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

Emergency Room

Research has shown that more than half of all emergency room visits in the US are for non-emergencies. The trend to use the emergency room as if it were a doctor’s office is wasteful in several ways. First of all, it wastes money. The cost of seeing a doctor in the emergency room can be three times more than seeing a doctor in his office. Time is also wasted while the person who is ill waits his turn to be seen by a physician. Contrary to what many people seem to believe, patients are not seen on a ‘first come, first served’ basis. Not even close. An emergency room is designed to see the most critical patients first, and everyone that comes through the doors of the emergency room goes through ‘triage’, French for sorting. The less urgent the case, the longer patient will wait. According to statistics the average wait in an emergency room is about 2 hours.

Emergency room physicians like Josyann Abisaab urge people to only come to the emergency room if a real emergency arises which requires urgent care. Otherwise schedule an appointment with a primary care physician who will be glad to see you at a scheduled time and for a reasonable price.

Josyann Abisaab: Avoid Wasting Time and Money- Go to the Doctor, Not the ER is a post from: Josyann Abisaab

Strep throat is generally not an emergency and almost never requires a visit to the emergency room, but the development of a sudden and severe sore throat, especially in a young child, might drive a frantic parent to the emergency room anyway.

In most cases, even without treatment, strep throat will resolve on its own and go away within a few days. However, one of the dangers from step throat, aside from the pain, fever and lost time from work or school, is if it goes undiagnosed and/or untreated with antibiotics. Without antibiotics the infection can spread to other parts of the body, including the sinuses or the middle ear.

There is also a possibility that when the body’s immune system responds to the untreated strep it will attack healthy tissue which can cause rheumatic fever and some other illnesses. It has been shown that antibiotics given even nine days after the start of the infection will prevent rheumatic fever from developing.

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To that end, the British Royal Air Force has started its Trauma Inoculation Programme (TIP), in which RAF medics carry out a two-week placement at a hospital, receiving the ER training they need to be able to treat troops on the front lines. The results have been so successful that that the RAF hopes to put all of its trainee medics through similar training.

ER Doctors Train RAF Medics 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

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.

Avoiding the ER: Wrist Fractures is a post from: Josyann Abisaab

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.

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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.

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Once in the emergency room, there are a number of treatment techniques that doctors may use. These include:

1. A nebulizer machine with bronchodilators.  These work to relax muscles around the bronchial tissue to help with better breathing.
2. Iptratropium combined with nebulized albuterol is often used for acute asthma attacks in the E.R.  This helps to stop spasms of the muscles surrounding lung tissue.
3. An intravenous injection of corticosteroids may be given to reduce the inflammatory processes.
4. In severe situations, patients may be treated with an injection of adrenergic medications including epinephrine or terbutaline.

Oxygen may be administered through a breathing mask and a pulse oxymeter will most likely be placed on a finger or earlobe to evaluate blood oxygen concentration levels.  While the administration of oxygen won’t stop the attack, it will provide more oxygen to the blood and may help to prevent death.

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