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Don’t Spend Your Holidays in the ER: 5 Hazards to Watch For—Commentary

Commentary
12/5/2016 Amy H. Kaji, MD, PhD, Harbor-UCLA Medical Center;

Nothing cuts holiday celebrations short quite like a trip to the emergency department. The holidays are supposed to be about enjoying time away from work and school, maybe a new toy or two, and relaxing with friends and family. But for thousands of people every year, the merry-making is interrupted by an injury or illness that requires a visit to the hospital.

Emergency departments often see an uptick in patients around the holidays. Although winter-weather illnesses (including the dreaded flu) send some seeking treatment, many ER visits are the result of holiday-specific hazards and issues. Let’s take a closer look at some.

1. Overindulgence

For many of us, Thanksgiving kicks off a month-long marathon of celebrating that includes bigger meals and more drinking than the rest of the year. For people with existing health conditions like diabetes, limiting intake of sugary holiday treats is a key step to avoiding a trip to the ER. People with heart conditions should be especially careful about how much salt they eat. Eating extra salt will make heart failure worse. According to a recent study, the number of people admitted to the hospital for heart failure increases in the days right after major holidays.

Overdoing alcohol has its own set of serious potential issues, including falls, car crashes and other injuries. In addition, drinking too much alcohol can cause a temporary irregular heartbeat, even in people who don’t have any known heart problems. This occurs so often around the holidays that doctors refer to it as holiday heart syndrome. Be careful how much you drink, and certainly don’t drink and drive.

2. Depression

While the holidays are a time of joyous celebrations for many, they can also be a painful reminder of lost loved ones and difficult times. This increase in depression, often dubbed the holiday blues, makes the holiday parties and other social expectations of the season challenging for some people. That depression results in ER visits for attempted suicide, substance abuse, and panic attacks. Some people might feel better if they accept fewer invitations and limit themselves to gatherings with select, supportive friends and family. Continue the stress relievers that you know work for you (e.g., exercise, journal writing, talking to friends), and allow yourself to be selective of the number of events you attend.  

3. Exhaustion

Long travel days, working late to prepare for time off, weeknight parties, endless shopping– the holidays are a recipe for exhaustion. However, people must be careful not to chalk up important physical symptoms such as chest pain, shortness of breath, irregular heartbeat, or abdominal pain to exhaustion. These symptoms are warning signs of dangerous conditions for which you should see a doctor.

Those Black Friday sales and marathon trips to the mall pose another danger. Standing still in long lines after skipping breakfast or not getting enough to drink can easily cause fainting. People should get enough rest and stay hydrated. It is important to schedule in meals and rest periods if you plan on a long day of shopping—otherwise people may end up in a hospital after literally shopping until they drop. Make sure sleep is a priority by maintaining a regular nighttime routine and good sleep hygiene.

4. Falls

Slips, trips, and falls in crowded aisles and icy parking lots are a common source of ER visits. Falls from ladders while hanging lights or topping the tree are also common, especially among older individuals and people who had a drink or two before decking the halls. In fact, according to the Consumer Product Safety Commission, every year holiday decorating causes about 15,000 injuries that result in ER visits. And new holiday toys sometimes injure people learning to use them. For example, last year, at least 70 kids went to the hospital thanks to falls and collisions from the popular new hoverboard toys.

5. Cuts

That pesky packaging that can only be opened with a pair of garden shears and an engineering degree causes many cuts that require a trip to the ER. Same goes for lacerations in the kitchen from carving the turkey or dicing sweet potatoes. Think twice and cut once!

Before the holidays

It may be hard to reach doctors during the holidays, so try to anticipate problems before the holidays start. If a medical condition has been slowly getting worse—for example blood sugar levels have been rising—or medicine is running low, don’t wait until the holidays arrive to make a call. During the holidays, a different doctor is often returning calls, and they may not feel comfortable refilling a prescription or solving problems when they don’t know a person.

When is the ER necessary?

What holiday mishaps and symptoms warrant a trip to the ER? It’s not always easy to tell, and in fact 71 percent of ER docs say they treat patients every day who first went to urgent care and were then told they needed to go to the ER. Here’s a good rule of thumb: For minor cold symptoms, stay home. For cuts, strains, and sprains, go to urgent care. If it’s more serious, head for the hospital—particularly for chest discomfort, trouble breathing, neurologic symptoms (for example, dizziness, fainting, or weakness), new severe pain anywhere, and anything that causes great concern.