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The Emergency Department at Montrose Memorial Hospital is staffed 24 hours a day by Board Certified Emergency Medicine Physicians and registered nurses who are certified in Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS) and in Trauma Care.

MMH is the only Level III Trauma Center in this region. The difference between the previous Level IV Trauma designation and a Level III Trauma designation is significant.
Level III Centers must meet particular criteria, such as:

  • Board Certified Emergency physicians in the emergency department at all times
  • A general surgeon available within 20 minutes of a trauma notification, as well as orthopaedic surgeons

…and more. Our Level III quality assurance program is very extensive and a trauma committee oversees the care of every trauma patient that comes to our hospital.  As a Level III, we are also required to participate in injury prevention activities and community education to reduce the incidence of injuries.

If you have any questions, please feel free to contact our Emergency Department Nurse Manager at (970) 240-7178.

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For other uses, see. Sildenafil, sold as the brand name. Viagra among others, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension. 3, its effectiveness for treating sexual dysfunction in women has sildenafil generic cheap not been demonstrated. 3, common side effects include headaches and heartburn, as well as flushed skin. Caution is advised in those who have cardiovascular disease. Rare but serious side effects include prolonged erections, which can lead to damage to the penis, and sudden-onset hearing loss. Sildenafil should not be taken by people who take nitrates such as nitroglycerin (glycerin trinitrate as this may result in a severe and potentially fatal drop in blood pressure. 3, sildenafil acts by inhibiting cGMP-specific phosphodiesterase type sildenafil generic cheap 5 (phosphodiesterase 5, PDE5 an enzyme that promotes degradation of cGMP, which regulates blood flow in the penis. Pfizer scientists, andrew Bell, David Brown, and Nicholas Terrett originally discovered sildenafil as a treatment for various cardiovascular disorders. 4 5, since sildenafil generic cheap becoming available in 1998, sildenafil has been a common treatment for erectile dysfunction; its primary competitors are tadalafil (trade name Cialis) and vardenafil sildenafil generic cheap (Levitra). Contents Medical uses 50mg tablets of sildenafil Sexual dysfunction The primary indication of sildenafil is treatment of erectile dysfunction (inability to sustain a satisfactory erection to complete intercourse). Its use is now one of the standard treatments for erectile dysfunction, including for men with sildenafil vs viagra diabetes mellitus. 6 Antidepressant-associated sexual dysfunction Tentative evidence suggests that sildenafil may help men who experience antidepressant -induced erectile dysfunction. 7 Pulmonary hypertension While sildenafil improves some markers of disease in people with pulmonary arterial hypertension, it does sildenafil generic cheap not appear to affect the risk of death or serious side effects as of 2014. 8 Raynaud's phenomenon Sildenafil and other PDE5 inhibitors are used off-label to alleviate vasospasm and treat severe ischemia and ulcers in fingers and toes for people with secondary Raynaud's phenomenon ; 9 10 these drugs have moderate efficacy for reducing the frequency and duration. 9 As of 2016, their role more generally in Raynaud's was not clear. 10 Adverse effects In clinical trials, the most common adverse effects of sildenafil use included headache, flushing, indigestion, nasal congestion, and impaired vision, including photophobia and blurred vision. 2 Some sildenafil users have complained of seeing everything tinted blue ( cyanopsia ). 11 Some complained of blurriness and loss of peripheral vision. In July 2005, the FDA found that sildenafil could lead to vision impairment in rare cases 12 and a number of studies have linked sildenafil use with non-arteritic anterior ischemic optic neuropathy. 13 Rare but serious adverse effects found through postmarketing surveillance include prolonged erections, severe low blood pressure, myocardial infarction (heart attack ventricular arrhythmias, stroke, increased intraocular pressure, and sudden hearing loss. 2 In October 2007, the FDA announced that the labeling for all PDE5 inhibitors, including sildenafil, required a more prominent warning of the potential risk of sudden hearing loss. 14 Interactions Care should be exercised by people who are also taking protease inhibitors for the treatment of HIV infection. Protease inhibitors inhibit the metabolism of sildenafil, effectively multiplying the plasma levels of sildenafil, increasing the incidence and severity of side effects. Those using protease inhibitors are recommended to limit their use of sildenafil to no more than one 25 mg dose every 48 hours. 2 Other drugs that interfere with the metabolism of sildenafil include erythromycin and cimetidine, both of which can also lead to prolonged plasma half-life levels. The use of sildenafil and an 1 blocker (typically prescribed for hypertension or for urologic conditions, such as benign prostatic hypertrophy ) at the same time may lead to low blood pressure, but this effect does not occur if they are taken at least. 15 Contraindications Contraindications include: 2 :11 Concomitant use of nitric oxide donors, organic nitrites and nitrates, 16 such as: Concomitant use of soluble guanylyl cyclase stimulators, such as riociguat Known hypersensitivity to sildenafil Sildenafil should not be used if sexual activity is inadvisable due. 18 Sildenafil's trade name, Viagra, is widely recognized in popular culture, and the drug's association with treating erectile dysfunction has led to its recreational use. 19 The reasons behind such use include the belief that the drug increases libido, improves sexual performance, 19 or permanently increases penis size. 20 Studies on the effects of viagra when used recreationally are limited, but suggest it has little effect when used by those not suffering from erectile dysfunction. In one study, a 25-mg dose was shown to cause no significant change in erectile quality, but did reduce the postejaculatory refractory time. 21 This study also noted a significant placebo effect in the control group. 21 Unprescribed recreational use of sildenafil and other PDE5 inhibitors is noted as particularly high among users of illegal drugs. 22 Sildenafil is sometimes used to counteract the effects of other substances, often illicit. 19 Some users mix it with methylenedioxymethamphetamine ( mdma, ecstasy other stimulants, or opiates in an attempt to compensate for the common side effect of erectile dysfunction, a combination known as " sextasy "rockin' and rollin or "trail mix". 19 Mixing with amyl nitrite is particularly dangerous and potentially fatal. 19 Jet lag research The 2007 Ig Nobel Prize in Aviation went to Patricia. Plano, and Diego. Golombek of Universidad Nacional de Quilmes, Argentina, for their discovery that sildenafil helps treat jet lag recovery in hamsters. 23 24 Sports Professional athletes have been documented using sildenafil, believing the opening of their blood vessels will enrich their muscles. In turn, they believe it will enhance their performances.

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Dogsters managing editor, Vicky Walker, recently relayed a query from one of her friends: I just came from the doctor and pharmacy. At the pharmacy there was a lady waiting for her prescription to be filled. In her lap was a rather listless Collie mix dog. I felt such compassion for the dog, who looked so cute but sad. She told me that her dog has heart problems and was 14 years old. She was waiting for five Viagra pills, prescribed by her vet. She also said the dog was on two other people pills. Using, viagra to stimulate the dogs heart Ive never heard of that. The story of Viagra is sildenafil side effects in dogs one of Pfizer getting lucky. Its famous effect was discovered accidentally. In the 1990s, researchers at Pfizer synthesized and studied sildenafil as a potential treatment for high blood pressure and angina (a common and painful heart condition). In terms of these desired uses, the drug yielded limp results. However, during initial clinical trials, men taking the drug reported an uplifting side effect. The side effect stimulated Pfizer to take a hard look at the drug; it was determined that marketing the drug for the side effect could lead to firm profits. The company came up sildenafil side effects in dogs with one of the all-time best ever drug names one that evokes the concepts of virility, vitality, and the, um, gushing and flowing majesty of Niagara Falls, while not in and of itself sounding vulgar. Viagra was born, and it had sildenafil side effects in dogs a large and lasting impact on Pfizers bottom line. Although Viagra came up short in the treatment of angina or systemic hypertension, it turns out that it does have a potent impact on a relatively uncommon condition called pulmonary sildenafil side effects in dogs hypertension, read more t/product/viagra/. In fact, over the years I have had about a dozen patients who were diagnosed with the syndrome and therefore took the little blue pills. Most dogs on Viagra also require other cardiac medications, sildenafil side effects in dogs so its not uncommon for dogs to take a few other people medicines along with their Viagra. I have not yet had a client report any issues with Viagra causing its famous side effect in dogs. (Nor have the female canine companions of dogs on Viagra complained about being relentlessly pursued.) But, to be honest, I have gone out of my way not to ask about these matters. That sort of knowledge would be, plain and simple, too much information. However, there is one universality of Viagra use sildenafil side effects in dogs in dogs, and it is well demonstrated in the original query. Something about Viagra makes dog owners talkative. It seems that every person whose dog takes the medication tells their story to everyone at the pharmacy every time they go: The Viagra is for my dog. Honestly, its for the dog. Got a question for. Ask our vet in the comments below and you might be featured in an upcoming column. (Note that if you have an emergency situation, please see your own vet immediately!). Call, overview, therapeutic Class, vasodilator, Phosphodiesterase V Inhibitor (pedvi species. Dogs, Cats, and Horses, indications, pulmonary hypertension, fDA Status. Sildenadil (as Citrate)is commercially available as Viagra tablet, 20mg, 25mg, 50mg and100mg; and IV solution 10mg/12.5ml. Search for Available Dosage Forms, basic Information, sildenafil is a selective vasodilator that works by inhibiting the enzyme phosphodiesterase. This enzyme is found in relatively high concentrations in the lung and erectile penile tissue. Sildenafil preferentially relaxes the smooth muscle cells in the pulmonary vasculature, the corpus cavernosum, and other erectile tissue. Sildenafil is approved for use in human medicine under the trade name of Viagra. It is used for the treatment of pulmonary hypertension and erectile dysfunction in men. Its primary use in veterinary medicine is for the treatment of pulmonary hypertension in dogs and cats. It has been reported as a possible adjunctive treatment for exercise-induced pulmonary hemorrhage (eiph) in the horse. Sildenafil is used to treat moderate to severe pulmonary hypertension in dogs and cats.

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