Josyann Abisaab

The summer is certainly the hottest time of the year. Most people don’t want their children sitting inside all summer, but they need to be aware of the safety tips that can keep their children safe while exercising during the hottest months. Emergency room doctors like Dr. Josyann Abisaab treat children each summer for heat stroke and dehydration; and these situations can easily be avoided with a bit of preparation and knowledge.

If there is a high heat or humidity warning in your area, children should only participate in intense physical activities for 15 minutes or less. Before they participate in prolonged physical activities, children need to be well-hydrated.

During the first hour of exercise, children should then be given plenty of water to drink and they should continue drinking either water or a sports drink every 20 minutes for as long as they are exercising.

During strenuous activities in the heat, children should have on light-colored and lightweight clothing and should only be wearing one layer.

If children start to feel lightheaded, too hot, or fatigued, they should get to a cooler, shaded environment and should drink plenty of water or carbohydrate-electrolyte beverages.

These tips will help to reduce the number of visits to the E.R. where physicians like Josyann Abisaab treat heat-induced sicknesses each summer.

With the advent of summer the possibility of suffering from heat stroke increases. Over exertion in hot, humid weather when not staying properly hydrated can lead to heat stroke, which is a medical emergency.

Heat stroke is a kind of hyperthermia, when the body temperature becomes elevated. This happens when the body is not able to regulate its temperature properly, either because the cooling mechanism of evaporation of sweat is hampered, due to extreme heat and humidity causing the body temperature to rise dangerously, sometimes to as much as 106 degrees Fahrenheit.

Another contributing factor to heat stroke is dehydration, so it is important to drink plenty of fluids, especially water, when exercising or otherwise exerting yourself outside on hot, humid days.

Some signs and symptoms of heat stroke are:

• Nausea
• Vomiting
• Fatigue
• Dizziness
• Weakness
• Headache
• Muscle Cramps

Sometimes individuals can get heat stroke without warning and without showing signs in advance.

Other things to look for in someone who you suspect may have heat stroke:

• high body temperature
• the absence of sweating, with hot red or flushed dry skin
• rapid pulse
• difficulty breathing
• strange behavior
• hallucinations
• confusion
• agitation
• disorientation
• seizure
• coma

Heatstroke is a true medical emergency, and should be dealt with immediately. If you suspect someone is suffering from heatstroke do the following:

• Take steps to cool the victim: Take him into the shade, take off clothing, place cool or lukewarm water on the skin, you can use a garden hose to gently spray the victim, fan the sufferer to encourage evaporation, and place ice into the armpits and on the groin.
• Encourage the intake of cool liquids such as water or other drinks which do not contain caffeine or alcohol.
• Observe body temperature and continue the cooling steps until the temperature drops down to 101 or 102 Fahrenheit. (38.3 – 38.8 Celsius)
• Call 911 as soon as the heat stroke is detected. If they will be delayed they can help you with instructions for how to help the victim further.

Emergency room doctors such as Josyann Abisaab, MD see many victims of heat stroke all summer long. Keep cool, drink a lot, and you will hopefully be able to avoid such an emergency.

Next month, a conference will take place from November 11-13 in Beirut, Lebanon of The Lebanese Society of Emergency Medicine.  This 4^th annual conference, where Dr. Josyann Abisaab is on the Scientific and Organizational Committees, will include lectures and workshops about everything from Neuropsych and Trauma to Oncology, Cardiovascular Emergency, and even a Wilderness Medicine Track.

The conference is being co-sponsored by The Global Emergency Medicine Program at Weill Cornell Medical College/Division of Emergency Medicine, where Dr. Josyann Abisaab is a faculty member.  In addition to Dr. Abisaab, ten other faculty members from New York Presbyterian Hospital will participate in the conference in Lebanon.

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.

A new study published recently in Pediatrics highlights that more children and teenagers are suffering traumatic brain injuries while playing basketball.  Taking a ten year range from 1997 to 2007, researchers looked at visits to emergency rooms like the one where Dr. Josyann Abisaab works.  They found that, for people under the age of 20 treated for basketball related injuries, the number of traumatic brain injuries had shot up by 70%.

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.

In a fascinating new study by Dr. Janice Bell and others from the University of Washington, they found that babies and children up until age 4 who didn’t sleep enough at night were more likely to be obese five years later than were their better-rested peers.   Those children who slept for less than 10 hours a night were 80% more likely to be obese five years later.

Bell believes that this is actually the first large, nationally representative study that links lack of sleep with childhood obesity.  Their study, in addition, did not find any differences by ethnicity or social status, as have other similar studies in the past.

Pediatrician Dr. Jennifer Shu said, in response to the study results, that it “gives parents one more reason to prioritize healthy sleeping habits in their young children’s lives.”

Certainly, with obesity on the rise in America and E.R. doctors like Dr. Josyann Abisaab seeing many complications from obesity, this study may be a helpful first step.

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.