Staying out of the ER and urgent care in the COVID era is even more important these days. Many infections are believed to occur in the hospital through droplet exposure. Here are my TIPS for anyone with cancer:
1) Reduce your risks for infectious exposure (wash hands incessantly, wear a clean mask, social distance, avoid surfaces and items that may be contaminated or decontaminate them, etc.)
2) Don’t hesitate to call your oncology office (or 911 or ER in an emergency)
—20% of ER visits in cancer patients are due to their “need to talk with the treating physician.” Many of these ER visits are avoidable with a call to your oncology office.
—Don’t wait to call the oncologist if you have any concerning symptoms. 64% of oncology patients admitted to a hospital stated that the symptoms leading to their presentation had developed over several days; those symptoms could have been managed in a different setting had they been addressed in a timely fashion. https://ascopubs.org/doi/full/10.1200/JOP.17.00081
—Generally, over the phone, your oncology provider or nurse can make a determination as to the best course of action. Someone is available 24/7. Don’t worry about being a ‘bother.’ We want you to call us so we can address your issue and hopefully avoid an ER visit.
—If you experience a true medical emergency (such as difficulty breathing or severe chest pains), you should not wait to contact your physician. You should proceed immediately to the ER or call an ambulance if needed.
Symptoms that warrant a visit to the ER can include:
—A single temperature above 101°F or a temperature above 100.4°F for more than 1 hour, especially if you are undergoing chemotherapy
—Confusion or a change in mental status, including hallucinations
—Difficulty breathing
—A new rash
—Trouble swallowing, drooling, or facial, neck, or tongue swelling (concerns regarding anaphylaxis)
—Increased pain
—Headache
—Abdominal pain
—Constipation or uncontrollable diarrhea
—Uncontrollable nausea and/or vomiting
—Bleeding
—Swelling in legs or arms
As a general rule, a medical emergency is defined as a sudden unexpected occurrence of circumstances like changes in physical or mental status, or a new symptom, such as severe pain, that affects a person’s well-being and demands immediate action.
If you experience chemotherapy or radiation side effects, for example, nausea, vomiting or diarrhea, and you are unable to control them with medications prescribed by your doctor, you should seek medical care in the ER.
3) Minimize your risks of personal injury or trauma. This is not the time to be doing anything that increases your risk. Be extra careful. Some of the most common injury-related reasons people go to the ER include:
—Broken bones and sprains
—Cuts and contusions
—Back pains or muscle strains
—Skin infections
4) Call your dentist first. The American Dental Association estimates that emergency room visits for dental issues occur roughly every 15 seconds, for a total of 2.2 million patients per year.
—If you think you might have a broken jaw or severe bleeding from the mouth, then an emergency room visit is in order.
—However, when it comes to severe discomfort from a toothache, broken teeth, or extensive decay, your dental office is a much better option to help treat you.
Contact My Office
My office number: 509-987-1800
—My cell phone is also given to all of my patients. After hours, they are encouraged to call me.
