Until recently most PAs worked in family practice medicine. However, between 1996 and 2008 the percentage of PAs working in this area decreased substantially from almost 40% to only 26%. The decrease is attributed to the move of PAs from family practice to emergency room practice as their presence in the emergency room became more accepted while patient use of emergency rooms went up during the same period by 32%.

Patients should always be aware who is treating them, and whatever diagnosis that is made should be verified with a staff physician.

Josyann Abisaab, MD is an emergency room physician practicing in the Columbia Presbyterian Medical Center in New York City.

Physician’s Assistants Help Cut Costs in the Emergency Room is a post from: Josyann Abisaab

Symptoms of a Heart Attack

Sometimes it’s necessary, and sometimes it’s not, but it is certainly true that almost all of us have been to the emergency at one time or another. Maybe it was a broken leg, or the fear of one. Perhaps it was a poisoning or a burn. Whatever it was, we are certainly glad for the existence and accessibility of the ER, and we all want them to run as efficiently as possible.

Unfortunately many times people just don’t know the difference between a good reason to go to the ER, and a “not such a good reason” to go. The more people can tell the difference, the better the emergency rooms can service their patients.

Here are the five most common reasons people go the ER, whether they are good reasons or not.

1.    Stomach pain, cramps, and spasms- Severe stomach pain can be frightening. It is no wonder that this is the most common reason for visits to the ER. Stomach pain can also pose a more serious danger than simple food poisoning, so this is a reasonable reason to visit the ER.

2.    Chest pain and related symptoms- Since chest pains can mean the possibility of having a heart attack most people rush to the ER if they have this symptom.

3.    Fevers are the third most common reason for trips to the ER, but on the first day of a fever this is almost always not necessary. There are many reasons for people to exhibit a fever, from too much stress or even bad weather. However fever can be a sign of danger if it is already the third day of a fever which has not returned to normal, or if the fever is very high.

4.    Cough-There are many reasons a person can develop a cough, but almost always the cough is harmless, meaning that it does not present a threat to life in and of itself. Although coughs should definitely be checked by a doctor, especially persistent coughs; there is almost never a reason to go to the ER to do this. Just make an appointment with your doctor. An exception is if the cough is combined with blood or other symptoms. Then off to the ER with you.

5.    Headache- Head pain can be quite severe, and if it is people will go to the ER to get quick relief. But if your headache is not a recurrent symptom, it is most likely just a plain headache. Another thing to note; doctors can not treat a headache fast. If the only symptom is the headache, the doctor will want to run some tests to determine what is wrong.

Dr. Josyann Abisaab is an emergency room physician at the New York Presbyterian Hospital.

Josyann Abisaab: The Most Common Reasons for Going to the ER is a post from: Josyann Abisaab

Although the underlying cause of asthma is unknown it often runs in families. What happens is that certain substances which the person with asthma is sensitive to, such as dust, smoke, or animal fur irritate the lining of the bronchial tubes causing the production of phlegm, which blocks the air passageway. The increased level of mucus (phlegm) makes breathing difficult, causing the main symptom of asthma.

View this video to learn a bit about how asthma is often treated and which inhaler is right for children.

Asthma in Children:Josyann Abisaab is a post from: Josyann Abisaab

Normal blood pressure readings are around 120/80. If you experience blood pressure where the systolic (first) number is at or above 180, or the diastolic (second) number is above 110, you should probably have it checked by a physician. If your instincts have a bad feeling about it, or its accompanied by any other symptoms, it is probably a good idea to go to the emergency room where a qualified emergency room doctor like Josyann Abisaab can check you and make a proper diagnosis.

When is High Blood Pressure an Emergency? is a post from: Josyann Abisaab

When a blood test is performed, the patient’s blood is placed into different colored tubes, each with a specific additive that relates to the test in question. A CBC (complete blood count) test uses a purple-top tube. The CBC measures the numbers of each of the three types of bloods cells: red blood cells, white blood cells, and platelets, in order to help diagnose specific illnesses and health conditions. A serum (the liquid/non-cellular part of the blood) test uses a tube with a red top, while a blue-top tube is used to test blood clotting.

ER Blood Tests: Dr. Josyann Abisaab is a post from: Josyann Abisaab

• 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

When to Visit the ER is a post from: Josyann Abisaab

Overall, the traumatic brain injury proportions doubled for boys and tripled for girls during this time, said senior study author Dr. Laura B. McKenzie.

Certainly, doctors like Josyann Abisaab, researchers and centers like the Brain Trauma Foundation encourage coaches, athletes and parents to understand what causes traumatic brain injuries and to recognize the signs of a possible concussion.

Traumatic Brain Injuries from Basketball Increasing: Dr. Josyann Abisaab is a post from: Josyann Abisaab

The most classic symptom of Lyme disease, and the one that most doctors like Dr. Josyann Abisaab, will ask you about is a rash.  The circular rash occurs at the site of the tick bite approximately 7-14 days after the initial bite. The rash actually resembles a bulls-eye.  Other symptoms are commonly flu-like symptoms including fever, muscle aches, chills, headache, fatigue and joint pains.

Unfortunately, when Lyme disease goes untreated, it can cause many problems including continued fever and fatigue, swollen glands, pink eye, aseptic meningitis, Bell’s palsy, arthritis and concentration problems.

If you live in an area where Lyme disease is more common, like in the Northeastern area of the United States, and you are exhibiting these types of symptoms, you should seek attention from a medical professional.

Learning about Lyme Disease: Dr. Josyann Abisaab is a post from: Josyann Abisaab

Advice on Small Children & Falls with Josyann Abisaab

Once your child is between 6 and 12 months old, make sure that all furniture is away from windows so that they can’t climb up on the furniture and fall out of the window. Put window guardrails on all second-story windows and above. Obviously, one of the most tragic things that emergency room doctors like Josyann Abisaab see is children who have fallen from windows in the home. Make sure to put safety gates at the top and bottom of each staircase.

Older Children & Falls Advice with Josyann Abisaab

Finally, for slightly older children, make sure to keep the stairways clear so that no one trips over toys, clothing and other items. Also place rubber pads under any loose rugs so that they don’t slide across the floor and cause accidents.

Josyann Abisaab on Protecting Your Children from Falls is a post from: Josyann Abisaab

Certainly, there are times when a child gets hurt badly enough that you know they need to go to the emergency rooms. There are other situations, however, that aren’t as clear cut.  During these times, you have five main options.

You can handle the problem at home.  Minor illnesses and cuts, some rashes, minor coughs, colds, bruises and the like can all be handed with over the counter treatments and love.  If you aren’t sure what your child needs, you can always call your primary care physician.  The doctor or nurse can help you to figure out what steps need to be taken.

You can always visit an urgent care center if you have a non-emergency at night or on the weekends.  You can usually have X-rays taken, have stitches done, and have care for minor injuries that require medical attention but that aren’t life threatening.

The last two actions are more extreme and they include visiting the ER where emergency room physicians like Josyann Abisaab will care for you, or calling 911.  Many serious conditions require a visit to the emergency room including head trauma, dehydration, meningitis, breathing issues and more.  Sometimes, you may feel that you need the help immediately and that you’ll need the help on the way to the hospital. In this situation, it’s best to call 911 and to get the care that you need immediately.

Josyann Abisaab on Children’s Health Care is a post from: Josyann Abisaab