In this post I review the book Labor Day by Joyce Maynard . It explores an unexpected and transformative weekend for a 13-year-old boy named Henry, his emotionally fragile mother Adele, and a mysterious man named Frank.
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How to know when an ER visit is needed for a medical problem
updated January 17, 2024
During the fall and winter, hospitals see an increase in patients with respiratory illnesses due to influenza, COVID-19, and pneumonia, as well as disorders due to cold exposure and injuries due to ice and snow.
One shouldn’t go to an emergency room unless they truly need to.
But what is an emergency?
An emergency can be a medical condition which
is new, sudden, and/or unexpected,
worse than usual or uncontrolled,
of unknown origin,
not responding to treatment,
not improving or resolving,
interrupts normal life.
However, a more specific definition is
An emergent medical condition is one that, if not treated promptly
Threatens life
Threatens one or more limbs
Threatens vision/hearing/speech/mental function/ function of any major internal organ or organ system
In the United States, a federal law known as EMTALA defines a medical emergency as
“a condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual’s health [or the health of an unborn child] in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of bodily organs.”
Examples of emergent conditions include
Sudden or new changes in heart function, like a myocardial infarction (heart attack), arrhythmia (abnormal heart rate or rhythm) or congestive failure (poor pumping capacity)
Brain conditions including stroke, head trauma, seizure, psychosis
Pulmonary (breathing) dysfunction including pulmonary embolus (blood clot), severe pneumonia, asthma or COPD
Multiple trauma, including extensive burns , multiple fractures, or trauma to any major organ like the liver or kidneys
Chemical changes in the blood; for example high /low blood sugar, low blood potassium, low platelets,
Severe depression and/or anxiety
Drug and alcohol overdoses
SYMPTOMS of an emergency include
Shortness of breath, or difficulty breathing, especially if not associated with exertion
Uncontrollable bleeding
A seizure, especially in a person with no previous diagnosis of seizures
Sudden or severe loss or difficulty with vision, hearing , speech, or other functions such as swallowing, thinking, walking, passing urine or stool
Fainting, passing out, loss of consciousness, severe dizziness
Hallucinations, confusion, thoughts or threats of harm to self or others
In a pregnant woman- any of the above plus loss of fetal movement
Persistent/severe nausea/vomiting/diarrhea
Severe pain, especially if it prevents or inhibits body function
Persons at risk
Certain groups of people are more at risk of significant illness with any of these symptoms, so emergency care should be sought sooner rather than later. They include
infants up to age 2
elderly-most medical references still call this over age 65
pregnant women
people with suppressed immune systems as from cancer chemotherapy, HIV, malnutrition, other drugs
Chest pain must always be taken seriously, even if mild.
Although in persons under 40 years old it is less likely due to a heart attack, there are other life threatening conditions that can occur in this age group. Again, especially if it is associated with any of the other symptoms, it is emergent.
Learn more about common heart diseases at this previous post
While on a mission trip to Panama, my husband had a near emergency when a board flew into his leg causing a deep gash; a local surgeon was working with our medical team , and with their help he sutured the wound at the small rural church where we were holding clinic; his leg has healed well, just a scar to remind us of the adventure.
IN AN EMERGENCY CALL 911!
You should not call your doctor’s office, your mother, your best friend, or post a question on social media (which I have seen done!)
If it’s not an emergency but is urgent, then the next best options are calling your doctor’s office or going to an urgent care clinic. Posting on social media is still a bad choice. Do you really want your “friends” giving you medical advice about something they know nothing about?
We doctors don’t expect you to diagnose your condition before coming to the ER or the office, and insurance companies shouldn’t either. With using the above guidelines, if you even suspect your problem is an emergency, you are wise to seek help.
watercress words by Dr Aletha 