What A Year Of Trauma Looked Like For The Emergency Department

Dr. Akash Mehta is an Emergency Medicine board-certified specialist, health and fitness consultant, and Concierge Medicine physician based out of Los Angeles. Dr. Mehta first studied at the Honors College at the University of Florida where he obtained a Bachelor of Science. Afterward, he began working as a microbiologist for a year. He decided to change careers and then entered the Touro College of Medicine in Manhattan. After finishing medical school, Dr. Mehta completed his Emergency Medicine residency at Mount Sinai Medical Center in Miami Beach. Then Dr. Mehta joined Kaiser Permanente as an Emergency Medicine attending physician in West Los Angeles. After some years of obtaining intricate knowledge of the healthcare system by working for such a conglomerate, he decided to branch on his own and create Nyla Health. He continues to work with various Emergency Medicine groups in and around Los Angeles, and most notably had extensive experience in the frontline during the COVID-19 pandemic. 

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Dr. Akash Mehta is an Emergency Medicine board-certified specialist who is dedicated to the diagnosis or treatment of unforeseen illnesses and injuries. Over the past year, he has seen a substantial number of patients who arrived at the emergency department (ED) with their own stories to tell. To review this year of trauma, Haute Beauty sat down with Dr. Mehta to discuss the main reasons patients walked through the ED doors. Here's what he had to say:

As you can imagine, in the emergency department (ED), I have to see whoever walks in or is brought in by helicopter or ambulance. 2020 was very atypical for everyone given the pandemic. In EDs across the country, if you weren’t in a peak of COVID-19 infection in your region, many areas had medical providers “twiddling their thumbs” at work because (rightfully) a large amount of the population was afraid of coming to a medical facility due to risk of infection. The peak of the COVID-19 pandemic in Los Angeles was around December 2020 - February 2021. Thus, 2021 started off in the middle of the most hectic portion of my career. The majority of patients arriving in the ED at that time had a COVID-19 infection, and I was attending the most cardiac arrests (when someone dies and they try to resuscitate their heart to bring them back) I ever had. (Most workdays I do not have anyone go into cardiac arrest. At that time, I was having 2-5 COVID-19 related cardiac arrests every 8 hour day.)

As COVID-19 infection rates regressed here in the spring of this year, there was a large bolus of patients from the general population, and I became extremely busy with issues that unfortunately were ignored due to fear of coming to an ED earlier during the pandemic. For instance, there were patients that had a heart attack or stroke and did not come promptly; they could now have a weakened heart or weakness from a stroke indefinitely.

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As the year progressed, it became a mix of mostly “routine ED complaints” and some COVID-19 cases. “Routine ED complaints” vary extremely, and despite working in emergency medicine, EDs in this country are often still used as primary care offices by those without access to medical care, and for those who feel as if they cannot wait for their appointments with their physicians. For example, I may see patients with acute vision loss or chest pain, but I will also see many patients with a knee pain for 3 years or intermittent “stomach pain” for 2 years. Although extremely busy with patients in general, in the early summer, I was seeing less than one COVID-19 case per day that I worked (at least that we suspected by symptoms and subsequently tested.) However, with the arrivals of the Delta and now Omicron variants, I am unfortunately seeing an increase in COVID-19 cases again, specifically as we trudge through December.

Just as a reminder, please get your COVID-19 vaccination and/or booster. There is clear statistical data that the unvaccinated are at a much higher risk of disability and death from COVID-19 than are the vaccinated. Every COVID-19 case I personally have admitted to the hospital this month (which means they have low oxygen or otherwise are very sick) have been in unvaccinated individuals. Just because some individuals who are vaccinated have gotten infected does not mean the vaccine does not work; it specifically helps to lower the severity of illness they will encounter from the virus, including the Delta and Omicron variants!