Before they changed the signs on the doors, before they released the balloons, before they left their jobs at the Baton Rouge General Mid City Emergency Room on Tuesday, the staff responded to one last emergency.

The Baton Rouge General Medical Center’s Mid City Emergency Room officially closed at 7 a.m. Tuesday but an EMS ambulance with its lights flashing and sirens blaring rushed up to the hospital at 7:05 a.m. It was a cardiac arrest patient.

The doctors and nurses had been told that they were to stop operating at 7 on the dot. But they could not turn the patient away.

“We do what we always do,” said emergency room nurse Shelia Gremillion. “We save lives.”

EMS spokesman Michael Chustz said they always bring cardiac arrest patients to the nearest ER. They picked up the patient from the Plank and Hooper road area at 6:54 a.m. and dropped him off at the ER at 7:06 a.m., he said.

Baton Rouge General would not comment on whether the patient lived or died once admitted to the hospital.

Before the ambulance came in, the hospital was dark and quiet in the early hours of Tuesday morning while the Emergency Room was still operating. But minutes after the clock struck 7, signs on the door were already being changed.

Workers used double-sided tape and glue to add blue signs on the brick walls of the former emergency room entrance. The blue signs are a warning for the public that say, “No ER services on this campus.”

New signs in white lettering on the once-automatic glass doors now read, “This is not an entrance. Please enter at main entrance on Florida Boulevard.”

As the signs were going up, a group of Baton Rouge General Mid City Emergency Room doctors, nurses and other workers rushed outside wearing T-shirts with the logo #midcitystrong on them.

The employees carried blue balloons and formed a circle.

“One, two, three, Mid City!” the hospital workers shouted as they let go of their balloons and watched them ascend. Then they all threw their arms around one another and formed a group hug.

Many posed for photos, showing off their T-shirts made just for the occasion. The front of the shirts featured a drawing of a red heart organ in place of the word “love” on the “I love Mid City ER” shirts.

They pulled out Silly String and doused each other to enjoy their last day of work together at Mid City ER.

Gremillion said the staff has been finding ways to commemorate their last day of work, like adding a wreath made of blown-up latex gloves, tourniquets and syringes to the ER’s doors. She has been working at the Mid City hospital for 12 years, but she starts work at the Baton Rouge General Bluebonnet Boulevard campus on Wednesday.

“It’s been like a roller coaster,” Gremillion said. “But we have jobs. It’s the people in this community that we’re worried about.”

She said the presence of an emergency room in the north Baton Rouge area is vital, and that she worries about people who have emergencies and will now have to travel across the city in heavy traffic to find a hospital.

It is an unavoidable fact that some distress calls will result in longer transports, because the absence of Mid City’s ER will increase the distance to an ER from many locations in the central area of the parish. The question is whether such changes will greatly alter or diminish emergency health care in the parish, particularly for residents in north Baton Rouge.

Hours after the ER closed its doors, paramedics continued to respond to emergencies but had to adjust to one fewer ER where they could deliver patients.

The ER’s closure meant that a handful of people who might normally have been taken to Baton Rouge General Medical Center’s Mid City campus went instead to other area hospitals. Several times on Tuesday morning, half of EMS’ ambulances were either en route or already at Our Lady of the Lake Regional Medical Center.

EMS typically has between 11 and 13 ambulances in action at any given time, plus some suburbans and SUVs for extra assistance.

As usual, a number of calls led first responders to areas around Mid City. A man overdosed at a clinic not too far from the General’s Mid City campus.

Chustz, the EMS spokesman, said the man likely would have been taken to Mid City in the past but he was taken to Our Lady of the Lake on Tuesday.

Paramedics also went to help a different man several blocks away, off Florida Boulevard, at about the same time. That man, too, likely would have ended up at Mid City in the past, Chustz said, but instead was transported to Baton Rouge General at Bluebonnet.

“We were sad to lose Earl K. Long,” Chustz said, referring to the north Baton Rouge state hospital’s April 2013 closure. “And this is a double-whammy for us.”

Other hospitals continued their daily routines despite the closure of the Baton Rouge General Mid City Emergency Room.

Lane Regional Medical Center’s emergency room in Zachary has had “a little more ambulance traffic but nothing of any significance,” said Randy Olson, chief executive officer of Lane Regional Medical Center in Zachary.

“We really can’t say it’s the patients who would normally go to Mid City,” Olson said in an late afternoon interview.

As of late Tuesday afternoon, there had been no increase in the number of patients treated in Our Lady of the Lake Regional Medical Center’s ER, either.

“It’s been a smooth day so far,” said Catherine Harrell, the Lake vice president of marketing and communications.

The Lake reported that the LSU Health MidCity Urgent Care clinic on North Foster continues to see about 40 patients per day since expanding hours last week. In addition, the North Urgent Care Center is seeing about 140 patients per day.

The two clinics have been expanded to provide health care services in the area and officials are encouraging people to use them to fill some of the void.

Chustz anticipates that the emergency room closure will lead to longer transport times on some occasions. EMS officials spent the past few weeks preparing for the change, Chustz said, trying to figure out ways to decrease the amount of time ambulances spend dropping off patients at hospitals.

Floyd Roberts, Baton Rouge General’s chief medical officer, said they have also been preparing for the transition for weeks now. But he said Tuesday was still busy and emotional. He noted the millions of patients and thousands of staffers who have walked through the ER’s doors — himself included.

“I’ve taken care of my share of patients in the emergency department and intensive care,” he said, noting his 34 years of work at the hospital. “I’ve worked shoulder to shoulder with this staff. What you come to appreciate is the way a team is necessary to take care of patients and the wonderful teamwork we have been able to establish.”

The Baton Rouge General Mid City hospital on Florida Boulevard opened in 1950 after being relocated from Government Street. On its first morning open, ambulances brought 19 patients to the emergency room.

The ER grew and expanded over the next several decades, adding a surgery room, X-ray facilities, a pediatric patient room and more. The department also added a split between its trauma side for accident and injury victims and its medical side for those with serious illnesses and heart attacks.

Roberts said he’s proud of the emergency department’s history, especially when the hospital became the region’s first to have all board-certified emergency department doctors in the 1980s. He also said around 300 doctors have been trained at Baton Rouge General as part of the hospital’s partnership with Louisiana State University for an emergency medicine training residency program.

The number of patients has also shot up over time, as the Mid City Emergency Room treated around 34,000 patients a year in 1981 and 56,000 patients in 2014.

The ER still had 12 patients on Tuesday morning, Baton Rouge General reported. They said the patients would continue to be treated until they were stable enough to be discharged or admitted to the hospital.

Baton Rouge General also reported a 10 percent drop off in ER volume at Mid City over the past several weeks.

Christiane Eisele, an emergency department physician, was the last doctor on shift for the Mid City ER on Tuesday. Her shift ended at 7 a.m. Tuesday morning and she’ll return to work at Baton Rouge General on Bluebonnet at 11 p.m. Tuesday night.

Mary Uter, a Baton Rouge General Mid City social worker, said she will remain at the Mid City location but is sad to lose the presence of the emergency room.

She has been there for 25 years and many of her co-workers have been at the hospital for decades. She said it is not uncommon for her to see four employees in an elevator and calculate 80 to 100 years of service between them.

“As a social worker, we work with our patients here on stages of grief,” Uter said. “It’s really true ... we’ve all been going through those stages.”

She said she and many co-workers have gone through the feelings of denial, anger, bargaining and depression. But the finale stage of grief is acceptance.

“I ain’t there,” she laughed. “I’m not there yet.”

Staff writer Marsha Shuler contributed to this report.