Is This Really an Emergency?

Emergency Tips from The Doctors


• Keep emergency phone numbers, such as your doctors, hospital, poison control and 911 in your cell phone, next to your home phone and in your car. The National Poison Control Hotline number is 1-800-222-1222.

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“Another thing to remember,” Dr. Jim says, “is if you’re out cold, the authorities are maybe going to grab your cell phone, and they’re going to look in your index and look for I.C.E., in case of emergency. Have a loved one entered under I.C.E.”

If you take medications, keep a list of those with you so if you do end up in the hospital, the doctors will know what they are.

Keep an updated first aid kit in the house and know how to use it.

Get first aid certified so you are ready to handle basic problems and injuries at home.

Heart Device Recall

Pulling a defective medical device off the shelf is one thing, but removing it from the bodies of thousands of patients is much more complicated and dangerous. This is the predicament many people find themselves in after Medtronic recalled the Sprint Fidelis, a heart defibrillator cable, in 2007 after five patients died from a malfunction. However, nearly 150,000 Americans still have the cable implanted, and four people have died during extraction of the product.

“First of all, I think it’s safe to say that Medtronic is one of the most important device companies in the world,” cardiac surgeon Dr. Greg Fontana says. “They’ve supplied us with the first pacemakers decades ago, and a lot of work goes into these devices before they’re ever released into the market with FDA approval.


“But devices fail, and we know that, but we hope that it’s just at a very, very low level, and if they do fail they can be identified and safely dealt with,” he continues. “In this case, a quarter-million patients had implanted defibrillators, not just the simple pacemaker, but the pacemakers that also shock a patient out of dangerous rhythms. One of the cables in the heart fractured within the first couple of years, which can lead to inappropriate shocks or inappropriate pacing. But obviously, to go back in there and remove that carries risk as well.”

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“Most of the time, it’s fine,” Dr. Fontana says. “Are you going to go through replacing every one of those devices for those few that have a problem, or not? The company, Medtronic, the physicians who are treating these patients, and the patients have to get together and really kind of discuss if they are a patient who has an appropriate strategy for their problem. Should they be having the device removed, or should they be watched carefully?”


Medtronic estimates that the cable fails in about 5 percent of patients.


“The main [focus] I think we ought to have is not to panic,” medical director of Medtronic, Dr. David Steinhaus says. “Remember, the chances of this malfunctioning are quite low.


“The other thing I think is really important for patients to remember is they are much better off with the device than without a device,” Dr. Steinhaus says. “The disease we’re trying to treat, sudden cardiac arrest, is the largest single cause of death in the United States. In fact, it is 95 percent fatal. It causes more deaths every year than HIV, AIDS, breast cancer and lung cancer combined. It’s a serious disease, and in fact, we estimate that in the last five years, over 70,000 patient lives have been saved by this device. We generally don’t recommend replacing these unless they’re malfunctioning.”


Dangers of Animal Bites

If you’ve ever been bitten by a dog or a cat, you’re not alone. Every day, more than 13,000 people are bitten by pets and wild animals. But do you know what to do if this happens?

“Typically, a lot of bites are really just puncture wounds,” Dr. Ordon says. “So, really there -- the issue of how big is the cut, there’s really not much bleeding -- what we’re more concerned with is that bacteria that’s been seeded by the bite, or what is deeper in that area. Especially on the hand you’re concerned about tendons, blood vessels, nerves. And, the way that spaces are in the hand, if you seed bacteria into a part of it, it can spread.”


The risk for infection from an animal or human bite is greater if it occurs on your extremities, which is why it is vital to have the wound cleaned out as soon as possible. Signs of infection include redness, increased swelling and puss coming from the wound. If you suffer from these symptoms, seek medical attention immediately. “And last, but not least, if you get fevers after being bitten, you'd better go to your doctor sooner rather than later,” Dr. Travis says.


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For more on animal bites, visit

If you are bitten by a wild animal, such as a bat or raccoon, make sure to be checked for rabies. Dr. Sears explains what to do if your child is bitten by an animal.

Initial Cleaning of All Bite Wounds (

As soon as possible, preferably within eight hours, do the following:

• Gently wipe away any dirt.

Irrigate the wound. Go to a drug store and buy a large bottle of sterile saline and a large syringe. Flush the wound with at least 16 ounces of the saline using the syringe. Use as much force with the syringe as the child will allow. If it is too painful, apply an antibiotic ointment that also contains an anesthetic ointment. This may ease the pain.
Apply an antibiotic ointment.
Use the guidelines below to determine whether further medical attention is necessary.


General Bite Situations that Always Require You to Call a Doctor (

Here are some situations that require you seek medical attention the same day.

Any large bite that results in a large tear that looks as if it requires stitches.
Any bite on the hand, finger, foot or toe (unless it is just a little scrape).
Any bite on the face (unless it is just a little scrape).
Any deep puncture bite (those from long, thin teeth, such as a deep cat bite)


Fever: How High is Too High?

In pain?

To determine the severity of your condition, use our pain assessment chart.

Julie, 25, has a 6-year-old son, and is concerned because whenever he gets a fever, it is typically a few degrees higher than her normal fever.


“Kids will run a higher fever in general,” Dr. Jim says. “If you get the same illness, the child may have a 103, 104, while you may have a 101, 102, and it’s still the same level of sickness.


“What fever does is if you get sick, fever’s actually good because it helps the body fight off the infection,” Dr. Jim adds. “It’s kind of the body’s immune response. All those infection-fighting cells are rushing to wherever the infection is, and that’s what creates the fever. It’s a sign that there’s some sort of infection going on. And kids get sick more often, so they get fevers more often, but that’s just kind of how it works. How they’re acting is much more important than what the level of fever is.”


If a fever rises above 103 degrees, if a baby under 3 months old has a rectal temperature of 100.4 or higher, or if a fever lasts more than three days, call your doctor as soon as possible. Also, never give a child aspirin to treat a fever, Dr. Jim warns.

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OAD 5/14/09