Josyann Abisaab

Sometimes it can be a difficult decision whether or not to visit the emergency room. No matter what you do end up deciding, remember that it is always a good idea to get your primary care doctor involved, the sooner the better. When your primary care doctor is kept informed he will be your guide and help direct you to the care of a specialist as well as insuring that your own personal history is considered before treatment is given. Your primary care physician will also help you decide whether a trip to the ER is needed, or to an urgent care center, or if it is something that can wait until a regular appointment can be made.

Here are some guidelines to help decide what to do in different cases requiring a decision about the next step in treatment.

In the case of a child who is injured over the weekend who was already brought to the emergency room for treatment:

•    Contact your child’s pediatrician and tell him/her what the ER doctors said over the weekend. If your pediatrician agrees with the assessment, then have him make an appointment for you to see the specialist that the ER doctor recommended. It is very common to need a referral to see a specialist.

•    Make the appointment yourself if your pediatrician can’t get an appointment for you  soon enough. Call the specialist and tell him “My doctor (give his name) said that we need an appointment with you as soon possible.”

If you feel that you need a diagnosis of an illness or other similar situation urgently then it is best to proceed as follows:

•    Ask your doctor if he agrees with the urgency of the matter. If you don’t have a primary care physician, you can call a nurse’s hot-line. This is a good way to find out just how urgent it is. Just as you should not stay home if you have bronchitis, you should also not wait for hours at the emergency room for just a cold.

•    Before you leave for the ER, call a local urgent care center and find out how long the wait there is. Consider going to the urgent care center instead of the emergency room if the line there is not long. If it turns out the situation is a minor one, then you’ve saved yourself a trip to the ER, and if it is truly dire, then the urgent care referral will get you into to see an ER doctor sooner.

Josyann Abisaab is an emergency room doctor practicing medicine in New York City’s Presbyterian  Hospital.

People often make the mistake of going to the ER when their condition is not an emergency. Not only is this a waste of time and money, it also causes stress and unnecessary disorder in the emergency room. Doctors such as Dr. Josyann Abisaab recommend that you think objectively about the condition you encounter, before making that decision. Here is a general list of symptoms which may need to be dealt with in an ER:

• Loss of consciousness
• Poisoning
• Signs of a stroke such as numbness or sudden weakness in one side of the body such as in the face, an arm or a leg; sudden loss of vision, especially in one eye; loss of speech, trouble talking or understanding; sudden memory loss; unexplained dizziness or sudden falls
• Serious traumatic injury (to the head, for example)
• Instant, severe, inexplicable pain
• Bleeding which does not cease after ten minutes of direct pressure
• Signs of a heart attack such as a feeling of pressure, squeezing, fullness or tightness in the chest for over two minutes; burning or aching under the breast bone; chest pain accompanied by lightheadedness
• Sudden severe/ persistent vomiting

Certainly, emergency room doctors like Dr. Josyann Abisaab see children who have swallowed serious choking hazards. As a parent, it is very important to child-proof the house and to check each room for choking dangers. Make sure, when you purchase toys, that you only purchase items that are age-appropriate.

Obviously, if you have older children, this poses a problem. Keep toys with small parts far out of reach of small children and teach your older children about the dangers that their toys can pose to their small siblings.

One interesting idea is to purchase a parts tester which you can get at most toy stores for only a few dollars. These will test objects for you to see if they are small enough to pose a choking hazard.

When you enter a room, look around for choking hazards. Make sure you know CPR and that any caregivers that you hire or take your children to know CPR as well.