Things that go bump in the night

Despite our best efforts, kids still seem to manage to find ways to bump their heads. The vast majority of these injuries are not serious and cause no long-term effects but sometimes a knock to the head can be so serious that it damages the brain. When your child hits their head it can be difficult to tell whether they need to be taken to hospital or if they can safely stay at home with you. The team at My Emergency Doctor are here to help you to ensure your child receives the most appropriate care.

 

A head injury is any bump to the head resulting in a bruise, lump or cut. Head injuries can be mild, moderate or severe and while mild head injuries are generally safely observed at home, anything moderate or severe requires immediate medical attention. Before we discuss the management of mild head injuries it is important that you become familiar with the features of moderate to severe head injuries. If, after hitting their head, your child shows any of the below-mentioned features, or if you are concerned about your child, call an ambulance by dialling 000.

 

Signs of a moderate to severe head injury include:

– any loss of consciousness (‘passing out’)
– drowsiness
– confusion
– memory loss
– one or more seizures
– two or more vomits
– persistent or recurrent headache
– visual disturbance
– large cut, bruise or bump on the head (or any object stuck in their head)
– unequal pupils
– arm or leg weakness
– clear discharge from the nose or ears

 

If your child has not lost consciousness and is awake, interacting with you and behaving normally, they most likely have suffered a mild head injury. They may have vomited, but only once, and they may have a bruise or a cut where they bumped their head. Mild head injuries may be safely managed at home but as it can sometimes be tricky to tell the difference between a mild and a moderate head injury it is always a good idea to seek medical advice; that’s where My Emergency Doctor can help.

 

Our Emergency Specialists will ask further details about the injury and about your child’s behaviour. If they deem that your child has had a moderate head injury they will recommend that you present to an Emergency Department but if they determine that your child has had a mild head injury they will recommend a period of observation at home (saving you a trip to hospital). You will receive clear instructions on what to look out for over the following days to weeks as your child recovers from the injury and returns to normal activities.

Ways to stay healthy at work

In our modern day life office work is very common with employees spending an increasing amount of time sitting at desks. Sedentary behaviours such as sitting at a work desk or reclining watching television result in no physical activity or energy expenditure with research establishing that prolonged sitting poses significant risks to the health of workers. Sedentary behaviour is behaviour such as sitting or reclining which when done for extended periods during the day have been shown to increase the risk of multiple preventable health conditions and have a secondary negative effect on the workplace.

 

The length of time spent sitting per day is directly related to the risk of developing conditions such as: cardiovascular disease, type 2 diabetes, obesity, cancer, musculoskeletal disorders and premature death. It’s important to remember that humans are built to stand upright – our heart and lungs function more efficiently when we are standing upright. Major muscle groups are also engaged when we stand causing an amount of energy to be expended. When we sit down for long periods our muscles lose size and bulk and our internal organs become sluggish and less effective at regulating sugar and other hormone levels.

 

For those who do spend many hours a day sitting there are simple changes you can make to lessen your risk of cardiovascular and lifestyle related diseases.

 


Diet

– Eat sensibly with 6 small meals a day high in protein, vegetables and fibre

– Drink 6-8 glasses of water a day to stay hydrated

Exercise

– Reduce your sitting time at the workplace desk and aim to walk thousand steps a day

– Stand when taking a call

Posture

– Maintain good posture whilst seated and use desk based stretches to prevent workplace injury

Weight

Moving your muscles helps your body digest the fats and sugars you eat. If you spend a lot of time sitting, digestion is not as efficient, so you retain those fats and sugars as fat in your body.

Mental state

– Take regular breaks to refresh and reenergize your mind standing and taking a break from the computer every 30 min

Sun exposure

– Seek a balanced approach to sun exposures your office based location to ensure you get enough Vitamin D from sunlight whilst whilst protecting against skin cancer

 

If you are at work and become unwell MyEmergencyDr can help – download the My Emergency Dr app to connect to a Specialist Emergency Doctor for an urgent health assessment and treatment. Available from https://www.myemergencydr.com

Diabetes, sugar and your health

Diabetes is a worldwide chronic health condition that affects over 400 million people and which has doubled in incidence in those over the age of 18 years. There are two types of diabetes – Type 1 diabetes predominantly affects children and teenagers because their pancreas does not produce insulin where Type 2 diabetes affects adults because their body is unable to use the insulin it produces effectively.

 

Insulin is a hormone in the body, which helps sugar (glucose) to be absorbed by the body’s cells. When the body becomes resistant to the effect of insulin the sugar cannot be absorbed and this causes a high level of sugar in the body. Type 2 diabetes is caused by being overweight, physically inactive and eating a poor diet.

 

The rise of processed foods which are rich in sugar, low in fibre and high in calories; combined with reduced physical activity has caused rates of obesity to increase. The excess fat carried on the body directly affects the body’s ability to use insulin to drive sugar into the cells and muscles for energy use and storage. When the sugar is no longer used or stored it causes damage to the major organs of the body.

 

Common effects of chronically raised blood sugar includes:

 

– damage to the heart causing heart attacks and lifelong coronary artery disease

– damage to the kidneys causing kidney failure

– damage to the eyes causing loss of sight

– damage to the nerves causing loss of sensation to limbs

– damage to blood vessels causing infections and amputations

 

To prevent the onset of diabetes it is imperative that you incorporate simple lifestyles measures. These include:

 

– maintaining a healthy weight

– participating in 30 minutes of regular daily exercise

– eating a healthy diet plant based diet and avoiding foods high in fat or sugar

 

If you have diabetes and are unwell and need to speak with a doctor download the My Emergency Dr app to speak with and be assessed by a qualified specialist doctor today.

Prescribe me a tracker

Wearable electronic devices are the ‘it’ item in fitness and health. Calorie counter? Step tracker? Sleep monitor? Is there anything these wearables can’t track, measure or count for the every day fitness of an individual? The media is full of ambassadors and athletes preaching their love for these wrist gadgets. So, should we follow them?

 

The modern fitness tracker varies in price, with higher-end devices allowing options such as GPS route tracking, heart rate monitoring, and waterproof technology. They typically work with your smartphone, tablet or a website, enabling you to keep an eye on your progress over time with graphs and figures. The main idea is that they will hopefully spur you on to exercise more, get fitter and/or lose weight. Imagine you finished your walk and you could see the calories you burnt, or the steps you did, or even how much you pushed your heart rate. Now imagine you could build a virtual diary of this information, allowing you to compare data weekly or monthly to help motivate yourself. This is the type of useful functionality that sets fitness trackers apart.

 

This usage and adoption into mainstream has prompted serious research into trackers with interesting results. A recent University of Pittsburgh randomised controlled trial recently tracked 470 overweight or obese people aged 18 to 35, for 24 months. The group using the tracker lost an average of 3.5kg over two years, compared with an average 5.9kg in the self-monitored group. Their conclusion? Fitness trackers may not help weight loss. There were a lot of variables which could have influenced the result, namely that the study recruited only young adults, as well as the fact that the wearable devices were used only 6 months into the trial.

 

Ultimately, it shows that the basis of living a healthy lifestyle is exercising regularly combined with a balanced diet. However, plenty of people struggle with motivation. Fitness trackers can keep us accountable for missing exercise. They can remind us to keep moving at sedentary jobs. They are also personalised, taking into account our gender, age, height and weight.

 

They may not do the exercise for us, but they have the ability to be part of our lifestyle and general wellbeing. They are more than just fancy pedometers. They can motivate us to lose weight, reduce risk factors for health conditions, improve our cardiovascular health, and even diet and sleep better because we have the ability to track and monitor.

 

Research may not show the significant impact of fitness trackers in terms of objective measures such as weight loss or improving cardiac function, but its really the psychological effects that may prove beneficial, providing a permeable and persistent motivation to improve adherence to exercise and diet.

Urinary Tract Infections

Have you ever felt like you are passing razor blades when going to the toilet? Or found your urine to be blood stained? Or feel as if no matter how many times you go to the toilet you are unable to completely empty your bladder? You’re not alone.  Both women and men can both suffer from urinary tract infections (UTI) however they are more common in women with one in 2 women compared to one in 20 men contracting a UTI in their lifetime.

 

Urine is normally sterile. This means it doesn’t contain any of the bad guys – bacteria, fungi or viruses which can make us unwell. Most often it is bacteria that enters the urinary tract causing an infection in the bladder or if more severe, an infection in the kidneys. Urinary tract infections are very common, particularly in women, babies and the elderly.

 

Some of the symptoms of UTI’s include painful urination, feeling the need to go more often and urgently, pain in the lower abdomen and blood in the urine.  Generally signs of a more serious infection in the kidneys include fevers and chills, nausea and vomiting, abdominal and low back pains.

 

UTI’s are easily treatable with a medical assessment, urine sample and script for antibiotics and they are important to treat in order to prevent the spread of infection to the kidneys and bloodstream. Here at MyEmergencyDr our focus is on helping you get better. Simply download the MyEmergencyDr app on your phone and we will provide a specialist emergency doctor to assess you.

 

Once you’ve been assessed we will provide you with a treatment and follow up plan. This requires a urine sample to be sent off to the pathology lab to ascertain what bacteria is present in your urinary tract to make sure that the antibiotics we commence you on can destroy it.  We will provide you with a script for antibiotics and have you follow up with a repeat urine sample once finished treatment to ensure your urine is clear of the harmful bacteria.

 

With our service you can avoid the queue at your GP and Emergency Department and seek expert care from MyEmergencyDr at a time that suits you 24 hours a day, 7 days a week.

Are you up to date with the latest Food Pyramid changes ?

Nutrition is an integral part of your wellbeing. Check it out to make sure you’re eating the right quantities of the right food.

 

– eat a diet rich in vegetables, lean meat, fish and chicken

– avoid saturated fats and processed foods

– reduce sugar and salt intake

 

Part of staying well and reducing chronic disease involves eating a varied balanced diet rich in whole foods. In 2015 Nutrition Australia modified the food pyramid to reflect the increasing obesity rates in the Australian population. Currently Australia has one of the highest obesity rates in the world with almost two out of 3 adults and 1 in four children defined as overweight or obese.

 

Unhealthy diets and obesity are leading contributors to poor health in Australia. The redesigned Healthy Eating Pyramid has been intended for use as a simple visual guide to aide people in choosing the types and appropriate amount of food that we should eat every day for good health.

 

The pyramid’s foundation layer focuses on plant-based foods such as vegetables and legumes, fruits and grains. Plant foods are rich in vitamins, minerals and antioxidants. They are also high in fibre and low in fat helping you to feel fuller for longer. Grains also make up the foundation layer of the triangle and reflect their role in lowering risk of chronic diseases like diabetes and heart disease.

 

The middle layer recommends dairy foods such as milk, yogurt and cheese plus lean meats, poultry, fish, eggs and nuts. These foods are important in moderate amounts in our diet so we can obtain protein for muscle growth plus healthy fats, vitamins and minerals for cellular repair and strengthening our immune system. The top layer of the pyramid encourages the use of healthy plant-based fats to support heart health and brain function.

 

What foods should I avoid? Foods with bad fats are those high in saturated and trans fats. Types of food high in unhealthy fat include cakes, pastries, margarine and takeaway food likes hamburgers and chips. Eating food high in saturated fat increases your blood cholesterol and places you at higher risk of heart disease.

Who says you can’t do that with Telemedicine and medical apps?

“You can’t do that by Telemedicine!”

 

TLDR;

– Telemedicine is being increasingly used worldwide because of its numerous advantages, primarily easier access to highly qualified physicians.

 

– Appendicitis is unlikely in a child with abdominal pain who is still active and running around.

 

My Emergency Dr helps distinguish between patients who need to go to the emergency department and those who can stay at home and/or be followed up by a GP.

 

The electric lightbulb. The telephone. Aeroplanes and cars. Personal computers and online shopping. These are just a few examples of concepts that were once ridiculed and heavily criticised but have now become ubiquitous and indispensable.
And yet, telemedicine is not an entirely new concept, having been around in various forms since the late 1960s. Fifteen million Americans used telehealth in some form in 2014 and 72% of hospitals in America currently use telemedicine daily as part of patient management.1

What does this mean for a concerned mother who thinks her young child with abdominal pain could be having appendicitis? Firstly, the majority of patients presenting to emergency departments have medical conditions which are not life-threatening and do not require urgent intervention. Secondly, doctors obtain a lot of information about a patient’s condition just from taking a good history and looking at the patient “from the end of the bed”.

 

If your child has abdominal pain and is jumping on a trampoline in the backyard, he is unlikely to have appendicitis; children with appendicitis will usually prefer not to move as movement worsens the pain. The doctor who answers your call to My Emergency Dr is an emergency medicine specialist: s/he is highly qualified with several years’ experience in emergency medicine, and will be able to tell you based on your history and what your child looks like (via the High Definition camera on the app) whether or not to take your child to the emergency department.

In the case of My Emergency Dr, Telemedicine is essentially the difference between getting a qualified, highly experienced emergency physician to reassure you from the comfort of your home that your child is ok, or waiting several hours in a crowded emergency department to be told that your child is ok.
Telemedicine is the future, and the future is now.

 

References

1. The Wall Street Journal: “How Telemedicine is Transforming Healthcare.” https://www.wsj.com/articles/how-telemedicine-is-transforming-health-care-1466993402. Accessed 30/07/2017

Common cold information and treatment. How can a medical app work for me?

This has been a tough winter for illness! It seems that nearly everyone has the sniffles, not least our little ones.  But what is the common cold?  How is it spread?  How do you treat it?  And when should you take your child to see the doctor? When can you use a medical app?

 

Symptoms and Definition of Common Cold

 

The common cold is a viral infection of the nose and throat.  Many different viruses can cause a cold but one called rhinovirus (which is easy to remember because ‘rhino’ means ‘of the nose’) is responsible for most colds.  Symptoms include sneezing and coughing, a blocked or runny nose, a sore throat, a headache, ear pain and watery eyes.  Younger children often develop a fever (a temperature of 38°C or more); this is the body’s way of supporting the immune system while it fights the infection and is not dangerous.

 

How exactly are colds spread?

 

We all know that colds are spread when someone sneezes or coughs around others but many people don’t know that most colds are transmitted by touching infected secretions then touching your nose or eyes.  For example, if you shake hands with someone who has coughed into their hands, and then you rub your nose, you’re at risk of catching a cold.  So wash your hands! (And your kids’ hands, and their toys, and your door handles too).

 

How Can I Treat It?

 

Unfortunately, there is no wonder treatment for the common cold.  Sorry.  Antibiotics won’t help because colds are caused by a virus (remember, antibiotics only work for bacterial infections).  The aim is therefore to treat the symptoms until the body can clear the infection.  Symptoms are usually at their worst on days 2 to 3 before gradually improving over the next 10 to 14 days.  Many kids will then go on to have a lingering cough for a few more weeks – this is called a ‘post-viral cough’.

 

Top Cold Busting Tips

 

1. Give your child plenty of fluids (if your child is old enough, warm liquids such as good quality chicken soup are great)

2. Try unblocking little noses with gentle suction followed by sterile saline nose drops or sprays (and don’t ever use nasal decongestants in children under the age of 12)

3. Humidified air may be helpful

4. Paracetamol and/or ibuprofen are available over the counter at the chemist, and help painful ears and throats. They will also help if your child is grizzly or uncomfortable due to a fever (always follow the instructions on the bottle)

5. A teaspoon of good-quality honey given 30 minutes before bedtime may help to reduce the severity and duration of the cough (but don’t ever give honey to any children under the age of one as it can cause life-threatening muscle weakness).

6. Use your best veggie-disguising skills to get lots of brightly coloured vegetables into your kids

7. Many cough medicines are dangerous for children under the age of 12 and we therefore do not recommend them

8. Don’t ever smoke around children (and better still, don’t smoke at all)

 

What to do if they are still sick?

 

If your child is very unwell or sleepy, not drinking enough fluids or having difficulty breathing you should see your doctor.  Please also see your doctor if your child has had a fever for five days or more, or if the post-viral cough has persisted for three weeks or more.

 

And remember: if you’re just not sure if you need to go to the emergency department, download the My Emergency Dr medical app and talk to our friendly doctors!

Worried about food poisoning on holidays? Rest easy with My Emergency Dr

So you have been hanging out for that break away, work has been hectic and you are looking forward just to have time, your time, to do things at your pace or do nothing at all.

 

What happens however when you get on that holiday and you or a family member gets sick? It’s not always easy to know where to go or who to call. Should we use the local emergency department? Where can I get medical advice that I can trust?  With good internet access and My Emergency Dr on your smartphone, you can access specialist medical assessment within minutes, wherever you are in the world. (*only for Aussies OS and for travellers within Australia)

 

Unfortunately when on holiday, illness sometimes occurs. It take many forms: food poisoning is the commonest, followed by accidental injury from holiday activities or even what has been termed“ holiday heart syndrome”.  MED Blog  has some tips to help you reduce the likelihood of illness when away.

 

Studies from overseas show that 50% of travellers returning to Europe and North America from the tropics experience health problems related to their travel and that 8% consult doctors either abroad or on return. Figures are not available for Australian travellers but are probably similar. Over the last decade Australian travellers increasingly visit tropical and developing countries and hence can now present with infections that are rare in Australia.  For those heading to such countries, a visit to your GP beforehand is essential to receive the recommended vaccines for the region where the holiday is based, and other medication such as antimalarials. The need for travel insurance is also highly recommended.

 

Let’s look at the common illnesses and any preventive measures that can reduce their frequency.

 

Food Poisoning


This is the number 1 cause of holiday sickness and is caused by eating contaminated food. It can range in its presentation from mild stomach cramps to life threatening severe gastrointestinal losses from diarrhoea and/or vomiting.  In 2015 the World Health Organisation (WHO) compiled a report on foodborne illness and concluded that 550 million people a year develop a diarrhoeal illness. They noted that most foodborne diseases are preventable through good standard food hygiene, improvements in sanitation and risk assessments by food preparation staff.

 

While on holiday you may be unfamiliar with the hygiene standards of many of the restaurant’s kitchens that you visit. It can be hard for you to know if your food has been reheated, stored at the correct temperature or even left open for pests to contaminate.

 

So what can you do to reduce your risks?


– check your food is cooked through properly


– avoid drinks with ice and be careful with the local tap water


– avoid salads and any uncooked fruit and vegetables  that may have been handled unhygienically (this is more applicable to overseas destinations)


– wash your hands frequently before and after meal times and after using bathroom


– frequently use alcohol-based hand gel

 

How good are the alcohol-based hand gels?


The Centre for Disease Control (CDC) Guidelines for Hand Hygiene recommend alcohol based gels over washing your hands with soap and water!  This is because they are often more accessible, they kill many more germs and also are less drying to the skin. However if your hands are visibly dirty (eg soil contamination) then a soap-and-water wash is superior.

 

How good is soap and water?


As discussed above soap and water manages to remove visible dirt as alcohol based gels cannot degrade organic materials. It is important to ensure that your hands are washed adequately with soap and water if it is to be effective. The CDC recommends washing your hands thoroughly for at least 15 seconds ( if you don’t have a timer this is equivalent to singing “Happy Birthday” twice).

 

How do you treat food poisoning?


Oral Rehydration Therapy
irrespective of the cause or type of food poisoning, the most important treatment is to replace the excessive salt and water losses that occur.. Fluid and electrolyte replacement is key to preventing dehydration and worsening of a patient’s medical state. At its most extreme, acute kidney injury and even death can occur.

 

A number of oral rehydration therapies are available and providing they have the correct proportion of sugar and salt, they allow adequate rehydration. It is important to give oral fluids in small volumes to prevent stomach distension and reflex vomiting. They readily available over the counter at the local pharmacy. If you are not near to a pharmacy a homemade oral rehydration can suffice: 5 cups of sterile (eg boiled) water, 6 level teaspoons of sugar, half a teaspoon of salt mixed until all is dissolved.

 

Reduce exposure to agents that can exacerbate diarrhoea:


Magnesium supplements, antibiotics, sorbitol containing foods and drinks (often found in artificial sweeteners), alcohol and antibiotics.

 

Medications: Antidiarrhoeal Agents


If diarrhoea is persistent, medications can be used in adults to help reduce the frequency eg Loperamide. This drug slows the gut down a dose of 4mg is given to slow the diarrhoea down and a further dose may be required a few hours later if it returns.

Furthermore if severe cramping abdominal pains occur, Hyoscine (eg ‘Buscopan’) is an antispasmodic agent that sometimes helps reduce the pains severity. There are certain conditions where buscopan cannot be used eg glaucoma, myasthenia gravis and certain heart arrhythmias.

 

What organisms cause food poisoning?


From the WHO global report the infective agents that cause diarrhoea include 5 types of bacteria, 1 virus, 3 protozoa and 10 parasitic worms. In Australia the commonest causes are:

 

– Bacteria: Campylobacter, Eshcerichia Coli, Salmonella, Listeria

– Viruses: Norovirus, Norwalk virus

– Protozoa: Giardia, cryptosporidium, amoeba

 

Campylobacter is one of the commonest causes of holiday sickness in Australia and abroad. Symptoms include vomiting and diarrhoea (often blood stained), stomach cramps, fever, muscle aches and headaches. It occurs when food is prepared in an unhygienic manner and is classically spread by food being left to cool in environments such as Hotel buffet areas. Campylobacter can incubate for between 2 and 10 days after the contaminated food has been eaten.

 

Warning
If diarrhoea is ongoing beyond a few days or if bloody and associated with a fever then medical attention should be sought. Furthermore young children and the elderly are much more susceptible to the ill effects of severe diarrhoea and acute dehydration should seek medical attention sooner.

 

Ear Infections: Swimmers Ear
On holidays we frequently swim daily and hence increase our susceptibility to a condition called swimmer’s ear. Swimmer’s ear is infection of the outer ear canal often brought on by ear remaining in your ear canal thereby providing a moist warm environment for bacteria to flourish. It is not contagious. Prompt treatment of this can prevent more severe infection and complications. It may start as itching in your ear canal and mild irritation.  When it progresses it becomes more itchy, more painful, hearing may become muffled, redness may be noted around the ear canal, a discharge may develop as may  fever.

 

Risk Factors: Swimming in water with elevated bacteria levels: a lake, some swimming pools if not regularly cleaned, a  narrow ear canal, aggressive cleaning of the ear canal with cotton buds, irritation from devices such as headphones or hearing aids.

 

Treatment: topical eg drops with antibiotics are often required plu additional preventive measures to stop recurrence eg getting rid of ear plugs that may be a potential source of reinfection

 

Prevention of Swimmer’s Ear
-Tip your head to the side and empty your ear canal of water after swimming
– some pliable ear plugs providing they fit your ear canal and keep it dry can be used, but ensure to change these regularly
– Avoid putting cotton wool or any materials into your ear canal

 

 

Accidents abroad

 

It is often on holiday that thrill-seeking behaviour is indulged. Skiing, water sports, horse riding, moped riding all seem more enticing when we are away and hence accidents are more likely to occur on holiday. Sadly accidents can occur on something even more trivial such as slipping on the edge of the swimming pool. Preventive measures seem obvious here and in retrospect we often wish we hadn’t indulged. It is in this situation that a My Emergency Dr specialist can asses whether you need to go to an emergency department, go to a radiology practice for an Xray or manage with simple measures such as ice pack and elevation.

 

 

“Holiday Heart Syndrome”

 

This term has been coined for the increased incidence of heart irregularities that occur when individuals are on holiday. It was first described in the 1970s when doctors noticed an increase incidence of heart rhythm abnormalities following public holidays and holidays. These patients were apparently healthy with no prior heart history but following binge drinking noticed a racing heart, shortness of breath and sometimes chest pain.

 

It mainly associated with what are known as supraventricular heart arrhythmias, with atrial fibrillation being the most common cardiac arrhythmia in this syndrome. However, other less frequent types of arrhythmias can also occur such as atrial flutter and extra ectopic heart beats. If these heart arrhythmias persist there is a potential risk of stroke and hence any symptoms should be investigated.

 

Holiday heart syndrome can occur in both regular and non-regular drinkers. It can occur due to excess alcohol but also is associated with some electrolyte  (salt abnormalities) or when someone has undiagnosed thyroid disease. It is more prevalent in the middle aged and elderly when on holiday. It would appear that while all alcohol leads to structural changes to the heart over time. One study has suggested that beer is more likely to cause rhythm disturbances than wine.

 

Prevention: Once the symptoms described occur, abstinence is the best treatment or at least avoidance of binge drinking. Chronic drinkers tend to drink more on their holidays and hence A patient should have a complete cardiac work up if these symptoms occur and hence see either their Gp or if unwell present to an emergency department.

 

In the elderly traveller forgetting your heart medication or forgetting to bring your medication can also make you heart more vulnerable to the effects of alcohol. Telehealth can allow you access to an urgent prescription if you have forgotten to pack you medications.

 

Summary

 

In summary, illness can occur when we are away on holidays sometimes for reasons out of our control but also may be as a result of our risk taking behaviour.  In the event sickness does occur, My Emergency Dr can provide you with the reassuring comfort of an Australian Specialist in Emergency Medicine to assess whether you can stay and be treated in your holiday home or need to attend the local emergency department.

 

 

References:

https://www.cdc.gov/handhygiene/patients/index.html

http://www.gastrohep.com/conreports/bangkok/JGHS3.pdf

https://www.mja.com.au/system/files/issues/181_10_151104/ell10338_fm.pdf

http://www.mayoclinic.org/diseases-conditions/swimmers-ear/symptoms-causes/dxc-20201445

https://www.cdc.gov/healthywater/pdf/swimming/resources/pseudomonas-factsheet_swimmers_ear.pdf

Alcohol and Risk of Atrial Fibrillation : A Prospective Study and Dose Response Meta analysis https://www.ncbi.nlm.nih.gov/pubmed/25034065

Holiday Heart Syndrome Revisited after 34 years. Arq,Bras cardiol 2013: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3998158/

Nervous about going away? Get peace of mind with My Emergency Dr

In-flight

 

Almost all travellers have encountered someone with an in-flight medical emergency. When we think about in-flight emergencies, the most dramatic episodes come to mind.  These include heart attack, trauma from falling objects and deep vein thrombosis (blood clots in the legs) leading to a pulmonary embolism (clot traveling to your lungs).  However, the most common things are somewhat more mundane. A general understanding and approach to them will make flying a bit smoother and less daunting for the hypochondriac in us all.

 

So, what are the common concerns?

 

Most studies and data show that “syncope” or fainting is by far the leader among presentations on a flight. The issue with syncope is that it can be caused by visual or emotional stimuli which trigger nerve pathways which can cause a person to faint. So, if you are a nervous flyer, or encountered a rather surprising and powerful stimulus, it may cause you to faint. Most of these episodes are self-limiting and cause no long-term issues. The second most common are gastrointestinal symptoms, and by far the common complaint is nausea and vomiting caused by air sickness. While air sickness is mediated by your nervous system, the usual combination is nausea, vomiting and spatial disorientation. Third, and potentially more serious, are heart / lung issues. These include mostly hyperventilation and chest pain, keeping in mind some cases of chest pain may be related to anxiety rather than a problem with the heart.

 

Oxygen

 

The issue is that altitude has an effect on the partial pressure of oxygen. While the oxygen in the atmosphere is 21% everywhere, the partial pressure is 160mm Hg at sea level and 118mm Hg at 8000 feet. Why is 8000 feet an important number? Because the Aviation authorities require the cabin to be pressurised to somewhere below 8000 feet. The decreased partial pressure leads to a decrease in the proportion of oxygen you breathe in and the ease with which the body can take the oxygen in. Most of us can handle this level of oxygen, with popular tourist destinations such as Aspen sitting at about 7800 feet above sea level and Machu Picchu at about 8000 above sea level. However, those with significant heart or lung disease are more susceptible to these changes and should seek medical advice before travelling.

 

Our travel advice

 

Think about if you are a settled flyer or if you are a nervous flyer, what makes you that way? If there are certain symptoms that bother you, appropriate medications may help. Sensible precautions are still relevant, such as calf exercises and adequate hydration, alerting crew members early and providing support if you are able. You also might want to think about learning basic life support if you haven’t already – it can be really useful wherever you are. And rest assured that there are well trained people traveling with you (be it crew members, doctors or nurses) and the emergency kit on flights have now evolved to become quite sophisticated. A little insight goes a long way. Think about your existing medical conditions. If you are concerned you can use our doctor app and speak with a Specialist Emergency Doctor via video based chat directly from your smartphone. Download the app from our website or talk to your GP before flying.

 

Summary

 

In summary, illness can occur when we are away on holidays or even while we are travelling to our holiday. If you are concerned prior to your flight, the My Emergency Doctor App will allow you to have a review with a Specialist Emergency Doctor before you fly. In the event sickness after your flight, our medical app can provide you with the reassuring comfort of an Australian Specialist in Emergency Medicine to assess whether you can stay and be treated in your holiday home or need to attend the local emergency department. Please note that the My Emergency Dr service is unavailable during flight.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789915/