Mount Auburn Healthcare Connection

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You suddenly experience shortness of breath or feel very weak. Or perhaps you have a cut on your leg that won’t stop bleeding. Or maybe you are nauseated and can’t stop vomiting. Or what if your child has a bad cough or a sore throat? Do any of these conditions warrant an emergency department visit?

Gary Setnik, M.D., chair of emergency medicine at Mount Auburn Hospital, a teaching hospital of Harvard Medical School, says, “If you feel you have a condition that is in need of emergency medical treatment, you should go to the emergency department. It’s always better to err on the side of caution if you have any doubts about the seriousness of your symptoms.”

Dr. Setnik emphasizes that for less urgent conditions, you want to contact your primary care doctor first, but at times, that may not be possible. And you should always call 911 for potentially life-threatening symptoms such as chest pain or severe injuries. It’s much better to have care in an ambulance on the way to the hospital than to try to drive yourself while you’re experiencing a serious medical problem, such as a heart attack. Also, if necessary, paramedics can begin initial treatment in your home.

“Symptoms of a heart attack are variable,” says Dr. Setnik. “While the classic symptoms are severe tightness or pain in the chest, sometimes heart attack symptoms are more subtle.” Other symptoms may include shortness of breath, sweating, weakness, or pain in the shoulders, arms, upper abdomen or back. Any symptoms that last for more than a few minutes require evaluation.

For more information about cardiac symptoms, please read Pay Attention to Your Heart with Dr. Cynthia McGinn.

Dr. Setnik says that while you should come to the emergency department with any severe symptoms that cause you concern, the following symptoms generally warrant medical attention:

• Sudden severe pain anywhere in your body, especially in the chest

• Pain in the shoulders, arms, neck and jaw or upper abdomen, especially when associated with weakness, lightheadedness, sweating or a clammy feeling

• Suspected poisoning (call poison control first if possible)

• Shortness of breath

• Sudden severe headache

• Loss of consciousness

• Sudden change in ability to talk, see or think clearly

• Weakness on one side of your body or in one arm or leg

• Slurred speech

• Continuous bleeding from a cut that will not stop with applied pressure

• Persistent nausea and vomiting

• Vomiting blood

• Bright red blood in bowel movements

• A major injury, such as a fracture or large burn

• Concern about a serious reaction to an insect sting or a medication

• Suicidal or homicidal feelings

It’s important for you to be prepared for emergencies before they happen. Dr. Setnik says, “Everyone should take some responsibility for their own healthcare. You should have a primary care physician and regular physical exams as appropriate. In addition, you should keep detailed information with you about your medications (and dosages), including over-the-counter medications. Also keep accurate information about your allergies and immunizations. Finally, you should be aware of emergency departments and other healthcare facilities in your community.

For more information on medications, read Know Your Medications with Jeanne Donovan, R.N.

Once you arrive at Mount Auburn Hospital’s Emergency Department, a team of specialists will coordinate your care. A triage nurse will assess your situation and refer you to the FasTrack program if your symptoms are relatively minor. (FasTrack is open 12 hours a day seven days a week.)

For more information, read FasTrack: Timely, Quality Care with Dr. David Binder.

If you have more severe symptoms, such as those associated with a heart attack or stroke, you will immediately be evaluated by an emergency medicine physician who will examine you and run tests to determine what is causing your problem. If necessary, you will then be treated for your condition or referred to appropriate specialists.

Dr. Setnik emphasizes, “Emergency medicine is available to help you no matter how severe or minor your symptoms may be. At Mount Auburn Hospital, we work as a team to coordinate your care and make sure your needs are met.”