The Tourist’s Guide to
Emergency Medical Care in Las Vegas
by
Mike Barnum, MD FACEP
Emergency Physician
Las Vegas, Nevada
What do you do if you get sick while visiting Las Vegas, Nevada?
Getting sick or injured is always difficult. When it happens while you are in an unfamiliar city it can be terrifying. Las Vegas, Nevada calls itself the entertainment capital of the world and with more than 38 million visitors annually1 that’s not an exaggeration. While the glitz and gambling in Las Vegas are legendary to Sin City, it also serves as an important hub for outdoor enthusiasts of all types. Las Vegas is the portal to Red Rocks, the Grand Canyon, Zion, Mt. Charleston, Lake Mead, Death Valley and many other wilderness attractions. The mix of activities and tourists creates a medical environment that is unique.
The medical system in Las Vegas serves tourists as well as the almost two million people2 who live and work here. To provide for this diverse and fluctuating population there are 15 hospitals, networks of urgent cares and primary care clinics and various ambulance services. All of these facilities and services have different capabilities, alliances and destination preferences. It’s a very complicated system. Residents have difficulty navigating it and visitors can quickly get overwhelmed especially when they don’t feel well to begin with. This disorientation is often made worse by language or cultural barriers.
This article is intended to provide people who are planning a trip to Las Vegas with information about the medical system here so that you can plan ahead and make the best decisions if a medical problem arises. This information can not replace actual medical advice you get from a doctor. You should always call 911 or contact hotel security (who will call 911 for you) if you have a medical emergency.
Visitors From Other Countries
In the US healthcare is not provided by the government. Patients are expected to pay for medical care or have insurance. This can be a shock for patients who are from countries where healthcare is paid for by taxes such as Canada and the UK. Healthcare here is expensive. A visit to an Emergency Room (ER) will cost in the thousands of dollars (>$1000 USD). Hospitals will frequently ask for a deposit in cash or on a credit card of $5000 USD.
Another issue with healthcare in the US is that our legal system allows doctors to be sued easily by patients. Consequently American medicine has become very conservative and uses a lot of tests. We frequently admit patients to the hospital for 24
hours or longer for testing for problems such as chest pain, fainting or weakness. If you go to the ER for any of these problems you may be asked to stay in the hospital. You can refuse but you will have to sign yourself out and take liability for your decision (see the section on Refusing Care below).
There are two important things to know if you are visiting the US and need emergency healthcare:
First
US federal law requires that any person with a medical emergency gets the treatment they need whether they can pay for it or not. So if you have an emergency we will take care of it and we’ll figure out the money issues later. This law only applies to ERs, not urgent cares or doctors’ offices.
Second
I highly advise buying travel insurance for your trip. That will remove the stress of dealing with financial issues in addition to medical issues.
Hospitals in Las Vegas
There are 15 hospitals in the Las Vegas metro area representing several health systems. Here are the things that visitors need to know:
Geography
The two main tourist areas in Las Vegas are the Strip and Downtown. The Strip refers to the resort corridor on Las Vegas Blvd. south of Sahara Avenue and includes such properties as Bellagio, Caesars, MGM, City Center, The Stratosphere, Mandalay Bay and many others. Downtown refers to the properties surrounding Fremont Street including The California, The Golden Nugget, Binion’s and others.
The hospitals closest to the Strip include Sunrise Hospital, Desert Springs Hospital and Spring Valley Hospital. Hospitals closest to Downtown include University Medical Center (UMC), Valley Hospital and North Vista Hospital.
You can always ask your hotel or taxi driver which hospital is nearest.
Pediatric Hospitals
There are four pediatric hospitals in Las Vegas. the closest ones to the resort areas are UMC and Sunrise. The others are Summerlin Hospital which is in Summerlin north west of the main tourist areas and St. Rose Sienna to the south.
If you have a sick child I recommend seeking out a pediatric hospital. These facilities have dedicated pediatric ERs. The nurses there are often better at starting IVs and getting blood from kids which means fewer pokes and fewer tears. These facilities also admit pediatric patients. If you take your child to a non-pediatric facility and they require a hospitalization they will have to be transferred to a pediatric hospital.
Trauma Centers
Las Vegas has three trauma centers, UMC, Sunrise and St. Rose Sienna. As trauma patients (patients who have been severely injured) are usually transported by ambulance the paramedics make sure they get to the right places.
Stroke Centers/Chest Pain Centers
The majority of hospitals in Las Vegas are capable of treating strokes and heart attacks. However if you think you are having either of these problems you should call an ambulance and they will get you where you need to go.
VA Facilities
There are two VA affiliated hospitals in Las Vegas. Michael O’ Callaghan is a VA/Air Force facility that is on base at Nellis Air Force Base(http://www.lasvegas.va.gov/ facilities/mike_o_callaghan_federal_hospital.asp). There is also the new VA Southern Nevada Healthcare System Hospital (http://www.lasvegas.va.gov/index.asp). As of this writing the only Michael O’ Callaghan has an emergency room. Both VA hospitals accept ambulances only sporadically. So even if you ask an ambulance crew to take you to a VA facility it may not be possible for them to grant your request. The VA does not take transfers from other hospitals. If you are a VA patient with an emergency medical problem you will wind up at a non-VA hospital for the duration of your stay. The new VA hospital is set to open new services soon including an emergency room so this should change in the near future.
Psychiatric Facilities
Emergency psychiatric care is Las Vegas is a big problem. Psychiatric resources are scarce and the system has allowed itself to become dependent on the ERs. Patients with a psychiatric emergency are taken to emergency rooms and then held until a psychiatric evaluator can see them. If they are deemed to need psychiatric hospitalization they will be held in the ER until a bed open up. That can take days to weeks.
Urgent Care Clinics
There are urgent care clinics in Las Vegas that are available to care for minor problems. They are not bound by the law that says you will get care regardless of payment. So you must pay or have insurance. However they are much cheaper than going to an ER. Most urgent cares require around $200 for a visit. This may be less with insurance or more if you need more services like x-rays. Many of the urgent cares and do x-rays and administer IV fluids and medicines. Some even have access to CAT scanners and ultrasound machines. Some (for example Southwest Medical Associates) have clinics that are open 24 hours. If an urgent care clinic determines you have a more serious problem they will transfer you to a hospital ER. Ambulances will not take you to an urgent care rather than an ER.
Some of the urgent care clinic systems in Las Vegas are:
Southwest Medical Associates http://www.smalv.com
Healthcare Partners (formerly Fremont Medical) http://www.hcpnv.com
UMC Quick Care https://www.umcsn.com/Quick-Cares/Quick-Cares-Index.aspx? intMenuID=100&intPageID=112
Doctors’ Offices
Primary care in Las Vegas is stretched very thin. It is unlikely you will get an appointment with a doctor in a reasonable amount of time for an urgent problem. I would stick to the urgent cares or ERs. There are some services where a doctor will come to your room to see you. They can administer some medicines and write prescriptions. They are expensive but they are an option. Ask your hotel concierge who they recommend.
Ambulance Services
There are several ambulance services in Las Vegas. All of the fire departments operate ambulances and there are three private ambulance companies. Most medical emergencies get both a fire department and a private ambulance response. The paramedics assess the situation and decide who will transport the patient if necessary.
You are allowed to request transport to the hospital of your choice. The only reasons you can be denied are if you are unstable (so sick you must get to the nearest ER and fast) or if the hospital you want is closed to ambulance traffic (which is rare but does happen from time to time). If you don’t have a preference you can rely on your paramedics to get you to the right place.
Refusing Care or Leaving Against Medical Advice
Frequently people find themselves in a medical situation and they don’t want to do what their medical provider is recommending. For example you may feel ill and someone calls an ambulance for you. This happens a lot when people get sick in public areas. The ambulance will want to take you to an ER. You may not want to go. Another example would be if you are in an ER and the doctor recommends that you be admitted to the hospital for treatment which means you will be there for a few days. In general you have the right to refuse transport or treatment or to leave the hospital whenever you want. This gets much more complicated if you are impaired. If you are intoxicated or delirious or having a psychiatric emergency you can be held even against your will.
Medical Equipment
ERs and urgent cares can usually not arrange for medical equipment such as wheel chairs, oxygen, nebulizers, CPAP machines, etc. quickly. If you need these things arrange of them in advance or bring them with you. Many people fly in expecting that oxygen can be arranged at the airport or in the ER. They wind up spending days in the hospital waiting for paperwork and insurance issues to be resolved.
Dialysis
If you are a dialysis patient you must arrange your dialysis prior to coming to Las Vegas. If you arrive at a dialysis center without pre approved orders you will be sent to an ER. Most ERs won’t do it unless your lab work indicates you need it urgently and then there will be a wait for a dialysis nurse and the equipment. Often it takes 12 to 24 hours to actually get your dialysis done. That’s compared to the usual 3 to 4 hours if you set it up beforehand so plan ahead.
The Airlines
The airlines are a special problem in regard to medical issues. If you have a medical problem and the airline becomes aware of it (either because you got sick on a plane or in the airport or if you had to delay your departure) they will require you to have a letter from a doctor clearing you to fly. This letter represents a lot of legal risk for any doctor who signs it so they will want to make sure you have had enough testing to show you are safe. If your doctor recommends that you be admitted to a hospital for tests and you refuse the doctor can’t write you a clearance letter. This will result in you being trapped in Las Vegas. So if the airline is demanding a letter be prepared to either go along with your doctor’s recommendations or find another way to get home.
Specific Problems
Some specific problems generally require a stay in the hospital for fully evaluate. Chest pain, passing out (fainting), stroke symptoms and trouble breathing often result in a hospital stay. Most sprains and fractures (fractures and broken bones are the same thing) can be taken care of with splints and you can go home. For these you will need to see your doctor for follow up care once you get back. Hip fractures are a notable exception. If you break your hip in Las Vegas you will need to get your hip surgery to fix it here. That’s because hip fracture have to be fixed within a few days and they are too painful to travel with. Don’t worry. We have orthopedic surgeons who fix hips all the time.
Following Up at Home
Once you get home you will need to follow up with your regular doctor. If you don’t have one get one. The best thing to do is call your doctor the morning of the next business day even if you’re still in Las Vegas. Make an appointment to see them (or a specialist if you need one, ask your primary doctor who to go see) for after you get back. The reason for this is that you will have better luck getting in faster if you call a few days before you return rather than on the day you are hoping to get in.
You should also tell your doctor you were seen in the ER so they can request the records of you visit. If you had testing such as CAT scans or lab work you want your doctor to get these records for your file. The number for the hospital will be on your discharge paperwork. Your doctor will have you sign a release and then we will fax your results to them.
Intoxication
Many people over indulge in alcohol in Las Vegas. In the ERs here we see dozens of patients a day who are simply too drunk to take care of themselves. If you get so drunk that you pass out at a casino or on the sidewalk an ambulance will be called and you will be taken to an ER. You will have to stay there until you are sober enough to walk and talk normally. The ambulance and ER bills will wreck your vacation.
So if you drink know your limits. Don’t over do it and watch your friends and family to make sure they don’t over do it.
Dehydration
Remember that Las Vegas is in the desert. It is hot and dry. Alcohol and caffeine make you more dehydrated. To compensate for this you must drink water or you will feel sick. Too many people forget to hydrate, pass out and wind up in the ER. This will ruin your vacation. I recommend ordering a glass of water every time you order anything else, particularly drinks with caffeine or alcohol. Drink at least one glass of water for every other drink you have. Also you should pick up a few bottles of water from the hotel sundry store for your room. They tend to be ~$2 or $3 in the store and ~$10 if you drink the bottles placed in your room by the hotel. Las Vegas tap water tastes terrible so plan ahead.
So enjoy your trip to Las Vegas. Have fun and as far as emergency medical problems go you will be fine if you:
- Plan ahead for your health care needs
- Have medical or traveler’s insurance
- Enjoy in moderation
- Stay hydrated
1 - http://www.lvchamber.com/visiting-las-vegas
