Josyann Abisaab

Asthma, according to The American Academy of Allergy, Asthma and Immunology, affects nearly 34 million Americans.  Each year, over 200,000 emergency room visits are due to allergy attacks, as are 300 deaths.  Serious asthma attacks may warrant a visit to the emergency room where doctors like Dr. Josyann Abisaab will assess the situation and treat the patient accordingly.

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.

Lyme disease is an infection which is often misunderstood by parents and misidentified by the health community.  One of the reasons for the confusion is that Lyme disease manifests in many different ways in the body.  Another reason is that it varies so widely from state to state.

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.

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.

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.

One of the main reasons that children end up in the E.R. is because of falls. The more precautions you take in the home, the less likely it will be that you’ll experience a dangerous fall. For very small children, this means never leaving a child unattended on the bed, sofa or changing table.

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.

Children’s Health Care: Is it an Emergency?

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.

Chest Pains: A Leading Cause of Er Visits

According to AHRQ News and Numbers which is based on data in Emergency Department Visits for Adults in Community Hospitals from Selected States, 2005, chest pains are one of the leading reason that people visit the emergency room.  Chest pains that did not appear to be a heart attack upon examination accounted for 1.6 million visits in 23 states in 2005.

The top four reasons to visit the emergency room, as reported by this study were: sprains and strains (2.4 million visits), bruises and superficial injuries (2 million), abdominal pain (1.7 million), and then chest pains at 1.6 million.  In less than 5% of the cases, the patient was actually admitted to the hospital.

Five additional conditions that were seen a great deal by the emergency room were: back problems (1.4 million), leg and arm open wounds (1.3 million), headaches (1.2 million), nose and throat infections (1.1 million), and skin infections/urinary tract infections (1 million).

Dr. Josyann Abisaab was awarded a citation along with warm congratulations for 20 years of dedicated service in the field of medicine. The Dean of The Weill Cornell Medical College, Dean Gotto, is seen here at the awards ceremony which took place in November 2009, with Dr. Abisaab.

The more prepared you are before you have to visit the hospital, the more smoothly the experience should go when you actually have an emergency.  If you are elderly and living alone, there are a number of precautions that you should take before an emergency room visit is necessary.

Make sure that you know which emergency room you’ll want to go to.  Plan out how you will get there and have the phone numbers for your friends, your taxi service or your other ideas easily accessible and by the phone.

Going to the hospital for a visit isn’t a bad idea, particularly if you’ve never been to this particular hospital.  Find out when you are there where you check in, where you wait and how the system works.  Obviously, if you are brought in by an ambulance, this information won’t be relevant.  But, it’s certainly possible that you will be coming on your own with a driver who has brought you.

The question of when a visit to the emergency room is warranted and when to just go to the doctor or wait it out is sometimes a difficult one, especially with children. According to Elda Ramirez, PhD, RN, you should bring your child in after an injury if you feel at all uncomfortable. She believes in trusting the parents’ instincts about their children’s health.

“You know your kid, how they respond, how they behave. Better to be sent home from the ER than to have wished you had made the trip,” says Ramirez, an associate professor of clinical nursing for emergency nurse practitioners at The University of Texas School of Nursing at Houston.

The types of injuries or illnesses that can happen are many and each one must be assessed with care. These emergencies include, but are not limited to:

1.    Head injuries- any loss of consciousness, vomiting, sleepiness is a sign of a concussion and should be checked. Lacerations with head injuries indicate a hard impact and should also be attended to. But even without loss of consciousness, if your child just doesn’t seem to be “herself” could be a good enough reason for a visit to the emergency room.

2.    Bone and spine injuries- injuries of the spine, especially the neck should be examined by a doctor. Numbness, tingling or lingering pain is suspicious. Broken bones which are obvious, such as legs bent backwards or bones sticking up out through the skin not only require the emergency room, but transport there in an ambulance. If the tips of the fingers or toes or blue or whitish, this can indicate a break and needs immediate attention.

3.    Stomach ailments- don’t let a “mere stomach-ache” catch you off guard. Yes, usually it is just a tummy ache, but if there is severe vomiting or diarrhea in which fluids are not retained by the body, it is crucial that children or older people be seen within 24 hours. Dehydration can be life threatening, and can happen with lightning speed.

Josyann Abisaab is an Assistant Attending Physician at New York Presbyterian Hospital, where all these injuries and illnesses, and a lot more, are treated by her and the expert staff of doctors found there. The bottom line is to be cautious and alert to the signs of illness or serious injury, and respond responsibly and promptly.