Avoid the ER: Emergency room doctors offer helpful advice

by Symptom Advice on April 11, 2012

You can’t prevent every trip to the emergency room, but simple steps can keep you safe — or keep you alive when the worst happens.

Americans made more than 119 million visits to emergency rooms in 2006, according to the National Hospital Ambulatory Medical Care. among the most common causes cited by the Centers for Disease Control and Prevention are trauma, abdominal pain, chest pain, fever and acute upper respiratory infection.

To find out how to cope with those issues, we turned to experts.

To help you keep out of the ER, they say you should be getting ongoing care from a primary physician who may be able to catch small problems before they escalate. at the same time, they echo the position of the American College of Emergency Physicians: Don’t hesitate if you are experiencing bleeding you can’t stop, gaping wounds, breathing troubles, chest pain, extreme pain, vomiting that will not stop, extremely high fever or suicidal thoughts.

In addition, they note that the danger signs for children sometimes vary from those for adults; parents should consult with their pediatricians for symptoms that warrant an ER visit, such as any fever in a baby less than 3 months old.

When it comes to preventing and coping with the most common ER problems, here’s the advice we received from Dr. Matt Bush, Medical City Dallas Hospital’s Medical Director of Emergency Services; Dr. Ketan Trivedi, emergency department medical director at Methodist Mansfield Medical Center; and Dr. Halim Hennes, medical division director of pediatric emergency medicine at Children’s Medical Center.

Prevention: Use bike helmets, seat belts and motorcycle helmets when you ride. Watch children in grocery carts to make sure they don’t fall. be wary of sharp objects. Practice safety measures around swimming pools.

Before heading to the ER: Immobilize broken arms and legs with a straight object wrapped alongside the bone with a bandage. Create a sling for an arm with a large cloth pinned with a safety pin over the shoulder.

Put an ice pack on any area that is swelling. Stop bleeding with pressure. Apply gauze and wrap the bandage around the gauze. be aware that anyone taking blood thinners is at increased risk for excessive bleeding and should share that information with the ER staff. Know the signs of concussion and get checked out immediately if the person shows signs of headache, nausea, confusion or slurred speech after hitting his head.

Use CPR immediately on someone who doesn’t have a pulse. Each second without oxygen can cause permanent damage to the organs.

Prevention: Maintain a healthful lifestyle, and don’t be a weekend warrior who exercises inconsistently. see your family practitioner regularly and be aware of your stroke and heart attack risk. Sweating and shortness of breath are red flags for a serious problem.

Before heading to the ER: call 911 and go in an ambulance, where technicians can help if your condition worsens. Baby aspirin helps thin the blood, which can avoid clots in most cases but can make things worse if the problem is aortic dissection, or bleeding of the main artery from the heart.

Prevention: Make good food choices, because abdominal pain can be caused by indigestion. if it is, over-the-counter stomach medication may offer relief.

Pain can also be caused by food poisoning, appendicitis, diverticulitis, inflammation or colitis. Expectant mothers should ask about a possible ectopic pregnancy. if a head injury is involved, let the ER staff know immediately, as this could be a sign of a fatal blood clot.

Before heading to the ER: if you’re vomiting, stay hydrated. Drink a half-ounce of clear liquid every 15 minutes and continue as long as it stays down. take ibuprofen and aspirin for pain and fever as needed.

Respiratory diffi culty

Prevention: be aware of triggers for breathing problems — smoke or allergies — and avoid them if possible. People with asthma and chronic obstructive pulmonary disease, or COPD, are at the greatest risk for respiratory difficulty. if you have signs of bronchitis, see your family practitioner before it leads to pneumonia.

Before heading to the ER: People with breathing conditions should use an inhaler and go to the doctor immediately for treatment. Stay calm, as hyperventilation can aggravate the problem.

Prevention: Avoid germs by washing hands frequently and not sharing drinks or utensils. Cough into your sleeve rather than your hand. Use hand sanitizers. Check with your primary care physician to make sure you are up to date on vaccinations.

Before heading to the ER: Babies younger than 3 months, senior citizens, cancer patients undergoing chemotherapy, patients taking steroids and people with a weakened immune system should go to the hospital with any fever, says the American College of Emergency Physicians.

Danger signs for otherwise healthy people can be a fever of 104 degrees Fahrenheit or higher, a fever that lasts for more than four to five days, trouble breathing, a change in behavior, headache or neck stiffness. be alert to exposure to bacterial or viral infections if the person is not vaccinated or has been recently exposed to possible parasites or bacteria in the water.

Bacteria can cause potentially fatal infectious diseases if they get into cuts and wounds. Wash open or infected areas well with soap and water and apply antibiotic ointment and bandages. Bring fever down with acetaminophen or ibuprofen and stay hydrated.

Even ER doctors find themselves rushing to the hospital sometimes. Trivedi recalls being at a play with his wife and three children when the youngest, who was 2, started playing with his wife’s purse. “one minute she had a quarter in her hand and the next minute it disappeared,” he recalls. “I asked her, ‘Where is that quarter?’ and she pointed to her mouth.”

The American Academy of Family Physicians advises taking a child who has swallowed a battery or something sharp or metal like a coin to a doctor immediately. Even though most small objects will pass through the gut without causing problems, things can get stuck in a child’s windpipe that could prove dangerous even in the absence of obvious symptoms such as vomiting, gagging, drooling, not eating, stomach pain, coughing or wheezing.

Happily, the X-ray at the ER showed that the coin passed safely through his daughter’s system. But Trivedi doesn’t regret the trip.

“better safe than sorry,” he says.

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