Immediate Care or Emergency?

When you or a loved one gets sick or injured, going to the right place helps ensure getting the care you need quickly and efficiently. This helpful checklist will help you evaluate whether you should seek attention at an Immediate Care or the Emergency Room.

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Sunburn and Heatstroke - Dangers to Avoid


It's a beautiful summer morning and you head to the beach. By mid-afternoon you're on your way to the ER. What went wrong?

Odds are, you thought the sun was your friend. But too much of a good thing can make you sick.

The most common sun-related problem is sunburn. Fortunately the risk of sunburn often chases us inside before we suffer an even worse fate. Sunburn is indeed a burn, caused by the ultraviolet rays of the sun, both UVB and UVA. The superficial layers of your skin are actually cooked and start leaking fluid, like a sizzling steak. Once the damage is done there is no medical cure except to allow your body to heal itself. Pain medications and cool compresses may relieve the discomfort, but do not speed healing. Do yourself a favor and leave your sunburn alone. You don't want scarring from peeling a deep sunburn, or infection from opening the blisters.

Certainly prevention is the best answer. Avoid direct exposure to the sun between 10 and 4 p.m. Always use a sunscreen of SPF 15 or higher, and apply it to all sun-exposed areas a good half hour before exposure. Even sunscreens that claim to be water resistant should be reapplied every few hours after sweating or swimming.

When the core of your body becomes overheated, not just the skin, the danger becomes much greater. The body core can become overheated due to direct sun exposure on a hot day, or other high temperature environments, especially when physical activity is involved. Below 80 degrees Fahrenheit this rarely happens. Above 130 degrees F the danger is extreme. Between 80 and 130 degrees the danger rises dramatically.

The body becomes overheated from a combination of internal heat production (as in fever) and external heat. In order to maintain a normal body temperature the body must be able to get rid of excess body heat. Think of your car engine, for example. If the fan goes bad or the water leaks out, it will overheat. Similarly, if the body cannot be cooled through a combination of evaporation (sweating), convection (a cool breeze), conduction (cold packs or cool water, or radiation, it, too, will become overheated.

A car that overheats will start sputtering and steaming, and eventually quits working. So will your body. The first symptom you are likely to experience is heat cramps, which generally occur in the calf muscles or abdominal muscles. Stretching your muscles before exercise and keeping yourself hydrated with a sports drink such as Gatorade can help prevent heat cramps. If they do occur, stop exercise, cool your body, and if you haven't done so already, drink some Gatorade.

Heat exhaustion occurs when the body loses too much water and/or sodium. Core body temperature is usually between 100.4 and 104 degrees F. Again, an adequate intake of sports drinks can help prevent heat exhaustion. In addition to heat cramps, you may experience light-headedness, confusion, headache, nausea, vomiting, and lack of urination. For milder symptoms, immediate cooling with fans or water is helpful. However for severe symptoms, especially disorientation, other mental symptoms, or a rapid heart rate, you should seek immediate medical attention, where a doctor can check your electrolytes and provide the proper balance of replacement fluids through an I.V.

The worst case scenario is heat stroke (sun stroke, if due to the sun). Heat stroke can be deadly, especially if treatment is delayed. At an internal temperature of 104 or above the internal organs stop functioning properly. Therefore, heat stroke is a medical emergency - call 911 immediately.

Symptoms of heat stroke can occur even when a person is not sweating. Confusion is common, which may delay recognition of the problem, especially in the elderly. Persons suffering from heat stroke should be moved to a shady area and excess clothing should be removed. A heat stroke victim should be doused with water and/or fanned, and ice packs should be applied to the armpits, groin, and neck until professional help arrives.

In summary, avoiding hot environments and keeping well-hydrated are the answer to preventing most heat and sun related problems. Don't plan to run a marathon on a hot summer day, especially if you are not conditioned to the heat. Keep an eye on granny, in particular if her home is not air-conditioned. Don't leave your children or pets in the car where the sun can bake them. Preventing the problem in the first place is the key to avoiding life-threatening illness.

For practical advice on affordable health care visit: Cynthia J. Koelker MD is a family physician of over twenty years, and holds degrees from MIT, Case Western Reserve University School of Medicine, and the University of Akron. She is the author of "101 Ways to Save Money on Healthcare."  Article Source:

For Ankle Sprains, It's Cold Comfort

This question came up again recently, and it's been a frequent one over the years.  Should treatment for a sprained ankle include cold or warm applications? A sprained ankle is considered an acute injury, and can include both pain and swelling.  Once it's been determined that the injury is actually a sprain and not something more severe, cold therapy with ice to the site is the treatment of choice, even if initial application is delayed by as much as 24 hours.

Here’s how it works. The cold acts as a vasoconstrictor (a fancy phrase that means it tightens blood vessels) and thereby reduces the swelling in the ankle; in theory, it should also decrease some of the pain.

Ice to the affected area should be used for up to three days. Heat is usually applied for chronic injuries (they go on for a longer period) that have no inflammation or swelling. Another aid to faster healing is to keep the affected foot elevated and stay off of it as much as possible, as this helps to promote healing.

Bottom line:  Staying cool is the rule of thumb when dealing with minor ankle sprains.

Copyright © Christine Hammerlund – 2011. Christine Hammerlund is a registered nurse and the owner of Assured Healthcare, a healthcare staffing service headquartered in Gurnee, Illinois.

5 Things to Keep Handy When You Have a Sick Child


Parents who have an infant keep a diaper bag packed at all times. Parents of a child diagnosed with a chronic condition or newly diagnosed acute illness need to be equally prepared. Here are five things to keep packed in a tote for easy grabbing for that emergency room visit or unexpected hospital admission.

  1. Keep a list of current medications and current medical history in your bag. When you are flustered in an emergency situation, you can easily forget to mention an important piece of information about your child, especially if your child is on chemotherapy or other intermittent medication. Write it down.
  2. Keep a change purse with a roll of quarters and a few singles zipped into your tote bag. Emergencies tend to happen when you are low on cash in the wallet. A change purse with at least vending machine money will keep you prepared for that unexpected hospital admission.
  3. Keep a sweater or sweatshirt for yourself. Hospitals are always cooler than you expect and nerves will make you shiver. It is the little things that make a difference and being comfortable eases your stress level.
  4. Keep a favorite comfort stuffed toy or blanket for your child, a book, or other item that helps to distract your child during painful procedures like blood draws and exams. Keep an extra dose of Tylenol or other as needed medications your child may need on an intermittent basis. Children who need anti- nausea medications or seizure medications may need a dose if travel has lasted longer than expected or some other unforeseen circumstance occurs. Keep those medicines in a childproof container in your bag.
  5. Keep a notebook with emergency phone numbers, notes from previous admissions, or any other information you may not always recall immediately. The notes you have made may make a difference in the immediate care of your child in an emergency.

Parents who have a small tote bag packed with these items can survive until family can bring other belongings for that unexpected hospital stay. Have the bag in the car to easily grab if and when it may be needed.

For more information on children coping with illness or death and dying issues, or health and safety tips for children visit

Visit for an interactive website where kids can blog or read articles geared towards them.

Terri Forehand is a pediatric critical care nurse and freelance writer. She has a passion for kids of all ages, especially kids who are fighting against tough illnesses and diseases. Visit her blog and website for more information. She is currently working on fiction for kids.

Four Fave Healthcare Tech Advances


At one of my networking group meetings, someone recently asked what I considered to be the four most important advances in healthcare technology over the past twenty or thirty years.   Considering the huge leaps in knowledge, daily bio-medical discoveries and amazing technology breakthroughs, that would be a very time consuming task.  But, off the top of my head, I did come up with a list of four personal favorites: Computer software that supports the needs of the staffing industry - specifically, full service medical staffing.  In order to make the best, most efficient and safest matches of healthcare professionals with the people who need them, we process a lot of critical information.  The specialized software programs we now have access to enable us to rapidly query, sort and filter extensive database records to quickly fill a staffing need.  This ability is a far cry from the pull-out drawers of color coded candidate file cards that were still the norm for many staffing agencies well into the 1990s.

New glucometers and sugar testing devices used by diabetic patients.  What a relief and convenience for people who often need to test multiple times a day.  The devices now used can test from various parts of the body, patients can use them on their own, there is less scar tissue and higher accuracy, and these devices are far more specific and reliable than the urine sticks used way back in the past.


Publically accessible defibrillators.  It may take a while for them to be in common use before we fully realize the value of these devices, but that day is coming.  With the growth of an aging and highly mobile population,  the number of lives saved by defibrillators can only increase.  The technology of these devices has been streamlined and simplified to walk the person providing aid through the process, further increasing the odds of survival for someone stricken with a cardiac-event while in a public or private venue.

The migration to electronic medical recordkeeping, or EMR. Let's face it, this one is a no-brainer.  Anything at all that helps to minimize risk to a patient caused by illegibly scrawled prescriptions, diagnoses, instructions, chart notes and medical records is a blessing.  Other advantages are the same as the computer software benefits described above - patient diagnostic and treatment records can be queried, accessed, reviewed, and properly routed to the patient and multiple treatment providers quickly and ACCURATELY!

This list is sure to grow with the blog - keep an eye out for future tech faves!

Copyright © Christine Hammerlund – 2009.Christine Hammerlund is a registered nurse and the owner of Assured Healthcare, a healthcare staffing service headquartered in Gurnee, Illinois.