Dr. Stephen Brooke Cox MD
Emergency Physician
8401 Datapoint Dr Suite 500 San Antonio TX, 78229About
Dr. Stephen Cox practices Emergency Medicine in San Antonio, TX. Dr. Cox assesses patients who seek immediate medical attention at any time of day or night. Emergency Medicine Physicians are trained to efficiently work with each patient and situation no matter how acute or life-threatening. Dr. Cox examines patients, determines means of testing, diagnoses conditions, and decides the best treatment methods.
Education and Training
Univ of Va Sch of Med, Charlottesville Va 1989
Provider Details
Dr. Stephen Brooke Cox MD's Expert Contributions
What is the lethal dose of Klonopin?
Call 911 and get her to the hospital immediately. This is a serious overdose. She could vomit and inhale (aspirate) it, stop breathing, have brain damage. Thank you very much, Stephen B. Cox, MD, BCEM, FACEP READ MORE
Caffeine overdose?
Take her directly to the ER. Don't take chances. READ MORE
Can fentanyl metabolize into blood alcohol?
No. They are completely different chemicals. Thank you very much. READ MORE
How do I know if someone is overdosing?
What happened to all of you was a near-death experience. Taking unknown pills from a stranger or acquaintance can easily end in your death or that of a friend. From you description, the most likely case is that you ingested/snorted pain pills, probably oxycontin, mixed with fentanyl - an extremely powerful narcotic (100 times stronger than morphine) that can cause you to stop breathing and die, and that often causes nausea and/or vomiting. If anyone in your group gets out of it enough to be unresponsive even to a painful stimuli, you should immediately call 911 and get them to the ER. It is possible that sometimes this will turn out to have been unnecessary. It is guaranteed to save a life some of the time. Mixing heroin or oxycontin with fentanyl is becoming increasingly common, and I have personally seen people come in dead on arrival from using one or the other, and others I couldn't bring back no matter how much Narcan I gave them. Be careful! Thank you very much, Stephen B. Cox, MD BCEM FACEP READ MORE
What to do next?
Short answer: If you are still having any of those symptoms, then go to the ER immediately as you may be having a stroke. IF the symptoms have resolved, you need to see your regular doctor (or get one if you don't have one) within 3-4 days. You need lab work, an EKG, and possibly a CT scan of the brain. These are very serious symptoms and need to be evaluated by a doctor. Just in case the keto diet is a factor, I would stop it immediately until you can discuss your options with a physician. Stephen B. Cox, MD, BCEM READ MORE
Are hallucinations serious?
Hallucinations are always serious. They indicate a serious malfunction in your brain's ability to process sensory input and tell the difference between reality and illusion. It is often due to mental illness such as schizophrenia or bipolar disorder. There are good treatments for these that a doctor can prescribe. Doing some street drugs such as methamphetamine or heroin or cocaine can also cause hallucinations. In any case, it is extremely important that you see a doctor right away. I would recommend going to an emergency room. I am an emergency doctor and can promise you that an emergency doctor will be able to help you to figure out the cause and refer you to the right specialist. One last thing. Hallucinations often get worse over time. I strongly urge you to seek immediate emergency medical care. Good Luck! Stephen B. Cox MD BCEM txerdoc1@yahoo.com READ MORE
Should I go to the ER for chest pain?
Yes definitely. The reasons are 1. Pain is in your chest, a dangerous area 2. You describe pain as bad or severe, which means it is more likely to be serious 3. You seem to say that the pain is still there. All three are reasons to go to the ER. When you have all 3 you definitely need to go to the ER. It might be nothing serious but it isn't worth taking a chance. Good luck! Stephen B. Cox MD BCEM txerdoc1@yahoo.com READ MORE
Should I go to the ER for a UTI?
If you think you have a simple bladder infection then you should see your family doctor or (if its more urgent) go to an urgent care center. If you develop pain in your back /flank or fever over 102 or vomiting then go to the ER as the infection may have spread to your kidneys, which is more serious. If you are pregnant see a doctor within 24 hours of having burning with urination- can be urgent care, your OBGYN, or family doctor. READ MORE
What is the treatment for anaphylaxis?
If he gets anaphylaxis the only safe answer is to call 911 for an ambulance to take him to the ER. Anaphylaxis can kill- by swelling the throat closed. You should have his doctor prescribe 2 pediatric epi (epinephrine) pens. These are for you to inject in his thigh as soon as the anaphylactic reaction begins and buy him enough time to go to the ER. READ MORE
Is strep throat a reason for an emergency ENT visit?
If he is having trouble breathing or is unable to swallow his saliva then take him to an ER right away. If not, an urgent care center or his primary care doctor are the best choices. An ER will cost you a lot ($1000 and up) more without any benefit. READ MORE
Is it possible to have a small heart attack?
Yes it happens all the time. If you have any concern this is definitely worth an ER visit, especially if you're over 40 and/or have diabetes/hypertension/high cholesterol which increase your risk. READ MORE
Can lymph nodes swell due to a tattoo infection?
Yes, lymph nodes serve as the body's immune system filtering process.They can swell in response to any infection (viral or bacterial) or foreign material(tattoo). If your lymph nodes swell near a tattoo make sure to look carefully for redness of the skin around the tattoo (if redness spreads out from actual tattoo may be an infection). Other signs of an infection (tattoo or other) are increased warmth over the area and increased tenderness. I recommend that you see a doctor promptly to make sure it isn't getting infected. That can be a serious problem. Stephen B. Cox, MD, BCEM READ MORE
What are the first steps when someone drowns?
The best thing for you to do is take a basic life support course. These are inexpensive, only take 1 or 2 days, and teach you how to deal with all kinds of emergencies including drowning. They are offered by the Red Cross and YMCAs as well as others. If you google Basic life support course in your area you should find plenty. READ MORE
Can being hit in the head cause a seizure?
Yes that can happen. It would take a pretty forceful punch to do it though. If a person is having a seizure, make sure there is nothing near them that they can roll onto and hurt themselves, and turn them face up. DO NOT EVER put anything in their mouth (especially your fingers) to "keep them from swallowing their tongue (that's impossible to do). Most seizures go away on their own within 5 minutes. Have someone call 911 or you do it and stay with them until the ambulance arrives. IF the seizure stops but they don't appear to be breathing, you can give them mouth to mouth. Check for a pulse at their neck (carotid artery) and if no pulse start CPR. READ MORE
Expert Publications
Data provided by the National Library of Medicine- Vapor-phase analysis of isobutyl acetate, isopropyl acetate, n-propyl acetate and their respective alcohols using solid-phase microextraction-gas chromatography with a mass selective detector.
- Monitoring perchlorate exposure and thyroid hormone status among raccoons inhabiting a perchlorate-contaminated site.
- Determination of N-nitroso derivatives of hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) in soils by pressurized liquid extraction and liquid chromatography-electrospray ionization mass spectrometry.
- Assessment of pathogens and toxicants in New Orleans, LA following Hurricane Katrina.
- Reproductive effects of hexahydro-1,3,5-trinitroso-1,3,5-triazine in deer mice (Peromyscus maniculatus) during a controlled exposure study.
- Metal distributions in New Orleans following hurricanes Katrina and Rita: A continuation study.
- Etiological study of esophageal squamous cell carcinoma in an endemic region: a population-based case control study in Huaian, China.
- Examination of the mutagenicity of RDX and its N-nitroso metabolites using the Salmonella reverse mutation assay.
- Spatial and temporal evaluation of metal concentrations in soils and sediments from New Orleans, Louisiana, USA, following hurricanes Katrina and Rita.
- Effect of two major N-nitroso hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) metabolites on earthworm reproductive success.
- Modulation of aflatoxin biomarkers in human blood and urine by green tea polyphenols intervention.
- Effects of HMX exposure upon metabolic rate of northern bobwhite quail (Colinus virginianus) in ovo.
- Scale-dependent responses of plant biodiversity to nitrogen enrichment.
- Characterization of the structural and functional diversity of indigenous soil
- Multigenerational effects in deer mice (Peromyscus maniculatus) exposed to hexahydro-1,3,5-trinitroso-1,3,5-triazine (TNX).
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