Josyann Abisaab on Tips for Emergency Room Visits

We all hope to never have to visit an emergency room, but if you ever do find that you need to visit it is better to come there prepared than not, so that your time there is as productive and pleasant as possible. We hope these tips will also make your visit as safe as possible and help save you money, too.

Prepare in advance a folder with all your medical information such as past doctor visits, tests you have taken, er signmedicine you use, allergies you may have, any vitamins or other nutritional supplements you may be taking, and all other relevant information that could help a doctor know about you and your state of health without having to discuss it with you. You may be in pain or be nervous, and you might forget to tell the doctor something, or not want to talk at all.

Find out from your health insurance company which hospitals your insurance will pay for and keep this list in a handy place so you don’t have to search for it when the emergency arises.

When you go to the ER be sure to bring with you the folder you prepared in advance, and come expecting to have to wait. Many emergency rooms are extremely busy places. The ER at New York Presbyterian Hospital where Josyann Abisaab is on staff is one of the country’s busiest and best. Although you can expect excellent care in such a place, you may have to wait for it. Therefore it is a good idea to come prepared for such an eventuality with comfort items like  water, hand sanitizer, coins for vending machines and pay phones (if you don’t have a cell phone), tissues, snacks, something to read.

Josyann Abisaab on Ear Infections in the Emergency Room

There are many reasons people visit emergency rooms- such as the ER at New York Presbyterian Hospital where Josyann Abisaab is an emergency room physician. Often young children are brought in due to fever, pain, runny nose, which could very likely be caused by an ear infection, also called acute otitis media. This illness happens to be the most common reason doctors prescribe antibiotics for children in the United States. It is estimated that more than 15 million prescriptions for antibiotics are written each year to treat ear infections at a cost of millions of dollars.

About two thirds of cases of AOM are caused by bacteria, with the remaining due to viral infection. AOM is an illness that affects mostly young children, with very few cases in children over five years old. According to an article published in the American College of Emergency Physicians’ Newsletter, if AOM goes untreated, 80% of the cases will resolve on their own, with no medical intervention needed.

ear infection checkTherefore it is relevant to ask the question if it is good medical practice to prescribe antibiotics every time a child presents with a runny nose, a slight fever and a tympanic membrane only slightly erythematous. Of increasing concern is the growing worldwide problem that overprescribing of antibiotics has led to an increase in the prevalence of antibiotic-resistant bacteria, making many illnesses that used to be easily treatable more dangerous, and even deadly in some cases.

In the Netherlands physicians have been treating AOM with a different strategy for the past 20 years. Instead of immediately prescribing antibiotics to children with AOM, they instead treat the symptoms of pain and fever with analgesics and antipyretics such as ibuprofen or acetaminophen and observe the patient for 2-3 days. Only in the few cases in which the child does not improve or gets worse during those 2-3 days, are antibiotics prescribed.

Due to this practice the number of patients prescribed antibiotics is much reduced, amounting to only 31% of the cases and the occurrence of the resistant strain of S. pneumonia is only 1%. This is an important achievement and worth emulating in the United States.

About Dr. Abisaab

Doctor Josyann Abisaab Dr. Josyann Abisaab is an Assistant Attending Physician at New York Presbyterian Hospital in New York City. In addition, she is an Assistant Professor of Clinical Medicine in the Department of Internal Medicine at Weill Cornell Medical College in New York City.  She has held both of these positions since 1992.

Educated at the American University of Beirut in Lebanon where she received a Bachelor’s of Science Degree, Dr. Abisaab went on to complete her medical degree at the University of Rochester School of Medicine.  Her numerous academic honors included receiving the Janet H. Glasgow Memorial Achievement Citation and being part of the Alpha Omega Alpha Honor Society.

She is board certified by the American Board of Internal Medicine, the American Board of Emergency Medicine and by the State of New York. She is affiliated with the American College of Emergency Physicians (ACEP), the American Medical Association (AMA), and the American Board of Emergency Medicine (ABEM).

Dr. Abisaab, along with N. Nevadunsky and N. Flomenbaum, published an article which appeared in the November, 2004 issue of the Annals of Emergency Medicine: “Emergency department presentation of bilateral carotid artery dissections in a postpartum patient”.