Donald Alves

Not necessarily.  The body's response to most ingested substances that it identifies as toxic or potentially harmful to it are expelled as rapidly as possible.  This means vomiting and often diarrhea. However, as its objective suggests, this is usually accomplished within a couple of hours, and the GI tract settles down.

Prolonged vomiting/retching is the main feature that will necessitate ER or Urgent Care visit. If, however, you become lightheaded or dizzy with position change, that can indicate that you are volume depleted and may also need to go to the ER.

Unlikely as a general answer. Not all hospitals staff their MRIs 24hrs/day; when staffed, they have a schedule of inpatient and outpatient exams to do. An acute MRI is rarely needed for "back pain," unless in the setting of fevers; IV drug-of-abuse or immune-compromising or blood-thinning medication; or an abnormal neurological exam. Usually pain/spasm relief is sought, and if obtained, the patient is discharged home, to follow up with their Doctor or an Orthopedist for further evaluation and management as an outpatient. If it is a very urgent question, it is more likely that a CT scan will be obtained of the area of the spine where the pain is localized to, as CT scan is quick, usually staffed 24hrs/day but definitely more than MRI, and ER has ready access to it. 

The Emergency Department is not a good place for anxious people.  It may feel like a life-threatening condition while it is actively causing symptoms,  but it actually triages far down the list of conditions that bring people to the ER. That means you could wind up waiting for quite a while.  Urgent care centers are not all equipped to deal with anxiety and panic. So, if feeling desperate,  the ER is the safe place of last resort, and we will not turn you away.

A dislocated finger needs reduced back to its usual position as soon as reasonable to reduce the risk of nerve or tendon injury and need for further care. (That, and they look very weird pointing off in the wrong direction). Many Urgent Care centers can take care of this, including x-ray capability, should the history of how it happened or exam be concerning for the presence of an associated fracture. 

It depends on the content. If you hear voices, as long as you are not being told / "commanded" to hurt yourself or another, then you may follow up with your Primary Care Provider and/or Mental Health Provider -- which sometimes can be accessed via a "one call" phone number, depending on where you live. Visual hallucinations can be more distressing, increasing the urgency of need to address, however if you are able to rationalize that what you are seeing is not / can not be actually there --a six foot tall, green, gorilla, as an example that a patient described to me, then added "I must be crazy." The conclusion is not correct, as the logic was still in place to determine that this was not the actual situation, so presented for outpatient evaluation and medication. 
If in doubt, or if being commanded to do something--good or bad--by auditory hallucinations, or if upset by visual or tactile (sense of touching or being touched by something that is not there), then the Emergency Department is always a safe place to go. 

It is not the military or prison,  as long as you are competent and not contemplating self- (or other person) injury, you are free to do what you want.  You usually cannot take an inserted IV line with you,  though. The "dwell time" in the ER depends upon many things,  NONE of which do the ER doctors or nurses have ANY control over,  and yet often receive the frustrated patient's scathing diatribe over. There is no ER-mind-control over other departments (lab, imaging, consultants, pharmacy--who each, in their work space have competing demands to prioritize and process), the "next patient" that can always appear at any time, very self-centeredly attempting to die and thus demanding the complete attention of several ER team members for an unknowable duration of time until "stable" in either sense of the word, and we can pick back up (ideally) where we left off with everyone else.  The paperwork components,  so your insurance does not arbitrarily deny your visit and leave you with the large (undiscounted) bill, are onerous and require some focused time along the way, as there is never a predictable down time to finish it after you are discharged, but if incomplete not done may cost you.  Prescriptions and follow up / cautionary guidance take time to generate. Etc., etc.

Keep in mind, that "tv time" is not reality based, otherwise that CPR the Paramedics brought in,  and took us from your care, would be revived, diagnosed with and cured of whatever failed him/her at the time, and be ready for discharge ahead of you,  since they got our collective focused attention (as above). Also, if you have a Primary Care Provider,  the time frame for comparison is different: couple of days to weeks to get in, orders for outpatient testing,  some of which needs scheduled,  then return visit to review and see if you are better, worse, or the same. This leads to the next round of testing,  and/or consulting,  and on and on. Each step can be a day to weeks long. The ER can often jumpstart the process several steps, but will likely take most of the day to accomplish.  And, this assumes that you have come in early in the day on a weekday that is not a holiday, so testing and specialists are readily available.  Everything is not the same evening or overnight hours,  weekends or holidays.  Bring a book or something else to pass the time with during your stay. Also, EAT if coming near a mealtime, the staff often does not get a break to eat, and it is admittedly NOT the emphasis of a location with "Emergency" in the name. Also, there is likely "no stars" rated for our "box lunch" cuisine.

If you keep your expectations realistic,  and are a "patient patient," your visit with the dedicated staff of the ER will be more palatable, and a few more minutes to get the discharge paperwork will not seem like such a long time.

Call 911. Have the patient sit down.  Loosen restrictive clothing. If have, give four baby aspirin (81mg x 4 = 324mg) -OR- an aspirin (325mg). Make sure you or someone else has called 911. If the person has medication to take when having chest pain, you may help open the little bottle and put one of the even smaller pills into their hand, so they do not wind up dropping the pills while fumbling with them.

Pain in the right lower quadrant (RLQ) is a classic indicator of appendicitis. That said, it is rarely the only one. Many others are often also present: fever, loss of appetite ("anorexia"), a loose/diarrheal stool (but not prolific), pain that increases over time, increasing sensitivity to any movement of the abdomen, and initially ("classically") pain that starts at/near the belly button and then migrates to the RLQ.

If the pain is the only feature, if it has been there for awhile (hours to days), and is stable (not worsening), then it is less likely appendicitis. In males, the system is less anatomically complex (no female reproductive system components that could also be responsible), and it is usually musculoskeletal related or the GI tract (including the appendix) as the source.

If the pain is persistent, worsening, and/or associated with any of the other symptoms above, you should be seen in an ER, in general, not an office or clinic, as the ER can get rapid diagnostic imaging (ultrasound or CT), give pain medication and antibiotics, and obtain a surgical consultation.

Not unavoidably.  It is an increased risk because of the pressures, changes in them, and amounts of time involved; however, as long as you respect the risks and follow the time-tested procedures,  you can minimize your risk to close to the general public.  Usually the more common occurrence is the random / chance event. Hyperbarics gives you the added benefit of "diving" in 100% oxygen, so you wash out the nitrogen that is usually the culprit.

If you have a fever with general muscle aches and feeling oogy, over-the-counter Acetaminophen (/Tylenol) or Ibuprofen (/Advil) should help control the fever and your symptoms.  If an hour passes without any improvement in how you are feeling or your temperature coming down towards normal--you should be seen by a Healthcare Provider  (your Doctor/PA/NP or an Urgent Care) to be sure nothing more serious is going on.  If things do improve,  try and drink plenty of clear liquids and rest for a day or so. Remember that the medicine only lasts about six hours,  so you may need more than one dose. If the symptoms persist beyond 2-3 days total, you should be seen by a Healthcare Provider.  Feel better!

Hopefully your tattoo artist and/or prior experience can assist you somewhat, as you should be putting some form of antibiotic ointment on the site already. If so, it could also potentially be an allergic reaction to one of the inks used, which would need treated differently. Since it is an unusual response/reaction, and is concerning to you, it should be looked at by a Healthcare Provider. That said, I would not suggest going to the ER for it, as could result in a long wait while patient's triaged as more acutely ill get taken first. A local urgent care center or your primary care provider should be able to evaluate the site and prescribe reasonable course of treatment. --Good luck!

Unless you happen to have an undiagnosed kidney, endocrine or metabolic disorder that is complicating your hydration status, the only answer is to DRINK MORE. The military learned decades ago that you cannot "train to be dry," and that "salt tablets" as a general concept (limited specific exceptions notwithstanding), do more harm than good. You need to push your intake to the limit of absorption, which is about 1L/1qt per hour. Water works well for the majority of that volume, but if not eating regularly, or sweating profusely, about every third quart should have some electrolytes in it. Some recommend using 1/2 strength electrolyte drink throughout--it depends on the expert and your situation. Even with the best efforts, though, you can still potentially expend more moisture (skin/sweat losses, urinary processing losses, respiratory humidification losses, and GI losses) than the 1qt/hr you are able to absorb--the best way to check this is to weigh yourself in the morning and again at the end of the day (use the same scale). Any weight loss is liquid, and water weighs about 2 pounds per quart (/1kg per Liter)--translate that deficit into your "homework," that you need to make up to be fully hydrated for the next day--with the same 1qt/hr intake limit. Good luck!

You should discuss this with your therapist / prescriber, as what is unbearable torture for one person can be an unpleasant distraction for another. In general, it is better to be in a safe space (like the ER) than not if you are decompensating or contemplating injuring yourself or someone else, however short of that, you should have some ground rules or options in place--if I drift down to feeling like "x" then I (we agree), I should page my therapist for a phone triage. If I lose more altitude to "y," then I should page my prescriber to see if an additional dose or phone-in prescription is warranted...and if I am 'scraping the treetops ("z"), then I need to go to the ER...knowing that it is a very busy place and I will be there for several hours, but am likely to come away (eventually) in a better place, with any adjustments they may have considered reasonable, and an outpatient follow up plan made with my providers. 

Even as should go without saying, "drown-proofing" is important in young kids, but you absolutely should have effective fence/gate/latch to deter visitors (them or others), and it is wise to invest in a pool surface alarm--it is a LOUD alarm that floats on the surface of the pool and is motion sensitive--if a breeze blows it around, OK, but if a wave (like from someone falling in) jars it...!!!  After these, be sure to remove the person from the water and call 911. You should be (or become) trained in CPR, as essentially that is what comes next: tilt the head back to open the airway and then look / listen / feel for any efforts at breathing (unless they are awake enough to be coughing--then keep them laying on one side or sitting up and observe them CLOSELY and CONTINUOUSLY until EMS arrives. If not breathing, then give two breaths via mouth to mouth-and-nose (for 3yo) or mouth to mouth (if older) or mouth to mask (if you have one), and check for a pulse at the carotid artery in the neck. If present, continue with rescue breathing until EMS arrives, if absent, begin CPR...did I mention that prevention is the best option? Good luck, and happy swimming!

The answer depends on what is the underlying cause -- if culture shows bacteria or fungus, then it should be eradicated in order to determine if it was the cause, or if it is inflammatory/autoimmune. Once the antibiotics are done, naturopathic options can be considered, and they usually focus on inflammation reduction. The specific selection of herbals depends upon the suspected source, and more information is available online.

Heat stroke is a lethal medical emergency if not aggressively cooled. The term, however is frequently overused--as likely your case--and should more properly be termed heat exhaustion.Anyone who overdoes it in the heat, particularly with direct sun and/or inadequate hydration, will tend to feel "wiped out," very fatigued, and listless. That is exhaustion. Heat stroke generally is accompanied by a markedly elevated body temperature, due to the failure of autoregulation, sometimes reaching 106-109F. In part as a consequence of this high temperature, the patient is usually delerious, and some sources require altered mental status with temperature elevation given a history of heat exposure to confirm heat stroke. This condition must be rapidly cooled, and the subject often has some associated muscle tissue breakdown, so is generally hospitalized for further care. 

Try this first: Gently close off the non-Lego nostril with a finger or thumb, then place your mouth over his and quickly blow a puff of air into his mouth--just like in rescue breathing. In many cases, the foreign object will be blown out the nostril and trip to the ER averted. If this does not work--and given its hard corners and geometry, might not, then unfortunately, yes, either your pediatrician (if day time), or the ER so the item can be retrieved.

A heart attack in a pediatric patient is still an uncommon event and is usually due to a vascular or metabolic anomaly ("birth defect"), although the "typical" American diet (high fat and high total daily calories) in combination with a plummeting physical activity level is rapidly dropping the age of onset for more classic causes of heart disease as seen in adults--arterial plaques in the vessels that supply the heart. For the latter, obesity, diabetes, and autoimmune diseases, to name a few, contribute and accelerate the process. Symptoms of a heart attack in a tween or teen age patient are often the same as those reported by an adult: pain in the mid-chest (under the sternum), radiation of the pain to the neck, jaw, or arm (left more than right, but may be either or both), in association with increased work of breathing,  sweating and nausea. Family history of "usual" heart disease may help support the concern for symptoms' origin, but still requires the  caregivers to maintain an awareness of the possibility in order to identify early on the ill-appearance coupled with symptoms in order to intervene rapidly and call 911, as while "time is muscle" with a potential heart attack, it is even more essential in a pediatric patient, as they will be living with the consequences of the event for much longer. 

The answer depends on the age of the child, the severity and rapidity of the reaction, and the school. In general, yes, the child should have the EpiPen in their backpack with them if they move between classes, or with the teacher if they stay in one place or are too young to be responsible for it and its self-administration. Parents need to identify the allergy to the Teacher(-s), the symptoms indicating the onset of the reaction, the time critical need to call 911 (AND, not "or"), summon the School Nurse (if fortunate enough to have one), and where/how to arm and administer the EpiPen to the child, or assist with this procedure. If a rapid onset and/or severe reaction history, it should be stressed to the Teacher that the reaction could potentially be triggered by contact with small amounts of the allergen (such as peanut butter) inadvertently transferred to other objects, and thus at "non-lunch" or "non-snack" times of the day. [An example of this would be a non-allergic person who eats a PB&J, then touches common items/areas, such as door knobs, counters, keyboards, etc, with transfer of microscopic amounts of the allergen to those surfaces. The susceptible (/allergic) person then follows behind later and picks up the allergen from these areas and has a reaction. (This is why some schools have taken the extreme precaution of banning peanut containing products.)

High blood pressure (HTN) and heart attack (AMI) often arrive in the same "ride-share" vehicle, and making the heart work (24/7, btw) against elevated resting and peak pressures in the vascular system will increase its workload, and thus its need for oxygen and other nutrients. The entire system is working harder and as with any machine--man-made, or hu-man--it can fail. HTN is referred to as "the silent killer," as its victim is usually unaware that the system is working so hard until something catastrophic happens--which usually means a stroke or heart attack. Each disease process carries its own risks, but the two together multiply these risks. Everyone should periodically check their blood pressure (like on a public machine in a pharmacy) or at their Doctor's on well-person visits or sick calls.