Remarkable Patient Care
At the BerbeeWalsh Emergency Departments, we pride ourselves in continuously providing the highest quality of emergency care for our patients. Given Madison’s excellent access to primary care, our emergency departments (EDs) care for the highest acuity patients presenting along the full spectrum of illness and injury. Providing patient and family-centered care in every decision, we put our patients first by focusing on their unique medical and emotional needs. We are fortunate to work alongside an excellent team of skilled and compassionate nurses, techs, social workers, pharmacists, respiratory therapists, case managers and care coordinators who are similarly dedicated to providing the highest quality of care.
In effort to provide exemplary care, all clinical care is reviewed through our quality improvement programs. This includes a robust peer review process with monthly M&M conferences, as we strive to continually improve the care we provide.
The BerbeeWalsh Department of Emergency Medicine is proud of the care we provide our patients, and on behalf of the department, I encourage you to explore more.
Joshua Ross, MD
Executive Vice Chair
Where We Work: Clinical Sites & Services
The 505-bed University of Wisconsin Hospital is the flagship hospital for UW Health and home to a level 1 adult and pediatric trauma center. The hospital also includes a certified comprehensive stroke center and UW Carbone Cancer Center, a National Cancer Institute-designated center, and it launched the state's first Lupus Clinic in February 2018.
U.S. News & World Report ranked the University of Wisconsin Hospitals and Clinics No. 1 in the state in 2020, a record it's held since 2011.
Caring for approximately 60,000 patients annually, the BerbeeWalsh Emergency Department is an ACS-certified, Level 1 Adult and Pediatric Trauma and Burn Center. All adult and pediatric medical and surgical specialties are available 24/7. As part of our redesign and expansion in 2016, the ED increased to 41,000 square feet, including 58 state-of-the-art patient care areas, a 10-bed Clinical Decision Unit, and an 11-bed dedicated Pediatric ED (staffed by six PEM board-certified/eligible physicians, dedicated pediatric nurses, pediatric respiratory therapists, and 24/7 Child Life Specialists). We are also fortunate to have 24/7 pharmacists and social workers in our department.
Our ED redesign is not just about doubling our clinical footprint; our design incorporates innovative workflows to provide highly efficient care of our patients:
- CareSTART (Safe Timely Assessment and Rapid Treatment) is a physician-driven intake process that allows the EM physician rapidly to initiate care for our patients upon arrival.
- Our Clinical Decision Unit is designed for patients who require a longer stay than a typical emergency department visit, but do not require a hospital admission.
- Our Multipurpose Procedure Room is a new and innovative space that bridges the gap between the OR and the ED. Complex procedures requiring specialty consultation, where the patient traditionally had to wait for OR availability, can be safely accomplished in our ED while not hindering our ability to care for other patients.
UW Health at The American Center (TAC) opened in east Madison in August 2015 and has grown rapidly, seeing over 20,000 adults and children annually. Our faculty, residents and APPs working at TAC care for a diverse group of patients in a community setting.
Many of our faculty and residents also see patients at the William S. Middleton Memorial Veterans Hospital just next door to the University Hospital. The VA serves military veterans living in south-central Wisconsin and northwestern Illinois and ranked 9th out of 170 VA medical centers in the country in 2018. Faculty and residents also see patients at Beloit Memorial Hospital, a community hospital located between Madison and Chicago. The addition of these two hospitals yields a combined clinical volume of over 120,000 patients per year.
Our Prehospital division includes active EMS, critical care transport, and HEMS programs. Our four EMS board-certified/eligible faculty provide medical direction and education throughout Dane County. Our Med Flight program is unique as Emergency Medicine physicians are core members of the team, transporting critically ill and injured patients across a large catchment area. Our critical care transport services also includes the Children’s Hospital Emergency Transport Ambulance which provides specialized transport for pediatric patients.
Extracorporeal Life Support Service (ECMO)
Available at the BerbeeWalsh Emergency Department at University Hospital and UW Med Flight, extracorporeal membrane oxygenation (ECMO) is a method of life support that uses a cardiopulmonary bypass machine to temporarily assume the work of the heart and lungs in cases of extreme cardiac or respiratory failure. It is a life-saving option for patients who have not responded to other respiratory therapies.
The University of Wisconsin ECLS Center has been recognized a Gold Level Center for Excellence in Life Support by the Extracorporeal Life Support Organization (ELSO).
This award recognizes our:
Exceptional commitment to evidence-based processes and quality measures
Specialized equipment and supplies
Advanced education of all staff members
Ongoing clinical care and education
How ECMO Works
ECMO works by sending the patient’s blood through an artificial membrane that infuses oxygen, removes carbon dioxide, and monitors critical blood parameters, including venous oxygen saturation, hemoglobin, hematocrit, and arterial and venous blood temperature.
Our Extracorporeal Life Support (ECLS) Service offers veno-arterial life support for patients whose hearts are not adequately supporting circulation or who have suffered cardiac arrest. It is vital to ensure cardiopulmonary support as early as possible to prevent organ damage.
Using Extracorporeal Membrane Oxygenation (ECMO), blood is removed from the right atrium or a femoral vein and returned to the aorta or a femoral artery after oxygenation. Some of the blood bypasses the heart in a parallel circulatory system, thus relieving stress on the heart muscle.
When Is ECMO Used?
This form of ECMO treatment may be considered for a variety of critical illnesses, including:
- Septic shock
- Heart failure
- Peri-partum complications
Our First ECMO Patient
In March 2019, a 21 year-old man who fell into Lake Mendota became the first to use life-saving ECMO technology at University Hospital.
When paramedics arrived on-scene, the man was lying on the ice with his head in a crater, his head totally submerged in water. After he was dragged him from the ice, EMTs checked his vitals. He had no respiration or pulse. When he was hooked up to a monitor, they found that his heart was weak but still working. The EMS/paramedic team began chest compressions and contacted University Hospital's emergency department for guidance.
After arriving at the BerbeeWalsh Emergency Department, the ED attending and a thoracic surgeon activated the ECMO protocol that saved the young man's life; a protocol which had been tested in the emergency department for the first time less than 72 hours before the man's accident.
One year later in March 2020, UW Med Flight established its ECMO transport program capable of activating ECPR therapy via helicopter and ground ambulance.