Emergency Care For You

Dear Patient: A Letter from Your Emergency Physician

I’m sorry I had to meet you tonight. I know that just by ending up in my ER, you’ve had a bad day, perhaps even the worst day of your life. Thank you for trusting me to share in that day.

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Your Summer Guide to Bug Bites & Skin Rashes

Summer is here, the sun is out, and so is our skin. It’s important to know when to treat at home, when to see a doctor, and keep in mind some basic prevention tips.

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Heat Stroke and Hot Cars

Since 2017, the total number of children in the US that died from heatstroke after being left in a car is 72. Most of these children are under 3 years of age.

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Why We Do What We Do: Love, Leadership and Gunga Din

You may wonder, with all that’s going on, how can these doctors have any feelings left for me? Or, into whose emotionally calloused hands am I entrusting my sprained ankle, my laceration, my life? We are here because the emergency department is where we want to be. This is where we have chosen to be.

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Not the Right Time for a Selfie: A Conversation about Hawaii and Volcano Safety

Hawaii is a beautiful place to live or visit. The eruption of Kilauea on the Big Island continues to raise questions about the safety and health of residents and visitors.

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A Day in the Life of a Female Resident

Residency is an important time in medical training, working toward independence yet still requiring supervision. I am the only female in my residency class and I have found that being a female resident in the Emergency Department can be difficult at times. But, the challenge has its rewards.

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Don’t Go to the Hospital Alone: The Impact of an Advocate in the ED

As a medical student many years ago, I remember caring for a 20-year old woman in the intensive care unit (ICU) with a very severe infection that resulted in her being on a ventilator for months. Let’s call her Jane. Her hospital course was complicated: re-infections, loss of digits, muscle wasting.

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When in Doubt, Sit Them Out: Recognizing Concussions in Children

According to the CDC, a concussion is a form of traumatic brain injury that results when there is a sizable hit that occurs to one’s head, face, neck or even body.

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Dry-Drowning Doesn't Exist

It seems once the weather warms up and pools open, there is an effort to scare parents with the threat of the modern day boogie-man, silent killer, stealing lives in the night, known as "dry-drowning." "Dry-drowning" doesn't exist. In fact, there has never been a documented case in medical literature of a completely asymptomatic person dying as the result of drowning at a later time.

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Stop the Bleed: Simple Steps to Save a Life

Bleeding is the leading cause of preventable trauma-related death in the United States. The key word here is PREVENTABLE. There are some simple steps that anyone can take to save a life.

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When - and when not - to call an ambulance

An ambulance provides transport to a hospital and enables emergency medical technicians (EMTs) to begin medical treatment on arrival, extending treatment through the ride to the medical center.

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Cold Weather Crisis: Spotting and Preventing Hypothermia

Bitter cold temperatures continue to strike nationwide this season. Overexposure to cold can be extremely dangerous, especially for people in regions less accustomed to harsh winter weather. It is important to know the signs of hypothermia and take steps to avoid an emergency.

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Prescription Safety and Pain Management: Lessons from San Diego

More than 90 precious lives are lost every day from prescription drug abuse and chances are that you know someone who has died or had their life immeasurably affected by this public health crisis.

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Flu FAQ: Spread the Word, Not the Germs

Flu season is rapidly descending upon us, let’s spread the word and not the germs. You can take steps to limit your exposure, prevent spreading or treat complications. Your biggest flu questions are answered here.

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When a Loved One Has Dementia

The holidays can be a tough time if you are caring for someone with dementia or Alzheimer’s.

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My Patient - The Shark Attack Victim

One mid-morning, a pick-up truck drove into our ambulance parking site and a young man in wet surfing pants ran into the ER shouting: "the shark took his whole lower leg off!!"

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That Thing You Ate – A Look at Food Poisoning

Many things can cause food poisoning, including: bacteria, viruses, toxins, parasites, etc.

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ER Doctor: It's Time to Bring Back Hugging – Everywhere

The need to be hugged and experience human contact is in the root of our DNA. It is the building block of our soul. It is as much a part of each of us as the air we breathe. We curl up and we die inside without it.

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Summer Can Sting: How to Stop Jellyfish and Stingrays from Ruining Your Beach Trip

“Stings” by jellyfish and stingrays are common during the summer months.

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No Ordinary Bath Salts: Dealing With The Nation’s Synthetic Drug Problem First-Hand

Synthetic drugs first appeared in the United States nearly 10 years ago.

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The Fading Light of a Time of Heroes

The medical student pulled up a chair and began to discuss her patient with me. She rattled off his stats 94 years old, surprisingly healthy, looks 80…couple bumps and bruises, better safe than sorry kind of stuff.

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Today’s Special: CPR with a Side of Fries? - How to Talk About End-of-Life Decisions

Physicians are not waiters. When talking about treatment plans with patients in the emergency department, we lay out our concerns, the pros and cons of different options, and why we recommend one over the other for the particular patient. We do not ask patients which antibiotic combination they would prefer.

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My Patient Mr. "J" — The Front Lines of America's Heroin Crisis

I was caring for a heroin patient a few months back. This person was comatose and barely breathing.

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What is holiday heart syndrome? Is it a real thing?

As the holiday season approaches, many of us may be tempted to overindulge in food and drink. But here's something you should know: increased alcohol consumption can trigger a heart rhythm disorder known as atrial fibrillation.

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Sickle Cell — What Is It?

I received the sad news last week that a colleague and a friend had died. A hard working, caring and thoughtful leader dedicated to helping people with sickle cell disease.

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The Forgotten Emergency: The Mental Healthcare Crisis

Emergency medicine is the only medical specialty to care for every patient regardless of complaint or insurance status. This includes tens of thousands of patients a year with mental health emergencies who have nowhere else to turn and who have arguably suffered the most.

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Sugar and Spice Is Not Always Nice

It was right around 2 am, and I was working an overnight shift in our busy downtown emergency department. Suddenly, the paramedics burst through the door with a young male patient in his twenties who was spitting, screaming, fighting and attempting to hit EMS providers.

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How to Keep Yourself and Your Family Safer Near Guns

With all that’s been going on lately in America, the dual issues of gun violence and gun safety are of paramount importance to concerned parents.

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How Can We Save Teens From Themselves When Behind The Wheel?

In January of this year, I got the dreaded text from my teenage son that he had wrecked my 12 year-old Jeep Liberty when he slid on ice into a fence during one of our infamous Atlanta ice storms.

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Coming to America... the Zika Virus

Since 2015, the Zika virus has progressed across the Americas and heightened concern over expansion and impact of this mosquito-borne illness.

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When Sunburn Requires Medical Attention

The days are longer, the trees are blooming and baseball season is in full swing. Outside spring and summer activities bring with them risks of skin damage, from sunburn in the short term to skin cancer in the long term.

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"Our Baby's Head Looks Funny" - Spotting Child Abuse

Child abuse is one of the most serious national health problems facing children in America.

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Why won't you give me antibiotics for my cold?

Occasionally someone will come to the emergency department with a request for an antibiotic shot or a prescription for antibiotics to treat their common cold.

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When Exercise Is Not So Healthy

I was sitting at home one day after a long shift in the emergency department when I received a call from a family member seeking medical advice. She had been doing a new kickboxing workout routine and was complaining of muscle soreness.

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What I wish every person knew when taking an elderly person to the emergency department

I was taking care of a very pleasant elderly woman, whose daughter had brought her in for evaluation of general weakness. We had completed a comprehensive examination, spoken with the patient’s primary care provider, and updated the family on the plan which included discharge and follow-up with her doctor the next day.

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What Appears To Be a Minor Symptom, May Actually Be Something Serious

Years ago, I cared for a young man who came to the emergency department for an unusual complaint: tingling hands and feet. This is a non-specific symptom that often does not have a serious cause.

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On The Front Lines – Emergency Departments and Mass Casualty Incidents

The most stressful day at our office would be a mass casualty incident, which is when the supply of patients far exceeds the staff, stuff and structure capability and capacity of the emergency department.

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"I'm Not a Doctor, But I Play One on TV" — Fact vs. Fiction in the ER

I explained to them that based on complete lack of breathing or heart beat upon EMS arrival, and that nothing had changed with 20 minutes of CPR, given his age and not knowing how long he was not breathing prior to EMS arrival, that there was no hope of any meaningful recovery. The patient’s daughter immediately jumped up and screamed, “get back in there and shock his heart…it always works on TV”.

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Vaccines: Can't Imagine Life Without Them

Can you name the top 5 infections that cause death in children less than five years of age in the world today?

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"It's All Fun and Games Until Someone Loses an Eye!"

Some of the phrases we learn in kindergarten still ring true as adults. One of my favorites is, “It’s all fun and games until someone loses an eye.”

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Snow and Ice Is Not Always Nice

The recent blizzard on the east coast showed once again just how dangerous snow and ice can be and how easy it is for injuries to occur.

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Carbon Monoxide — The Hidden Killer

Carbon monoxide poisoning occurs when carbon monoxide builds up in your bloodstream. When too much carbon monoxide is in the air, your body replaces the oxygen in your red blood cells with carbon monoxide. This can lead to serious tissue damage, or even death.

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When the Prescription Becomes the Problem

When you see a doctor for pain, you don’t expect the medicine he or she prescribes to become a problem, but unfortunately it can. These powerful pain medications can lead to misuse and abuse of prescription opioids. As an ER doc, I’ve seen this all too often.

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6 Ways This ER Doctor Keeps Flu-Free Every Year

Very little scares emergency physicians. Trauma? Strokes? Nope. Ebola protocols? Not that either. But a bad flu season? That's a whole different story. With 1.3 million emergency visits every year, 200,000 hospitalizations, and up to 49,000 deaths, a bad flu year is enough to scare even the most intrepid of us.

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Medicine Cabinet Clean-Out—What To Do With Those Old Prescription Drugs

If your medicine cabinet contains unused or expired medications you no longer use, it is critical that you dispose of them properly.

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Vampires Amongst Us, Even in the ER

It all started out seeming like a pretty routine visit. My patient was in her early 30’s and had come into the emergency department for weakness, but was in no distress. As I was talking with her about her symptoms she would flash the occasional smile. It was then that I noticed that she had fangs. Not the kind that some people naturally have from misaligned teeth, but she had really long, sharp canine teeth.

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That Time I Treated a Heart Attack

A 74-year-old man comes in to the emergency department complaining of chest pain. This was immediately after he played two hours of tennis on a warm spring morning day.

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Emergency Department Boarding - Like a Busy Restaurant with Too Few Tables

Emergency departments nationwide are open 24 hours a day, seven days a week ready to serve you in your moment of need. We do not send anyone away.Occasionally, large numbers of patients fill our emergency departments, taking all of the available beds in a hospital filled with sick and injured patients.

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Drunk Driving Is Personal To Me

Tragedies of all types find a way into emergency departments every day. Some of the hardest situations to understand are those tragedies that are easily preventable in the first place. Drunken driving injuries and deaths associated with drunk driving often strike emergency department workers especially hard because they are so tragic and senseless.

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My Patient, Mrs. Jones (Elderly Care in the ER)

A 90-year-old grandmother is lying alone in my emergency department, who we will call “Mrs. Jones.” She is a bit confused, unsure where she is or why she has been taken from her home. People are often hustled on to an ambulance and brought in for evaluation because of medical concerns.

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How Is Your Home Medical Kit Looking?

When is it a good time to build your basic first aid kit for your home? Right now! Many items needed for basic first aid can be found among or adapted from school supplies that are on sale this time of year.

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Lyme disease: More than a tick and bulls' eye rash

In Room 2 is a 50 year-old man who works as a lumberjack and is in the emergency department with a “bulls’ eye” rash on his arm that he says is probably from a tick bite. In the waiting room is a 10 year-old girl with a chief complaint of a tick bite.

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The Face of Heroin

Running into the ambulance bay, we find a patient slumped over and barely breathing in the passenger seat of a car. After transferring him to a stretcher, we rush him into the emergency department.

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Back to School, Back to the Doctor's Office

Most children dread the pediatrician's office as they know it as the place of painful shots. While kids prep their arms, thighs, and backsides for crucial health maintenance and protection, parents should read up on the importance of immunizations.

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From One Parent to Another -- Childproofing Lessons Learned Working in the ER

As a new mother, working in an emergency department made me want to go home and childproof every nook and cranny of our house. On a daily basis at work I care for children, most often toddlers, injured at home in various ways. I learned of all the potential household dangers and how to keep my children safe.

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The Sport of Staying Injury-Free

It was already a busy shift in my emergency department when I saw my next patient — an injured teenage boy, still in his football shoulder pads with his jersey cut open to expose a clearly broken wrist. As I cared for him, two more teammates came in – both with broken bones, each boy more exasperated than the last. Sensing a pattern, I silently wondered to myself what sort of gladiator football game were these boys playing?

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The Pressure Is On

I bet you haven’t actually thought about your blood pressure in quite a long time. I know I haven’t. But that does not mean we shouldn’t. The main reason we haven’t thought about it is likely because we don’t feel our blood pressure. We don’t feel bad when it is bad and we don’t feel good when it is good. And maybe that is the problem.

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When Severe Weather Becomes Your Emergency

While we often associate severe storms with southern states, thunderstorms and tornadoes can, and have, occurred in all fifty states. Falling trees, downed power lines, flooding, and the injuries associated with the cleanup afterward, are all dangers that can bring someone to the emergency department.

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What is a surprise balance bill for emergency room services?

Say you go to an ER that is in a hospital that your health insurance plan tells you is in the plan’s network. You expect that the physician services you receive in the ER will be covered under the “in-network” provisions of your plan. However, this may not always be the case.

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Dying To Be Pain Free

Drug abuse is not new. Opium, for example, and its derivatives have been used medically for thousands of years predating the Egyptians.

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An Ugly Side of Not Washing Your Hands: Hand-Foot-Mouth Disease

Summertime is a few months each year where the cold weather fades from memory. Time is spent outside enjoying all that the warm weather has to offer such as swimming, family gatherings and barbecues. Frequently, we are not as mindful of good hand hygiene as fewer among us are sick with those infections that are so prevalent during the winter months such as the flu.

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The 4th of July through My Eyes

For many — including me — the 4th of July is just about the best holiday for celebrating outdoors. Falling mid-summer, the patriotic celebrations often focus on leisure activities, family get-togethers often including outdoor barbecues and fireworks.

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Heatstroke: When "I'll just be a minute" is too long

Christine could not believe where she was — standing in my emergency room — holding her young son’s hand as he received intravenous fluids for the early signs of heat stroke.

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An ER Doc's Advice to Stay Safe This Summer

Summer is almost officially here. That means it’s time for fun in the sun. Here are a few tips to help keep your kids safe at the beach, in the water and on the road.

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Could I Be Having a Stroke?

Mable, usually a very active 75 year old woman, woke up feeling just fine. She went to the bathroom, spoke briefly with her husband as she dressed for the day, and then she went downstairs to have breakfast with her husband.

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Spring Injuries That Can Lead You To My Emergency Room

Falls are a common cause of injury. Many times, this happens to a person that does not frequently work at heights. This is seen in the spring with people that are trimming trees, cleaning gutters, and painting the house.

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7 Step Challenge

ACEP has created a video designed to give people who have accidentally fallen – especially our more vulnerable elderly population – easy steps to avoid falls. It’s called the “7 Step Fall Challenge.” It’s designed to help people fight falls.

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