Dr. Mark Buckner

It is not necessarily different than regular medicine but, since the late 1970s, emergency medicine became a specialty in its own right. As a medical student in the early 90's I chose to become an emergency physician. I did a 3-year residency in emergency medicine and became a board-certified emergency physician. Emergency medicine encompasses a specific, and large, knowledgebase, which is why emergency medicine residencies started and it became a specialty. Board-certified emergency physicians have had more training in all of the many medical problems that may present in the er than, say a family medicine dr, or a surgeon. There are many ER's still who do not have board-certified emergency physicians, as there is a shortage, but that shortage is shrinking, and today there are more bc er physicians than ever. In summary, emergency medicine is a specialty of medicine that encompasses any possible emergency situation that may present to the emergency department.

Yes, if the inhaler is not doing enough to decrease the breathing troubles your child has. Look at the area below the neck - if it is going back and forth with breaths, the ER is needed. You likely need a nebulizer - they work much better than an inhaler.

I'm not sure why you think you have sepsis, but if you do you need to be admitted to a hospital. sepsis is an overwhelming illness, that starts with any type of infection. The infection becomes systemic, meaning it is in the bloodstream and bacteria are going to all organs, and sepsis causes organ damage, such as to the kidneys, heart, liver, brain etc. septic patients will have fever, and will look extremely ill. typically the heart rate rises 1st, then the blood pressure drops, then anything can happen. so if you are having an infection or fever or whatever makes you feel you are septic, you need to go to an ER immediately

Back pain is usually not an emergency if it is related to the spine. If your pain is related to walking, or is positional, and you feel that it is caused by your spine, then I suggest you see your PCP or an urgent care clinic. You may need an MRI. There is one condition that can cause back pain that is an emergency: the aorta, which is the largest artery in our body, leaves the chest, then runs through the abdomen right along and anterior to the spine. If someone has an aneurysm of the aorta, it can start causing back pain. If the aneurysm ruptures or dissects, the patient would die in minutes. Sometimes an aneurysm can be seen on a plain X-ray, sometimes not. But it will show up on an MRI of the spine, which your PCP or an urgent care clinic can order.

YES YOU SHOULD TAKE YOUR NEWBORN TO THE ER FOR A DOCUMENTED TEMPERATURE OF 102*. I DON' KNOW THE AGE OF YOUR CHILD, BUT, I AM ASSUMING IT IS DEFINITELY LESS THAN 2 YEARS OF AGE. CHILDREN <6 MONTHS OLD WITH FEVER ARE A DIAGNOSTIC CHALLENGE FOR ER DR'S, BUT THAT DOESN'T MEAN A DIAGNOSIS CAN'T BE MADE. MOST COMMONLY A FEVER INDICATES INFECTION IN A NEWBORN. YOU NEED TO HAVE A PHYSICIAN EVALUATE YOUR CHILD, SO THEY CAN COME UP WITH A DIAGNOSIS, A REASON FOR THE FEVER. THEY WILL DO THIS FROM ASKING QUESTIONS, EXAMINING YOUR CHILD , AND ORDERING TESTS. WITH NO OTHER INFO, I WILL NOT GO THROUGH THE TESTS THAT MAY BE NEEDED. BUT THERE IS NO DOUBT YOU SHOULD TAKE A NEWBORN TO THE ER FOR A TEMPERATURE OF 102. THE YOUNGER THE CHILD, THE MORE IMPORTANT IT IS.

You can try this first, and if it doesn't work, then take him to the ER. Put one of your fingers on the nostril that does not have the Lego in it. Have him take a deep breath and blow his nose. If he has trouble with this, you can tell him you are going to give him a kiss, then put someone's finger over the unaffected nostril, take a deep breath, and give him an open mouth kiss. Make sure your lips are sealed with his, then blow. If it moves enough that you can grab with forceps, then do so gently. If that doesn't work, go to the ER.

Give him some Benadryl, a dose of Zyrtec, put ice on the sting, and wash and keep it clean. Get a magnifying glass and see if there is a stinger still in the skin. If so, it should be removed.

Yes, you should, especially if you have any change in vision, headaches, nausea, facial pain, or swelling. A baseball can hit with enough force to cause eye injuries as well as facial fractures and other injuries. Not something to ignore.

Yes. Lymph nodes or glands typically swell somewhere near where infection is present. They will be tender, and resolve when the infection is treated.

Emergency physicians are trained to see any patient with any condition that may walk through the doors of the emergency department. We do a residency in emergency medicine. Emergency medicine is now a specialty, just like an ENT doctor is a specialist. We are experts in true emergencies and are able to rule out the real emergency conditions, including ones that are maybe just urgent. In our day-to-day work, we see things over time that other doctors will likely never see.

Yes, especially if you have risk factors for heart disease or other serious chest, lung, or heart disorders such as smoking, high cholesterol, high blood pressure, diabetes, a family history of heart disease, etc.

It would depend on how severe your allergic reaction had progressed, how much symptom relief you got, and, in general, how you are feeling. If your reaction was severe, and for example, you still had a rash - hives - then I would recommend you take two Claritin 10mg by mouth, take 50mg of Benadryl, then, yes - go to the hospital or a freestanding ER. The effects of the epipen will wear off, but the antigen, which in your case is the peanut, would still be lingering in your body. So, when the medication in the epipen wears off, your symptoms may very well return. So, it is a good idea to be in a place where medical professionals can observe you for a period of time, and be able to treat you if the returning symptoms are severe. The short answer is, yes. I recommend you read the instructions that came with it, and also maybe Google "epipen." This will give you a good idea of what is recommended.

Emergency physicians are trained to treat and stabilize any type of patient that comes into the ER. For severe trauma cases, they may call a surgeon to come to the ER to assist in the care of the patient. It all depends on the injuries that were sustained by the patient. In general, surgeons work in the operating room. Emergency physicians in the ER. In a few hospitals, such as a level 1 trauma center such as Parkland in Dallas, they may have a trauma surgeon either in the ER 24/7 or always on call for them. A trauma surgeon is a general surgeon who has gone further in training, and requires doing a trauma fellowship. So, they specialized in trauma. Just like a plastic surgeon specializes in plastics. A general surgeon can take care of a certain level of trauma patients, but those patients who are still critical will usually get stabilized by the general surgeon and the ER doctor, then transferred to a level 1 trauma center. General surgeons typically operate on things like the gallbladder, appendix, and other standard operations. Emergency physicians are trained in trauma, but they are also trained in practically everything else: pediatrics, heart attacks, basically emergency medical conditions.

I would prefer not to use the word "worry." Instead, I would ask, "When should I think about taking my child to the doctor if there is a fever?" Any child with a documented temperature of 102 should go see a doctor. Children with a fever are at a higher risk of having bad outcomes if less than 2 years old. There are many causes of fever. Some are serious and may require hospitalization, and some are less serious and can be treated as an outpatient. "Serious" = meningitis, septic shock, or influenza, as examples. Less serious are an ear infection, throat infection, etc. The take-home answer is, it takes a physician to be able to tell what is causing the fever, and separate the bad causes from the not-so-bad ones. But, a fever is always a sign of infection in a four-year-old, and they should always see a doctor ASAP. Tylenol and ibuprofen are okay and wise to give, but that doesn't change the need to go to the doctor.

If you are having abdominal pain and fever, you need to go to the ER. It's as simple as that. That's because there are a number of serious conditions that can cause fever with abdominal pain. The UTI symptoms may be a completely separate matter. Many patients will have more than one diagnosis at the same time.

The first thing to do is be sure it is "Food poisoning", which we call "Food-borne illness". Typically if it is a food borne illness, patients will have both vomiting and diarrhea. If no diarrhea, a food borne illness is less likely. Treatment at first consists of simply treating the symptoms. Start a clear liquid diet, drink small sips of a clear liquid such as water. If vomiting and can't keep liquids down, the patient will likely need a prescription medicine to stop the vomiting. Preventing dehydration is the main goal. When you have vomiting and diarrhea, you are losing electrolytes such as sodium and potassium, so drinking gatorade or pedialyte is good to add to drinking water. For the diarrhea, use only pepto bismol. I advise against using otc medications like lomotil, imodium, etc. They paralyze the smooth muscles of the colon, and if the diarrhea is infection related, those will make things worse.

If vomiting and diarrhea go on for more than 2 days, or if there is fever, it is most likely a bacterial infection and antibiotics will be needed. Most food borne illness is viral, and should resolve within 1-3 days. Anything longer than that will require a dr visit. In short, prevent dehydration is the primary goal in the treatment, and stopping the vomiting.

As with any patient that I can't see or talk to, it depends. I am going to assume she is a type 2 diabetic, which means she takes oral medications for her diabetes. 1 thing it depends on is HOW LOW the BS is. The more important question is, does the sugar get so low that she has symptoms, such as light headedness, or becoming less alert or even unconscious? Hopefully that hasn't occurred, and if she keeps good track of her blood sugars, as soon as it starts getting to around 75 or less, she needs to eat something with carbohydrates. If she is becoming less alert, but can still swallow, give her a sugary drink - OJ, Pepsi, whatever, or even some sugar. I would always rather see someone with a BS of 190, than 30. 1 thing to remember is that if she takes pills for her diabetes, these are typically long acting meds, and even if you get the sugar back up, that medication is still in her system, and there is a good chance her sugar will drop again later on. It sounds like she needs to see her doctor, and have them adjust her medications.

First, I am assuming, which I don't like to do, that your child is young, probably less than 5-6 years old. Febrile seizures, which is what you are describing, can happen to younger children, and often it's just a one-time thing. The next time your child has a fever, they may not have a seizure. Most children with this don't end up later in life needing seizure medicines. I am also assuming the doctor in the ER did some tests on your child, because some febrile seizures can be associated with serious infections such as meningitis. As an ER doctor, it is a decision we must make in each scenario, whether or not to do a lumbar puncture, or spinal tap (same thing), to rule out meningitis.
Directly to your question - first, do not try to put anything in your child's mouth; that will only increase the chance that you obstruct the child's airway. Make sure that the child is laying somewhere where the seizure will not cause them to injure themselves, such as a concrete floor. Then, just keep the child protected from injury and watch for a short time, watch exactly what type of movements they are making so you can describe them well to the ER doctor. Nearly all of these seizures will stop within a minute or so. If it continues for much longer than a couple of minutes, I suggest you call 911, as it may be something else that paramedics can start to treat. If it stops after one minute or so and your child becomes alert again, place them in a comfortable place, and give them tylenol and ibuprofen to decrease the fever. Take their temperature so you can tell ER staff. Those are about the only things you need to do at first. Then you should go to the ER, as long as the child is alert, like I said. If they aren't, call 911.
In the ER, tests should be done to rule out causes of the fever, such as meningitis, ear infection, etc. It is not a "normal" side effect of the fever. Most children who get a feverdo not have a seizure. But some do, and it is due to the fever, although this is not really well understood. It is believed to be somewhat hereditary, in other words, many children who have a febrile seizure have a relative who also had these when they were young. Typically, as the child ages, the chances of a febrile seizure decrease. Also, the degree of fever does not seem to matter. A child with a temp of 101F can have the same seizure as one with a temp of 104F. The primary thing, when you first see that your child is having a seizure, is to protect them from harming themselves further by falling or hitting their head, etc. That is your first priority.

There is not a set of tests for every patient in the ER. The tests we do depend on the patient's problem, age, vital signs, and other factors. So, we often do tests, but it is not a "one size fits all" type of thing. It is very individual, dependent on the patient's condition. For migraines, sometimes there aren't any tests that need to be done. Some migraine patients might need a head CT scan, especially if it's their first migraine, or if it's the worst headache they've ever had.

If you were bitten by a black widow, number 1, it would depend on the amount, if any, of venom that went through the skin. But I would highly expect you to have symptoms by now, so it's unlikely.