomiting
  • Flu-like symptoms that improve but then return with fever and worse cough

Looking for a same day appointment with a primary care provider? Check out TMCOne.

In children

  • Fast breathing or trouble breathing
  • Bluish skin color
  • Not drinking enough fluids
  • Not waking up or not interacting
  • Being so irritable that the child does not want to be held
  • Flu-like symptoms improve but then return with fever and worse cough
  • Fever with a rash

In addition to the signs above, get medical help right away for any infant who has any of these signs:

  • Being unable to eat
  • Has trouble breathing
  • Has no tears when crying
  • Significantly fewer wet diapers than normal

Some people are at much higher risk of developing serious complications from the flu than others.

They include:

  • pregnant women or new mothers who have given birth in the past two weeks
  • children, especially those under 2 years old
  • adults over 65
  • people whose body mass index is over 40
  • people with diabetes
  • anyone with a medical condition that compromises his or her immune system

“The important thing to do is to prevent the flu in the first place,” said Cynthia Carsten, interim director of TMC’s Emergency Department. “Wash your hands. Avoid close contact with people who have the flu and get a flu shot – and particularly if you are in a high risk group. If you’re sick, stay home if you can.”

*Arizona Department of Health Services Influenza Summary.

Mission Moments: Missing tennis shoes meet a bulldog of a nurse

After an elderly patient left Tucson Medical Center following a stroke, her sister called in a panic.
The patient had compromised movement with partial paralysis of the left side that required special shoes to help with her mobility. They would be important in physical therapy sessions to help rebuild her strength.

And they were missing.

Will Bascom was the charge nurse that evening in the Emergency Department when the frantic call came in. He promised to track them down.

They weren’t in the Emergency Department and they weren’t in the room she recovered in. It took a bit of sleuthing, but ultimately it turned out they already had been brought back to the patient’s care home and were waiting for pickup.

The patient’s sister called later to say how appreciative she was. “Amidst his busy scheduled, he hunted them down. I can’t say enough about how he treated me when we were going through such a hard time.”

For Bascom, of course, he was going to help.

“More often than not, we see people in some of the worst times of their lives. It’s as simple as that. So if I get a request like this – to help someone out at a time when they’re going through this life-changing event and even a small thing means the world in that moment – I’m like a bulldog,” he said.

Bascom said people typically get into health care because they have compassion and empathy for others. “I treat everyone like my own family. I don’t care why you’re here and where you’re from. I’m not a judge. My job here is to take care of you. I think many people just lead such busy lives that it’s hard to have time for anyone else. I’ve always done what I could to help others.”

Tucson Medical Center earlier this year adopted a new mission statement. To celebrate, we are sharing an ongoing series of “mission moments.”

What are mission moments? They aren’t necessarily dramatic stories of heroism, although our medical staff saves lives every day. These are moments that breathe life into words – moments that are profound or powerful or touching and that remind us why we do the work we do. Hundreds of these reminders happen every day. Thank you for letting us share some with you.

Do you have a TMC mission moment you’d like to share? Send it to Communications@tmcaz.com.

Mission Moments: Inspired by a 6 year old to first assume good intentions

Family of four standing in front of a bay

The call was enough to make a parent’s heart drop: Come to the school now. Your daughter may have to go to the Emergency Department.

Sanjay Timbadia, Tucson Medical Center’s Laboratory manager, rushed to school to find his first-grade daughter’s head bandaged with blood in her hair and on her dress.

A child had been throwing rocks on the playground and one of them had struck his daughter in the head while she played on the monkey bars. There wasn’t any malice: It was just an accident.

It was later, after she had been treated at the TMC Pediatric Emergency Department, that the little girl said something that was a poignant reminder for her father.

“That boy that threw the rock: I think he was just trying to get it out of the playground so that no one would trip on it,” she said.

It was a moment for pride and reflection, Timbadia said, and he shared the story with his team as they entered the holiday season.

“She has reminded us of an amazing lesson: to always assume positive intent first,” Timbadia said.

The lesson can be applied in the lab, which is a busy place that processes more than 2 million tests every year. It can also just as importantly be applied in everyday life as a balm against the divisions that can cause cultural and political divides – and it’s even stronger when peppered with gratitude, he noted.

“If I’m delayed because I’m in traffic or if I get a flat tire, I just try to remember that at least I have a car to take me places because there are many others who are waiting for a bus in the summer heat,” Timbadia said. “And if someone gets in front of me and drives slowly, you never know: Maybe that person just prevented me from getting into an accident.

“I think like anything else, assuming positive intent and being grateful is something we learn, and it’s also something that gets stronger with practice. At TMC, we are committed to being here to make things better for our patients and our community when they need us – and we approach that work with positive intent.”

Tucson Medical Center earlier this year adopted a new mission statement. To celebrate, we will share an ongoing series of “mission moments.”

What are mission moments? They aren’t necessarily dramatic stories of heroism, although our medical staff saves lives every day. These are moments that breathe life into words – moments that are profound or powerful or touching and that remind us why we do the work we do. Hundreds of these reminders happen every day. Thank you for letting us share some with you.

Do you have a TMC mission moment you’d like to share? Send it to Communications@tmcaz.com.

TMC now offering scheduled appointments for Pediatric Emergency Department visitors

TMC now offering online appointmentsEmergencies and convenience don’t often intersect – but for those who can wait to seek medical care, Tucson Medical Center now offers scheduled pediatric appointments to make emergencies just a little easier.

Emergency Department appointments are not appropriate for those children with emergent medical conditions.

But for others, the new service offers a convenient alternative that allows them to rest in the comfort of their own home while waiting for a prescheduled time.s.

The new tool, which is easily accessible on the TMC website at www.tmcaz.com, allows patients to go online to review a list of open appointment times and secure that time slot.

Patients should know that although TMC strives to see patients as close to their appointment time as possible, projected wait times may be impacted if patients with more significant emergencies present for emergency care or if their case is determined to be more serious after a medical screening exam by a provider.

For more information, please visit www.tmcaz.com

TMC seeing an influx of flu patients, same-day primary care appointments available

BDP31676Winters are busy times for local hospitals because of the influx of winter visitors combined with flu season.

Dr. Rick Anderson, vice president and chief medical officer at TMC, said this year’s flu epidemic seems to be more widespread in Arizona, and the virus is proving to be especially nasty. “We’re seeing the H1N1 virus, which seems to affect younger patients,” he said.

“Respiratory issues are the biggest reason children are being admitted. Flu typically affects the very young and the very old, but this year’s strain is also infecting young adults to the point where their symptoms can’t be managed as an outpatient, and they have to be admitted to the hospital with respiratory issues. Some of these patients – in their 20’s and 30’s – have been admitted to the intensive care unit because of the severity of the virus. We’re also finding some patients being diagnosed with pneumonia on top of the flu.”

Flu symptoms and when to seek emergency care:
▪ Flu symptoms include: fever, body aches, headache and a cough.
▪ If you are young and healthy, but you are not short of breath, contact your primary care physician and do your best to manage your symptoms at home.
TMC One logo ▪ If you don’t have a primary care physician, or you can’t get in to see yours, TMC One offers same-day appointments with TMC One providers, including Dr. William Abraham, a board-certified internal medicine physician with more than 30 years of experience. His office is located at 1396 N. Wilmot Road. Call (520) 324-2160 to make an appointment.
▪ Your doctor may prescribe you a medicine called Tamiflu. Doctors say it works well if it’s taken within 48-72 hours of coming down with the flu. While it won’t cure you, it will shorten the course of the virus.
▪ If your symptoms get worse or if you are having difficulty breathing, go to the emergency department.

What to know:
▪ While we are very busy, if you come to TMC, we will care for you. No one will ever be refused care.
▪ If you come to TMC, thank you for being patient. We know your time is valuable and you would not be at TMC if you were feeling well.
▪ TMC’s emergency department strives to make your visit as timely and efficient as possible.
▪ Finally, if you haven’t received the flu vaccine, it’s not too late to protect yourself. You can make an appointment at TMC One, conveniently located on the TMC campus, 2424 N. Wyatt Drive, #100. Valet parking is available.

A miraculous recovery prompts Tucson stroke patient to give TMC staff a heartfelt thank you

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Tucson Medical Center clinical staff will tell you that simply helping people when perhaps they need it most is all the reward they need in their noble profession.  So when a patient comes back to say ‘thank you’ following an extraordinary recovery, it is instantly uplifting for them.

Sandy Goodsite recently came back to say ‘thank you,’ and hug the people who she credits with not only saving her life, but also giving her the quality of life she essentially had before April 22, 2014.

That’s when Goodsite, 72, suffered a significant stroke. She was rushed to TMC and received a clot-busting drug called tPA just 22 minutes after hitting the doors of the Emergency Department (ED), one of the fastest response times in the city.  You can read about her incredible ordeal here.

Goodsite is now about 95 percent recovered, as she continues speech and occupational therapies.  She and her husband, semi-retired pediatrician Dr. Ron Goodsite, felt compelled to come back and personally thank those who were working the day she was brought in via ambulance.  They were armed with thank you notes, addressed to every staff member who helped care for her.  As the Goodsites were ready to make their way to their first stop, they were greeted in the lobby by two members of the Neuro Red team, which responds to stroke victims.  “Talking to her, and seeing how well she’s doing reminds me why we do what we do,” said Shannon Bachman, RN.

The Goodsites headed inside TMC’s ED where staff was just as touched that Sandy is not only doing so well, but also took the time to come back.  “It is so fantastic that she came back because it’s typically very rare that we get to see a patient after they leave the ED,” said Heather Williams, ED clinical nurse lead.  Melissa Ritchey, director of TMC’s ED, echoed that sentiment.  “It reminds us why we come to work each day.  I’m so grateful that she came back to say thanks.  You only need to hear that one time to remember each and every time why we do what we do.”

Next stop: TMC’s Intensive Care Unit where Goodsite was greeted and immediately recognized by staff who hadn’t seen her since her two-day stay there in April.  “It’s so nice to see you up walking and talking!” said Jenny Tuttle, ICU clinical nurse lead.  “We always appreciate when people take the time to come back because we see them in a bed, in an acute setting.  It’s not very often we get to see the progress they’ve made, so it means a lot to us to see her doing so well,” she said.

On the neurological unit, clinical nurse lead Nancy Box said she was in awe.  “It’s so neat to see somebody come back and look so good because we rarely get to see the end result.  When they leave here, they typically have some sort of deficit, so it’s amazing to see Sandy talking and moving so well, and how her hard work during rehabilitation has paid off.”

The Goodsites are also catering a savory dinner for the three departments involved in Sandy’s care.  “We wanted to provide a little something for them – to do more than just say thank you,” she said.  But they realize that her incredible care started with the lightning fast response by Tucson Fire paramedics Bill Nielson and Robert Smith.  The Goodsites paid the boys in blue at station No. 7 a visit, and catered a dinner for the crew that was covered by the Arizona Daily Star and KGUN 9 On Your Side.

*Special thank you to TMC volunteer Mary Goeke who stayed late to accommodate the Goodsite’s visit.  Goeke helped transport the Goodsites from the different departments at TMC and said she felt honored to be a part of something so special.

TMC’s top emergency doc insists award is a team effort

Dr. Rich Rosenthal TMC Emergency Department medical director

Dr. Rich Rosenthal
TMC Emergency Department medical director

TMC’s Emergency Department medical director, Dr. Richard Rosenthal, was honored as Emergency Physician of the Year for 2014 from EmCare, the nation’s leading national practice management company. Dr. Rosenthal was awarded the Commitment to Care Award for emergency medicine, and was selected from more than 10,000 affiliated clinicians. He was selected because he embodies EmCare’s mission of making health care work better.

A press release issued by EmCare said Dr. Rosenthal received the award because of his commitment and implementation to lean methodologies, which helped guide TMC’s emergency and pediatric emergency departments to improved and sustained quality metrics.

“Awards are nice, and certainly appreciated,” said Dr. Rosenthal. “But it is our team here – the nurse managers, the pediatric emergency medical director, and a fantastic, dedicated administration that allows us to work together to improve the processes and improve the care we deliver.”

Dr. Rosenthal said his team continually works on improving the patient experience by decreasing wait times and the total amount of time a patient spends in TMC’s Emergency Department.

Some highlights of TMC’s Emergency Department improvements include:

▪ The wait time to see a physician decreased 48 percent down to an average of 37 minutes, according to data from July 2012 to December 2013.

▪ Patient satisfaction scores increased by more than 43 percent from July 2012 to March 2014.

▪ During the same time frame, more TMC Emergency Department patients reported they felt their physician cared about them as a person. TMC was ranked in the 99th percentile for this patient satisfaction question.

In TMC’s Pediatric Emergency Department:

▪ Patients are triaged an average of 13 minutes after they arrive.

▪ On average, children are consistently treated and released in less than two hours.

▪ Patient satisfaction scores have consistently run in the 80th to 90th percentile.

“While some major changes have been made in TMC’s Emergency and Pediatric Emergency departments, which have led to successful outcomes, we will continue to work on improving our service and increasing patient satisfaction,” Dr. Rosenthal said.

That dedication and commitment to improving care for the community is one of the reasons Dr. Rosenthal was selected as EmCare’s Emergency Physician of the Year.

“So many of our physician leaders do so much more than their physician job duties or their leadership job duties require. They help their communities; they help people outside of their communities. They offer outstanding patient care while improving operations for their organizations. We feel an obligation to recognize these outstanding clinicians in a grand way, in front of all of their peers,” said Dr. Dighton Packard, EmCare’s chief medical officer.

“We established an awards program to honor these physicians who really go above and beyond their job duties every day, while inspiring others to do the same,” said Todd Zimmerman, EmCare president and CEO.

Gary Brauchla’s great race

Gary & Kathie Brauchla

Gary & Kathie Brauchla

Before he died, Gary Brauchla always had it in the back of his mind that he wanted to run a 5k.

It took his death to make it happen.

His remarkable journey from death to the completion of his first 3.1-mile run began sometime around 3 a.m in the early morning of Sept. 29, 2012, when the home builder went into cardiac arrest as he slept in his rural home about 90 miles from Tucson.

Earlier that evening, he had complained of pain in his right shoulder, but shrugged it off since he had had chili for dinner and thought he might be experiencing indigestion.

Later, his wife, Kathie, was awoken by a loud snort, which she assumed then was snoring. In retrospect, it was probably her husband’s last gasp. She nudged him. Nothing. Nudged him again. Nothing. Pushed harder a third time. No response. “Then it all clicked together what was going on,” she recalled. “I flipped the light on and he was not breathing.”

A former surgical technician for 15 years, Kathie immediately started CPR, called 911 and sustained the chest compressions until help arrived. The wait was excruciating. The sound of the diesel engines of emergency vehicles never sounded so good. A defibrillator restored his heart rhythm.

Brauchla was flown by helicopter to Tucson Medical Center, where doctors induced a coma, put in some coronary stents to reopen blocked arteries and cooled his body temperature through therapeutic hypothermia in order to reduce the brain’s oxygen requirements and reduce the chance of brain injury.

He would remain in a coma for 2.5 weeks, while loved ones wondered about the degree of brain damage he may have sustained.

He was already unspeakably fortunate. According to the Centers for Disease Control and Prevention, approximately 300,000 people in the U.S. experience a cardiac arrest outside of a hospital setting. More than 92 percent of them die. But he would be more fortunate still. He fully recovered.AP2A0615

“By doing everything TMC did, I am still here physically and mentally,” Brauchla said.

Once he was strong enough, his cardiologist wrote a prescription for him to attend the cardiac rehabilitation program at Tucson Medical Center to rebuild his strength and heart. Even though it is a 90-mile drive from his home in Pearce, Arizona, he attends three days a week.

He’s taking advantage of the program’s nutritional training, watching his diet and making conscious choices about the fuel he gives his body. And he appreciates that experienced staff is monitoring his heartbeat, making sure he is exercising safely but also challenging his heart, under proper supervision.

And on June 1, at 68 years old, he ran his 5k, at the TMC-sponsored Meet Me Downtown 5k Night Run/Walk.

He finished middle of the pack. But he figures that’s pretty good for a guy who faced down death.

“I was given a gift of life,” Brauchla said, adding he has become an advocate of making sure rural areas have access to automatic electronic defibrillators and promoting CPR. “My wife, God bless her, saved my life.”

Brauchla also volunteers at TMC’s cardiac ward four times a month, calming the fears of new patients about what the future holds. “I have a pretty good story I can tell,” he says. “Heart attacks are not necessarily a death knell. You can heal yourself, but you have to take steps to do it.”


Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461