Dr. Josyann Abisaab

One of the more common reasons for emergency room visits is head trauma. A new study published in November’s issue of the official journal of the Congress of Neurological Surgeons, Neurosurgery, has shown that low oxygen supply, or hypoxia, to vulnerable brain tissue is a crucial factor in the risk of death or severe disability after serious traumatic brain injury (TBI.)

The study showed that the larger the decrease in brain oxygenation, then the higher was the risk of severe disability or death later on. The study strongly suggests that patients with prolonged periods of brain hypoxia have an increased likelihood of having poor prognosis separate from the results of intracranial pressure, brain blood flow and other risk factors.

The results of the study support the recommendation of including brain oxygen monitoring as a part of an integrated monitoring policy after severe TBI. Results are not yet in of whether treatment adjustments in response to the brain oxygenation monitoring lead to improved outcome in patients with severe TBI.

Joanne Abisaab, MD, practices emergency room medicine at New York Presbyterian Hospital.

After Triage

If your child’s problem does not require immediate attention, then you will need to wait. Luckily you have some books, toys and/or crayons (see part 1) to help pass the time with your child.

Your child might need an x-ray or other tests, and you might be told that your child should not eat or drink until after the tests are completed.

Your Turn Arrives

Finally you and your child will be called into the examination room. You may have to wait a bit longer until a doctor arrives, and when she does arrive she will ask you about your child’s medical issue, and decide what additional tests are needed in addition to any that have already been done.

When the doctor decides what treatment is needed, most of the time the patient is sent home. On occasion the doctor might decide that your child needs to stay in the hospital, either overnight for observation, or longer for proper treatment, depending on the medical issue.

If you do go home the ER doctor might tell you that your child should be examined by your regular doctor at a later date; to make sure the treatment is working and recovery is progressing properly.

Dr. Josyann Abisaab is an emergency room physician at New York Presbyterian Hospital.

If you ever need to bring a child to the emergency room, it’s a good idea to prepare her/him in advance. If he knows what to expect, the trauma of the visit will be reduced to a minimum.

On the Way to the ER

Although it is certainly possible to drive to the emergency room yourself, if you need to get your child there quickly, consider calling 911 for an ambulance. Not only is an ambulance the fastest way to get to the ER, but there are trained professionals in the ambulance who can administer whatever care that is immediately necessary. If you have time, bring some of your child’s belongings that can comfort and calm him while he is there, like a stuffed animal, small toy, crayons or books.

What to Expect

Explain to your child that the first thing you do when you get to the ER is sign-up at the front desk. In this way the doctors know you are there and that your child needs attention. If it is a problem requiring immediate care your child will probably be seen right away. After the initial signing-in a nurse will perform triage, which is how the nurse decides who needs to be seen first by the ER doctors.

Dr. Josyann Abisaab is an emergency room physician at New York Presbyterian Hospital.