BronxCare Health System

Dr. Robert Favelukes, Chairman, Emergency Medicine, attending to ER patient.
Dr. Robert Favelukes, Chairman, Emergency Medicine, attending to ER patient.
Dr. Nelson Tieng, Vice Chair, Emergency Medicine (center), administering care to patient. He is assisted by Tashauna McQueen, RN, and Dr. Ryan Schlobach, Attending, Emergency Medicine.
Dr. Nelson Tieng, Vice Chair, Emergency Medicine (center), administering care to patient. He is assisted by Tashauna McQueen, RN, and Dr. Ryan Schlobach, Attending, Emergency Medicine.

Emergency Medicine

Successfully Responding to Crisis Situations

Under the leadership of Dr. Robert Favelukes, Chairman, Emergency Medicine, the Emergency Department has rebounded in volume post-COVID and continues to be one of the best and busiest in New York. “We are clearly meeting the needs of the community, providing high quality care to all patients,” stated Dr. Favelukes.

BronxCare’s ED continues to experience high patient volume as well as significant increases in the severity of illnesses treated, including more patients in the advanced stages of complicated conditions, such as heart disease, hypertension, asthma, sepsis, and diabetes. These patients often require extensive medical attention, transfer to the OR for surgical intervention, or admission. Frequently, such patients require continuing care in the Intensive Care Units or close monitoring and observation.

Tony Ramgahan, RN, Director, Emergency Nursing (center), in discussion with Thomas Osman, RN, and Najwa Khamashta, RN, Clinical Resource Manager.
Tony Ramgahan, RN, Director, Emergency Nursing (center), in discussion with Thomas Osman, RN, and Najwa Khamashta, RN, Clinical Resource Manager.

The nursing team, led by Tony Ramgahan, RN, Director, Emergency Nursing, is continuing to triage and identify sick patients. Critically ill and life-threatening conditions are immediately treated in BronxCare’s state-of-the-art code and trauma rooms. There, staff performs cardiac monitoring and pacing, defibrillation, intubation, and mechanical ventilation, as well as administers intravenous medications. BronxCare’s 911 designation as a Primary Stroke Center is helping patients suffering from a possible stroke obtain immediate care in the ER and receive vital medications. 

“Patients arriving at our Emergency Department are entering a place of safety, where the best possible care will be provided to them promptly and effectively,”

—Tony Ramgahan, Director, Emergency Nursing

As a New York State designated Heart Attack PCI (Percutaneous Coronary Intervention) Treatment Center, BronxCare’s ED is successfully responding to this most serious problem. The department utilizes cutting edge technology to treat heart attacks by opening blocked coronary arteries. This life-saving treatment is being performed by the Emergency Department in close collaboration with the Division of Cardiology.

Emergency Room ambulance entrance.
Emergency Room ambulance entrance.

As an accredited American College of Emergency Physicians (ACEP) Level 3 Geriatric Emergency Department, the ED and its staff are able to address the specific needs of the vulnerable and ever-increasing geriatric patient population. In the Pediatric area, the ER team treats all types of conditions in children. Families can take comfort in knowing that we are providing their children with superior emergency care. BronxCare receives ED cases through the New York City Fire Department’s 911 system and also operates six ambulances, including four basic life support and two advanced life support vehicles. These ambulances provide vital assistance to the community in emergency-related situations. “We have a strong working relationship with the FDNY and NYPD. They depend on us and have total confidence in our ability to respond to any kind of trauma or life-threatening emergency,” stated Dr. Daniel Lepp, Medical Director, EMS.

Staff members from the ER’s dedicated adult and pediatric teams are also addressing the high incidence of asthma in the Bronx with up-to-date medical care and follow-up referrals to BronxCare’s outpatient team. 

For those individuals or families with mental health emergencies, BronxCare’s Comprehensive Psychiatric Emergency Program (CPEP) is responding to the challenge. When necessary, its special Mobile Crisis team is stabilizing and resolving emotional crisis situations directly in the community.

The ED staff also works closely with the hospital’s centralized registration call center to expedite the patient referral process. When ER patients are discharged, appropriate follow-up plans, including referrals to BronxCare’s outpatient network, are made.

"As busy as the ER can become, the staff makes every effort to attend to the needs of our patients."

Dr. Nelson Tieng, Vice Chair, Emergency Medicine

ER patients have available to them the most advanced radiology services, including diagnostic films, sonography, CT scans, and magnetic resonance imaging. Consulting physicians from other specialty areas at BronxCare are also called in when necessary. Additionally, the ER is fully computerized, an important tool in monitoring and tracking patients throughout the course of their Emergency Department stay. The ED has also begun implementing artificial intelligence tools to help risk-stratify patients for potential deterioration in order to address this problem at an earlier stage.

In recent years, BronxCare has also expanded and repurposed areas in the ED to allow for increased flexibility in resources, enabling us to direct resources in real time to areas of need and provide more urgent care to the most critically ill patients.

“BronxCare’s Emergency Department will continue to support our community’s medical needs with high quality, patient-centered care by successfully responding to and treating all adult and pediatric conditions, as well as mental health problems.”

—Dr. Robert Favelukes, Chairman, Emergency Medicine

 

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