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What we know about the 10-year-old Ohio girl who had to travel to Indiana for an abortion

Following the arrest of 27-year-old Gerson Fuentes in connection with accusations of rape and impregnation of a 10-year-old girl , a variety of questions have been asked surrounding the investigation and the case.

The girl's pregnancy and its termination, which happened after she traveled from Columbus to Indianapolis for the procedure, has become a flashpoint nationally in the debate surrounding abortion in the wake of the U.S. Supreme Court's decision to overturn Roe v. Wade.

When were police notified of the case?

According to court records and testimony from Columbus police detective Jeffrey Huhn, Franklin County Children Services made a report to Columbus police June 22, after receiving information from the child's mother.

First in The Dispatch: Arrest made in rape of Ohio girl that led to Indiana abortion drawing international attention

Children Services workers are mandated reporters, meaning they are obligated under Ohio law to report any suspected child abuse to authorities.

What happened next?

Huhn testified the girl went to Indianapolis and had a consultation June 29. A medical abortion was performed the next day, June 30.

Police obtained genetic material from the Indianapolis clinic July 2, Huhn testified.

Why wasn't Fuentes arrested June 22?

It is unclear at what point detectives first interviewed the 10-year-old girl. Court records show the girl identified Fuentes during a July 6 interview with detectives as the person who impregnated her.

Data: Fewer Ohio minors getting abortions: 10-year-old who sought abortion was rare case

After that interview, Huhn testified, detectives obtained a search warrant for a DNA sample from Fuentes. Police served that warrant July 12, at which point detectives interviewed Fuentes.

Huhn testified, and court records show, Fuentes confessed during that interview to assaulting the 10-year-old girl on at least two occasions.

Police arrested Fuentes on July 12.

Was the arrest made too soon or not soon enough?

In many sexual assault cases where DNA evidence is available, such as in this case, an arrest takes place after DNA testing is complete.

Columbus police arrested Fuentes after, they said, he admitted to assaulting the girl, which is enough probable cause to make an arrest. The DNA testing results will be included as evidence, should the case proceed to trial.

How is the DNA testing being done?

Columbus police have their own crime lab and scientists who will test the DNA samples and evidence collected to see if it matches.

While the Ohio Bureau of Criminal Investigation also operates a crime lab for agencies across the state, Columbus primarily uses its own laboratory and is not required to alert BCI when it tests DNA in its own cases.

When did Fuentes come to the United States?

Franklin County Public Defender Clark Torbett said during Wednesday's hearing that Fuentes had been in the country for about seven years, so since about 2015.

Fuentes had been working in a café, Torbett said. The address listed on court documents as where Fuentes lived was an apartment on the city's Northwest Side.

Heading across state lines for abortions: Patients head to Indiana for abortion services as other states restrict care

What's next in the case?

A grand jury will review Fuentes' case for potential indictment. An indictment could be filed as early as thist week.

After an indictment, Fuentes would have an arraignment, during which he would formally enter a plea and a future trial date would be set.

Why has the police report not been released?

Under Ohio public records law, police reports generated from a mandatory reporter and involving accusations of child abuse may not be released until the case is finished.

Columbus police formally denied a public records request from The Dispatch — and all other media agencies — under this public records law exemption.

Did the girl have to go to Indiana for an abortion?

In the hours after the Supreme Court overturned Roe v. Wade on June 24, a federal judge lifted an injunction on Ohio's "heartbeat law," which does not allow abortions to take after cardiac activity, often interpreted as a heartbeat, is detected. This typically occurs around six weeks of pregnancy.

Pain, panic, praise at Ohio's clinics: The day that Roe v. Wade fell: Panic, praise at Ohio's abortion clinics

The 10-year-old girl was six weeks, three days pregnant, according to the Indiana doctor who performed the procedure.

Ohio law does not make any exceptions for rape or incest but does allow exceptions for the health of the mother. Because of the girl's age, Ohio Attorney General Dave Yost said the girl would have fallen under that exception .

For Dispatch subscribers: Do 10-year-olds meet 'life of mother' abortion exemptions? Ohio lawmakers, doctors divided

However, the Indiana doctor told the IndyStar that she received a referral from a doctor in Ohio who felt they could not perform the procedure in the state.

Legislators, lawyers and doctors in Ohio said there are a number of factors to consider in determining whether the health of the mother is at risk. Those factors include the child's overall health, their size and how far they are into puberty.

[email protected]

@bethany_bruner

This article originally appeared on The Columbus Dispatch: What we know the 10-year-old Ohio girl who had an abortion in Indiana

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ER Trips Often Point to Larger Health Problems for Older Patients

Researchers say it should be a wake-up call to caregivers and family.

Twice a day, the 86-year-old man went for long walks and visited with neighbors along the way. Then, one afternoon he fell while mowing his lawn. In the emergency room , doctors diagnosed a break in his upper arm and put him in a sling.

Back at home, this former World War II Navy pilot found it hard to manage on his own but stubbornly declined help. Soon overwhelmed, he didn’t go out often, his congestive heart failure worsened, and he ended up in a nursing home a year later, where he eventually passed away.

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“Just because someone in their 70s or 80s isn’t admitted to a hospital doesn’t mean that everything is fine,” said Timothy Platts-Mills, M.D., codirector of geriatric emergency medicine at the University of North Carolina School of Medicine, who recounted the story of his former neighbor in Chapel Hill.

Quite the contrary: An older person’s trip to the ER often signals a serious health challenge and should serve as a wake-up call for caregivers and relatives .

Research published in the Annals of Emergency Medicine underscores the risks. Six months after visiting the ER, older adults were 14 percent more likely to have acquired a disability — an inability to independently bathe, dress, climb down a flight of stairs, shop, manage finances or carry a package, for instance — than those of the same age with a similar illness, who didn’t end up in the ER.

These older adults weren’t admitted to the hospital from the ER; they returned home after their visits, as do about two-thirds of older adults who go to ERs, nationally.

The takeaway: Illnesses or injuries that lead to ER visits can initiate “a fairly vulnerable period of time for older persons” and “we should consider new initiatives to address patients’ care needs and challenges after such visits,” said one of the study’s coauthors, Thomas Gill, M.D., a professor of medicine (geriatrics), epidemiology and investigative medicine at Yale University.

Research by Cynthia Brown, M.D., a professor and division director of gerontology, geriatrics and palliative care at the University of Alabama at Birmingham, confirms this vulnerability. In a 2016 report, she found sharp declines in older adults’ “ life-space mobility ” (the extent to which they get up and about and out of the house) after an ER visit — which lasted for at least a year without full recovery.

“We know that when people have a decline of this sort, it’s associated with a lot of bad outcomes — a poorer quality of life, nursing home placement and mortality,” Brown said.

Why would seeking help in an ER often become a sentinel event, with potential adverse consequences for older adults?

Experts offer various suggestions: Older adults who previously were coping adequately may be tipped into an “I can’t handle this any longer” state by an injury or the exacerbation of a chronic illness, such as diabetes or heart failure. They now may need more help at home than what is available, and their health may spiral downward.

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Beaumont Emergency Hospital

24-Hour Emergency Room - Beaumont, Texas

When Should I Visit The Emergency Room With a Cut?

We’ve all had a small cut before. They aren’t fun, but they are easy to clean, put a band-aid on and take care of at home. But when is a cut serious enough that it requires a trip to the emergency room?

One of the top reasons we see patients here in the emergency room is for cuts. But the truth is, not all cuts require a visit to the ER. When it comes to cuts, here are a few instances where I would recommend a quick visit to Beaumont Emergency Hospital.

ER Trip Recommended, if…

• If your cut is deep and exposes the deeper layers of your skin gaping open
• You can’t push the edges together with gentle pressure
• Located on or across a joint from an animal or human bite
• Caused by a foreign object impaling the area
• Made by a high-pressure impact such as a gunshot wound
• Is due to a very dirty or rusty object
• Refusing to stop bleeding
• On the face or on or near your genitalia

Even If you make the decision to come in, there are things you should consider prior to your visit to the ER because of a laceration.

Important Things To Rember

• Leave foreign objects alone If you have been impaled by something, leave it in and let the doctors take care of it. You can not be sure how much damage the object has caused and removing it has the potential to cause even more damage with devastating consequences.
• Bites and dirty wounds need special treatment
• If you’ve been bitten or if your cut was caused by something contaminated or rusty, seek out an ER immediately.
• If you haven’t had a tetanus booster in the last 10 years, plan on receiving one during your visit.

Cleaning The Wound

Clean the wound if you can If possible, gently clean the lacerated area before you arrive. You can use tap water with liquid antibacterial soap Avoid other cleaning agents since they have the potential to cause damage tissue. Do not apply topical antibiotics such as Neosporin and Bacitracin since they will eliminate the option to use surgical glue when appropriate

Stop The Bleeding

Lastly, be sure to elevate the wound and apply pressure on the way to the ER. The goal here is to slow or stop as much bleeding as possible. Chances are if you suffer a laceration of any kind that it will be minor enough to care for at home. Keep it clean and covered and be sure to keep an eye on it. Should you begin to suspect or see signs of infection, seek medical help immediately.

Don’t Eat Or Drink Anything

Something else to consider is avoiding anything to eat or drink before arriving at the ER. There is a chance, depending on the severity of your wound that sedation will be necessary. Many times this is to help smaller children remain still during suturing. So, until you are sure that sedation is not required, wait to eat or feed your child.

We obviously hope you avoid any cuts whatsoever, but should disaster strike, rest easy and know that I, along with our team of ER doctors and nurses are here 24/7 at Beaumont Emergency Hospital are ready to deliver the quickest and the best treatment available

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Lumberton hospital 5 minutes, waxahachie er 5 minutes, cuts and scrapes – when to go to the er.

When to go to the ER or Urgent Care for Cuts and Scrapes

When it comes to cuts and scrapes, our bodies can take quite a beating over the years. Luckily most of the incidents we will experience will be minor injuries which won’t require medical attention.

However, there will be instances where we might not be sure if we need medical attention or not, and if we do where should we go for treatment, the Emergency Room or an Urgent Care center?

How to Tell If Your Cut or Scrape Requires Medical Attention?

Scrapes can usually be treated at home with the use of an antibiotic ointment and a thorough cleaning. Determining if your cut is deep enough to warrant seeing a doctor, however, is not always easy, but, we can safely say that your wound will require stitches and possibly other medical attention when:

• The cut is deeper than a ¼ inch and gapping or jagged
• The cut was made by a dirty or rusty object
• Fat, muscle, bone or other deep body structures are visible through the wound
• The cut is over a joint and continues to open every time you move the joint
• After 10-15 minutes of applying direct pressure, the cut is still bleeding

If you feel your injury requires medical attention, then you should know that the sooner you see a doctor, the better. You should be checked by a medical practitioner preferably within a few hours of being injured, as this will help reduce the risk of infection and minimize scarring.

If your cut was caused by a dirty or rusty object, you will require a tetanus shot if you haven’t had one within the past five years. Tetanus is a disease caused by bacteria that is transmitted through open cuts or wounds.

So, how can you know if your wound can be treated at an urgent care center or if you need to go to the emergency room instead? Here is a helpful guide to help you make an informed decision:

Visit Altus Emergency Centers When:

• You have a deep gaping wound where muscles, veins, subcutaneous fat or bone are exposed
• Your injury has cut through a major vein or artery, and the bleeding won’t stop
• The cut is over a joint
• The edges of the cut are jagged and uneven
• It’s a deep or long facial laceration
• You have an object embedded in the wound (don’t try to remove it on your own, this should always be done by a physician)
• A partial or complete amputation such as a severed finger or any that has resulted in the partial or full removal of an appendage or tissue from on your body
• You’ve sustained a scalp cut

Visit an Urgent Care Center When:

• The cut requires stitches, but the edges are straight, and even that can easily be pushed together
• Shallow facial cuts
• Cuts and scrapes that are embedded with dirt
• Minor animal or human bites
• Non-life-threatening wounds that were caused by a dirty or rusty object

An urgent care is good for a minor emergency. However, you can save time, money and a great deal of pain by knowing when to go directly to the emergency room. To learn more about the different types of Cuts & Scrapes and Treatments, Cuts and Scrapes .

Altus Emergency Centers are open 24/7 and will always be available to treat non-life-threatening injuries that would typically be handled by urgent care clinics when these are closed.

Know Where to Go In the Event of an Emergency

If you are ever in need of quality emergency care, you will not have to wait in line at Altus Emergency Centers . All of our ERs are fully equipped and open 24/7.

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10 Symptoms That Warrant A Trip To The ER

It can be hard to tell when your best bet is to rush to the emergency room.

When you wake up in the middle of the night with an alarming symptom—maybe it's a high fever or splitting headache—it's hard to know whether to rush to the emergency room or not. You don't want to overact, but you definitely don't want to underreact either. So how do you know when that stomach pain needs to be treated ASAP or if that numb feeling can wait until morning to deal with? We spoke to Ryan Stanton, MD, a board-certified emergency physician and spokesman for the American College of Emergency Physicians to find out.

While you may be used to an occasional headache from stress or one too many drinks, certain types of headaches can be cause for more concern. The three most common—and not dangerous—types of headaches are tension, cluster, and migraines , but "there are a couple of characteristics we look for as emergency doctors that tip us off that a headache is more than the average headache," explains Stanton.

Head to the ER if...  the pain is intense and sudden. "Is it the worst headache of your life? Did it come on suddenly like you were struck by lightning or hit in the head with a hammer?" says Stanton. "These are the two major questions we will ask to gauge the risk for a potentially deadly cause of headache known as subarachnoid hemorrhage." A headache is also worrisome if it is accompanied by a fever, neck pain, or stiffness and a rash, which could signal meningitis.

Abdominal Pain

From tummy aches to belly bloat, abdominal pain is the number one non-injury reason for adult emergency room visits, according to the National Hospital Ambulatory Medical Care Survey. The pain can be caused by a number of factors from gas or a pulled muscle to the stomach flu or more serious conditions like appendicitis or urinary tract infections. 

Head to the ER if... you're experiencing intense localized pain, especially in the right lower part of your abdomen or your right upper region, explains Stanton, as this could hint at an issue with your appendix or gallbladder that may require immediate surgery. Other concerning symptoms are abdominal pain accompanied by an inability to keep down any food or fluids; blood in the stool; or a severe and sudden onset of the pain.

With heart attacks as the number one killer for both American men and women, it's no surprise that sudden chest pain can be scary and is one of the leading causes of emergency room visits for adults. "Heart attacks are at the top of the list due to their frequency and potential risk," says Stanton. 

Head to the ER if... you are experiencing chest pain along with shortness of breath, decreased activity tolerance, sweating, or pain that radiates to the neck, jaw, or arms—especially if your age or family history puts you at a higher risk for heart attacks. "This is not a time for the walk-in or urgent care clinic," says Stanton. "They will just take a look and send you to the ER since they don't have the ability to deal with cardiac-related issues."

Infection can run the spectrum from a simple infected skin wound to serious forms such as kidney infections. The vast majority of infections are viral, which means they won't respond to antibiotics and can be treated at home with over-the-counter symptom management until the virus passes. The key then is to look at the severity of the symptoms. "The more severe infections are sepsis (infection throughout the body), pneumonia , meningitis, and infections in people who have weakened immune systems," says Stanton.

Head to the ER... based on the severity of your symptoms. "You want to show up at the ER if there are any concerns, such as confusion, lethargy, low blood pressure , or inability to tolerate any oral fluids," says Stanton. "These may suggest a more sinister infection or may just need a little emergency room TLC, such as medications to help with symptom management, fluids, or possibly antibiotics, to turn the corner."

Blood in your stool or urine

Blood shouldn't ever be found in your stool or urine, so even if your symptoms don't require a trip to the ER, it's important to make an appointment with your physician as soon as possible to determine the source and decide on a treatment plan. "Blood in the urine is usually caused by some kind of infection such as a urinary tract or kidney infection or kidney stones," says Stanton. "When it comes to stool, it's often benign, but it can be the sign of something very dangerous." The number one cause is hemorrhoids followed by fissures, infections, inflammation, ulcers, or cancer. If you have a little blood with no other symptoms, make an appointment to talk with your doctor. 

Head to the ER if... you have large amounts of blood in your stool or urine, or if you have blood in your stool or urine in addition to other symptoms such as a fever, rash or fatigue, intense pain, or evidence of a blockage.

Difficulty Breathing

"Shortness of breath is one of the most common emergency department presentations," says Stanton. The most common causes are asthma, Chronic Obstructive Pulmonary Disease ( COPD ) from smoking or infections such as pneumonia. When it comes to shortness of breath, it's pretty straightforward, says Stanton. "If you can't breathe, get to the ER."

Head to the ER ... always.

Cuts, Bumps & Falls

Whether it's a knife accident chopping veggies for dinner or a misstep off the deck stairs, many cuts, bumps, and bruises can be handled at home with ice or a home first aid kit supplies.

Head to the ER if... what's supposed to be on the inside is on the outside, or what's supposed to be on the outside is on the inside, says Stanton. If you can see muscle, tendons, or bone, it requires more than just a BandAid. "It's important to get these addressed because they are fraught with potential secondary complications from infection to loss of function and ischemia [reduced blood flow]," warns Stanton.

While not pleasant, vomiting is a common symptom that can be caused by various conditions, most often viral gastroenteritis ("stomach flu") or food poisoning. Usually, vomiting can be managed with home care and a check-in with your primary care doctor.

Head to the ER if... there is blood in the vomit, significant stomach pain, or dark green bilious vomit which could suggest bowel obstruction. Another important factor with vomiting is dehydration. "If you are unable to keep anything down, you will need to get medication or treatments to help you stay hydrated," explains Stanton. "Young children can become dehydrated rather quickly, but most healthy adults can go several days before significant dehydration becomes an issue."

"Rarely is a fever anything other than an indication that you are ill," Stanton explains. It's actually a healthy sign that your body is responding to an infection. The concern then is not with the fever itself, but with what infection is causing the fever. Don't hesitate to treat it with over-the-counter medicines such as ibuprofen. 

Head to the ER if... a fever is accompanied by extreme lethargy or there are other symptoms of infection present. Most concerning to Stanton are "fevers in kids with lethargy, fevers in adults with altered mental status, and fevers with headache and neck pain ."

Loss Of Function

Numbness in your legs, slack facial muscles, a loss of bowel control—if a certain body part or body function stops working suddenly or over time, it's worth finding out why. 

Head to the ER... always, recommends Stanton. "Whether it is due to a trauma or just develops over time, any loss of function requires immediate evaluation." The two most common causes are physical trauma and stroke, both of which are serious and require medical attention. "When something is not working, don't try to 'sleep it off'," advises Stanton. "If it doesn't work, there is a reason, and we need to see if we can diagnose, reverse, or prevent ongoing problems."

The bottom line for any symptom: If you truly can't decide what to do, it's better to be safe than sorry. "Any time you have a concern or emergency, it's always better to get checked than to wait until the problem escalates," recommends Stanton.

Other things to consider

While not symptoms, per say, according to the National Institutes of Health , you should always head to the ER if you:

• Inhaled smoke or poisonous fumes
• Consumed a toxic substance or overdosed on a medication or drug
• Possibly broke a bone 
• Are having seizures
• Suffered a serious burn
• Had a severe allergic reaction and are have trouble breathing, swelling, or hives
• Are having suicidal thoughts 

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Can Patients Be Taught to Avoid Unnecessary Trips to the ER? A Study in AJMC® Suggests Some Can

Efforts to cut down on unnecessary trips to the emergency room can take many forms. A new study by Kaiser Permanente, appearing in The American Journal of Managed Care®, suggests that the best education tools may vary depending on the patient’s age.

Unnecessary trips to the emergency room (ER) are a recognized cost driver in healthcare, but not everyone agrees on how to prevent them. Health plans have tried higher co-payments, and Anthem has taken the controversial step of refusing to pay for ER care if it later determines that a visit based on potentially serious symptoms turned out not to be.

Kaiser Permanente, meanwhile, has a study appearing in The American Journal of Managed Care ® ( AJMC ® ) that examines a more common problem: how to find patients who sought low-acuity ER care and teach them to seek ambulatory care for similar symptoms the next time.

Researchers speculated that patients might have different responses to education strategies, depending on their age. Across six ERs in the Kaiser Permanente Health Network, they identified a total of 9,093 patients who had made a low-acuity emergency visit; of these, 609 patients would receive a phone call and 771 would receive educational materials in the mail to tell them about other venues for their future medical needs. Patients were matched with controls, and researchers looked at ER use six months later.

They found that patients age 65 or older had a 22 percent drop in use of the ER after the phone call follow-up from an ER physician, while those younger than 65 had a 27 percent reduction after receiving educational materials in the mail. They agree that these differences call for more study: older patients appeared easier to reach by phone, for example.

Dr. Pankaj Patel, emergency physician at Kaiser Permanente Roseville/Sacramento Medical Center and lead author on the study, said his research team had anticipated these results. “We were pleased to find that our patients were so responsive to such simple interventions. A three-minute phone call from an emergency physician or a one-page information letter appeared to be effective ways to educate our patients about the multiple venues of care that were available. With that knowledge, patients could choose which setting best fit their future low-acuity medical care needs, not just the ER. We hope that our findings motivate others to utilize physician-directed education to give patients their healthcare access options.”

Accompanying the study is an editorial by Dr. Adam Sharp, of Kaiser Permanente Southern California and Dr. Mark Fendrick of the University of Michigan, who is co-editor in chief of AJMC ® . Sharp and Fendrick ask the question: who gets to decide whether unscheduled acute care is “appropriate” or not? In most cases, they note, the patient must ultimately decide whether to go to the ER, and where is the value if they are thinking about a possibly large financial penalty instead of where they will get the best quality care?

“Consumers must not be left on their own to decide whether acute care is necessary and where it should be provided. Patient-centered approaches to optimize the use of the [emergency department] must be integrated into more comprehensive population health initiatives,” they write. “A key element of this strategic plan includes the development of user-friendly tools that help patients decide when to seek care and where best to receive it.”

About The American Journal of Managed Care ® :

The American Journal of Managed Care ® ( AJMC ® ) is a peer-reviewed, MEDLINE-indexed journal that keeps readers on the forefront of health policy by publishing research relevant to industry decision makers as they work to promote the efficient delivery of high-quality care. AJMC.com is the essential website for managed care professionals, distributing industry updates daily to leading stakeholders. Other titles in the AJMC ® family include The American Journal of Accountable Care ® , and two evidence-based series, Evidence-Based Oncology ™ and Evidence-Based Diabetes Management ™ . These comprehensive offerings bring together stakeholder views from payers, providers, policymakers and other industry leaders in managed care. To order reprints of articles appearing in AJMC ® publications, please contact Jeff Prescott at 609-716-7777, ext. 331.

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David J. Meyers, Ph.D., Honored With the 2023 AJMC® Seema S. Sonnad Emerging Leader in Managed Care Research Award

This annual award celebrates emerging leaders in managed care research with outstanding long-term contributions.

OneOncology and Its Practice Partners Celebrate 5 Years of Cancer Care Excellence

“OneOncology was started by physicians and for physicians,” said Jeff Patton, MD, OneOncology CEO. “As we’ve grown and enhanced world-class cancer care in communities across the country, strengthening practice independence and empowering their decision-making has always been our north star."

The American Journal of Managed Care® Is Seeking Manuscript Submissions for the 13th Annual Health Information Technology Special Issue

Issue will feature guest editor, Sunny C. Lin, Ph.D., of Washington University in St. Louis

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AJMC® Presents Dr. Ishani Ganguli With Seema S. Sonnad Emerging Leader in Managed Care Research Award

Ganguli, a well-published author in both clinical and mainstream media, is an expert in the investigation of the value of ambulatory care

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Mental Health

How my urgent er trip shows the stigma toward mental health over physical health.

Recently, I had yet another stark reminder of how differently people view and react to mental illnesses versus physical ones, especially in medical settings like the emergency room.

Please bear in mind that I am by no means a frequent flyer in the emergency room. The last time I was in the ER was about two years ago when I had a large cyst and tissue growth on my left ovary that had twisted and contorted it, causing severe pain. I was in no way crying wolf or looking for attention. My ER visit resulted in a surgical referral and the removal of that ovary.

One of my family members was a hypochondriac. She had doctors for everything and scheduled appointments with specialists on the drop of a dime. Somewhere along the way in my journey to not become her, I became the polar opposite in that aspect. I avoided doctors and only sought medical treatment as a last resort. I once tried to walk off appendicitis for a few hours as bad stomach cramps. On some level, I know it is irrational and I need to make my health a bigger priority, but I still struggle to go to the doctor unless it is absolutely necessary.

Last week, I had a bit of a scare. I had gotten upset after a spat with my partner and had gone for a walk to calm down and clear my head. Somewhere along the way, though, my head began to hurt and spin. I knew I was upset but the details felt distant and fuzzy, as if the facts were lost in my head somewhere yet I was unable to access them. The harder I tried to root out facts, the more my head spun and the more confused I felt.

While I do struggle often with losing numbers, words or specific facts as a result of my mental illness and have also had memory issues following anxiety attacks and post-traumatic stress disorder (PTSD) flashbacks as well, I have never experienced anything like this before. When I realized I could not even recall my own name, it sent me into a panic. I knew something was seriously wrong so went into the first business I saw and asked the clerk to call 911 for help.

An ambulance arrived to take me to the hospital. Their initial fear was a stroke . They started running multiple tests and sent me for a CT scan. As tests began to come back ruling out the prognosis of a stroke, the demeanor of the staff treating me began to change drastically.

Their next possible prognosis was that it was purely a mental issue or I was lying about the severity of my condition, putting on some sort of act for attention. Despite the fact I was visibly agitated and distressed at being unable to recall even basic facts, their demeanor changed. All of a sudden, they became outright accusatory and began to question whether I was telling the truth. One nurse went so far as to tell me point blank that they would have to start doing uncomfortable and painful tests, including taking my temperature rectally, putting in a catheter for a clean urine sample (though I had given them one in a cup not 20 minutes prior) or even putting a needle in my back to withdraw fluids for tests “unless I had something I wanted to confess”.

As I laid there in a state of panic not because of the possible upcoming uncomfortable tests but rather because my brain just was not working like it should, and I could hear that nurse at the desk nearby laughing with her co-workers about how she was “going to get a rectal thermometer and make me talk,” the results of my CT scan came back.

It turns out I have two meningioma on my brain, tumors between the surface of my brain and the inside of my skull. The larger of the two is in the falx region, in the front of my head, which deals with memory. The smaller of the two is in the middle, presiding predominantly over balance.

Neither was particularly large thankfully, but when housed in the small space between my brain and skull, even smaller tumors could cause issues. Apparently in my already agitated state following the spat with my partner earlier, there must have been just enough pressure put on the memory portion of my brain to cause a temporary memory loss.

The whole demeanor of the staff treating me shifted once again, becoming very serious and somber. They gave me some sedatives and anti-anxiety medication to calm me and slowly the fog began to clear. They began bringing in paperwork and test results for me to bring to my primary doctor to get a referral for a neurologist, stressing the urgency of the situation. Though they informed me that something like 80 percent of meningiomas are benign, even benign tumors continue to grow and could cause temporary or even lasting damage to my brain if left untreated. Ultimately, I’ll need surgery regardless of whether biopsy results conclude the tumors are benign or malignant.

The whole situation made me nauseous, even beyond the fact I have tumors on my brain. Just the fact I was only taken seriously when they feared for a physical condition like a stroke or when the tumors were found on my brain was appalling. As I had mentioned earlier, I have had memory issues related to my mental illness in the past, though thankfully never quite to this extent before. However, following PTSD flashbacks or severe anxiety attacks, my brain is always fuzzy and muddled, as well, and I often have periods of impaired memory afterward. The fact that professionally trained medical staff at an emergency room would treat any condition they believed had a mental origin less seriously, let alone as a joke, is beyond disgusting to me.

I did not make a scene or call them out on their obviously shifting behavior, in part because the very idea I had tumors growing on my brain left me in a state of shock. Even more so, like many others struggling with mental illness, I have sadly become accustomed to my mental health not being taken seriously. However, it is deeply disconcerting to me that emergency personnel at a hospital would be so openly cavalier about anyone’s mental health, treating their patients as a joke.

I walked away from this situation with a few distinct feelings and thoughts in my head. First and foremost, I have a newfound anxiety and wariness about going anywhere alone until this is resolved, particularly when upset. I was lucky I was in an area with easy access to other people and was blessed to have maintained enough reason to know to ask for help. But I carry with me now an ever-present fear that next time I might not be as lucky, especially considering I regularly operate under conditions of extreme anxiety and depression due to my mental illness.

I also am distinctly aware of all the unknowns in my foreseeable future. I am not sure exactly where I go from here. I understand the basics. Get a neurology referral, get an MRI, get a biopsy, have surgery, possibly radiation if needed. But I have no idea of the time frames of anything just yet and probably won’t until tests and biopsies start coming back. I don’t deal well with the unknown. Not being able to plan to any degree heightens my anxiety to dangerous levels.

There is a strange sense of underlying optimism, as well. Somehow I know I will get through this, that I’m a tough cookie. I come from strong stock. Both my parents survived multiple types of cancer and other ailments before they passed. My time is not up yet. I have too much left to do. I have a lot of fight left in me.

However, I am very aware of the fear growing inside me, too. Cancer scares me to the core. I remember going to the hospital day after day when my mother had part of her lung removed due to lung cancer , watching her fade in and out in the CCU, not sure whether she would make it or not. I remember reconnecting with my father just in time to watch cancer wreak havoc on his body, going through repeated cycles of surgeries and chemotherapy. His cancer always seemed to be one step ahead, reappearing again and again in different areas until it eventually killed him. I’ve seen cancer eat away at and kill multiple friends over the years, as well. Cancer is, by far, my biggest fear and it is now on my doorstep.

More than anything, though, I came away from this with a harsh reminder of the stigma that still surrounds mental illness, even in medical facilities . When they believed my issue was a mental one, I was a joke they saw fit to threaten with unneeded, uncomfortable and painful tests as a way to get me to “come around,” expecting my condition to magically cure itself and disappear under threats of unpleasantness. It took finding tumors on my brain, something they could physically see, for my condition to finally be taken seriously.

This piece originally appeared on Unlovable .

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Photo by Ken Treloar on Unsplash

I am a 46-year-old happily married mother of three. I have survived physical, mental, emotional and sexual abuse, a failed previous marriage and a long engagement imploded by an ex’s repeated infidelities. I have been diagnosed with major depression, post-traumatic stress disorder (PTSD) and anxiety disorder. I have many facets and have filled many roles. At different times in my life, I have been a student, a teacher, a mother, a daughter, a fiance, a wife, an artist and an author. Throughout my life, I have been both strong and courageous, weak and afraid. I may be a product of my experiences and choices, but I refuse to let them define me. After years of suffering in silence, I have found my voice. My first book, “Unlovable: A Story of Abuse and Depression from Someone Drowning in the Abyss,” is available for purchase in both paperback and e-book versions on Amazon.com and at barnesandnoble.com.

An Unusual Cause of Back Pain in a 10-Year-Old Girl

Affiliation.

• 1 From the *A.I. DuPont Hospital for Children, Wilmington, DE; and †St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA.
• PMID: 27455343
• DOI: 10.1097/PEC.0000000000000808

A 10-year-old girl with a 2-week history of atraumatic back pain presented to the emergency department with difficulty ambulating and a history of 2 episodes of urinary incontinence in the past week. Her examination was significant for pain with movement, tenderness to palpation in the lower thoracic spine, and no neurological deficits. In this case, the child was found to have a Schmorl node at T8 in the superior aspect of the vertebral body. Schmorl nodes are protrusions of the cartilage of the intervertebral disc through the vertebral body endplate and into the adjacent that is more commonly reported in the adult population. In this child, radiographic findings were normal, with no evidence of the Schmorl node. The diagnosis was made by magnetic resonance imaging. The child's symptoms significantly resolved with ibuprofen anti-inflammatory therapy. In children with atraumatic back pain lasting greater than 2 weeks with a sudden increase in severity and associated with a neurological deficit, advanced imaging is strongly recommended.

Publication types

• Case Reports
• Back Pain / diagnostic imaging*
• Back Pain / drug therapy
• Back Pain / etiology
• Back Pain / pathology
• Diagnosis, Differential
• Emergency Service, Hospital
• Intervertebral Disc / diagnostic imaging*
• Intervertebral Disc / pathology
• Intervertebral Disc Degeneration / diagnostic imaging*
• Intervertebral Disc Degeneration / pathology
• Intervertebral Disc Displacement / diagnostic imaging*
• Intervertebral Disc Displacement / pathology
• Magnetic Resonance Imaging
• Thoracic Vertebrae / diagnostic imaging*
• Thoracic Vertebrae / pathology
• Treatment Outcome
• Urinary Incontinence / diagnosis

Supplementary concepts

• Intervertebral disc disease

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10 Tips to Get You Through a Trip to the ER

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Knowing there are 136.3 million people in the U.S. who visit an emergency department every year might scare you off from your own trip there [source: CDC ]. That's a lot of people. Wait times for care can be so long that it's easy to start thinking that the best way to get through a trip to the ER is to avoid going in the first place. Well, yes and no. If you're having severe chest pains, for instance, don't self-diagnose it as gastroesophageal reflux disease (GERD) when it could be a heart attack . But, on the other hand, if something like a wait time is enough to keep you away, maybe your medical emergency isn't really a true emergency. If you know what a medical emergency is and what it isn't, you can save both time and money by relying more on your doctor, urgent care centers or retail health clinics to treat your problem. Save the ER for when life or limb is in jeopardy.

While emergency care is intended for people in life-threatening medical circumstances, as many as half of the people visiting the ER aren't actually there for life-threatening problems [source: Cunningham ]. Care is focused on treating patients who have the most severe or dangerous symptoms such as severe pain, severe vomiting, difficult breathing, severed limbs or appendicitis. So if you find yourself heading to the ER — either as a patient, a parent or a health buddy (we'll talk about that later) — expect that others may be in more critical condition than you, take a deep breath and prepare for the best.

• Keep a Wallet Card (and Keep It Updated)
• Bring All Doctor and ICE Contact Information
• Bring a Medications List and Any Assistive Devices
• Timing is Everything
• Be Prepared for a Long Wait (Bring a Diversion)
• Bring a Buddy
• Contact Your Doctor Before Going to the ER
• Never Exaggerate Symptoms
• Disclose All Allergies
• Advocate for Yourself: Speak Up

10: Keep a Wallet Card (and Keep It Updated)

No one plans to go to the ER, but planning ahead can stack the odds in your favor. When you arrive for emergency care, a member of the emergency team, typically a triage nurse, will assess the severity of your condition. For example, you could be assessed with a life-threatening condition requiring immediate care, an injury or illness needing urgent but not lifesaving attention, or, for many patients, a less urgent problem. Be prepared to answer questions about your health history, not just your current symptoms, as part of your ER check-in.

Along with your health insurance card, keep a wallet card with important personal health stats, including current and past health conditions, medications, supplements, allergies, vaccinations , previous hospital stays, previous surgeries and emergency contact information [source: Belchetz ].

While it's likely that patients with less urgent needs will be able to verbally communicate their medical histories, you'd be surprised how the anxiety and stress of the situation makes it difficult for many of us to remember details. Obviously, those who are unconscious or in life-threatening situations can't take a minute to tell the medical team about their Cesarean section, cholecystectomy (that's gallbladder removal surgery) or knee replacement.

9: Bring All Doctor and ICE Contact Information

The more the emergency medical team knows about your health history, the better. The name and phone number of your primary care doctor, in addition to any specialists you've seen or are seeing, is important information to bring to the ER. In fact, it's a good idea to carry that information with you at all times, right along with your medical history .

Additionally, emergency workers and hospital personnel want every single one of us to carry in case of emergency (ICE) information, either tucked in a wallet or as an entry to a phone contacts list. ICE information should include, at the very least, the name and contact numbers for the person or people who should be called by the paramedics, police or ER staff if you're in an accident or have any other type of emergency. Make sure the person listed as your emergency contact knows that they'll be contacted if there's an emergency, and review your medical history and regular doctor's information with them.

8: Bring a Medications List and Any Assistive Devices

Most Americans, 70 percent, take at least one prescription medication. That's not so bad, considering, for example, that one out of every three Americans has high blood pressure (hypertension). About 20 percent of adults take five or more medications [sources: Mayo Clinic , CDC ]. When you look at elderly Americans, the number is much higher: More than 60 percent of people over the age of 65 take at least five prescribed drugs per week, and more than 15 percent of seniors take double that [source: Worth]. Who can keep track of all that information, from dosage to refills to the name of the doctor who prescribed what and when, right?

Keeping an updated list of all the medications and supplements you take, in addition to doses, frequency, information about your allergies and your vaccination history, can help reduce both drug interactions and allergic reactions. And you don't have to worry you've misremembered a dose or forgotten an important medication. Store your medications list on a piece of paper in your wallet, use a medical alert bracelet or download a medications app to keep track of your drug information across devices. At the very least, bring all current prescriptions, over-the-counter medications and supplements with you.

Additionally, if you use any assistive devices — such as hearing aids , glasses, a walker or other mobility aid — on a daily or frequent basis, bring those devices with you to the ER. The more the emergency medical team understands your wellness baseline, how you normally function during the day, the better your odds of receiving an accurate — and potentially faster — diagnosis.

7: Timing is Everything

Here's a statistic that may make you think twice about going to the ER: Patients admitted for hospital treatment after being first seen in an overcrowded emergency department have a 5 percent greater chance of dying than patients whose ER experience was less crowded [source: Groeger ]. Timing your visit to the ER, which by the nature of the situation may not be possible, can be smart time management. And also, apparently, smart for your overall health — if you can pull it off. (Of course, accidents aren't always polite about happening at the most convenient time.)

Emergency departments have busy trends throughout the day and night, coinciding with the hours we're not at work or in school. For example, weekend trips to an ER are typically going to be crowded. Before work (before 8 a.m.) or after 5 p.m. on weekdays are busy, too. And Mondays in the ER can be brutal. Decrease your wait time by arriving between 7 a.m. and 3 p.m., preferably aiming to get there before 11 a.m. [source: Marte].

6: Be Prepared for a Long Wait (Bring a Diversion)

There's so much waiting going on in America's emergency departments. Administrative tasks such as registration (and discharge), initial evaluation and examination all add to wait times. You'll be cooling your heels even longer if you throw in a few tests for good measure.

While the average time spent waiting in the ER is a little longer than four hours, it probably won't surprise anyone that, in 2009, almost 400,000 people waited for 24 hours or more before it was their turn to be seen [sources: Marte, Rice ]. And in 2007, most of the 2 percent of people who left the emergency department before being treated did so because of all that waiting [source: McHugh ].

If you're able to do a little pre-ER planning, grab a diversion or two, such as a book, an electronic device or maybe your most recent knitting project to help the time pass.

5: Bring a Buddy

OK, so a trip to the hospital might not make for great date or a fun girls' night out. But it can be incredibly helpful to bring a buddy with you to the hospital. Ask a family member or friend to take you, or meet you, at the ER as your "healthy buddy." This role is for someone who can and will help advocate for you if you're feeling too unwell to do so yourself. This person will ideally also be ready to listen and record the details of your visit, such as questions and answers, tests, diagnosis, new medication list or schedule, and any follow-up notes. It's not a light responsibility, so make sure it's someone you trust to handle your personal information.

Be aware that some emergency departments may limit the buddies a patient can have, though, as space can be tight. This is not the time to invite your whole tribe along; limit yourself to just a +1 to keep from adding to the chaos around you.

4: Contact Your Doctor Before Going to the ER

Not only is it good policy to call your primary care doctor to help determine whether your circumstance does, in fact, need urgent or emergency care, it's also helpful to reach out on your way to the ER because your PCP may be able to make the experience a little smoother. For instance, your doctor may advise you to go to an alternate facility more experienced or equipped to treat your condition. Or, in some cases, your doctor may want to treat you. Additionally, a PCP may call the hospital before your arrival to give the emergency medical team a heads up on your condition.

Your primary care doctor is also important once you're discharged from the ER. More than 60 percent of patients are referred to their PCP or another health care specialist for follow-up diagnosis and care, in addition to any long-term care after emergency treatment if it's required [source: Marte].

3: Never Exaggerate Symptoms

Patients who are overly dramatic or who demand specific medications may not even realize they're doing so, or they may try it as way to move to the front of the line. But that just ends up raising suspicions that they may be malingering, which is what doctors call it when patients intentionally fake or exaggerate symptoms. For instance, if you complain of severe abdominal pains and vomiting during your ER evaluation but nosh on vending machine snacks to pass the time in the waiting room, your attending doctor may be skeptical of your story.

Be as complete and as clear as you can when describing the symptoms that brought you to seek emergency care. That should include, at the very least, what those symptoms are, when each symptom began, whether these symptoms have happened in the past, and whether you can link your symptoms to a trigger or cause (such as a new medication, food poisoning or accidental slip of a kitchen knife).

Also disclose whether you treated the illness or injury at home before you decided to seek emergency care. Be specific about how you've self-treated, such as if you took any fever-reducers or painkillers , and when.

2: Disclose All Allergies

Disclosing all of your medications allergies to the medical team caring for you is important to help keep you safe. That includes not only drug allergies, such as penicillin (the most common drug people are allergic to) but also any other allergies (such as to latex or any foods). What the ER staff doesn't know can hurt you. Harmful yet preventable medical mistakes kill roughly 98,000 patients every year, although that statistic might be a little light; it could be closer to 1 million, as it's estimated anywhere from 50 to 96 percent of errors aren't reported across the U.S. [source: Chamberlain ]. That's more than the number of people who die from complications of the flu and pneumonia combined each year [source: CDC ].

Not all reactions mean you're allergic to a medication, but any and all adverse side effects should be disclosed to the doctor. Drug allergies may cause itching, rash, hives, swelling, wheezing and shortness of breath, among other signs, depending on the severity the reaction. Drug interactions happen when there's an adverse reaction between two (or potentially more) medications as the body metabolizes them. And when it comes to drug interactions, if you take two medications, there's a 15 percent risk you'll have a toxic drug interaction. That risk rises to 40 percent for patients who take five or more medications and to an 80 percent chance when taking seven or more medications [source: Moffa ].

Interactions may cause gastrointestinal side effects, but they might also cause more serious problems such as kidney or liver damage or an overdose. For example, taking more than one sedative-hypnotic drug — those are drugs that depress the central nervous system such as Valium and Ambien — may cause life-threatening respiratory symptoms or coma and could be fatal.

1: Advocate for Yourself: Speak Up

In 2006, a 49-year-old woman complaining of chest pains, nausea and shortness of breath went to the Vista Medical Center Emergency Room in Lake County, Illinois, for evaluation, and two hours later she was found dead of a heart attack, sitting in the waiting room, still waiting for care [source: ABC News ]. While that story is horrifying, it's also a rare example of what could happen in an ER. It's a good reminder why each of us needs to be our own advocate.

Patients in the ER are treated based on the severity of their condition when they arrived for treatment. But just because you didn't have a high fever, arm weakness or trouble breathing during your initial evaluation by the triage nurse doesn't mean you haven't developed new symptoms as you've waited for your turn to see the emergency physician. If you feel your symptoms have worsened as you've waited, it's time to speak up. Ask a nurse or another health care worker to take your vital signs again (that's your blood pressure, pulse, respiratory rate and temperature), or talk to the charge nurse about your potentially escalating symptoms.

Advocating for your own care doesn't mean it's OK to be rude, however. Most of us would admit it can be difficult to maintain a healthy level of patience when there's no discernible light at the end of the waiting room tunnel, but remember, it's not only the words you choose. As much as 70 percent of our communication happens nonverbally — it really does matter if you make eye contact or if you roll your eyes [source: Pola-Mondey ]. Make an effort to remain calm and friendly, despite how long you have been waiting.

Lots More Information

Author's note: 10 tips to get you through a trip to the er.

The emergency department, where you're first when you're at your worst.

Related Articles

• How Emergency Rooms Work
• 10 Injury Treatment Priorities at the Emergency Room
• 10 Most Common Reasons for an ER Visit

More Great Links

• ER Wait Watcher
• ACEP: 2014 EM Report Card
• National Institute of Health: Recognizing Medical Emergencies
• ABC News. "Illinois Woman's ER Death Ruled Homicide." Sept. 19, 2006. (March 6, 2015) http://abcnews.go.com/GMA/OnCall/story?id=2458644
• Adetunji, A. Babatunde et al. "Detection and Management of Malingering in a Clinical Setting." Primary Psychiatry. Vol. 13, No. 1. Pages 61-69. Jan. 1, 2006. (March 6, 2015) http://primarypsychiatry.com/detection-and-management-of-malingering-in-a-clinical-setting/
• American College of Emergency Physicians. "ER 101: 10 Things Emergency Physicians Want You to Know." (March 6, 2015) http://www.emergencycareforyou.org/ER101/Default.aspx?id=1286
• Asthma and Allergy Foundation of America. "Allergy Facts and Figures." (March 6, 2015) http://www.aafa.org/display.cfm?id=9&sub=30
• Aungst, Timothy. "My Medications Is a Simple Tool for Patients to Record Their Medications, Immunizations and Allergies." iMedicalApps. Sept. 5, 2012. (March 6, 2015) http://www.imedicalapps.com/2012/09/mymedications-patients-track-immunizations-allergies-app/
• Belchetz, Brett. "5 Tips From a Physician to Help You Breeze Through the ER." Huffington Post. Aug. 19, 2014. (March 6, 2015) http://www.huffingtonpost.ca/dr-brett-belchetz/speed-up-er-visit_b_5500588.html
• Brady, M. Cait. "'I just saw Big Bird. He was 100 feet tall!' Malingering in the Emergency Room." Current Psychiatry. Vol. 12, No. 10. Pages 33-38, 40. October 2013. (March 6, 2015) http://www.currentpsychiatry.com/home/article/i-just-saw-big-bird-he-was-100-feet-tall-malingering-in-the-emergency-room/e853724c06895b3ab7a719646d650b78.html
• Centers for Disease Control and Prevention — National Center for Chronic Disease Prevention and Health Promotion, Division for Heart Disease and Stroke Prevention. "High Blood Pressure Fact Sheet." Feb. 19, 2015. (March 6, 2015) http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_bloodpressure.htm
• Centers for Disease Control and Prevention — National Center for Health Statistics. "FastStats: Emergency Department Visits." Jan. 22, 2015. (March 6, 2015) http://www.cdc.gov/nchs/fastats/emergency-department.htm
• Centers for Disease Control and Prevention — National Center for Health Statistics. "Leading Causes of Death." Feb. 6, 2015 (March 6, 2015) http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
• Chamberlain, Catherine J. et al. "Disclosure of 'Nonharmful' Medical Errors and Other Events." Archives of Surgery. Vol. 147, No. 3. Pages 282-286. 2012. (March 6, 2015) http://archsurg.jamanetwork.com/article.aspx?articleid=1107400
• Cooper, Jeffrey S. et al. "Sedative-Hypnotic Toxicity." Medscape. April 4, 2013. (March 6, 2015) http://emedicine.medscape.com/article/818430-overview
• Cunningham, Peter. "Before the U.S. Senate. Health, Education, Labor and Pensions Committee, Subcommittee on Primary Health and Aging — Nonurgent Use of Hospital Emergency Departments." Center for Studying Health System Change (HSC). May 11, 2011. (March 6, 2015) http://hschange.org/CONTENT/1204/1204.pdf
• Groeger, Lena. "How Long Will You Wait at the Emergency Room?" ProPublica. Dec. 19, 2013. (March 6, 2015) http://www.propublica.org/article/how-long-will-you-wait-at-the-emergency-room
• Hadjiliadis, Denis. "Acute vs. Chronic Conditions." MedlinePlus. May 30, 2013. (March 6, 2015) http://www.nlm.nih.gov/medlineplus/ency/imagepages/18126.htm
• Hitti, Miranda. "Put 'ICE' on Your Cell Phone." WebMD. Oct. 16, 2006. (March 6, 2015) http://www.webmd.com/news/20061016/put-ice-on-your-cell-phone
• Insure.com. "Emergency Room Care: Know Your Rights." Dec. 10, 2010. (March 6, 2015) http://www.insure.com/health-insurance/emergency-rights.html
• Keim, Samuel M. "Drug Allergy." eMedicineHealth. July 30, 2014. (March 6, 2015) http://www.emedicinehealth.com/drug_allergy/article_em.htm
• Marte, Jonnelle. "10 Things the Emergency Room Won't Tell You." MarketWatch. Jan. 24, 2011. (March 6, 2015) http://www.marketwatch.com/story/10-things-the-emergency-room-wont-tell-you-1295790468271
• Mayo Clinic. "Drug Allergy." Oct. 10, 2014. (March 6, 2015) http://www.mayoclinic.org/diseases-conditions/drug-allergy/basics/definition/con-20033346
• Mayo Clinic. "Nearly 7 in 10 Americans Take Prescription Drugs, Mayo Clinic, Olmsted Medical Center Find." June 19, 2013. (March 6, 2015) http://newsnetwork.mayoclinic.org/discussion/nearly-7-in-10-americans-take-prescription-drugs-mayo-clinic-olmsted-medical-center-find/
• McHugh, Megan. "Improving Patient Flow and Reducing Emergency Department Crowding: A Guide for Hospitals." Agency for Healthcare Research and Quality. AHRQ Publication No. 11. October 2011. (March 6, 2015) http://www.ahrq.gov/research/findings/final-reports/ptflow/ptflowguide.pdf
• Moffa, Donald A. Jr. "Preventing Toxic Drug Interactions and Exposures." Cleveland Clinic. 2014. (March 6, 2015) http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/preventive-medicine/preventing-toxic-drug-interactions-and-exposures/
• O'Brien, Shannon. "AMA Introduces 'My Medications' App for Patients." American Medical Association. Nov. 22, 2011. (March 6, 2015) http://www.ama-assn.org/ama/pub/news/news/2011-11-22-ama-introduces-my-medications-app.page
• Pola-Money, Gina. "Self-Advocacy." University of Utah, Department of Pediatrics - Medical Home Portal Project. March 2014. (March 6, 2015) http://www.medicalhomeportal.org/living-with-child/navigating-transitions-with-your-child/transition-to-adulthood/self-advocacy
• Press Ganey Associates. "Emergency Department Pulse Report 2010 Patient Perspectives on American Health Care." 2010. (March 6, 2015) http://www.pressganey.com/Documents_secure/Pulse%20Reports/2010_ED_Pulse_Report.pdf
• Rice, Sabriya. "Don't Die Waiting in the ER." CNN. Jan. 13, 2011. (March 6, 2015) http://www.cnn.com/2011/HEALTH/01/13/emergency.room.ep/
• Savard, Marie. "5 Tips for an Emergency Room Visit." ABC News. Sept. 22, 2008. (March 6, 2015) http://abcnews.go.com/Health/story?id=5843080
• Smith, Karen L. "Insider's Guide to the Emergency Room." Real Simple. (March 6, 2015) http://www.realsimple.com/health/first-aid-health-basics/hospitals-insurance/in-case-emergency
• St. Mary's Medical Center. "Emergency Care: What to Expect in the ER." (March 6, 2015) http://www.stmarysmc.com/en-US/ourServices/medicalServices/Pages/Emergency-Care.aspx
• U.S. Department of Health & Human Services — Agency for Healthcare Research and Quality. "Your Guide to Choosing Quality Health Care." AHRQ Publication No. 99-0012. July 2001.(March 6, 2015) http://archive.ahrq.gov/consumer/qnt/qntdr.htm
• Van Leeuwen, Danny. "Bring a Companion to Your Next Doctor's Appointment." Center for Advancing Health (CFAH) - Prepared Patient Blog. June 26, 2014. (March 6, 2015) http://www.cfah.org/blog/2014/bring-a-companion-to-your-next-doctors-appointment
• Worth, Tammy. "Helping Patients Keep an Up-to-date Medication List." American Pharmacists Association. April 1, 2014. (March 6, 2015) http://www.pharmacist.com/helping-patients-keep-date-medication-list

Please copy/paste the following text to properly cite this HowStuffWorks.com article:

‹ Back to Healthy Living

How to avoid the ER in your 20s

Landing in the emergency room at any age can be scary. But no matter how old you are, there are certain precautions and steps you can take to help you avoid a trip to the ER.

Individuals in their 20s are generally healthy people and may not visit the ER as frequently as some of their older counterparts. However, they are not immune to emergency situations, explains Jedidiah Ballard, DO, an emergency room physician and former Army Rangers Battalion Surgeon.

Life choices, says Dr. Ballard, are the most common cause of a 20-something visiting his emergency room.

COVID-19 and other common causes

“The vast majority of what we see in the ER among those in their 20s comes down to the unfortunate pairing of bad luck with a bad choice,” Dr. Ballard says, citing excess alcohol as a leading factor.

Alcohol is the number one drug associated with traumas like car wrecks, snake bites , fights, stabbings, and gunshot wounds, explains Dr. Ballard. Accidental drug overdose is also a frequent cause of death among those in their 20s.

Other common issues that bring young people into the ER include STD checks or concerns about a possible pregnancy. However, nowadays, other causes are bringing 20-somethings in as well.

“Recently, the number one thing I am seeing is the unvaccinated in this age group presenting positive for COVID,” says Dr. Ballard.

Preventive measures

In order to prevent a visit to the ER, Dr. Ballard suggests that 20-somethings get vaccinated , avoid drinking and driving, use condoms to protect from STDs and unwanted pregnancies, abstain from drugs, and stay away from significantly risky activities in general.

Additionally, though it is rare, Dr. Ballard says that people in their 20s are still at risk for heart attacks, blood clots in the lungs, and bleeding into their brain without any trauma.

Dr. Ballard says you should definitely head to the ER if “you cut yourself and can’t get the bleeding to stop, anytime you are having the sensation of being short of breath, having a crushing-type chest pain that won’t go away, or rapid onset headache that is severe and unlike any you’d had before.”

Type 2 diabetes is a growing risk for America’s young people

“Your primary care physician can also be a great resource on when to go to the ER,” says Dr. Ballard. “Simply call their office and let them know what you are experiencing and ask them if they think you need to go to the ER.”

Unique cases

Over the years, Dr. Ballard has seen his fair share of rare or unusual issues in his ER. Recently, a young male patient presented who had scratches all over his face. The man had tried to reach into a trash can to remove a scared raccoon, leading to his injuries.

While some reasons to visit the ER are less likely than others, people of all ages should remain vigilant and try to take the necessary health and safety precautions to keep themselves safe and healthy.

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The unimaginable trip

Since I was a kid I heard about Switzerland through soap operas, newscasts and boxes of chocolates. The conversation is always the same: a beautiful country, where it snows and everything works. With so much beauty and perfection propagated, Switzerland became a kind of myth, a distant and unreachable place. For all this, not even in my wildest dreams I imagined that one day I would leave the country and head to Switzerland. Yet life is really full of surprises. After doing some traveling and realize that the world has no boundaries, and an episode occurred, which led my trip to the country of the world’s best chocolate. The moment I knew I was visiting this so well-known place I was filled with excitement. As soon as I was told I was going, I started to plan all things, see the cities, check for cultural aspects and the history of the places and I found out that this trip wouldn´t be a simply family trip – it would be my chance to see whether all the things they’ve talked about this country are true or not – the organization, the friendly people and the amazing food. The day of the trip finally got, and I soon got my bags and headed to the airport. The voyage was long – almost a day long, but despite the discomfort and the tiredness, I arrived to Zurich’s airport excited to meet a new culture and new people. I asked my father: - Is there going to be time for us to visit everything we planned to? – As we would only stay 5 days and we’ve planned to visit half of the country, that, even if it is small, it has a wide range of things to do. He responded me affirmatively and we headed south to Interlaken – the region famous for its high peaks and alp-like edifications. We stayed two days in a nearby city called Lauterbrunnen. I have never seen such a beautiful place in my life – it was June and we could still see the snow high in the peaks shining like the way to paradise. Snow, something very rare in my hometown, is like a life achievement, and people always to see it in abundance. It was in the middle of June – summer in the northern part of the world. I was enchanted to see a little snow in the peaks, some thousand meters away from me, but I never imagined to be filled by it. When we were heading south to the Italian part of Switzerland, an unimagined thing happened to us – we were stuck in the middle of a midsummer snow storm. This fact was, in my opinion, a surprise. We were stuck in the road for hours. All that snow, that I always wanted to be surrounded by, was transformed into chaos. I was dressed for the hot summer days in Italy, and I never thought that this would happen to me. I was feeling cold, and we were the only ones in the road. Apparently, as we didn´t understand German, they’ve announced it in the radios, but we simply ignored and at that very unique moment we had nowhere to go. We’ve spend only four hours – enough for a car to pass by and help us to get off the trap we were in. At that very first moment, I noticed the difficulties of living in a country where weather surprises us and I saw how blessed I was to live in a country that, despite the heat, we can´t find ourselves in such situation.

This is a travel experience I had. Hope you like it. I am still practicing my writing skills, I am here due to this reason. 

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October 7, 2020

Always be ready for a trip to the ER

(HealthDay)—Accidents happen, and being prepared for an emergency room visit could help speed treatment and reduce anxiety if the need occurs, an expert says.

The first step is determining which ER you want to use in the event of a sudden or severe illness or injury, said Dr. Susan Promes, chair of emergency medicine at Penn State Health Medical Center.

"You'll want to know what's available in your area, and what options they offer," Promes said in a Penn State Health news release.

A convenient location is important, but so are the capabilities of the emergency department and hospital.

"Every emergency department offers general emergency care. But are the doctors trained in the specialty of emergency medicine? If you have children, you may also want to know if there are physicians with additional training in pediatric emergency medicine," Promes said.

For your research, go to a hospital's website, click its emergency department link, and then click on the providers to see if they've had specialty training. The website should also provide information about whether the hospital is a trauma center equipped to stabilize and treat critical injuries, she noted.

When you arrive at the ER, you should have a list of all current medical conditions, medications and doses, and any known allergies.

"I'd even list any previous surgeries and their dates," Promes said. "It would also be helpful to know who your doctors are and what their phone numbers are in case the emergency medicine physician needs more information to provide the best care."

Keep this health information in a purse or wallet, or store it in a cell phone, she suggested.

Another recommended document to have ready, especially for older adults , is a Physician Orders for Life-Sustaining Treatment form. "If you're critically ill, it's really important to be able to communicate what your wishes are," Promes said.

Copyright © 2020 HealthDay . All rights reserved.

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