Perhaps somewhat frightening to hear, very year, Americans incur 6,000+ snakebites. The good news is that, according to The American Family Physician, fewer than 12 of these (0.25 percent) have fatalistic snake venom poisoning consequences. The issue however is that most people will not know the difference between a fatalistic bite and the less dangerous ones. That is why it is essential that if one is bitten, they follow a set of established guidelines.
First, if you’re outside, get inside as quick as possible (to the car). Limit use of the bitten area as much as possible. Then figure out how to get to the ER to get assessed and treated. Most Emergency Room physicians – such as Dr. Josyann Abisaab who works at the New York-Presbyterian Hospital – have encountered many snakebites and will be able to administer the correct course of treatment. Patients invariably do not; thus any suspicious snakebite needs to be assessed as soon as possible by those who are qualified.
No matter the time of year, there are many ways that children can get hurt and end up in the emergency room. One of these hazards involves the pushing lawn mower. While parents often want their children to have chores around the house, it’s important to think about which chores are appropriate for which ages.
Emergency room doctors like Dr. Josyann Abisaab see a surprising 17,000 children a year who require emergency room care because of lawn mower accidents – and certainly some of these are quite serious.
Page Geske of Safe Kids Magic Valley says, “kids under 12 shouldn’t be allowed to operate a pushing lawn mower and some of the recommendations are children shouldn’t drive a lawn mower, a riding lawn mower until age 16.” Many safety experts recommend that children under six shouldn’t even be outside when the law mower is being used, as it’s hard to keep a constant watch on kids and they can easily get their hands caught in the machine.
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.
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.
With Spring Break quickly approaching, it’s important to think about safety considerations for the family. The many ERs throughout the country, where doctors like Dr. Josyann Abisaab work, see frequent avoidable injuries and accidents at this time of year.
If you’re heading to the beach, make sure that all babies under six months of age are kept out of the direct sunlight. If the sun can’t be avoided completely, it is acceptable to apply a small amount of sunscreen to the baby. Whenever possible, dress babies in light weight clothing that covers their arms and legs and give them brimmed hats for protection.
Statistics show that most people that come to the emergency room are not in need of emergency care. Here are some things that you need to know so that you do not become part of this statistic.
• First of all, use good judgment. Become knowledgeable about the signs of serious illnesses which need immediate attention such as heart attacks and strokes, and trust your instincts.
• Call your family doctor and describe to him/her your symptoms. If your doctor feels it’s warranted, then he/she will recommend a trip to the emergency room. If the problem is not urgent enough for a trip to the emergency room, but nevertheless urgent, your doctor will make room in his schedule to see you. Also, a good primary care physician should ideally be available 24/7 or else he/she takes turns covering after-hours on-call responsibilities with other doctors. In other words there are alternatives to getting off-hour or last-minute care instead of going to the emergency room.
• Keep a booklet in your home which is easily accessible which describes the types of symptoms which need emergency room treatment.
Dr. Josyann Abisaab is an emergency room physician practicing in New York City at New York Presbyterian Hospital.
ER doctors such as Dr. Josyann Abisaab often encounter unpleasant, remarkably painful and slow-healing injuries. One of the most common is a wrist or elbow fracture. People occasionally lose their balance or are knocked over while participating in a physical activity like skiing or mountain biking. Instinctually, they put out a hand or two to break their fall. This can easily result in a major gash or fracture which could take weeks or even months to heal properly. Occasionally physical therapy is needed, too. Sometimes the hand goes behind the body to break a backwards fall, which can result in an elbow injury as well.
There are a few things that can be done in advance to prevent such injuries:
1. Train your instincts. Practice falling on a safer surface, and train yourself to react by tucking in your chin and rolling with the initial impact. If you can, try to fall on the back of your shoulder as this is a strong area of your body.
2. Practice regaining your balance in a quick manner. Use a bike, or think of other ways to flex your balance muscles.
3. It is important to wear a helmet and wrist guards. They may seem foolish, but they really can make a significant difference in a fall.
Halloween is approaching, and already people can feel the excitement as they choose their costumes, make plans with trick-or-treat companions, and select pumpkins for their jack-o lanterns. Everyone is anticipating this fun, candy-filled night. Many ER doctors such as Dr. Josyann Abisaab and others have seen Halloween accidents first-hand, and, while Halloween night is certainly an exciting experience, parents are encouraged to be aware of the possible accidents that can occur.
The careful behavior should begin at home; children should not be allowed to carve pumpkins on their own. Pumpkin carvers, adults as well, should make sure to use a carving knife instead of a regular kitchen knife, so that their movements can be smoother and more controlled, even while cutting through the pumpkin’s thick skin. Also, make sure the handle of the knife is dry before it is used, to avoid slipping. If a cut on a finger or hand does occur, raise the area above the heart and apply direct pressure to the wound with a clean cloth. If the bleeding persists, a visit to the ER might be necessary.
Most people feel more sick during the night than they do during the day. Unfortunately, this often means that your child’s fever spikes, or the cough worsens, during the hours when your doctor is usually not available. This means that more parents end up being seen in the E.R. by doctors like Dr. Josyann Abisaab. Some of the time, these E.R. visits, or frantic middle-of-the-night calls, could be avoided.
If your child has an allergy attack at night, an antihistamine should help to calm the symptoms. Keep one on hand, and ask your doctor for a recommendation about which one to have available. If your child has asthma, make sure to have a bronchodilator, a peak flow meter to watch your child’s breathing and preventative medicines like steroid medications around.
Take preventative steps as well to keep your child’s room allergy and asthma free. Close the child’s windows, ban animals from the room, put all bedding into an allergy-proof cover, install hardwood flooring and use HEPA filters in your vacuum.
Summer is a time when children have more time off and more time to explore and to enjoy. At the same time, emergency room doctors like Josyann Abisaab see a great deal of avoidable injuries in the summer. Keep these tips in mind as you enjoy your summer with your children.
Drowning is one of the leading causes of accidental death among young children. Children shouldn’t be left unattended while in a bath, pool, lake or other body of water and home swimming pools should be protected and securely locked.
Since people drive more during the summer, there is an increased rate of car accidents. Make sure that children are always buckled and that they are always in the age-appropriate car seats while traveling. Heat and dehydration also cause a great deal of E.R. visits. Never leave a child in the car and keep kids well hydrated during the summer.
During the summer, there are a number of “typical” accidents that emergency room physicians like Josyann Abisaab see repeatedly. Planning ahead and paying attention to these danger areas can help to limit your exposure to the E.R. this summer.
Outdoor grills cause a great deal of accidents during the warmer months. It’s important for the grill to be thoroughly cleaned before it is used and for all tubes leading into the burner to be checked before usage. Don’t use the grill in a closed area such as a garage, carport or porch, or near a surface that can catch fire.
Drowning is, unfortunately, a common issue during the summer months. Avoid alcohol when swimming or boating and wear a lifejacket if you are going onto a boat. Keep your eye on your children at all times around water and never let anyone that you know swim alone. Certainly, all children should be taught to swim when they are old enough to do so.
Did you know that vehicle crashes are the number one cause of unintentional injury-related deaths for children under 14? Most of these accidents actually occur close to home, often when parents don’t bother to buckle a child since they are only driving a short distance.
ER doctors such as Josyann Abisaab will advise that you absolutely never turn on the engine to the car until everyone is buckled in – no matter how short the trip will be. In addition, air bags can kill and seriously injure children and children under 12 should always ride in the back. This is particularly true if the car has a passenger-side air bag.
Similarly, it’s essential to know which car seats to use for your children, and to use them correctly. Children who are under one and weigh less than 20 pounds need to be in rear-facing seats. The seat can be turned around when the baby is one and weighs between 20 and 40 pounds. Once your child reaches 40 pounds, he can be in a booster seat, and should remain so until he is approximately 80 pounds.
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.