How to know when it’s time to go to the ER.
A small cut, a slight burn, a bump on the head.
How do you know when to seek professional help?
Once you understand the severity, do not be afraid to go to a hospital if you need to, said Dr. Sara Andrabi, assistant professor of emergency medicine at Baylor College of Medicine. People may be feeling more anxiety about seeking hospital care for minor emergencies because of COVID-19, but don’t let that discourage you.
“Emergencies do exist even during a pandemic, and hospitals and emergency rooms have safety practices in place,” Andrabi said.
At Baylor, those safety practices include screening patients for fevers before they enter the waiting area and separating suspected COVID-19 patients from those with other medical emergencies.
But there are minor injuries that you can handle from the safety of your own home, and typically all you will need are bandages, antibiotic ointment, tap water and Tylenol.
CUTS
There are 6 million cuts treated in emergency departments across the country every year, Andrabi said. It’s one of the most common injuries emergency doctors see.
If the cut doesn’t go through the top skin layer (dermis), you will likely not need stitches, she said. If the cut is wide, jagged or it did break the dermis, then you likely will need them. It also depends on where the cut is on your body; if it’s on your face, then you will likely want a professional to look at it.
Be more careful with animal or human bites since there is bacteria that live in mouths that make the wound more likely to become infected. If you’re cut by glass, there is a higher risk of developing an infection as well.
Complications from wounds are common for people with diabetes, arterial disease, renal failure, tissue disorders or those who take steroids, Andrabi added.
When you get cut or scraped, immediately clean the area with soap and water. This decreases the risk of needing antibiotics or developing an infection.
If you’re bleeding, use a clean cloth or bandage to help stop the blood flow. If it’s on your hand, you can hold it above your heart to help slow the bleeding, Andrabi said. If it doesn’t stop bleeding after a few minutes, seek medical attention.
Once clean and dry, apply a thin layer of antibiotic ointment and keep it covered with a bandage or gauze. Change the dressing once or twice a day until it heals — typically about seven to 10 days. Do not pick the scab, she said.
Dr. Jason Knight, chief medical officer at Houston Methodist in the Woodlands and an emergency department doctor, said cuts less than 3 centimeters wide can be closed with over-the-counter steri-strips, medical-grade skin glue or even super glue.
After the wound is clean and dry, apply direct pressure and tape it with either a strip or glue; pinch the wound closed and make sure not to glue your fingers together. Medical-grade skin glue works better than super glue, he said.
“One of the things we are seeing is people really need to suture most lacerations within 24 hours of the cut occurring,” Knight said. “If people wait too long, they can’t close it, and it increases the risk of infection.”
Don’t slap a bandage on it and think you’re done, Andrabi said.
Seek medical attention if there is redness, swelling, warmth or increased pain around the injury, or you have developed a fever. Also do so if there is pus draining from the area, red streaks around it, numbness or tingling, the skin was deeply punctured or it has been more than five years since your last tetanus shot.
MINOR BURNS
Since the start of the pandemic, Knight said, local emergency departments are receiving more patients with minor burns. Most are from cooking or grease fires or boiling water.
“They’re usually watching YouTube cooking videos and getting second-degree burns from not practicing standards of safety,” he said. “Be aware of your surroundings when you’re pivoting in the kitchen from the stove to the counter with anything hot, and especially if you have little kids.”
For a mild first-degree burn, either from an open flame or hot water, immediately run it under cool water for 15-20 minutes. If a blister forms, it’s a second-degree burn. If it goes down to deeper tissue, it’s a third-degree burn.
Treat first- and second-degree burns with antibiotic ointment, such as Silvadene, two or three times a day. Keep it clean and covered.
“A lot of people come in because once a burn is seconddegree, the pain is severe. They feel that they need stronger pain medicine,” Knight said. “For minor scrapes, bumps and bruises, people underutilize Tylenol and Motrin for pain. You only need stronger pain medication when those aren’t providing adequate relief.”
CONCUSSIONS
Falls and head trauma are serious regardless of age.
Skulls have different thicknesses depending on the area: above the ear is thinner than the forehead. If you’re whacked in the forehead, it’s rare to have a serious traumatic brain bleed — unless you’re taking blood thinners.
After a bump on the head, it’s important to examine the area for a scalp hematoma, or a “goose egg.”
If the injury is on the back or the side of the head, observe the person for six hours or take them to the emergency room. If the person didn’t lose consciousness for more than five seconds, CAT scans typically aren’t recommended, Knight said.
Bring the patient to a hospital if they start vomiting.
“One of the things we see a lot are elderly people on blood thinners for various conditions who have had head injuries,” Knight said. “A minor trauma to the head could be potentially serious, so come in right away.”
The window of time for choosing a treatment option depends on the severity of the injury, Knight said. The main reason to go to the emergency room is to see whether the person needs emergency brain imaging, not if they have had a concussion.
If a senior citizen has fallen, it’s best to seek professional help, Andrabi said.
“One of the things I will always ask is what caused the fall,” she said. “They may have blacked out or have had a minor heart attack. These are important things to figure out and evaluate.”
Minor injuries can be handled at home. But when in doubt, call a professional or seek emergency care.