The school year is starting, bringing with it many changes and new experiences for young children. Emergency care doctors like Dr. Josyann Abisaab know that this is a vital time to go over safety rules regarding transportation and play.
The National Safety Council recently released a back-to-school safety checklist for parents and family members:
- “Review your family’s walking safety rules: walk on the sidewalk, if one is available. When on a street with no sidewalk, walk facing the traffic. Before you cross the street, stop and look all ways to see if car are coming. Never dart out in front of a parked car.
- Practice walking to school with your child.
- Make sure your child always wears a helmet when leaving the house. (When riding a bike)
- Teach your children the rules of the road they need to know to ride their bicycles.
- Go to the bus stop with your child to teach them the proper way to get on and off the bus.
- Make sure your children stand six feet away from the curb.
- If your child and you need to cross the street in front of the bus, walk on the side of the road until you are at least 12 feet ahead of the bus. You always should be able to see the bus driver, and the bus driver always should be able to see you.”
No one wants to be in a position in which they have to go to the emergency room, but each year 135m+ Americans do end up making a visit. Given this large number, it is probably worth reading up on some tips on how to make it as smooth an experience as possible. The less anxious the patient and the individual taking them are when going to the ER, the better for everyone.
With this in mind, the American College of Emergency Physicians (ACEP) put together “ER 101,” on “What to Expect,” offering easy-to-understand tips for the situation. In addition, it makes it much easier for physicians like Dr. Josyann Abisaab – an ER doctor at the New York-Presbyterian Hospital – when dealing with their patients. The better prepared the patient’s escort is, the easier it is for them to receive adequate treatment.
According to the ACEP’s guidelines, it is a good idea to bring an overnight bag for patients who are older and frailer, since they have a greater chance of being admitted to the hospital. The patient should try to avoid food and drink before being assessed by a physician (unless there are extenuating circumstances such as diabetes). For children, a lot of ERs have a “Welcome to the Emergency Department,” coloring book facilitating the process. The ACEP’s guidelines also includes advice on: what to expect when one arrives; what information is useful to take along; where to get medical history forms; important questions to ask before leaving the ER and more.
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
- 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.