Avoiding Heat Related Illnesses

The hot summer temperatures across the country are causing heat related illnesses.  Patients are visiting their doctors, urgent care centers and emergency rooms with symptoms related to the heat.   Here is information  shared on WJXX/WTLV-TV First Coast Action News during the evening news segment  8/9/2013 for the story “Avoiding Heat Related Illnesses”.

Question: “What are the main things people need to know about heat safety?”

Under normal conditions, the body adjusts to the heat.  Sometimes not so well if exposed to high temperatures, heavy sweating or not drinking enough fluid.  There are 3 levels of heat illnesses  people should know about.

  • Heat cramps –  Painful cramps usually in the calves, thighs or abdominal areas.
  • Heat exhaustion – May experience headache, weakness, cold, nausea, vomiting, feeling faint and temperature may go up to 104 degrees.
  • Heat stroke – May experience confusion, stop sweating and temperature over 104 degrees.  This is life threatening and the person needs medical attention immediately.

One of the keys to preventing heat illness is to avoid dehydration by drinking plenty of  fluids.  On a normal day, for most people it is recommended to drink 8 glasses of fluid such as water, fruit or vegetable juice.  There are about 2 glasses work in a typical 16.9 ounce water bottle so that would be about 4 bottles a day.  On a day with higher temperatures, when exercising or working outdoors in the heat, experts recommend drinking 24 ounces – about 1 1/2 water bottle equivalent- two hours before exercise, another 8 ounces (1/2 bottle) before and then 8 ounces every 20 minutes during exercise – regardless if feeling thirsty.

Question: ” Soon kids will be back playing after school sports… what do parents need to know?”

Parents can help their kids by educating them on how to avoid dehydration.  It may take some time for the child to acclimate to the heat.  It  is  important to encourage plenty of  fluids before, during and after practice.  Teach how to hydrate properly and what the signs and symptoms are of dehydration.  The symptoms can include thirst, dry mouth, feeling tired, headache, cramps and dizziness.  Parents should also encourage children not to be embarrassed to let their coach or other  adult know that they need to get something to drink or are not feeling well.

Sources: http://www.mayoclinic.com/health/dehydration/SM00037  http://firstaid.webmd.com/understanding-heat-related-illness-basics

When To Go To The Emergency Room or Urgent Care

When to go to the emergency room or the urgent care can save precious time and money.  Emergency rooms have access to the equipment and are staffed for life threatening emergencies such as chest pain, severe trauma, shock and head injuries.  Urgent care centers are an excellent option for conditions such as minor injuries, fractures, mile asthma or rashes.  If an urgent care is unable to handle the acuity of a condition, they will direct to the nearest emergency facility.

Having a plan ahead of time can help.  Know where the nearest emergency facility is and how to get there.  Doing some research on an urgent care ahead of time can help before illness or injury strikes.  Become familiar with the services that are offered, if it is staffed with physicians or mid-level providers, what are the hours of operation and what type of equipment is available.  Bookmark the website, keep the phone number handy and know where it is located.  Maybe a visit ahead of time to meet the staff and see how it operates can help in feeling comfortable in what to do in certain situations.

The National Association for Ambulatory Care provides the following information about emergency rooms and urgent care centers in their article, “Where do I go? The Emergency Room? Or an Urgent Care Center?”

When you have a life-threatening situation, such as chest pain, or a sudden and severe pain, the emergency department of the nearest hospital is the only option.  If you went to an urgent care clinic, they’d just send you on to the ER in an ambulance.  But if your condition is less serious, but still requires immediate attention, choosing an urgent care facility can save you loads of time and money, as well as keeping the emergency room free to handle more serious situations.

If you have a sprained ankle, or an ear infection, you may end up waiting for many hours in the emergency room and paying hundreds of dollars.  Most urgent care centers are open for extended hours, and will be able to accomodate you more quickly.

When you need to go to the Emergency Room:
If you have a serious condition – stroke, heart attack, severe bleeding, head injury or other major trauma – go straight to the nearest ER. Don’t take a chance with anything life-threatening. The ER is the best place for these and other critical conditions, including:

  • Chest pain
  • Difficulty breathing
  • Severe bleeding or head trauma
  • Loss of consciousness
  • Sudden loss of vision or blurred vision

When an Urgent Care Center can better meet your needs:

  • Minor burns or injuries
  • Sprains and strains
  • Coughs, colds, and sore throats
  • Ear infections
  • Allergic reactions (non life-threatening)
  • Fever or flu-like symptoms
  • Rash or other skin irritations
  • Mild asthma
  • Animal bites
  • Broken Bones

And when in doubt, call ahead.  If the urgent care clinic in question can’t accomodate your condition, they will advise you to go the nearest emergency facility.

Remember, urgent care clinics are also a resource for flu shots,  and physicals for sports or school.

Source: http://www.urgentcare.org/UrgentCareDefined/ERvsUrgentCare/tabid/253/Default.aspx

How To Treat Bee and Wasp Stings

 By: Ellen Sullivan
                                                                                                                   Image
A fun summertime day or plans to get that yard work done can quickly fade away when a bee or wasp shows up on the scene and someone gets stung!Most stings from bees or wasps typically don’t require medical attention although may cause discomfort. However, there are times when a person who has been stung does need medical attention and sometimes immediate action to help prevent shock or in some cases death. When in doubt call a healthcare provider, visit an urgent care center, or go to the nearest emergency room or call 911.

Here is what medical experts such as WebMD suggest to do following a sting:

Remove the Stinger  – Scrape the area with a fingernail or use tweezers to remove it. Don’t pinch the stinger — that can inject more venom.

 Control Swelling. -Ice the area. If you were stung on your arm or leg, elevate it. Remove any tight-fitting jewelry from the area of the sting. As it swells, rings or bracelets might become hard to get off.

Treat Symptoms– For pain, take an over-the-counter painkiller like acetaminophen or ibuprofen. Do not give aspirin to anyone under age 18.

For itchiness, take an antihistamine. You can also apply a mixture of baking soda and water or calamine lotion.

Follow-Up – It might take 2-5 days for the area to heal. Keep it clean to prevent infection

Experts at eMedicineHealth.com indicate that medical problems from bee and wasp stings are broadly broken down into two categories:

Local reactions (only the part of the body near the sting is affected)

  • Immediate pain, redness, swelling, and itching at the sting site may occur.
  •  A large (greater than four inches across) local reaction may develop over the next 12-36 hours.
  •  A bacterial skin infection, although uncommon, may also begin during the first 12-36 hours (or even after the first few days).
  •  These may cause an enlarging area of redness at the sting site. It may be difficult to tell a local skin reaction and a local bacterial skin infection apart.

Systemic or allergic reactions (parts of the body away from the sting are affected)

  • Hives (raised itchy bumps on the skin) and itching all over the body
  •  Swelling of the mouth or throat or both
  • Wheezing
  •  Shortness of breath or other difficulty breathing
  •  Nausea
  •  Vomiting
  •  Anxiety
  •  Chest pain
  •  In severe cases, marked difficulty breathing, unconsciousness, and even death may occur.

Call 911 immediately if the person has:

  •  Trouble breathing
  •  Feelings of faintness or dizziness
  •  Hives
  •  A swollen tongue
  •  A history of severe allergy reaction to insect stings

WebMD outlines these steps if the person has if the person does have severe allergy symptoms (anaphylaxis):

 Call 911

  •  Seek emergency care if the person has these symptoms or a history of severe allergic reactions (anaphylaxis), even if there are no symptoms:
  •  Difficulty breathing or wheezing
  •  Tightness in the throat or a feeling that the airways are closing
  •  Hoarseness or trouble speaking
  •  Nausea, abdominal pain, or vomiting
  •  Fast heartbeat or pulse
  •  Skin that itches, tingles, swells, or turns red
  •  Anxiety or dizziness
  •  Loss of consciousness

 Inject Epinephrine Immediately – If the person has an anaphylaxis action plan from a doctor for injecting epinephrine and other emergency measures, follow it. Otherwise, if the person carries an epinephrine shot or one is available:

  •  Inject epinephrine if the person is unable to.
  •  If the person has a history of anaphylaxis, don’t wait for signs of a severe reaction to inject epinephrine.
  •  Read and follow patient instructions carefully.
  •  Inject epinephrine into outer muscle of the thigh. Avoid injecting into a vein or buttock muscles.
  •  Do not inject medicine into hands or feet, which can cause tissue damage. If this happens, notify emergency room staff.
  •  The person may need more than one injection if there’s no improvement after the first. For an adult, inject again after 10 to 20 minutes. For a child, inject again after 5 to 30 minutes.

 Do CPR if the Person Stops Breathing

  •  For a child, start CPR for children
  •  For an adult, start adult CPR.

 Follow Up

  •  Make sure that someone stays with the person for 24 hours after anaphylaxis in case of another attack.
  •  Report the reaction to the person’s doctor.

Sources:

http://firstaid.webmd.com/allergy-insect-sting-treatment

http://www.emedicinehealth.com/bee_and_wasp_stings/article_em.htm#bee_and_wasp_stings_overview

Photo: Credited to: http://www.public-domain-image.com

http://www.doctorsexpressjacksonville.com/urgentcare-jacksonville/blogdetailspage/How-to-treat-bee-and-wasp-stings

When Was Your Last Tetanus Booster?

by: Ellen Sullivan
Do you know when you had your last tetanus booster? Has it been 10 years since your last one? Many of us don’t think about it until we get a cut or a wound and then we wonder if we need one. If you did write it down, now may be a good time to go back and see when you are due for another. By the way, men under age 59 are three times more likely than women to get tetanus because they have not had booster shots.

 What is tetanus and how do you get it? Well, it is a potentially fatal disease caused by bacteria found in dirt, dust and soil. The bacterial live all over the world and the disease can occur in both humans and animals. Tetanus is the only vaccine-preventable disease that is not contagious. You can’t catch Tetanus from someone else. It happens when dust or dirt comes in contact with an open wound  that can be from a from a pinprick to a deep wound. Some of the typical wounds that lead to Tetanus infections are cuts, scrapes, lacerations, animal bites, tattoos, postsurgical wounds, body piercings – even splinters! An infection can set in as little as two days or as long as a couple of months. Once Tetanus is inside the bloodstream, the bacteria grow, produce a deadly toxin that can cause spasm and paralysis of muscles.

Symptoms of Tetanus include headache, sweating, fever, difficulty swallowing and stiffness of the jaw (lockjaw) and abdominal muscles. Lockjaw is the most dangerous symptom because it can lead to death by suffocation.

What can you do to prevent tetanus? That is something that you can do by getting a regular tetanus vaccine booster shot. You probably received several tetanus shots when you were a child. Even though you may have, tetanus immunity does not last forever. The Center for Disease Control recommends that you get a tetanus booster every ten years. If you do get injured during that time, your doctor may request that you have another booster if it has been longer than five years since your last one. If you are traveling internationally , you’ll want to be up to date with your immunity because tetanus may be more common where you’re visiting, especially if you are visiting a developing country.

Tetanus boosters shots are easy to get. You can call your family doctor. We keep them on hand here at Doctors Express. You can walk in without an appointment any day of the week  even on the weekend – and receive your booster shot.

Be sure to write down the date you receive your booster so you won’t wonder next time!

http://www.doctorsexpressjacksonville.com/urgentcare-jacksonville/blogdetailspage/Tetanus-Booster?limitstart=15


What is the difference between an EMR and an EHR?

By: Ellen Sullivan

An electronic medical record (EMR) is a digital version of a paper chart that  contains all of a patient’s medical history from one practice. An EMR is  mostly used by providers for diagnosis and treatment. Instead of relying on paper charts, the EMR allows providers to easily store data, track it over time, identify when patients should be contacted for services and to be able to measure indicators used to monitor health. An EMR is typically used in a provider office and is basically a computerized version of the hard copy record.

 There are standards for documenting in the medical record. The main concern, or the chief complaint or why the patient is a key part of the medical history. Other information includes a family medical history. Immunizations are also recorded. Documentation of the physical examination and  details of the physician’s findings, particularly as related to the  complaint and any other observations. Vital signs such as pulse, breathing rate, temperature, and blood pressure are recorded. A  diagnosis and assessment as related to the chief complaint will be documented,  followed by a treatment plan or plan of care. This plan of care addresses how to manage the condition along with the appropriate medications, lab tests, or other  interventions. Discharge notes, follow-up care, referrals to specialists and test results are also documented.

There are benefits to the EMR which include:

Information is readily available to providers. It can also be shared via a secure portal to another provider when needed. Examples of how this can help includes transfer to an emergency room or if information is being to sent to another physician for follow up care.

  • The chances of errors in medication and treatments reduced especially reducing errors due to poor handwriting.
  • They are easily stored and not susceptible to damage from fire, flood or other calamities.
  • Records can be easily reviewed with alerts set up to ensure that important information is not overlooked that may impact patient care. This is important from a patient safety perspective.

Electronic health records (EHR) are designed to contain and share information from all providers involved in the care of a patient. EHR data can be created, managed and consulted by authorized providers and staff. It also allows patients to take their health record with them and it can be shared with other health care providers, specialists, hospitals, outpatient or ancillary providers.

Most patients want to know if their records are safe and if they are kept private. In 1996, Congress passed the Health Insurance Portability and Accountability Act known as HIPAA, in order to help protect personal  health information, including medical records. This law gave patients more  control over their health information, set limits on the use and release of  their medical records, and established a series of privacy standards for health  care providers which provides penalties for those who do not follow these EMR   safety and EHR security standards.

Here is a link to an article that further discusses this topic http://www.healthit.gov/buzz-blog/electronic-health-and-medical-records/emr-vs-ehr-difference/

http://www.doctorsexpressjacksonville.com/urgentcare-jacksonville/blogdetailspage/What-Is-An-EMR?limitstart=15

Entrepreneur Magazine Article – Two Medical Pros Change Course With an Urgent-Care Franchise

Two Medical Pros Change Course With an Urgent-Care Franchise </a

This article ran in Entrepreneur Magazine August 2012 about our opening a Doctors Express Center. We were the 16th Doctors Express to open in the country and the first to open in Florida. It has been a very rewarding experience to be part of a quality-driven, affordable business that meets the needs in local communities.