Ibuprofen/Tylenol discharge instructions:
You may take either Ibuprofen (Advil or Motrin are the brand names) or Naproxen (Alleve is the brand name) over-the-counter for your pain, but not both at the same time. You may also take Acetaminophen (Tylenol is the brand name) with one of the above medicines.
Ibuprofen (Advil, Motrin) instructions:
You may follow ONE of the following dosing schedules.
- 800 mg every 8 hours
- 600 mg every 6 hours
- 220-400 mg every 4 hours
Naproxen (Alleve) instructions:
You may follow ONE of the following dosing schedules.
- 660-750 mg once followed by 220-250 mg every 8 hours
- 440-500 mg every 12 hours
- 200-250 mg every 8 hours
Acetaminophen (Tylenol) instructions:
You may follow ONE of the following dosing schedules.
- 1000 mg every 8 hours
- 500 mg or 650mg every 6 hours
- 325 mg every 4 hours
Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen to make sure you are not taking more than 3000-4000 mg per day.
Hand Exam:
Extension intact throughout. 3rd digit. Sensation intact over the pad of the finger, thenar eminence, into webspace between 1st and 2nd finger. Patient able to spread fingers to resistance, extend wrist to resistance, patent oppose 1st and 2nd finger to resistance.
Eye Exam
OS OD
Visual Acuity (VA) 20/20 w PH 20/20 w PH
Visual Fields (VF) Intact by 4 Intact by 4
Extra Ocular Movements (EOM) Intact w/o diplopia Intact w/o diplopia
Lids Lashes Lacrimal (LLL) No lesions No lesions
Conjunctiva and Sclera (C/S) White and Quiet White and Quiet
Cornea (K) No Fluorescein Uptake No Fluorescein Uptake
Anterior Chamber (AC) Deep and Quiet Deep and Quiet
Iris (I) Round and Reactive Round and Reactive
Lens (L) Clear Clear
Retina (R) Sharp disc margins Sharp disc margins
Intra Ocular Pressure (IOP) 20 @ 5% 20 @ 5%
Tonometry (Ta) 15 (95) 15 (95)
Contrast Allergy Protocol:
13 hour:
-methylprednisone 12, 2 hours 32mg PO, then diphenhydramine 25mg PO
4 hour:
Follow-Up Clinics:
Metro Immediate & Primary Care
Concussion Clinic - Give the MFA Neurology Clinic info for follow-up in the DCI and instruct your patient to call to schedule an appointment.
The web site is: http://www.gwdocs.com/neurology/concussion-clinic
The # to schedule is 202-741-2700 (regular Neuro Clinic #)
Neurology Rapid Access Clinic (NRAC)
Providers who wish to refer their patients for urgent neurologic evaluation at Neurology’s 2150 Pennsylvania Ave site may call 741-2793* and ask to speak with the neurology provider who is covering the “NRAC”. Once we have the relevant clinical and patient contact information, we’ll take it from there.
[*The Neurology Rapid Access Clinic phone line is staffed from 8am-4pm, M-F. After hours and on weekends providers should leave a message that includes their contact information; calls will be returned promptly as soon as the clinic re-opens]
Next Day Ortho Availability at GW MFA Metro Immediate & Primary Care:
We are pleased to share with you that orthopedics has added a new provider that is offering next day availability for patients who need to see orthopedics.
Ellen Bishop, NP
For Next-Day Availability: Orthoreferrals@mfa.gwu.edu
For Appointment Scheduling: 202.741.3300
Also Available on Zocdoc.com and gwdocs.com/ortho
Radial Nerve Palsy
Ectopic Pregnancy
Radiculopathy
Burn injury
Otisis External
URI
Post-Operative Complications
Yeast Infection
Migraine
Lice
Bipolar
Mania
Fluid Overload/CHF (send home)
Today, you were seen in the ER for your shortness of breath and leg swelling. Your EKG and bloodwork were reassuring. We think this is because of congestive heart failure. **Please double your daily dose of your water pill (furosemide, otherwise known as “Lasix”).** We do not think it is an emergency or that you need to stay in the hospital at this time.
You should follow-up with your primary doctor in the next 1-2 days for a recheck.
Otherwise, please return to the ER if you have:
- worsening of your shortness of breath
-chest pain
-fever of 100.4 or higher
-fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Otitis Media
Today you were seen for pain in the ears and found to have an ear infection (otitis media). Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, the infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
You may take Ibuprofen (Advil or Motrin), Naproxen (Alleve) and Tylenol over-the-counter for your pain. You may even safely take up to 4 pills of Ibuprofen or Naproxen and 3 pills of Tylenol at a time. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours (about 10 pills). It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
Please return to the ER if you have:
-Fever greater than 104F that does not go away
-Nausea or vomiting to the point where you cannot eat or drink
-Any other concerns
Otherwise please follow-up with your primary care provider in the next week for recheck.
It has been a pleasure treating you and we hope you feel better soon.
Oral/Oropharyngeal Candidiasis
You were seen today for mouth and/or throat pain and found to have a yeast infection in your mouth. Please use the prescribed fluid as directed. Swish the fluid around in your mouth for as long as you can before swallowing. Use every 6 hours until symptoms have gone away for 2 days. Please follow-up with your dentist if you have dental pain, and follow-up with your primary care physician for recheck of your mouth and throat within 1 week.
Please return to the ER if you have any of the following:
-Fever greater than 101.4 Fahrenheit
-Nausea and/or vomiting that prevents her from eating
-Pain that is not controlled with pain medications at home
-Any other concerning symptoms.
It's been a pleasure taking care of you and we hope you feel better.
Chronic Pain
You were seen for your chronic pain today. The ER is not able to help with chronic pain very well. You need someone that can work with you to help manage your pain and try different approaches if necessary. Please call the number for the Pain Management Clinic to make an appointment.
Sprain
Today you were seen for pain in your ____. Your pain seems to be from soreness in the muscle or sprain of the ligaments or tendons. We do not know what caused this but do not feel you need to stay in the hospital at this time. Please follow up with your primary care provider if you pain continues.
You may take Ibuprofen (Advil or Motrin), Naproxen (Alleve) and Tylenol over-the-counter for your pain. You may even safely take up to 4 pills of Ibuprofen or Naproxen and 3 pills of Tylenol at a time. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours (about 10 pills). It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
In addition, follow the included instructions for R.I.C.E. treatment.
Otherwise, please return if the pain becomes significantly worse, you have any trauma to the same site, or if it feels dislocated.
It's been a pleasure taking care of you and we hope you feel better.
Conjunctivitis (pink eye)
You were seen for itchiness and discharge from your eye today. We examined you and think you have inflammation of the surface of your eye called conjunctivitis ("pink eye"). This is caused by a virus and does not need antibiotics. Your body needs to fight off the infection and this can take up to 1 week. In the meantime please use eye drops 5-6 times daily and wash your hands frequently as it can spread easily. In addition, you can take an over-the-counter antihistamine, such as Benadryl, Allegra, or Zyrtec.
Please return to the ER if you have:
-worsening pain in your eye
-redness of your eye
-changes in vision in your other eye
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Fall (with blood work and EKG)
Today, you were seen in the ER after a fall. We did not find any serious injuries. Your bloodwork and EKG were reassuring. The exact cause for your fall is uncertain, but we do not think there is any reason to keep you in the hospital at this time.
Please see your primary doctor or return to the ER if you have:
-chest pain
-shortness of breath
-vomiting
-fainting
-any other new or concerning symptoms
Otherwise, please see your primary doctor in about 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Subungual hematoma
You were seen for a collection of blood under your fingernail. We made a hole in your nail to try to release the blood. Please soak the finger in warm water 2-3 times per day for the next 7 days. Follow up with your PCP as needed.
Trigeminal Neuralgia
You were seen for pain in your face and we think you have something called trigeminal neuralgia (inflammation of the nerve on the side of your face). We gave you medications and you felt better.
**We have written you a prescription for the same medicines that you can continue until you see a neurologist in the clinic.
Please call the included number to make an appointment with the neurologist to either continue the medicine, try new medicine, or consider other treatments.
Please return to the emergency room if you have any of the following:
-Uncontrolled pain
-Nausea and vomiting with inability to eat or drink
-Severe vertigo that is incapacitating
-Loss of consciousness
-Numbness, weakness, tingling in any extremity
-Any other concerning symptoms
Is been a pleasure taking care of you and we hope you feel better soon.
Rib injury
You were seen for chest pain after and found to have an injury to your ribs. This will heal on its own but will take some time. Please use an anti-inflammatory medicine such as Naproxen (Alleve) or Ibuprofen (Advil or Motrin) on a regular schedule for the next several days for control of your pain. You may also take Tylenol at the same time if you prefer. It does not have anti-inflammatory effects, but should help with pain.
You may take the prescribed medication for break-through pain. The medication will make you sleepy. Please do not drive or do any other activity that requires you to be fully alert while taking the medication. If the medication contains Acetaminophen (the generic name for Tylenol), be careful taking additional over-the-counter Tylenol. Add up the amounts of Acetaminophen listed in each pill, and do not take more than 3000-4000mg in 24 hours.
It is also improtant to practice taking deep breaths, even if it is uncomfortable. When people don't breathe in and out as deeply as they should, some of the small airways in the lungs can close off. This raises the chances of getting a lung infection, called "pneumonia."
Please return to the ER if you have any of the following:
-abdominal pain
-worsening pain despite medications
-fever
-other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Bacterial Vaginosis
Today, you were seen in the ER for your belly pain. We found you have an imbalance in your normal vaginal bacteria called bacterial vaginosis (BV). You should take the antibiotic as prescribed in order to get rid of the infection.
Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, the infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
Please return to the ER if you have:
-fever of 100.4 or higher
-vomiting
-fainting
-shortness of breath
-new middle back pain
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 4-5 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Uveitis
You were seen for pain your eye today. We examined you and think you have inflammation of the inner part of your eye called uveitis. The Ophthalmologists (eye doctors) examined you as well and want to see you in their clinic at the included date and time. In the mean time please take the prescribed medicines, including the steroid (prednisolone or Pred Forte) and Ibuprofen as instructed:
Pred Forte:
Take 6 times per day for 2 days, then...
Take 4 times per day for 1 week, then...
Take 3 times per day for 1 week, then...
Take 2 times per day for 1 week, then...
Take 1 times per day for 1 week, then...
Stop.
Please return to the ER if you have:
-worsening pain in your eye
-redness of your eye
-changes in vision in your other eye
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Chemical Injury to Eye (small abrasion)
You were seen for pain your eye today after getting a chemical in it. We washed out your eye with fluid and examined you and found a small abrasion (scratch) on your eye. This should heal within 1-2 days. The Ophthalmologists (eye doctors) examined you as well and want to see you in their clinic tomorrow and every day until it heals.
In the meantime please use the prescribed medicines, including the antibiotic eye drop and eye ointment 4 times per day each in the affected eye. Apply the drop first and wait at least 10 minutes before applying the ointment. Or you can alternate every 3 hours: Apply the drops, waiting 3 hours, apply the ointment, wait 3 hours, apply the drops again, etc.
Please return to the ER if you have:
-worsening pain in your eye
-redness of your eye
-changes in vision in your other eye
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Shoulder dislocation
You were seen for pain in your shoulder and were found to have a shoulder dislocation. We put your shoulder back in place and placed it in a sling. Please use the sling as much at you can during the day and sleep with it. When you take it on and off, be careful not to move your shoulder too much. Please use the sling until you see an Orthopedic Surgeon for follow up in 4 weeks.
You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may even safely take double the dose indicated on the bottle. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours. It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
You may take the prescribed medication for break-through pain. The medication will make you sleepy. Please do not drive or do any other activity that requires you to be fully alert while taking the medication. If the medication contains Acetaminophen (the generic name for Tylenol), be careful taking additional over-the-counter Tylenol. Add up the amounts of Acetaminophen listed in each pill, and do not take more than 3000-4000mg in 24 hours.
Please return to the ER if you have:
-uncontrollable pain in the area
-further trauma to the area
-numbness, tingling, or weakness in that arm
-any other concerns
It's been a pleasure taking care of you and we hope you feel better.
Elbow dislocation
You were seen for pain in your elbow and were found to have an elbow dislocation. We put your elbow back in place and placed it in a sling. Please use the sling as much at you can during the day and sleep with it. When you take it on and off, be careful not to move your shoulder too much. Please use the sling until you see an Orthopedic Surgeon for follow up in 1 week.
You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may even safely take double the dose indicated on the bottle. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours. It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
Please return to the ER if you have:
-uncontrollable pain in the area
-further trauma to the area
-numbness, tingling, or weakness in that arm
-any other concerns
It's been a pleasure taking care of you and we hope you feel better.
Central Retinal Artery Occlusion (CRAO)
You were seen for loss of vision in one eye today. We examined you and think you have a blockage of the blood vessel that supplies your eye. The Ophthalmologists (eye doctors) examined you as well and want to see you in their clinic as soon as you leave today.
Please return to the ER if you have:
-pain in your eye
-rednees of your eye
-changes in vision in your other eye
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Bells Palsy
You were seen today for facial droop. We assessed you and do not think you are having a stroke. We think you have something called Bell’s Palsy, which is isolated facial paralysis on one side. We are giving you medications to take that can help this get better, but it can take a long time. Some people feel better after a few weeks, and some people take 6 months or more to feel normal. Most people recover fully.
Please use eye drops to keep your eye moist at least once per hour while you are awake (more if you feel dry). Also, it is important to tape your eye closed at night so it does not dry out. Apply the ointment to the eye before taping it shut every night. Do this until your symptoms have gone away completely.
Please return to the ER if you have any of the following:
-weakness, numbness, or tingling anywhere else in your body
-chest pain or shortness of breath
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Abrasion from fall
You were seen for a scrape on you ____ from falling. You do not seem to have any other serious injuries and the cause of your fall does not seem concerning. We cleaned your wound and dressed it. Please keep it clean and change the bandage every 24 hours (or sooner if they become dirty) until a scab is formed. You do not need antibiotics at this point.
Please return to the ER if you have:
-another fall with loss of consciousness or hit your head
-the scrap seems infected (redness, swelling, fluid leaking out)
-any other concerns
Otherwise, you should follow-up with your doctor in the clinic in the next 7 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Fall, No Injuries
You were seen after falling. You do not seem to have any serious injuries. Please take the prescribed or over-the-counter medicines to help with your pain.
Please return to the ER if you have:
-another fall with loss of consciousness or hit your head
-nausea/vomiting
-any other concerns
Otherwise, you should follow-up with your doctor in the clinic in the next 7 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Fall, Headstrike, No injuries but lac
You were seen after falling and hitting your head. You do not seem to have any other serious injuries and the cause of your fall does not seem concerning. We cleaned your wound, repaired it with ___ sutures, and dressed it. Please keep it clean and change the bandage every 24 hours (or sooner if it becomes dirty) until a scab is formed. You do not need antibiotics at this point.
Please return to the ER in 5-7 days to have the sutures removed.
Please return to the ER if you have:
-another fall with loss of consciousness or hit your head
-the scrap seems infected (redness, swelling, white fluid leaking out)
-any other concerns
Otherwise, you should follow-up with your doctor in the clinic in the next 7 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Temporal Arteritis (Giant Cell Arteritis) - Outpt f/u
You were seen for temporal and jaw pain. We are concerned you may have something called Temporal Arteritis and require a biopsy and an MRI. You have been scheduled for a biopsy on _ at _. You have also been scheduled for an MRI. It is very important you go to your scheduled appointments. Any delay could cause permanent damage, including blindness.
Please return to the ER if you have:
-worsening temporal pain
-loss of vision
-nausea and vomiting and inability to keep food or drink down
-any other concerning symptoms
Irritation Around G-tube (PEG)
You were seen for burning around your gastric tube site. We examined it and found that there might be a small infection of the skin starting. We are prescribing you antibiotics to treat it just in case. Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, the infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
Please return to the ER if you have:
-worsening pain
-abnormal discharge coming from around the tube
-any problems with the tube
-any other concerns
Otherwise, you should follow-up with your doctor in the clinic in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Priapism
You were seen today for an erection that did not go away (called priapism). You improved after treatment, but still need to follow up with a Urologist. Please call the included number to make an appointment if you do not have a Urologist already.
Please seek immediate medical attention if you have any of the following:
-worsening or return of your erection
-uncontrollable pain
-nausea and vomiting
-inability to urinate
-any other concerning symptoms
Otherwise, you should follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Homeless
You came to the hospital today because you have nowhere to stay. Our social worker gave you resources for trying to find shelter. Unfortunately, we have other patients that we need to see and treat and you cannot stay in the hospital overnight. Please contact the shelters and other resources for a bed. Many shelters begin having waiting lines in the afternoon around 4pm. Please go as soon as you can to try for a bed.
Smoke Inhalation
Today, you were seen in the ER after smoke inhalation. Your bloodwork showed signs that you the smoke entered your system but is not at a dangerous level. You other labwork was reassuring and we feel you are safe to go home.
However, things can change, and you should see your doctor or return to the ER if you have:
-chest pain
-difficulty breathing
-fainting
-worsening headache
-numbness, tingling, or weakness in arms or legs
-fever of 101 or higher
-vomiting that prevents your from drinking fluids
-any other new or concerning symptoms.
Otherwise, you should follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
SVT
You were see for having a fast heart rate called Supraventricular Tachycardia (SVT). We were able to slow your heart rate down to normal. We recommend you see a cardiologist in the office for a follow up appointment to see if you would benefit from medication to control this and prevent it from happening again. You can call the included number for an appointment as soon as available.
Please return to the ER if you have:
-chest pain
-shortness of breath
-vomiting
-fainting
-any other new or concerning symptoms
Otherwise, please see your primary doctor in about 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
AICD, Defibrillation, Cardioversion
You were see after your defibrillator discharged. We interrogated your device and you did not have a dangerous heart beat at the time. We feel it is safe for you to go home. Please follow up with your cardiologist within 1 week.
Please return to the ER if you have:
-another defibrillation
-chest pain
-shortness of breath
-vomiting
-fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Bradycardia
You were see for having a slow heart rate called bradycardia. We recommend you see a cardiologist in the office for a follow up appointment as soon as possible. You can call the included number for an appointment as soon as available.
Please return to the ER if you have:
-chest pain
-shortness of breath
-vomiting
-fainting
-any other new or concerning symptoms
Otherwise, please see also your primary doctor in about 1-2 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Lung Mass
You were see today and found to have a mass in your lungs. We do not know what this mass is and there is a possibility it may be cancer. You require further testing to determine what it is and need to follow up in the clinic for further testing. Please contact the included numbers to arrange appointments.
In the meantime, please return to the ER if you have any of the following:
- shortness of breath
-chest pain
-fever of 100.4 or higher
-fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Hematuria
You were seen for blood in your urine. We placed a catheter in your bladder (Foley catheter), which is a tube that automatically drains your urine. Please flush the tube with sterile saline (sterile salt water). Please make an appointment to see an Urologist as soon as possible.
In addition, please take the prescribed antibiotics to prevent a bladder infection. It is important you take the full course of antibiotics as instructed so that an infection does not return stronger.
Please return to the ER if you have any of the following:
-recurrent bright red blood in your urine
-abdominal pain
-nausea and vomiting preventing you from eating or drinking
-high fever (greater than 100.4 degrees F)
-any other concerning symtpoms
It's been a pleasure taking care of you and we hope you feel better.
Feeding Tube Problem
You were seen for a problem with your feeding tube. We do not feel you need to stay in the hospital and you are being discharged to follow up with your regular physician as scheduled.
Please return to the ER:
-blood coming from the tube or significant blood around the tube
-nausea and vomiting preventing you from eating or drinking
-severe abdominal pain
-the tube comes out on its own
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Deep Vein Thrombosis (DVT)
You were seen today for swelling in your leg and were found to have a DVT (Deep Vein Thrombosis) - in other words a blood clot in your leg. We are starting you on blood thinning medicine (anticoagulation) that you need to give yourself. Our nurse has shown you how to give yourself this medicine. It is important you take the medicine as directed and follow up with your primary care provider in the next few days to check your blood levels and make adjustments to your prescription.
It is very important for you to come back if you have any of the following:
-bleeding that will not stop
-you can’t get this medicine from the pharmacy
-you are unable to take the medicine
-you cannot see your primary care provider in the next few days
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Deep Vein Thrombosis (DVT) - Negative
You were seen today for swelling and redness in your ___. It seems that you have inflammation of a superficial vein. You can treat this by elevating the arm or leg (ie, waist level), use warm or cool compresses, nonsteroidal anti-inflammatory drugs (NSAIDs, like Ibuprofen or Naproxen), and possibly compression therapy (like and ACE wrap).
***You have signs of some infection of the skin. Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
It is very important for you to come back if you have any of the following:
-worsening pain, weakness, numbness, tingling
-you cannot follow up in clinic in the next few days
-shortness of breath
-chest pain
-fainting
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Frostbite
You were seen today for pain in your ________ after being exposed to cold for a long time. You were rewarmed and no other serious injuries were found. It is very important to keep the area warm and dry as it heals and to avoid exposing it to colder temperatures again. You do not require antibiotics, but your tetanus should be up to date.
If possible, soak the affected area in warm water for 30-45 minutes and gently move it around.
Taking low-dose Ibuprofen has been shown to help. Unless you have any reasons you should not take Ibuprofen or NSAID medicines, you can take Ibuprofen 400mg every 12 hours for the next week.
In addition, aloe vera ointment or lotion applied to the affected area every 6 hours can reduce inflammation.
Complete recovery can take several weeks.
Please return to the ER if you have any of the following:
-pain uncontrolled at home with over-the-counter and prescription pain medicines
-uncontrollable bleeding from injuries
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Thrombophlebitis
You were seen today for swelling in your leg. We checked you for a DVT (Deep Vein Thrombosis - blood clot in your leg) and were found not to have any on ultrasound.
It is very important for you to come back if you have any of the following:
-worsening leg pain, weakness, numbness, tingling
-you cannot see your primary care provider in the next few days
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Foot Drop
You were seen for foot drop today. We believe this is due to a compression of a nerve in your leg from either an injury or even possibly the way you slept. This should slowly get better with time, but we recommend you call the included Neurologist’s number (brain and nerve doctor) to make an appointment for further evaluation. We do not think you need to stay in the hospital today.
Please return to the ER if you have any of the following:
-worsening of your weakness or numbness
-tingling or pain in any part of your body including your foot or leg
-any other concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Weakness
Today, you were seen in the ER for your feeling of weakness. Your bloodwork, EKG, and imaging did not show any reason for these symptoms. We do not know the cause of your weakness but do not think you need to stay in the hospital today.
That said , things can change. Please return to the ER if you have:
-worsening of your weakness
-symptoms worse on one side than the other
-inability to walk
-vomiting that prevents you from drinking fluids
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Dehydration
Today, you were seen in the ER for your feeling of weakness. Your bloodwork, EKG, and imaging did not show any reason for these symptoms. We think you might have been dehydrated. We do not do not think you need to stay in the hospital today.
That said , things can change. Please return to the ER if you have:
-worsening of your symptoms
-inability to walk
-vomiting that prevents you from drinking fluids
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Angioedema (ACEI)
You were seen for swelling of your face that could have been caused by your blood pressure medication. It belongs to a class of medicines called ACE-inhibitors (drugs that end in -pril) that can cause this swelling, even in people that have taken them for years. It is important to stop taking this medication right away or you could have a more serious reaction involving you mouth and tongue. We are starting you on an alternative medication for blood pressure. Please take this until you can see your primary care provider to get a replacement medication for your blood pressure as soon as possible.
Please return to the ER if you have any of the following:
-difficulty breathing
-difficulty swallowing
-nausea or vomiting that prevents you from eating or drinking
-increased swelling in your face, tongue, or mouth
-any other concerns
It's been a pleasure taking care of you and we hope you feel better.
Easy Bleeding
You were seen for bleeding from several places on your body. We checked your blood and found that all your levels are reassuring. You should see your primary care provider within 1-2 weeks to recheck your blood levels.
Please return to the ER if you have:
-worsening of your bleeding
-fainting
-lightheadedness
-difficulty breathing
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Gun shot wound (GSW)
You were seen for having a gun shot wound to your _________. We do not see any broken bones but there might be fragments of the bullet.
*You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may even safely take double the dose indicated on the bottle. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours. It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
*You may take the prescribed medication for break-through pain. The medication will make you sleepy. Please do not drive or do any other activity that requires you to be fully alert while taking the medication. If the medication contains Acetaminophen (the generic name for Tylenol), be careful taking additional over-the-counter Tylenol. Add up the amounts of Acetaminophen listed in each pill, and do not take more than 3000-4000mg in 24 hours.
Please care for the wound according to the included instructions and make a follow up appointment with your primary care provider as soon as possible for a wound check.
Stab Wound
You were seen for having a stab wound to your _________. We found ___________.
You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may even safely take double the dose indicated on the bottle. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours. It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
You may take the prescribed medication for break-through pain. The medication will make you sleepy. Please do not drive or do any other activity that requires you to be fully alert while taking the medication. If the medication contains Acetaminophen (the generic name for Tylenol), be careful taking additional over-the-counter Tylenol. Add up the amounts of Acetaminophen listed in each pill, and do not take more than 3000-4000mg in 24 hours.
Please care for the wound according to the included instructions and make a follow up appointment with your primary care provider as soon as possible for a wound check.
Foley check
You were seen for possible urinary retention.
We did not find any retention and your urine analysis is reassuring. Please follow up with your primary care provider in 1-2 days for a recheck.
We checked your Foley catheter and scanned your bladder and kidneys and every seems to be working normally. You may take the prescribed medication for bladder spasm discomfort. Please follow up with your urologist as instructed.
Please return to the ER if you have any other concerns.
Urinary Retention
You were seen for possible urinary retention. We scanned your bladder and found that you had a significant amount of urine in your bladder that you were unable to pass. We placed a Foley catheter and and you felt better immediately and we scanned your bladder and found that it was empty afterward. We are leaving in the Foley catheter. Please follow up with your urologist within 1 week.
Please return to the ER if you have any other concerns or any of the following:
-bright red blood in your urine
-high fever
-nausea and vomiting preventing you from eating or drinking
-abdominal pain
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Urinary Incontinence (male, possible prostate, dc with Flomax)
You were seen for difficulty controlling your urination. You do not have signs of infection, but your prostate may be enlarged. Please take the prescribed medicine and follow-up with your primary care physician for further evaluation
Please return to the ER if you have any other concerns or any of the following:
-bright red blood in your urine
-pus coming from your penis
-new wounds or growths on your genitals
-high fever
-nausea and vomiting preventing you from eating or drinking
-abdominal pain
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Herpes (Male)
You were seen for wounds on your penis. There is a possibility these could be herpes sores. Please take the prescribed medicine as directed and follow-up with a Urologist for further evaluation.
Please return to the ER if you have any other concerns or any of the following:
-bright red blood in your urine
-pus coming from your penis
-new wounds or growths on your genitals
-high fever
-nausea and vomiting preventing you from eating or drinking
-abdominal pain
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
SANE Brochure for Victims
https://gallery.mailchimp.com/1f3a2d805df95ea01c0386839/files/6f7f9c7d-6892-4ac3-a726-e47c808e3d07/SANE.pdf
Swallowed Foreign Body
You were seen for swallowing a foreign body. The x-ray showed that the item has past beyond the esophagus into the stomach and should pass in your stool in the next few days without problems.
Please follow up with your primary care physician with the next 1 week.
Please return to the ER if you have any of the following:
-difficulty breathing or swallowing
-fever
-nausea/vomiting
-any other concerning symptoms
It has been a pleasure taking care of you and we hope you feel better soon.
Foreign Body in Nose
You were seen for having something stuck in your nose. We were able to remove the item.
Please follow up with your primary care physician with the next 1 week.
Please return to the ER if you have any of the following:
-difficulty breathing or swallowing
-fever
-nausea/vomiting
-any other concerning symptoms
It has been a pleasure taking care of you and we hope you feel better soon.
Foreign Body in Skin (non removal)
You were seen for having something stuck under your skin. There were no signs of infection and it seemed best to let it work its way out over time.
You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may even safely take up to 4 pills of Ibuprofen and 3 pills of Tylenol at a time. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours (about 10 pills). It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
Please follow up with your primary care physician with the next 1 week.
Please return to the ER if you have any of the following:
-uncontrollable pain
-fever
-worsening numbness, tingling, or weakness
-nausea/vomiting
-any other concerning symptoms
It has been a pleasure taking care of you and we hope you feel better soon.
Wrist Sprain
You were seen for an injury of your wrist. Your x-rays did not show any broken bones. Please use the wrist support for comfort and rest, elevate, and ice the wrist for comfort. You may use Ibuprofen and Tylenol to treat the pain.
Otherwise, please return if the pain become significantly worse, you have any trauma to the same site, or if it feels dislocated.
It's been a pleasure taking care of you and we hope you feel better.
Animal Bite, Rabies Vaccine
You were seen for an animal bite requiring rabies medicine. Please return to the emergency department to received additional vaccinations for rabies on the following days from the bite: 3 days, 7 days, and 14 days. In addition, please have someone check your wound to make sure they are healing properly.
Insect Bites
You were seen in the ER with concern for bug bites. We assessed you and did not find anything that we need to keep you in the hospital for. Please follow up with your primary care provider as needed.
However, things can change, and your child should see their doctor or return to the ER if they have:
-fever
-vomiting that prevents them from keeping down fluids
-fainting
-shortness of breath
-any other new or concerning symptoms
It's been a pleasure taking care of your child and we hope they feel better soon.
Cellulitis
You were seen today for an infection of your skin. We are prescribing you antibiotics. Please take the full course of pills until it is complete, even if you start feeling better before they are finished. Otherwise, you risk creating antibiotic resistant bacteria in the infection.
You should be feeling better after at least 2 days of starting antibiotics and you should start to see improvement after at least 3 days. If you do not, you may need a different antibiotic.
Please come back to the ER or see your primary care provider in 48 hours for someone to check your wound to make sure it is healing.
Otherwise, please return to the ER if you have any of the following:
-increasing redness and swelling
-pus or other discharge from the area
-fever, chills, nightsweats
-other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Planter Wart
You were seen for pain in the sole of your foot due to a Planter’s Wart. There is a chance that you may have an infection around the wart, but we decided not to try to remove any pus because of the increased risk of infection on the bottom of your foot, the need for you to continue applying Compound W acid for the wart, and the fact that you have another appointment with the podiatrist soon. You may want to call the podiatrist’s office to see if you can scheduled an even earlier appointment.
Please return to the ER if you have any of the following:
-redness and swelling around the wart
-pus or other discharge from the area around the wart
-fever
-other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Hypothermia
You were seen for having a low body temperature (hypothermia). We were able to warm you up to normal temperature and any bloodwork abnormalities you had went back to normal. We do not feel you need to stay in the hospital at this time.
Please return to the ER if you have any of the following:
-palpitations
-chest pain
-shortness of breath
-loss of consciousness
-unable to eat or drink
-any other concerning symptoms
Otherwise, please follow up with your primary care provider in the next 1 week for a check up.
It has been a pleasure caring for you and we hope you feel better soon.
Eczema
You were seen today for dry and itchy skin that appears to be eczema. We have prescribed you a topical steroid to help with the inflammation. Please use according to the instructions and follow up with a primary care provider and/or a dermatologist. We are giving you the number of our dermatologist so you can call to make an appointment.
Please return to the ER if you have:
-fever of 100.4 or higher
-worsening of the pain at that site
-redness spreading around the wound
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Fatigue
You were seen for feeling tired. Your exam did not show anything for which we think we need to keep you in the hospital. Please follow up with your primary care provider if your fatigue continues.
Otherwise, please return to the ER if you have any of the following:
-weakness, numbness, tingling
-loss of consciousness
-any other concerning symptoms
We hope you feel better soon.
Gallstones/Cholelithiasis
You were seen today for abdominal pain and found to have stones in your gallbladder, but no infection. Your pain has improved, but the stones can cause the pain to come back, or even cause your gallbladder to become infected in the future. Some people live with these stones their whole life, but many people have to have their gallbladder removed to prevent the pain and threat of infection from coming back. Avoid fatty foods, which can often trigger the pain, and see a surgeon to discuss removal of your gallbladder if you wish. We are including the surgeon’s number for you to call and make an appointment.
Please return to the ER if you have any of the following:
-return of your pain
-severe nausea and vomiting that prevents you from keeping anything down
-high fever with abdominal pain
-any other concerning symptoms
Otherwise, please follow up with your primary care provider in the next 1 week for a check up.
It has been a pleasure caring for you and we hope you feel better soon.
Transient Ischemic Attack
You were seen today for one or more of the following neurologic symptoms: tingling, numbness, weakness, confusion, slurred speech, difficulty finding words. One of the conditions that can cause your symptoms is something called a Transient Ischemic Attack (TIA), sometimes called a "mini stroke". Our Neurology colleagues (brain doctors) feel you can be sent home at this time, but it is important that you get further testing done in the next few days to see if you are at risk for having a full stroke. Please follow up with the directions they gave you for further testing.
Please see your primary doctor or return to the ER if you have:
-your same symptoms lasting longer than usual
-new symptoms such as weakness, slurred speech, confusion
-chest pain
-shortness of breath
-vomiting
-fainting
-any other new or concerning symptoms
Otherwise, please also see your primary doctor soon to let them know what is going on.
It's been a pleasure taking care of you and we hope you feel better.
Pneumonia
You were seen today for cough and shortness of breath. Your chest x-ray showed a pneumonia. We are giving you antibiotics and other medications for symptom relief. It is important to finish the full course of antibiotics, even if you start to feel better before the full course is completed.
You should follow-up with your primary doctor in the next 3-4 days for a recheck.
Otherwise, please return to the ER if you have:
- worsening of your shortness of breath
-chest pain
-fever of 100.4 or higher
-fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Pneumothorax
You were seen today for shortness of breath. Your chest x-ray showed a pneumothorax (air in the chest around the lung). It is small enough to just be watched. Please follow up in clinic as directed.
You should follow-up with your primary doctor in the next 3-4 days for a recheck.
Otherwise, please return to the ER if you have:
- worsening of your shortness of breath
-chest pain
-fever of 100.4 or higher
-fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Facial Pain/Swelling
Today you were seen for pain and swelling in your face. We did not find any specific area of infection and your pain improved with pain medicine here. We do not think there is any reason to keep you in the hospital, but it is important that your return right away if you have any worsening symptoms such as:
-increased swelling
-increased pain
-increased redness
-difficulty breathing
-difficulty swallowing
Otherwise, please take the anti-inflammatory medicine we are prescribing you and return or see your pirmary care provider within 24 hours if you feel the same (in other words, if there is NO improvement).
If you feel completely better and back to normal in 24 hours, you do not need to come back or see your primary care provider right away. You should schedule a check up with your primary provider soon, either way.
It's been a pleasure taking care of you and we hope you feel better.
Lab Result
You were seen for an abnormal lab result. Someone called you to come in for further evalution. We have determined you do not need to stay in the hospital right now, however please return if you have any of the following:
Please return to the ER if you have any of the following:
-high fever for several days
-uncontrollable vomiting
-uncontrollable pain
-loss of consciousness
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Impetigo
You were seen for an infection on the skin of your face. This is caused by baceteria and is treated with antibiotics. Please take the entire course of antibiotics even if you feel better before all the pills are done. Otherwise the infection may come back. It does not appear to require that we keep you in the hospital today.
Please follow up with your doctor as directed in the included instructions.
Please return to the ER if you have any of the following:
-fever, chills, nausea or vomiting
-worsening discharge of fluid from your infection
-lightheadedness
It has been a pleasure treating you and we hope you feel better soon.
Vessel Disease/PAD/Claudication
You were seen for pain in your right foot. You have disease of the blood vessels of your foot that may be getting worse. Our surgeons feel you need additional imaging tests of the blood vessels of your foot since you are having more pain and the pulse does not seem strong. We are concerned blood is not reaching all the parts of your foot, and this could lead to further damage of your foot, including the need to amputate it.
However, you did not want to stay in the hospital any longer for further testing. Please call Dr. Nevill'e's office number on Monday to schedule an appointment as soon as possible.
Please return to the ER right away if you have:
-worsening pain
-decreased feeling in your foot
-if your foot is cold
-if your foot changes color
-any other concerning symptoms
It has been a pleasure caring for you adn we hope you feel better soon.
Abortion
You were seen for vaginal bleeding during pregnancy. You lab work, exam, and ultrasound *** showed that you are likely having a miscarriage ***. We do not think you need to stay in the hospital right now. However, it is important that you follow up with your Obstetrician-Gynecologist soon to make sure you pass all the products of conception.
Please return to the ER if you have any of the following:
-repeat or worsening bleeding
-unusual vaginal discharge
-concerning belly pain
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Constipation
You were seen for constipation and were not found to need hospitalization at this time. _We are prescribing you laxatives. _You may use over-the-counter laxatives or use an enema. Please use as directed and follow up with your primary care provider at the next available appointment for reassessment.
Please return to the ER if you have any of the following:
-blood in your stool
-lightheadedness
-not passing stool or passing gas
It has been a pleasure taking care of you and we hope you feel better soon.
Hypothyroidism
You were seen today for _________. You were found to have decreased function of your thyroid gland (hypothyroidism). This is fairly common and usually can be treated by giving you medicine to replace the thyroid hormone your body is not making enough of. We are prescribing you this medication at a low starting dose.
You are also referring you to a Endocrinologist. These doctors are specialists in the hormones of the body, like the thyroid hormone. They may want to do more tests to figure out why you have hypothyroidism and also adjust the dose of your medication.
Please return to the ER if you have any of the following:
-worsening weakness
-fever
-nausea or vomiting
-any concerning symptoms
It has been a pleasure taking care of you and we hope you feel better soon.
Facial Fracture
You were seen today for a facial fracture. You were examined by emergency doctors; Ear, Nose, and Throat (ENT) doctors; and eye doctors and we did not find anything for which we need to keep you in the hospital. Please follow the below instructions and attend the follow up appointments as directed:
DO NOT:
-blow your nose (use nasal saline spray instead)
-use a straw
-put anything in your nose
-sneeze with your mouth shut (open your mouth when you sneeze)
DO:
-eat a soft diet for the next 6 weeks
-use ice to help the swelling on your face
Please see the ENT doctors in the outpatient clinic in 1 week by calling the number provided in the included paperwork.
Please return to the ER if you have any of the following:
-uncontrollable pain
-new bleeding from your wounds
-loss of vision in the injured eye
-worsening pain with eye movement
-any other concerning symptoms
We hope you feel better soon.
Hyponatremia
You were seen for your low sodium level on labs drawn 1 week ago. You level today is higher and closer to a normal value. You do not appear to be having any symptoms related to a low sodium level. We spoke with your primary care doctor who will call you tomorrow to check in on you.
If you have any of the following, please return to the ER:
-lightheadedness/feeling faint
-loss of consciousness
-seizure
-persistent vomiting and inability to keep food/drink down
-any other concerning symptoms
We hope you feel better soon.
Breast Pain
Today, you were seen in the ER for your breast pain. Your tests didn't show any explanation for your symptoms. The exact cause for your pain is unclear, but we do not feel you need to stay in the hospital at this point.
However, things can change, and you should see your doctor or return to the ER if you have:
-worsening of your pain
-unusual discharge from your breast
-changes to the skin over your breast
-fever of 100.4 or higher
-shortness of breath
-any other new or concerning symptoms
Otherwise, it is important that you see your primary doctor in 1-2 days for a recheck and to schedule a mammogram.
It's been a pleasure taking care of you and we hope you feel better.
Radiculopathy/Sciatica
You were seen for pain in your ___________. We believe this pain relates to compression of nerves in your spine. The best treatment for now is to take over-the-couter NSAIDs (non-steroidal anti-inflammatory drugs) such as Naproxen Sodium (Alleve) or Ibuprofen (Advil, Motrin) and follow up with your primary care provider. You may need to seek the help of a back specialist as well to discuss other treatment options (such as surgery).
Please return to the ER if you have:
-uncontrollable pain
-weakness in any extremity
-loss of control of bowel or bladder
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Vaginal Bleeding Pregnancy
You were seen for bleeding during early pregnancy. Your bloodwork was reassuring and your ultrasound showed a normal pregnancy. We do not think you need to stay in the hospital right now. However, it is important that you follow up with your Obstetrician-Gynecologist soon to make sure the pregnancy continues to progress healthily.
Please return to the ER if you have any of the following:
-repeat or worsening bleeding
-unusual vaginal discharge
-concerning belly pain
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Influenza
Today, you were seen in the ER for your cough. You tested positive for Influenza (Flu).This is a viral infection that your body needs to fight off and this can take up to a couple weeks. Please take the prescribed medications as directed and drink plenty of fluids.
Other over-the-counter medicines that may help your symptoms are:
Ibuprofen and Tylenol - for pain, fever, and inflammation; can be taken together or separately
Cough suppressant such as Robitussin syrup. DayQuil/NyQil - for cough suppressant, congestion, pain relief
Things can change, and you should see your doctor or return to the ER if you have:
-chest pain
-difficulty breathing
-fainting
-fever of 101 or higher
-vomiting that prevents your from drinking fluids
-any other new or concerning symptoms.
Otherwise, you should follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Beta List
You were seen for _______. Your blood work tested positive for pregnancy. The ultrasound did not show a definite normal pregnancy, though it is usually too early at this point to see one. Given your symptoms, it is important you follow up in 48 hours to have your blood drawn again to measure the "beta level". This will help us determine whether your pregnancy is progressing normally or if there are problems. Please follow the directions given to you be the Obstetrics and Gynecology team for your return visit.
If anything gets worse or you have any of the following, please return to the ER right away:
-worsening abdominal pain
-severe nausea and/or vomiting
-excessive vaginal bleeding
-any other concerning symptoms
It has been a pleasure taking care of you and we hope you feel better soon.
Cellulitis/Wound Infection
You were seen for an infection in your skin. It does not appear to require that we keep you in the hospital today. Please take the antibiotics were are prescribing you. Take the full course as instructed on the bottle until all the pills are gone.
Please follow up with your doctor as directed in the included instructions.
Please return to the ER if you have any of the following:
-fever, chills, nausea or vomiting
-worsening discharge of fluid from your infection
-lightheadedness
It has been a pleasure treating you and we hope you feel better soon.
Nose Bleed/Epistaxis
You were seen for a nose bleed. Your bleeding has stopped after treatment.
Please make an appointment as soon as possible to be evaluated by the Ear, Nose, and Throat doctors. They would like to see you in 3-5 days, so call tomorrow to make an appointment. Please leave the packing (Rhino Rocket) in place until they see you.
Please take the antibiotic medication we are prescribing you. It is important to take the full course, even if you do not feel sick, so that your nose does not get infected. Do not blow your nose and try not to sneeze or cough too hard.
Please return to the ER if you have any of the following:
-fever, chills, nausea or vomiting
-blood in your mouth or running down your throat
-lightheadedness
-swelling of your nose or face
We hope you feel better soon.
Paresthesias
You were seen for numbness or tingling in your __________. Your bloodwork and EKG did not show any reason for these symptoms currently. We do not feel you need to stay in the hospital right now.
That said , things can change. Please return to the ER if you have:
-loss of consciousness
-inability to walk
-weakness in any part of your body
-vomiting that prevents you from drinking fluids
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 1 week for a recheck.
It has been a pleasure treating you and we hope you feel better soon.
Thyroglossal Duct Cyst/Neck Mass
You were seen for a lump or mass in the front of your neck. We suspect what is called a "thyroglossal duct cyst" that has become infected. We are starting you on antibiotics. Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, the infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
In additional, please follow up in the clinic with our Ear, Nose, and Throat (ENT) doctors with the next 1-2 weeks. They will discuss with you any further treatment recommendations.
Please return to the ER if you have any of the following:
-redness around the mass
-difficulty breathing or swallowing
-fever
-nausea/vomiting
-any other concerning symptoms
It has been a pleasure taking care of you and we hope you feel better soon.
Mouth Pain/Dental
You were seen for pain in your mouth. Your pain appears to be due to your teeth or gums. Your dentist is the best person to help with this pain. Please make an appointment as soon as possible to be evaluated by the dentist.
Please return to the ER if you have any of the following:
-fever, chills, nausea or vomiting
-pus in your mouth
-excessive bleeding from your mouth
-unbearable pain
We hope you feel better soon.
Epididymitis/Orchitis/Testicular pain - abx
You were seen for pain in your testicle. We found that you have an infection of the epididymis, which is connected to the testicle. We are prescribing you antibiotics that will treat this infection and your urinary tract infection. Please take them as directed until they are finished, even if you feel better before they are done.
Please return to the ER if you have:
-worsening pain
-fever
-nausea or vomiting
-any concerning symptoms
It has been a pleasure taking care of you and we hope you feel better soon.
Epididymitis/Orchitis/Testicular pain - no abx
You were seen for pain in your testicle. We are unsure of the cause of your pain, but it does not appear to be due to twisting of the testicle, which is an emergency. You may use cold packs, scrotal elevation, and over-the-counter medicines for pain.
Please return to the ER if you have:
-worsening pain
-fever
-nausea or vomiting
-any concerning symptoms
It has been a pleasure taking care of you and we hope you feel better soon.
Pericarditis
Today, you were seen in the ER for your chest pain. Your EKG didn't show any definitie explanation for your symptoms. Your story and symptoms are consistent with pericarditis. Please take the prescribed medicine to help relieve the symptoms. We do not feel we need to keep you in the hospital right now.
However, things can change, and you should see your doctor or return to the ER if you have:
-worsening of your chest pain
-difficulty breathing
-fainting
-unusual sweating or anxiety
-any other new or concerning symptoms.
In addition, you should follow-up with your primary doctor within 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Peritonsillar abscess
Today, you were seen in the ER for your sore throat and peritonsillar abscess. We drained the abscess and you should start to feel better over the next few days. Please take the antibiotics we prescribed as directed until all the pills are gone. Take the pain medications as needed. DO NOT DRIVE WHILE TAKING THE PAIN MEDICATIONS.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Diabetes/Hyperglycemia
You were seen in the ER for your high blood sugar level. We gave you insulin and your sugar came down. It is important that you see your primary care provider as soon as possible to change your medications so that your blood sugar does not get this high. Please call them to make an appointment.
Please return to the ER if you have:
-worsening abdominal pain
-nausea/vomiting
-lightheadedness
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Anxiety/Panic
Today, you were seen in the ER for your ___________. Your bloodwork and EKG looked unconcerning. We do not know the cause of your symptoms, but does not seem to be an emergency right now. There is a chance this could be cause by anxiety or a panic attack. Please follow up with your primary care provider for further assessment of your symptoms.
That said , things can change. Please return to the ER if you have:
-loss of consciousness
-inability to walk
-weakness in any part of your body
-vomiting that prevents you from drinking fluids
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
MVC (Motor Vehicle Collision)
You were seen today after your car crash. We examined you and found ___________.
You will be sore for the next few weeks. You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may even safely take double the dose indicated on the bottle. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours. It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
Please return to the ER if you have any of the following:
-unusual bleeding
-loss of consciousness
-new severe pain
Otherwise, please see you primary care provider in clinic within 1-2 weeks for a check up.
It has been a pleasure caring for you and we hope you feel better soon.
Pedestrian hit by car (Peds struck)
You were seen today after being hit by a car. We examined you and found ___________. You will be sore for the next few weeks.
You will be sore for the next few weeks. You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may even safely take double the dose indicated on the bottle. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours. It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
Please return to the ER if you have any of the following:
-unusual bleeding
-loss of consciousness
-new severe pain
Otherwise, please see you primary care provider in clinic within 1-2 weeks for a check up.
It has been a pleasure caring for you and we hope you feel better soon.
Assault
You were seen today after being injured by another person. We examined you and found ___________. You will be sore for the next few weeks. Take over the counter pain medications like Ibuprofen and Tylenol for pain.
You may even safely take double the dose indicated on the bottle. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours. It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
Please return to the ER if you have any of the following:
-unusual bleeding
-loss of consciousness
-new severe pain
Otherwise, please see you primary care provider in clinic within 1-2 weeks for a check up.
It has been a pleasure caring for you and we hope you feel better soon.
Altered Mental Status
You were seen for being confused. Your legs were examined and the wounds were dressed. Your bloodwork did not show and reasons for your confusion and you were feeling better.
Please return to the ER if you have any of the following:
-feeling confused
-lightheadedness
-any concerning symptoms
Please see you primary care provider for a check up in the next week.
It has been a pleasure caring for you and we hope you feel better soon.
Gout
You were seen for your gout flare in your _________. We gave you pain and anti-inflammatory medicines to help. You should also use ice for comfort, and elevate it to help reduce the swelling. If your pain and swelling continues, please see your primary care provider. You may need a sample of the fluid in your joint taken out for analysis.
Please return to the ER if you have any of the following:
-worsening pain despite medications
-worsening redness and swelling of the joint
-fever
-other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Vaginal Bleeding (PCOS)
You were seen today for vaginal bleeding. The ultrasound did not show any additional reason for you bleeding (like fibroids) and did show that your have polycystic ovaries. You blood levels and urine looked completely normal. It is important that you follow up with your obstetrician-gynecologist in the next week for a check up. You may continue bleeding and they may have additional recommendations of ways to treat this.
Please return to the ER if you experience any of the following:
-lightheadedness
-loss of consciousness
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Vaginal Bleeding (nonpregnant)
You were seen today for vaginal bleeding. The ultrasound did not show any additional reason for you bleeding (like fibroids). Your blood levels and urine looked completely normal. It is important that you follow up with your obstetrician-gynecologist in the next week for a check up. You may continue bleeding and they may have additional recommendations of ways to treat this.
Please return to the ER if you experience any of the following:
-lightheadedness
-loss of consciousness
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Vaginal Bleeding (known fibroids)
You were seen today for vaginal bleeding. You blood levels were ok and you did not require a blood transfusion. It is safe for you to go home.
It is important that you follow up with your obstetrician-gynecologist in the next week for a check up. You may continue bleeding and they may have additional recommendations of ways to treat this.
Please return to the ER if you experience any of the following:
-lightheadedness
-loss of consciousness
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Vomiting
You were seen for feeling nauseous and vomiting. Your labwork looked ok and we don’t think there’s anything we need to keep you in the hospital for tonight. Hopefully you start to get better soon. You can take the prescribed medication for any more vomiting, and make an appointment with your primary care provider in the next few days for a recheck.
Vaginal Bleeding While Pregnant (Abortion)
You were seen today for bleeding during pregnancy. The ultrasound showed that the pregnancy was ended and we removed some tissue during the exam. It is important that you follow up with your obstetrician-gynecologist in the next week for a check up. You will likely continue bleeding for another week or two. Please use the prescriptions to help with pain.
Please return to the ER if you experience any of the following:
-excessive bleeding (>2 pads per hour for 2 hours)
-lightheadedness
-loss of consciousness
It has been a pleasure caring for you and we hope you feel better soon.
Vaginal Bleeding While Pregnant (No Abortion)
You were seen today for bleeding during pregnancy. The ultrasound showed that the pregnancy looks ok at the moment, and your labwork was reassuring. It does not look like you are currently having a miscarriage right now. There is still a chance you could have miscarriage, and it is important that you follow up with your obstetrician-gynecologist in the next week for a check up. If you do not have an obstetrician-gynecologist, please call the included number to make an appointment.
Please return to the ER if you experience any of the following:
-worsening bleeding
-lightheadedness
-loss of consciousness
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Abdominal Pain During Pregnancy (everything ok)
You were seen today for belly pain during pregnancy. The ultrasound showed that the pregnancy looks ok at the moment, and your labwork was reassuring. It does not look like you are currently having any complications right now. It is important that you follow up with your obstetrician-gynecologist in the next week for a check up. If you do not have an obstetrician-gynecologist, please call the included number to make an appointment.
Please return to the ER if you experience any of the following:
-worsening bleeding
-lightheadedness
-loss of consciousness
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Nausea/Vomiting during Pregnancy
You were seen today for nausea and vomiting during pregnancy. The ultrasound showed that the pregnancy looks ok at the moment, and your labwork was reassuring. It does not look like you are currently having any complications right now. It is important that you follow up with your obstetrician-gynecologist in the next week for a check up. If you do not have an obstetrician-gynecologist, please call the included number to make an appointment.
For your nausea, please take Vitamin B6 (pyridoxine) 10 to 25 mg orally every six to eight hours; the maximum treatment dose suggested for pregnant women is 200 mg/day. In addition, you can take Doxylamine (Unisom). Take one-half of the 25 mg over-the-counter tablet three to four times per day.
Please return to the ER if you experience any of the following:
-worsening bleeding
-lightheadedness
-loss of consciousness
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Allergic reaction
You were seen today for your allergic reaction. We gave you medicine to reduce the symptoms and you felt better. We are giving you some of the same medications to continue over the next few days at home to prevent the symptoms from returning. We are prescribing you an Epi-Pen (epinephrine injector) to use if this happens again and you have any shortness of breath. Please make an appointment with an allergist for further testing to find out what your allergies are.
Return to the ER if you have any of the following:
-shortness of breath
-any swelling of your mouth, lips, tongue, or throat
-any other concerning symptoms
Otherwise please follow up with your primary care physician in the next 2-3 days.
It has been a pleasure taking care of you and we hope you feel better.
Hyperemesis gravidarum
You were seen in the ER for vomiting during pregnancy. For persistent nausea and vomiting, please take the Zofran (Ondansetron) tablets as well as Reglan (Metoclopromide) with either the Diclegis (or, if your insurance will not pay for this prescription, you can take the same medicines by buying Unisom and Vitamin B6 tablets and taking 10mg of each in place of 1 pill of the Diclegis. Take 2 at night, and then add 1 in the morning if you are still nauseous and vomiting, and add another 1 the next afternoon if you do not feel better). Follow up with your obstetrician-gynecologist as soon as possible. Return to the ER if you are unable to tolerate fluids or food.
Seizure
You were seen today for having a seizure. Your bloodwork and CT scan of your head did not show any reason for your seizure and you are feeling better. We do not know the reason you had a seizure, but we do not think you need to stay in the hospital. You should make an appointment with a neurologist (brain doctor) to look into other reason you had a seizure. Please do not drive , swim, or climb anything high until you have been seen by a neurologist.
Please return to the Emergency Department if you have any of the following:
-another seizure
-loss of consciousness( fainting/falling out)
-any other concerning symptoms
Otherwise please follow up with your primary care physician in the next 2-3 days.
It has been a pleasure taking care of you and we hope you feel better.
Cannabinoid Hyperemesis Syndrome
Today, you were seen in the ER for your recurrent vomiting. This appears to be due to your cannabinoid hyperemesis syndrome from using excessive marijuana. You felt better after we gave you some medications and we will prescribe you medicine that dissolves under your tongue for further nausea. Please discontinue marijuana use and consider taking hot showers or baths to relieve your symptoms. You can also rub capsaicin lotion on your back and shoulders for relief.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1-2 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Staring Spell/ Absence Seizure
You were seen today for having a staring spell. Your bloodwork and CT scan of your head did not show any reason for your seizure and you are feeling better. We do not know the reason you had a staring spell, but we do not think you need to stay in the hospital. You should make an appointment with a neurologist (brain doctor) to look into other reason you had a staring spell. Sometimes these are something called an absence seizure.
Please return to the Emergency Department if you have any of the following:
-another episode
-loss of consciousness( fainting/falling out)
-any other concerning symptoms
Otherwise please follow up with your primary care physician in the next 2-3 days.
It has been a pleasure taking care of you and we hope you feel better.
GI Bleeding
You were seen today for blood in your stool. You blood levels were normal and your vital signs were stable and we do not feel you need to stay in the hospital at this time. We are giving you the contact information for a GI doctor. Please call their office to make an appointment.
Please return to the ER if you experience any of the following:
-large amount of bright red blood in your stool
-lightheadedness
-loss of consciousness
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Groin lymph node swelling
You were see today for swelling in your groin. It does not appear to be a hernia and is likely a swollen lymph node that will go away on its own. Lymph nodes can swell if there is an infection nearby, or sometimes swell for unknown reasons. If the swelling does not go away, please schedule an appointment with your primary care provider for further work up.
If anything changes or gets worse, please come back to the ER, including:
-severe pain
-high fever
-the swelling gets worse
-if you have an wounds that appear over the swollen area
It has been a pleasure taking care of you and we hope you feel better soon.
Hernia
You were see today for swelling in your groin. It appears to be a hernia but is reducible (can be pushed back in on it’s own), so does not require immediate surgery. However, it can become trapped on the outside and become non-reducible. This situation can be dangerous, so it is important you go see a surgeon soon. We have provided you with a number to call to make an appointment.
If anything changes or gets worse, please come back to the ER, including:
-severe pain
-high fever
-nausea/vomiting
-the swelling gets bigger and will not go down
It has been a pleasure taking care of you and we hope you feel better soon.
Hemorrhoid
You were seen for anal discomfort or bleeding that might be due to hemorrhoids. You can try over-the-counter medications such as Preparation H for discomfort. You can also use over-the-counter stool softeners. If your symptoms persist, you can call the included number to make an appointment with a colorectal surgeon for further management options.
Please return to the ER if you have:
-uncontrollable bleeding
-new discharge
-abdominal pain
-nausea and vomiting
-any other concerning symptoms.
Please follow up with your primary doctor for a reevaluation in the next 2 weeks.
It's been a pleasure taking care of you and we hope you feel better.
Eye pain
You were seen today for your eye pain. We found that you have a corneal ulcer, likely from your contacts. Please stop using your contacts until it clears up and use the antibiotic eyedrops we have given you every 2 hours during the day, and apply the ointment we have prescribed before bed at night. Please go to the ophthalmology clinic tomorrow for a follow up check to make sure it is healing.
Please return to the ER if you have any of the follow:
-increased eye pain/redness
-thick discharge from your eye
-worsening/blurry vision
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Subconjunctival Hemorrhage
You were seen today for redness of your eye. We found that you have a small amount of blood just under the surface of the eye. This can happen from sneezing, coughing, or straining with force. Often we do not know what caused it, but it should go away on its own and does not cause any permanent problems.
Please go to the ophthalmology clinic tomorrow for a follow up check to make sure it is healing.
Please return to the ER if you have any of the follow:
-increased eye pain/redness
-thick discharge from your eye
-worsening/blurry vision
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Facial Injury
Today you were seen for pain in your ______ after injury. Your CT scans did not show any fracture or dislocation. You will have some swelling for several days. You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may take them together if needed. Do not take more than 3000mg of Tylenol (acetaminophen in 24 hours).
Otherwise, please return if the pain become significantly worse, you have any trauma to the same site, or if it feels dislocated.
Please follow up with your primary doctor for a reevaluation in the next 2 weeks.
It's been a pleasure taking care of you and we hope you feel better.
Broken Bone/Fracture
Today you were seen for pain in your _______. Your x-ray showed a fracture of the _______. Your fracture was stablized and reduced if possible and you were put in support (a splint or cast). Please follow up with the Orthopedists by calling the attached number.
You may take the prescribed medication for break-through pain. The medication will make you sleepy. Please do not drive or do any other activity that requires you to be fully alert while taking the medication. If the medication contains Acetaminophen (the generic name for Tylenol), be careful taking additional over-the-counter Tylenol. Add up the amounts of Acetaminophen listed in each pill, and do not take more than 3000-4000mg in 24 hours.
Please return to the ER if your pain is uncontrollable, you have additional trauma to the area, or you have any other concerns.
It's been a pleasure taking care of you and we hope you feel better.
Patella Fracture (quad function ok, knee immobilizer, rest, ice, Ortho f/u)
Today you were seen for pain in your knee. Your x-ray showed a fracture of the patella (knee cap). You were put in knee immobilizer, which you should wear as much as possible for 4-6 weeks. Please follow up with the Orthopedists by calling the attached number and make an appointment for their next available time.
You may take the prescribed medication for break-through pain. The medication will make you sleepy. Please do not drive or do any other activity that requires you to be fully alert while taking the medication. If the medication contains Acetaminophen (the generic name for Tylenol), be careful taking additional over-the-counter Tylenol. Add up the amounts of Acetaminophen listed in each pill, and do not take more than 3000-4000mg in 24 hours.
Please return to the ER if your pain is uncontrollable, you have additional trauma to the area, or you have any other concerns.
It's been a pleasure taking care of you and we hope you feel better.
Joint Pain
Today you were seen for pain in your _______. Your x-ray did not show any fracture or dislocation of the joint, but is not able to show muscles, tendons, and ligaments well. If your pain continues, please see the orthopedic doctor who specializes in bones and joints and whose phone number is listed in this paperwork.
Otherwise, please return if the pain become significantly worse, you have any trauma to the same site, or if it feels dislocated.
It's been a pleasure taking care of you and we hope you feel better.
Pseudoseizure (PNES)
You were seen for weakness and seizure like activity. Your CT scan and MRI did not show evidence of a stroke or other concerning neurologic problem. We think you have what are called Psychogenic Non-Epileptic Seizures. These are not caused by a neurologic problem. You may need to see a psychiatrist if they continue.
Bursitis
Today you were seen for pain in your _______. Your x-ray did not show any fracture or dislocation of the joint, but is not able to show muscles, tendons, and ligaments well. We think you have inflammation of one of the fluid-filled spaces around your joint called a bursa. This can be due to an injury or an infection in the area. We are prescribing you antibiotics and medicines for pain. Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, the infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
*You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may even safely take double the dose indicated on the bottle. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours. It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
*You may take the prescribed medication for break-through pain. The medication will make you sleepy. Please do not drive or do any other activity that requires you to be fully alert while taking the medication. If the medication contains Acetaminophen (the generic name for Tylenol), be careful taking additional over-the-counter Tylenol. Add up the amounts of Acetaminophen listed in each pill, and do not take more than 3000-4000mg in 24 hours.
Otherwise, please return if the pain become significantly worse, you have any trauma to the same site, or if it feels dislocated.
It's been a pleasure taking care of you and we hope you feel better.
Muscle Pain
Today you were seen for pain in your ___________. Your x-ray did not show any fracture or dislocation of the joint, but is not able to show muscles, tendons, and ligaments well. Your pain seems to be from soreness in the muscle. We do not know what caused this but do not feel you need to stay in the hospital at this time. You may try the muscle relaxant prescription we are giving you, but be sure not to drive while taking it because it can make you sleepy. Please follow up with your primary care provider if you pain continues.
Otherwise, please return if the pain becomes significantly worse, you have any trauma to the same site, or if it feels dislocated.
It's been a pleasure taking care of you and we hope you feel better.
Anxiety/Panic
Today you were seen for an anxiety event/panic attack. Your symptoms went away and you felt better. We do not think there is any reason to keep you in the hospital for your symptoms right now and are discharging you. Please take the medicine prescribed by your doctor for any future episodes like this, and see your doctor in the office as needed.
Please return to the ER if you have any of the follow:
-fainting
-blurry vision
-headache
-shortness of breath
-any new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Sore Throat/Pharyngitis
Today, you were seen in the ER for your sore throat. You did not test positive for Strep throat, Flu, or Mono. These symptoms are usually caused by a viral infection in the throat and sinuses that your body will fight best on its own and antibiotics do not work on viruses. The best thing to do is drink plenty of fluids, get some rest, and use over the counter products for comfort such as Naproxen, Tylenol, NyQuil/DayQuil.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Pharyngitis (Not strep, not tested)
Today, you were seen in the ER for your sore throat. You tested positive for Strep throat and we gave you antibiotics to treat it. The best thing to do is drink plenty of fluids, get some rest, and use over the counter products for comfort such as Naproxen, Tylenol, NyQuil/DayQuil.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Kidney stone (confirmed)
Today, you were seen in the ER for your back and groin pain and were found to have a kidney stone. The size of your stone is small enough that it usually passes on its own at home. You can use over-the-counter medicines called NSAIDs: Non-steroidal Anti-Inflammatory Drugs. These include Ibuprofen (Advil, Motrin) or Naproxen Sodium (Alleve). You can safely take two times to over-the-counter dosage for a limited period of time (about 1 week).
Please take the pain medicine for break-through pain as prescribed and do not drive while taking it as it can make you drowsy.
Please call the urologist number included to make an appointment for follow up, especially if it's not passing on its own.
Please return to the ER if you have:
-fever of 100.4 or higher
-vomiting
-fainting
-shortness of breath
-new middle back pain
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 4-5 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Kidney stone (unconfirmed)
Today, you were seen in the ER for your back and groin pain and we suspect you might have a kidney stone. You can use over-the-counter medicines called NSAIDs: Non-steroidal Anti-Inflammatory Drugs. These include Ibuprofen (Advil, Motrin) or Naproxen Sodium (Alleve). You can safely take two times to over-the-counter dosage for a limited period of time (about 1 week).
Please take the pain medicine for break-through pain as prescribed and do not drive while taking it as it can make you drowsy.
Please call the urologist number included to make an appointment for follow up, especially if it's not passing on its own.
Please return to the ER if you have:
-fever of 100.4 or higher
-vomiting
-fainting
-shortness of breath
-new middle back pain
-any other new or concerning symptoms
The cause of your symptoms may be something other than a kidney stone, but teh Otherwise, please follow-up with your primary doctor in 4-5 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Chest pain (CP)
Today, you were seen in the ER for your chest pain. Your EKG, chest x-ray, and bloodwork didn't show any explanation for your symptoms. The exact cause for your pain is unclear, but we do not feel we need to keep you in the hospital right now.
However, things can change, and you should see your doctor or return to the ER if you have:
-worsening of your chest pain
-difficulty breathing
-fainting
-unusual sweating or anxiety
-any other new or concerning symptoms.
In addition, you should follow-up with your primary doctor within 1-2 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Dyspnea
Today, you were seen in the ER for your shortness of breath. Your exam, chest x-ray, and EKG did not show any reason for your symptoms. We do not know what the cause of your symptoms are, but we do not think it is an emergency or that you need to stay in the hospital at this time.
You should follow-up with your primary doctor in the next 1-2 days for a recheck.
Otherwise, please return to the ER if you have:
- worsening of your shortness of breath
-chest pain
-fever of 100.4 or higher
-fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Sleep Apnea
You were seen for having an episode where your felt like you stopped breathing while sleeping. You labs, EKG, and CXR were reassuring. We think this might have been an episode of sleep apnea. For further evaluation, you can talk to your primary care provider about arranging a sleep study.
Please return to the ER if you have:
-shortness of breath
-chest pain
-fever of 100.4 or higher
-fainting
-any other new or concerning symptoms
Otherwise, you should follow-up with your primary doctor in the next 1-2 weeks.
It's been a pleasure taking care of you and we hope you feel better.
Asthma Exacerbation
Today, you were seen in the ER for shortness of breath due to a flare up of your asthma. You received nebulizer treatments and steroids and your breathing improved. Please take the full course of steroids we are prescribing you, and continue to use your home inhalers and/or nebulizers as usual.
Please return to the ER if you have:
- worsening of your shortness of breath
-chest pain
-fever of 100.4 or higher
-fainting
-any other new or concerning symptoms
Otherwise, you should follow-up with your primary doctor in the next 1-2 weeks to see if you need an adjustment to your medications to help control your asthma.
It's been a pleasure taking care of you and we hope you feel better.
COPD Exacerbation:
Today, you were seen in the ER for shortness of breath due to a flare up of your COPD. You received oxygen, nebulizer treatments, and steroids and your breathing improved. Please take the full course of steroids we are prescribing you, and continue to use your home inhalers and/or nebulizers as usual.
_CHOOSE:
In addition, please complete the entire course of antibiotics you are prescribed.
Your chest x-ray did not show signs of pneumonia, however it is not a perfect test.
Please return to the ER if you have:
- worsening of your shortness of breath
-chest pain
-fever of 100.4 or higher
-fainting
-any other new or concerning symptoms
Otherwise, you should follow-up with your primary doctor in the next 1-2 weeks to see if you need an adjustment to your medications to help control your COPD.
It's been a pleasure taking care of you and we hope you feel better.
Cough:
Today, you were seen in the ER for your cough. Your chest x-ray and bloodwork didn't show any explanation for your symptoms. The exact cause for your cough is unclear, but these symptoms are typically caused by viral infections, which generally go away on their own after several days.
However, things can change, and you should see your doctor or return to the ER if you have:
-chest pain
-difficulty breathing
-fainting
-fever of 101 or higher
-vomiting that prevents your from drinking fluids
-any other new or concerning symptoms.
Otherwise, you should follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Upper Respiratory Infection (likely viral):
Today, you were seen in the ER for your cough. Your chest x-ray and bloodwork didn't show any explanation for your symptoms. The exact cause for your cough is unclear, but these symptoms are typically caused by viral infections, which generally go away on their own after several days.
You may take Ibuprofen (Advil or Motrin), Naproxen (Alleve) and Tylenol over-the-counter for your discomfort.. You may even safely take up to 4 pills of Ibuprofen or Naproxen and 3 pills of Tylenol at a time. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours (about 10 pills). It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
In addition, you can take cough medicine and sore throat medicine to treat those symptoms if you have them. Again, be sure to check the amount of Acetaminophen in each product.
You can also try over-the-counter anti-histamine medications for your congestion and runny nose, like Zyrtec, Allegra, or Claritin. Benedryl can also help, but may make you sleepy.
However, things can change, and you should see your doctor or return to the ER if you have:
-chest pain
-difficulty breathing
-fainting
-fever of 101 or higher
-vomiting that prevents your from drinking fluids
-any other new or concerning symptoms.
Otherwise, you should follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Abdominal pain:
Today, you were seen in the ER for your abdominal pain. Your bloodwork and CT scan and ultrasound didn't show any explanation for your symptoms. The exact cause for your pain is unclear, but we do not think there is any reason to keep you in the hospital right now.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1-2 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Weight Loss (unexplained)
Today, you were seen in the ER for your weight loss.The exact cause for your weight loss is unclear, but we do not think there is any reason to keep you in the hospital right now.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1-2 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Diverticulitis
Today, you were seen in the ER for your abdominal pain. Your CT scan showed that you have something called diverticulitis. Diverticulosis is when you have small outpouchings of your colon. Diverticulitis is when those outpouchings become inflamed. We do not think you need to stay in the hospital at this time, but we are prescribing you antibiotics. It is important you take the full course of antibiotics as instructed even if you feel better before they are finished so that an infection does not return stronger.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1-2 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Leg swelling:
Today, you were seen in the ER for the swelling of your leg. Your ultrasound showed no signs of a blood clot in your leg, and your exam does not show any signs of infection. The exact cause of your swelling is unclear, but we do not think there is any reason to keep you in the hospital at this time.
However, things can change, and it is possible for an ultrasound to miss an early blood clot. Therefore, you should see your doctor or return to the ER if you have:
-worsening of your swelling over the next 2-3 days
-shortness of breath
-fainting or lightheadedness
-fever of 100.4 or higher
-new or spreading redness of your skin
-any other new or concerning symptoms
Otherwise, you should see your primary doctor in 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Headache:
Today, you were seen in the ER for your headache. You exam and tests were reassuring and you felt better after medicines we gave you. The exact cause for your headache is unclear, but we do not think there is any reason to keep you in the hospital at this time.
That being said, things can change, and you should see your primary doctor or return to the ER if you have:
-sudden severe headache
-vision changes
-fever of 100.4 or higher
-neck stiffness
-new rash
-weakness, numbness, tingling in arms or legs or face
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 2-3 days for a recheck. It might be helpful to keep a diary of your headaches to share with your doctor. Write down when they happen, what you were doing, how long they last, how they feel and how intense they are, any associated symptoms, and any medications you took and how the headache responded.
It's been a pleasure taking care of you and we hope you feel better.
***Caffeine***
Caffeine seemed to help your headache, so you might want to try caffeine at home. It can be found in popular drinks such as coffee and tea, in pill form over-the-counter, and is included in some over-the-counter headache medicines, such as Excedrin (which also contains Aspirin, so do not take this if there is any reason you should not take Aspirin). Excedrin for Tension Headaches does not include Aspirin.
Closed head injury/Concussion:
Today, you were seen in the ER after having a head injury. Your CT scan showed no signs of dangerous brain injury, but you may notice yourself having signs of concussion in the coming days, including headache, nausea, or difficulty focusing, among other things. In general, you should avoid activities that worsen your symptoms, and you may use over-the-counter medications for your pain.
Please return to the ER if you have:
-fainting
-weakness in any single part of your body
-vomiting that prevents you from drinking fluids
-any other new or concerning symptoms
If your symptoms continue for more than 1 weeks, please make an appointment with the Concussion Clinic. Call the Neurology number included to make an appointment. The web site is: http://www.gwdocs.com/neurology/concussion-clinic
It's been a pleasure taking care of you and we hope you feel better.
Alcohol intoxication:
Today, you were seen in the ER for your alcohol intoxication. You should be more cautious with your alcohol use, as it can lead to medical problems, accidents, and poor life decisions.
If you find that you have difficulty stopping drinking, you may benefit from seeking rehabilitation services.
Substance Abuse and Mental Health Services Administration (SAMHSA)
National Helpline: 1-800-662-HELP (4357)
Confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information.
It's been a pleasure taking care of you and we hope you feel better.
Alcohol Intoxication (Spanish):
Usted fue visto en la sala de emergencia por abuso de alcohol. Debe dejar de beber alcohol o beber con moderación, ya que esto es peligroso para su salud y puede conducir a futuros problemas de salud. Usted debe buscar un grupo alcohólico anónimo local de la reunión para ayudar a parar el usar del alcohol. Debe regresar a la sala de emergencias con cualquier actividad de convulsiones, dolor incontrolado, fiebre / escalofríos, pensamientos suicidas o síntomas relacionados con usted. Debe hacer un seguimiento con su médico de atención primaria, o usar la siguiente información para encontrar un médico de atención primaria, para ayudar a controlar su salud.
Gracias por elegir el Departamento de Emergencias de George Washington.
You were seen in the ER for alcohol abuse. You need to stop drinking alcohol or drink in moderation, as this is dangerous to your health and may lead to future health problems. You should seek out a local alcoholic anonymous meeting group to help stop using alcohol. You should return to the ER with any seizure activity, uncontrolled pain, fevers/chills, suicidal thoughts or symptoms concerning to you. You should follow up with your primary care doctor, or use the below information to find a primary care doctor, to help manage your health.
Thank you for choosing the George Washington Emergency Department.
Hypokalemia due to Anorexia/Bulemia (eating disorder)
Today, you were seen in the ER for your low potassium level. This is likely due to your eating disorder. We gave you some potassium and your repeat level was higher. Your EKG did not show any problems with your heart currently, but having a low potassium level can cause your heart to beat incorrectly and even lead to death. We do not feel we need to keep you in the hospital right now, but it is important for you to start taking potassium supplements and to follow up with your primary doctor. In addition, we gave you resources for seeking further help with dealing with your eating disorder.
However, things can change, and you should see your doctor or return to the ER if you have:
-worsening of your chest pain
-difficulty breathing
-palpitations (racing heartbeat)
-fainting
-unusual sweating or anxiety
-any other new or concerning symptoms.
It's been a pleasure taking care of you and we hope you feel better
Drug abuse:
Today, you were seen in the ER for your drug abuse. You should be very careful with your use of drugs, as it can result in medical problems, accidents, and poor life decisions. You should, in fact, stop using drugs as soon as you are able.
If you are not able to stop, you should go to a rehabilitation facility, like at Psychiatric Institute of Washington at 4228 Wisconsin Ave NW, Washington, DC 20016, which is open 24 hours a day. You can call them at (202) 885-5600.
It's been a pleasure taking care of you and we hope you feel better.
Urinary tract infection (UTI):
Today, you were seen in the ER for your pain. We found that your urine test showed signs of infection, which may have been the cause of your symptoms. You should take the antibiotic as prescribed in order to get rid of the infection. Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, the infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
Please return to the ER if you have:
-fever of 100.4 or higher
-vomiting
-fainting
-shortness of breath
-new middle back pain
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 4-5 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Pyelonephritis
Today, you were seen in the ER for your pain. We found that your urine test showed signs of infection that appears to have spread to your kidneys, which may have been the cause of your symptoms. You should take the antibiotic as prescribed in order to get rid of the infection. Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, the infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
Please return to the ER if you have:
-fever of 100.4 or higher
-vomiting
-fainting
-shortness of breath
-new middle back pain
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 4-5 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Pelvic Inflammatory Disease, STD (Chlamydia, Gonorrhea), (PID)/Vaginal Discharge:
Today, you were seen in the ER for your belly pain. We found that your urine test did not show signs of infection, but it seems like you might have an infection in your uterus and tubes which may have been the cause of your symptoms. You should take the antibiotic as prescribed in order to get rid of the infection.
Please return to the ER if you have:
-fever of 100.4 or higher
-vomiting
-fainting
-shortness of breath
-new middle back pain
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 4-5 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Vaginal Foreign Body (Condom)
Today, you were seen for suspected object in your vagina. We were able to remove the object and did not see any signs of serious complications.
Please return to the ER if you have:
-fever of 100.4 or higher
-abdominal pain
-shortness of breath
-vaginal bleeding or discharge
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 4-5 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Back pain:
Today, you were seen in the ER for your back pain. Your bloodwork and exam did not give us an explanation for your pain and we do not believe you need to stay in the hospital right now for further assessment or treatment. The exact cause of your pain is unclear, but it may be due to to inflammation of the muscles of your back. You may take the prescribed medications for your pain.
Please return to the ER if you have:
-fever of 100.4 or higher
-vomiting
-weakness of your legs or numbness of your groin
-difficulty controlling your bowels or bladder
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Hygiene
You were seen for concerns about personal hygiene. We do not think you need to stay in the hospital at this time. The best approach is to take a shower daily as much as possible and wash your clothes frequently. It is also important to brush your teeth two times per day and go to a dentist every 6 months or at least once per year.
You can call the included numbers to setup a primary care provider for regular check-ups.
It's been a pleasure taking care of you and we hope you feel better.
Palpitations:
Today, you were seen in the ER for your palpitations. Your EKG, blood work, and x-ray showed no explanation for your symptoms. We do not think there is any reason to keep you in the hospital at this time.
You should follow-up with your primary doctor in 1-2 weeks for a recheck.
Please return to the ER if you have:
-fainting
-chest pain
-shortness of breath
-worsening of your palpitations
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
AFib (paroxysmal)
Today, you were seen in the ER for your palpitations. It appeared as though you had a heart rhythm called Atrial Fibrillation (or Afib). Your EKG, blood work, and x-ray looked good and you stopped having symptoms. We do not think there is any reason to keep you in the hospital at this time.
We do recommend that you follow up with a Cardiologist (heart doctor) for a recheck with in 1 week. You can call the included number to make an appointment. You should also follow-up with your primary doctor in 1-2 weeks for a recheck.
Please return to the ER if you have:
-fainting
-chest pain
-shortness of breath
-worsening of your palpitations
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Employee Occupational Exposure to Body Fluids (Post-Exposure Prophylaxis)
You were seen after being exposed to bodily fluid while working. Labs for the source person and for you were ordered and the information was shared with you. If you chose to take the PEP regimen, please fill the prescriptions. It is recommended you stop taking the medications if the source results have a negative viral load.
Be sure to follow up with Employee Health and your primary care provider. If you have any questions please let us know.
Syncope/near syncope:
Today, you were seen in the ER for your lightheadedness or fainting. Your bloodwork and chest x-ray showed no explanation for your symptoms. The exact cause for your lightheadedness is uncertain, but we do not think there is any reason to keep you in the hospital at this time.
Please see your primary doctor or return to the ER if you have:
-chest pain
-shortness of breath
-vomiting
-fainting
-any other new or concerning symptoms
Otherwise, please see your primary doctor in about 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Off Balance / Dizzy
Today, you were seen in the ER for feeling off balance. Your bloodwork and EKG of your heart showed no explanation for your symptoms. The exact cause for your lightheadedness is uncertain, but we do not think there is any reason to keep you in the hospital at this time.
Please see your primary doctor or return to the ER if you have:
-chest pain
-shortness of breath
-vomiting
-fainting
-any other new or concerning symptoms
Otherwise, please see your primary doctor in about 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Rash (resolve in 5-7 days):
Today, you were seen in the ER for your rash. The exact cause of your rash is unclear, but it does not appear to be due to a dangerous cause at this time. The rash is likely to resolve within the next 5-7 days.
If it does not got go away at that time, you may benefit from seeing a dermatologist.
Please return to the ER if you have:
-vomiting
-pain or ulcers in your mouth or on your eyes
-fever of 100.4 or higher
-lightheadedness or fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Eczematous rash (emollient w derm referral):
Today, you were seen in the ER for your rash. The exact cause of your rash is unclear, but it could be caused by irritation of something against it. Please stop using perfumes and fragrences in your lotions and soaps. Use basic Dove soap bar and an emollient lotion over-the-counter, such as Aquaphor.
If it does not got go away at that time, you may benefit from seeing a dermatologist. You can call the included number to make an appointment.
Please return to the ER if you have:
-vomiting
-pain or ulcers in your mouth or on your eyes
-fever of 100.4 or higher
-lightheadedness or fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Ring Worm
Today, you were seen in the ER for your rash. It appears to be ring worm. You can use over-the-counter products for ring worm, athelete's foot, or jock itch such as sprays or lotions to treat it.
If it does not got go away at that time, you may benefit from seeing a dermatologist.
Please return to the ER if you have:
-vomiting
-pain or ulcers in your mouth or on your eyes
-fever of 100.4 or higher
-lightheadedness or fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Shingles:
Today, you were seen in the ER for your rash. We think the most likely cause of your rash is shingles (a rash you get if you’ve had chicken pox in the past or are exposed to someone with shingles). We are prescribing you an anti-viral medication to treat the cause of the infection. Please take the full course of the medication until completed, even if the rash gets better before you are through all the pills. The rash should begin to go away over the next week, but we recommend you see you primary care provider for a check-up in the next week to make sure it is getting better.
Please return to the ER if you have:
-vomiting
-pain or ulcers in your mouth or on your eyes
-fever of 100.4 or higher
-lightheadedness or fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Rectal bleeding:
Today, you were seen in the ER for the blood in your stool. Your bleeding does not seem to be dangerous right now, and your blood count is reassuring.
You should follow-up with the Gastroenterology clinic for a further evaluation, which will likely include a colonoscopy.
Please return to the ER if you have:
-worsening of your bleeding
-fainting
-lightheadedness
-difficulty breathing
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Diarrhea:
Today, you were seen in the ER for your diarrhea. The exact cause of your diarrhea is unclear, but it does not seem to be caused by anything dangerous.
Please return to the ER if you have:
-fainting
-vomiting that prevents you from drinking fluids
-blood in your stool
-worsening abdominal pain
-fever of 100.4 or higher
-any other new or concerning symptoms
Otherwise, you may follow-up with your primary doctor in the next week for any other concerns.
It's been a pleasure taking care of you and we hope you feel better.
Sickle cell:
Today, you were seen in the ER for your body pains. It seems that your pains were due to a sickle cell pain crisis. Your exam and bloodwork showed no signs of infection or other major problems at this time.
Please follow-up with your primary doctor or hematologist within the next 2-3 days for a recheck and further recommendations on management of your sickle cell disease.
***In the meantime, you may use the prescribed pain medication. Please be cautious with the use of these medications, as they may result in drowsiness; please don't use these medications before driving, swimming, or any other potentially dangerous activities.***
Please return to the ER if you have:
-pain that is not controlled with medications
-weakness of any part of your body
-fever of 100.4 or higher
-difficulty breathing or chest pain
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Dizziness/vertigo:
Today, you were seen in the ER for your dizziness, or vertigo. Your head MRI did not show any reason for these symptoms (such as a stroke or tumor). The rest of your bloodwork and EKG looked unconcerning. We do not know the cause of your dizziness but it does not seem to be an emergency right now.
That said , things can change. Please return to the ER if you have:
-worsening of your dizziness
-inability to walk
-vomiting that prevents you from drinking fluids
-weakness in any part of your body
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Abscess:
Today, you were seen in the ER for your abscess. We drained the abscess, which should be enough for it to heal without antibiotics.
Please return to the ER if you have:
-fever of 100.4 or higher
-worsening of the pain at that site
-redness spreading around the wound
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 1-2 weeks for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Abscess Wound Check and Packing Removal
Today, you were seen in the ER to check on how your abscess is healing. The wound is looking healthy and we removed that packing material placed inside last time. Please change the dressing once a day and follow up as instructed.
Please return to the ER if you have:
-fever of 100.4 or higher
-worsening of the pain at that site
-redness spreading around the wound
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 1-2 weeks for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Paronychia
You were seen today for an infection around your nail. We made a cut near your nail to try to drain the pus. This should help the body to fight off the infection. We are also starting you on antibiotics. Please take the full course of antibiotics until the last day, even if you feel better before all the pills are gone. You may notice continued discharge from the area for the next day or two. Please change the dressing at least once a day until the drainage has stopped.
Return to ED sooner if any of these occur:
-Increasing pain in the wound
-Redness, swelling, or pus coming from the wound
-Fever of 100.4ºF (38ºC) or higher, or as directed by your health care provider
-Bleeding not controlled by direct pressure
It has been a pleasure caring for you and we hope you feel better soon.
Laceration repair:
Finger Laceration
You were seen today for a finger laceration. Your wound was closed with __ nonabsorbable sutures. Keep wound clean and dry for 24 hours. Do not get wound wet AT ALL x 24 hours. After that, wash gently with soap and water and apply neosporin/antibiotic ointment (optional) and a fresh bandage 2x/day. Watch for signs of poor healing, such as bleeding, dark wound edges, redness, increased pain, fever. Follow up in the ER or any other medical facility in 7-10 days for suture removal. Return to ED sooner if any of these occur:
-Increasing pain in the wound
-Redness, swelling, or pus coming from the wound
-Fever of 100.4ºF (38ºC) or higher, or as directed by your health care provider
-If stitches or staples come apart or fall out before your next appointment
-If the surgical tape closures fall off within seven days, or the wound edges re-open
-Bleeding not controlled by direct pressure
It has been a pleasure caring for you and we hope you feel better soon.
Lip Laceration
You were seen today for a laceration in your mouth/lip. Your wound was closed with __ nonabsorbable sutures. You need to return to the ER or go to a healthcare provider to remove the sutures in 5 days. Watch for signs of poor healing, such as bleeding, dark wound edges, redness, increased pain, fever. Follow up in the ER or any other medical facility in 12-14 days for suture removal. Return to ED sooner if any of these occur:
-Increasing pain in the wound
-Redness, swelling, or pus coming from the wound
-Fever of 100.4ºF (38ºC) or higher, or as directed by your health care provider
-If stitches or staples come apart or fall out before your next appointment
-If the surgical tape closures fall off within seven days, or the wound edges re-open
-Bleeding not controlled by direct pressure
It has been a pleasure caring for you and we hope you feel better soon.
Foot Laceration
You were seen today for a laceration on your foot. Your wound was closed with __ nonabsorbable sutures. Keep wound clean and dry for 24 hours. Do not get wound wet AT ALL x 24 hours. After that, wash gently with soap and water and apply neosporin/antibiotic ointment (optional) and a fresh bandage 2x/day. Watch for signs of poor healing, such as bleeding, dark wound edges, redness, increased pain, fever. Follow up in the ER or any other medical facility in 12-14 days for suture removal. Return to ED sooner if any of these occur:
-Increasing pain in the wound
-Redness, swelling, or pus coming from the wound
-Fever of 100.4ºF (38ºC) or higher, or as directed by your health care provider
-If stitches or staples come apart or fall out before your next appointment
-If the surgical tape closures fall off within seven days, or the wound edges re-open
-Bleeding not controlled by direct pressure
It has been a pleasure caring for you and we hope you feel better soon.
Absorbable-Only Sutures
You were seen today for a laceration (cut). Your wound was closed with absorbable sutures that will absorb over the next week. You do not need to have them removed.
. Return to ED sooner if any of these occur:
-Increasing pain in the wound
-Redness, swelling, or pus coming from the wound
-Fever of 100.4ºF (38ºC) or higher, or as directed by your health care provider
-Bleeding not controlled by direct pressure
It has been a pleasure caring for you and we hope you feel better soon.
Extremity Laceration
You were seen today for a _ laceration. Your wound was closed with __ nonabsorbable sutures. Keep wound clean and dry for 24 hours. Do not get wound wet AT ALL x 24 hours. After that, wash gently with soap and water and apply neosporin/antibiotic ointment (optional) and a fresh bandage 2x/day. Watch for signs of poor healing, such as bleeding, dark wound edges, redness, increased pain, fever. Follow up in the ER or any other medical facility in 7-10 days for suture removal. Return to ED sooner if any of these occur:
-Increasing pain in the wound
-Redness, swelling, or pus coming from the wound
-Fever of 100.4ºF (38ºC) or higher, or as directed by your health care provider
-If stitches or staples come apart or fall out before your next appointment
-If the surgical tape closures fall off within seven days, or the wound edges re-open
-Bleeding not controlled by direct pressure
It has been a pleasure caring for you and we hope you feel better soon.
Head Laceration
Today, you were seen in the ER for your laceration on your head or face. We repaired the laceration with (#) stitches. These stitches should be removed in 7 days. You may return to the ER to have them removed. You may notice yourself having signs of concussion in the coming days, including headache, nausea, or difficulty focusing, among other things. In general, you should avoid activities that worsen your symptoms, and you may use over-the-counter medications for your pain.
Please return to the ER if you have:
-increasing pain at the wound site
-pus draining from the wound
-redness spreading around the wound
-fever of 100.4 or higher
-fainting
-weakness in any single part of your body
-vomiting that prevents you from drinking fluids
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Generic Laceration
Today, you were seen in the ER for your laceration. We repaired the laceration with (#) stitches. These stitches should be removed in (#-#) days.
Please return to the ER of see your doctor sooner if you have:
-increasing pain at the wound site
-pus draining from the wound
-redness spreading around the wound
--fever of 100.4 or higher
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Dermabond
DERMABOND* Topical Skin Adhesive (2-octyl cyanoacrylate) is a sterile, liquid skin adhesive that holds wound edges together. The film will usually remain in place for 5 to 10 days, then naturally fall off your skin. The following will answer some of your questions and provide instructions for proper care for your wound while it is healing:
CHECK WOUND APPEARANCE • Some swelling, redness, and pain are common with all wounds and normally will go away as the wound heals. If swelling, redness, or pain increases or if the wound feels warm to the touch, contact a doctor. Also contact a doctor if the wound edges reopen or separate.
REPLACE BANDAGES • If your wound is bandaged, keep the bandage dry. • Replace the dressing daily until the adhesive film has fallen off or if the bandage should become wet, unless otherwise instructed by your physician. • When changing the dressing, do not place tape directly over the DERMABOND adhesive film, because removing the tape later may also remove the film.
AVOID TOPICAL MEDICATIONS • Do not apply liquid or ointment medications or any other product to your wound while the DERMABOND adhesive film is in place. These may loosen the film before your wound is healed.
KEEP WOUND DRY AND PROTECTED • You may occasionally and briefly wet your wound in the shower or bath. Do not soak or scrub your wound, do not swim, and avoid periods of heavy perspiration until the DERMABOND adhesive has naturally fallen off. After showering or bathing, gently blot your wound dry with a soft towel. If a protective dressing is being used, apply a fresh, dry bandage, being sure to keep the tape off the DERMABOND adhesive film. • Apply a clean, dry bandage over the wound if necessary to protect it. • Protect your wound from injury until the skin has had sufficient time to heal. • Do not scratch, rub, or pick at the DERMABOND adhesive film. This may loosen the film before your wound is healed. • Protect the wound from prolonged exposure to sunlight or tanning lamps while the film is in place.
Fall onto Tailbone (coccyx)
You fell backwards and you might have injured your tailbone. No special treatment is necessary. Time will heal the injury. Pain typically lasts four to six weeks, but with each passing week the pain is less.
Rest at home as possible. Give your body time to heal. Avoid sitting as possible. Sit on soft surfaces when necessary. A foam donut-ring apparatus can be purchased at a pharmacy or medical supply store. The donut apparatus allows sitting without pressure on the coccyx. Apply a cold pack to the coccyx off and on for two days after injury. Cold helps reduce pain and swelling. Do not apply ice directly to the coccyx if it causes discomfort. Aim for coolness, yet comfort, applying a layer or two of cloth between the cold pack and coccyx. After two days, apply heat in the form of warm soaks. Moist heat increases circulation in the tissues, promoting healing. Over-the-counter pain medications can relieve discomfort associated with a broken coccyx. Acetaminophen (Tylenol), ibuprofen, or naproxen can be taken, depending on individual preference.
Please make an appointment for a recheck with your primary care provider in 1 week to make sure things are healing properly.
Please return to the ER if you have:
-leg weakness
-losing control of your bladder or bowels
-any other concerns
It has been a pleasure taking care of you and we hope you feel better.
Occupational Exposure (Needle Stick, Body Fluid)
You were seen for being exposure to body fluid. We did initial tests on both you and the person to whom you were exposed and the screening tests for infectious diseases were negative. We do not feel that you need post-exposure prophylaxis.
Please return to the ER if you have any concerning symptoms, swelling or redness at the site of exposure, new fever or chills, nausea or vomiting preventing you from eating or drinking.
It has been a pleasure taking care of you and we hope you feel better.
Depression/Suicidal Ideation:
Today, you were seen in the ER for your depression and suicidal thoughts. You were seen by our Psychiatry team, who decided that, though you are depressed, you are safe to be discharged.
That being said things can change, and you should return to the ER if you have:
-worsening of your suicidal thoughts, especially if you find yourself in a position of truly considering killing yourself
-thoughts of hurting or killing other people
-hearing voices of people that are not present
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 1-2 days for a recheck. Also, please make an appointment with your Psychiatrist for the next available appointment.
It has been a pleasure taking care of you and we hope you feel better.
Hallucinations
Today, you were seen in the ER for your hallucinations. Your medical workup did not show any acute problems and we do not think you need to stay in the hospital today. Please follow up with a psychiatrist for further evaluation.
That being said things can change, and you should return to the ER if you have:
- suicidal thoughts, especially if you find yourself in a position of truly considering killing yourself
-thoughts of hurting or killing other people
-hearing voices of people that are not present
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 1-2 days for a recheck. Also, please make an appointment with your Psychiatrist for the next available appointment.
It has been a pleasure taking care of you and we hope you feel better.
Overdose (denying SI)
Today, you were seen in the ER for taking too many pills. You bloodwork was reassuring and we monitored you for long enough to make sure you would not have any further effects from the pills. You were also seen by our Psychiatry team, and we came up with a plan for follow up care.
That being said things can change, and you should return to the ER if you have:
-suicidal thoughts
-feeling overly sleep or losing consciousness
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 1-2 days for a recheck. Also, please make an appointment with your Psychiatrist for the next available appointment.
It has been a pleasure taking care of you and we hope you feel better.
Psychosis
Today, you were seen in the ER for your psychiatric issues. Your medical workup did not show any acute problems and we do not think you need to stay in the hospital today. Please follow up with a psychiatrist for further evaluation.
That being said things can change, and you should return to the ER if you have:
- suicidal thoughts, especially if you find yourself in a position of truly considering killing yourself
-thoughts of hurting or killing other people
-hearing voices of people that are not present
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 1-2 days for a recheck. Also, please make an appointment with your Psychiatrist for the next available appointment.
It has been a pleasure taking care of you and we hope you feel better.
Hypertension:
Today, you were seen in the ER for your high blood pressure. Your exam showed no signs of consequences of your blood pressure being elevated. We do not believe there is any reason to keep you in the hospital today. You should continue to take your blood pressure medications as prescribed and see your primary care provider for a recheck.
Please return to the ER if you have:
-new weakness
-difficulty speaking
-chest pain
-difficulty breathing
-loss of vision
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor within the next 1-2 weeks.
It's been a pleasure taking care of you and we hope you feel better.
Food Impaction
You were seen for food being stuck in your esophagus. The blockage was relieved and we do not feel you need to stay in the hospital at this time.
Please follow up with a Gastroenterologist (stomach and intestine doctor) for further evaluation within 1 week.
Please return to the ER if you have:
-difficulty swallowing
-difficulty speaking
-chest pain
-difficulty breathing
-uncontrolled nausea and/or vomiting
-uncontrolled pain
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor within the next 1-2 weeks.
It's been a pleasure taking care of you and we hope you feel better.
Pill Esophagitis
You were seen for pain in your chest that we think is most likely due to a pill being stuck in your esophagus. You should take the prescribed medication to reduce the amount of acid in your stomach and follow-up with the GI doctor in 2 weeks but calling the included number.
Please return to the ER if you have:
-difficulty swallowing
-difficulty speaking
-chest pain
-difficulty breathing
-uncontrolled nausea and/or vomiting
-uncontrolled pain
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor within the next 1-2 weeks.
It's been a pleasure taking care of you and we hope you feel better.
Hypotension
Today, you were seen in the ER for your low blood pressure. Your exam showed no signs of consequences of your blood pressure being low, and it was better here in the ER. We do not believe there is any reason to keep you in the hospital today. You should continue to take your regular medications as prescribed and see your primary care provider for a recheck.
Please return to the ER if you have:
-new weakness
-chest pain
-difficulty breathing
-loss of vision
-loss of consciousness
-bleeding
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor within the next 1-2 weeks.
It's been a pleasure taking care of you and we hope you feel better.
Hypoglcemia (IDDM):
Today, you were seen in the ER for your lightheadedness or fainting due to a low blood sugar level. The rest of your bloodwork and tests were normal. You might have taken too much insulin for the amount of food you had today. It is better for your blood sugar level to be a little high for one day rather than be too low, which can be dangerous, so please be careful about how much insulin you take. If you choose your own dose of insulin throughout the day, be sure to measure your blood sugar level first with a monitor. If your doctor has told you how much to take, please see them soon to talk about whether the dose you are taking is the still the right amount.
Please see your primary doctor or return to the ER if you have:
-chest pain
-shortness of breath
-vomiting
-fainting
-any other new or concerning symptoms
Otherwise, please see your primary doctor in about 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Vomiting/Gastritis/Gastroenteritis (no abx):
Today, you were seen in the ER for your abdominal pain and diarrhea. Your bloodwork didn't show any explanation for your symptoms. The exact cause for your discomfort is unclear, but your pain does not seem to require you to stay at the hospital at this time.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1-2 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Vomiting/Gastritis/Gastroenteritis/Dysentery (abx):
Today, you were seen in the ER for your abdominal pain and diarrhea. We found that you have an infection in your intestines. You do not need to stay in the hospital at this time, but we are prescribing you antibiotics.
Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, the infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1-2 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Crohn’s Flare
Today, you were seen in the ER for your abdominal pain that seems to be a flare up of your Crohn’s Disease. Your bloodwork looked ok, and we do not think there is any reason to keep you in the hospital right now.
Please take the course of steroids we are prescribing. Follow the instructions on the label.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your GI doctor for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
You may take either Ibuprofen (Advil or Motrin are the brand names) or Naproxen (Alleve is the brand name) over-the-counter for your pain, but not both at the same time. You may also take Acetaminophen (Tylenol is the brand name) with one of the above medicines.
Ibuprofen (Advil, Motrin) instructions:
You may follow ONE of the following dosing schedules.
- 800 mg every 8 hours
- 600 mg every 6 hours
- 220-400 mg every 4 hours
Naproxen (Alleve) instructions:
You may follow ONE of the following dosing schedules.
- 660-750 mg once followed by 220-250 mg every 8 hours
- 440-500 mg every 12 hours
- 200-250 mg every 8 hours
Acetaminophen (Tylenol) instructions:
You may follow ONE of the following dosing schedules.
- 1000 mg every 8 hours
- 500 mg or 650mg every 6 hours
- 325 mg every 4 hours
Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen to make sure you are not taking more than 3000-4000 mg per day.
Hand Exam:
Extension intact throughout. 3rd digit. Sensation intact over the pad of the finger, thenar eminence, into webspace between 1st and 2nd finger. Patient able to spread fingers to resistance, extend wrist to resistance, patent oppose 1st and 2nd finger to resistance.
Eye Exam
OS OD
Visual Acuity (VA) 20/20 w PH 20/20 w PH
Visual Fields (VF) Intact by 4 Intact by 4
Extra Ocular Movements (EOM) Intact w/o diplopia Intact w/o diplopia
Lids Lashes Lacrimal (LLL) No lesions No lesions
Conjunctiva and Sclera (C/S) White and Quiet White and Quiet
Cornea (K) No Fluorescein Uptake No Fluorescein Uptake
Anterior Chamber (AC) Deep and Quiet Deep and Quiet
Iris (I) Round and Reactive Round and Reactive
Lens (L) Clear Clear
Retina (R) Sharp disc margins Sharp disc margins
Intra Ocular Pressure (IOP) 20 @ 5% 20 @ 5%
Tonometry (Ta) 15 (95) 15 (95)
Contrast Allergy Protocol:
13 hour:
-methylprednisone 12, 2 hours 32mg PO, then diphenhydramine 25mg PO
4 hour:
Follow-Up Clinics:
Metro Immediate & Primary Care
Concussion Clinic - Give the MFA Neurology Clinic info for follow-up in the DCI and instruct your patient to call to schedule an appointment.
The web site is: http://www.gwdocs.com/neurology/concussion-clinic
The # to schedule is 202-741-2700 (regular Neuro Clinic #)
Neurology Rapid Access Clinic (NRAC)
Providers who wish to refer their patients for urgent neurologic evaluation at Neurology’s 2150 Pennsylvania Ave site may call 741-2793* and ask to speak with the neurology provider who is covering the “NRAC”. Once we have the relevant clinical and patient contact information, we’ll take it from there.
[*The Neurology Rapid Access Clinic phone line is staffed from 8am-4pm, M-F. After hours and on weekends providers should leave a message that includes their contact information; calls will be returned promptly as soon as the clinic re-opens]
Next Day Ortho Availability at GW MFA Metro Immediate & Primary Care:
We are pleased to share with you that orthopedics has added a new provider that is offering next day availability for patients who need to see orthopedics.
Ellen Bishop, NP
For Next-Day Availability: Orthoreferrals@mfa.gwu.edu
For Appointment Scheduling: 202.741.3300
Also Available on Zocdoc.com and gwdocs.com/ortho
Radial Nerve Palsy
Ectopic Pregnancy
Radiculopathy
Burn injury
Otisis External
URI
Post-Operative Complications
Yeast Infection
Migraine
Lice
Bipolar
Mania
Fluid Overload/CHF (send home)
Today, you were seen in the ER for your shortness of breath and leg swelling. Your EKG and bloodwork were reassuring. We think this is because of congestive heart failure. **Please double your daily dose of your water pill (furosemide, otherwise known as “Lasix”).** We do not think it is an emergency or that you need to stay in the hospital at this time.
You should follow-up with your primary doctor in the next 1-2 days for a recheck.
Otherwise, please return to the ER if you have:
- worsening of your shortness of breath
-chest pain
-fever of 100.4 or higher
-fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Otitis Media
Today you were seen for pain in the ears and found to have an ear infection (otitis media). Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, the infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
You may take Ibuprofen (Advil or Motrin), Naproxen (Alleve) and Tylenol over-the-counter for your pain. You may even safely take up to 4 pills of Ibuprofen or Naproxen and 3 pills of Tylenol at a time. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours (about 10 pills). It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
Please return to the ER if you have:
-Fever greater than 104F that does not go away
-Nausea or vomiting to the point where you cannot eat or drink
-Any other concerns
Otherwise please follow-up with your primary care provider in the next week for recheck.
It has been a pleasure treating you and we hope you feel better soon.
Oral/Oropharyngeal Candidiasis
You were seen today for mouth and/or throat pain and found to have a yeast infection in your mouth. Please use the prescribed fluid as directed. Swish the fluid around in your mouth for as long as you can before swallowing. Use every 6 hours until symptoms have gone away for 2 days. Please follow-up with your dentist if you have dental pain, and follow-up with your primary care physician for recheck of your mouth and throat within 1 week.
Please return to the ER if you have any of the following:
-Fever greater than 101.4 Fahrenheit
-Nausea and/or vomiting that prevents her from eating
-Pain that is not controlled with pain medications at home
-Any other concerning symptoms.
It's been a pleasure taking care of you and we hope you feel better.
Chronic Pain
You were seen for your chronic pain today. The ER is not able to help with chronic pain very well. You need someone that can work with you to help manage your pain and try different approaches if necessary. Please call the number for the Pain Management Clinic to make an appointment.
Sprain
Today you were seen for pain in your ____. Your pain seems to be from soreness in the muscle or sprain of the ligaments or tendons. We do not know what caused this but do not feel you need to stay in the hospital at this time. Please follow up with your primary care provider if you pain continues.
You may take Ibuprofen (Advil or Motrin), Naproxen (Alleve) and Tylenol over-the-counter for your pain. You may even safely take up to 4 pills of Ibuprofen or Naproxen and 3 pills of Tylenol at a time. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours (about 10 pills). It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
In addition, follow the included instructions for R.I.C.E. treatment.
Otherwise, please return if the pain becomes significantly worse, you have any trauma to the same site, or if it feels dislocated.
It's been a pleasure taking care of you and we hope you feel better.
Conjunctivitis (pink eye)
You were seen for itchiness and discharge from your eye today. We examined you and think you have inflammation of the surface of your eye called conjunctivitis ("pink eye"). This is caused by a virus and does not need antibiotics. Your body needs to fight off the infection and this can take up to 1 week. In the meantime please use eye drops 5-6 times daily and wash your hands frequently as it can spread easily. In addition, you can take an over-the-counter antihistamine, such as Benadryl, Allegra, or Zyrtec.
Please return to the ER if you have:
-worsening pain in your eye
-redness of your eye
-changes in vision in your other eye
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Fall (with blood work and EKG)
Today, you were seen in the ER after a fall. We did not find any serious injuries. Your bloodwork and EKG were reassuring. The exact cause for your fall is uncertain, but we do not think there is any reason to keep you in the hospital at this time.
Please see your primary doctor or return to the ER if you have:
-chest pain
-shortness of breath
-vomiting
-fainting
-any other new or concerning symptoms
Otherwise, please see your primary doctor in about 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Subungual hematoma
You were seen for a collection of blood under your fingernail. We made a hole in your nail to try to release the blood. Please soak the finger in warm water 2-3 times per day for the next 7 days. Follow up with your PCP as needed.
Trigeminal Neuralgia
You were seen for pain in your face and we think you have something called trigeminal neuralgia (inflammation of the nerve on the side of your face). We gave you medications and you felt better.
**We have written you a prescription for the same medicines that you can continue until you see a neurologist in the clinic.
Please call the included number to make an appointment with the neurologist to either continue the medicine, try new medicine, or consider other treatments.
Please return to the emergency room if you have any of the following:
-Uncontrolled pain
-Nausea and vomiting with inability to eat or drink
-Severe vertigo that is incapacitating
-Loss of consciousness
-Numbness, weakness, tingling in any extremity
-Any other concerning symptoms
Is been a pleasure taking care of you and we hope you feel better soon.
Rib injury
You were seen for chest pain after and found to have an injury to your ribs. This will heal on its own but will take some time. Please use an anti-inflammatory medicine such as Naproxen (Alleve) or Ibuprofen (Advil or Motrin) on a regular schedule for the next several days for control of your pain. You may also take Tylenol at the same time if you prefer. It does not have anti-inflammatory effects, but should help with pain.
You may take the prescribed medication for break-through pain. The medication will make you sleepy. Please do not drive or do any other activity that requires you to be fully alert while taking the medication. If the medication contains Acetaminophen (the generic name for Tylenol), be careful taking additional over-the-counter Tylenol. Add up the amounts of Acetaminophen listed in each pill, and do not take more than 3000-4000mg in 24 hours.
It is also improtant to practice taking deep breaths, even if it is uncomfortable. When people don't breathe in and out as deeply as they should, some of the small airways in the lungs can close off. This raises the chances of getting a lung infection, called "pneumonia."
Please return to the ER if you have any of the following:
-abdominal pain
-worsening pain despite medications
-fever
-other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Bacterial Vaginosis
Today, you were seen in the ER for your belly pain. We found you have an imbalance in your normal vaginal bacteria called bacterial vaginosis (BV). You should take the antibiotic as prescribed in order to get rid of the infection.
Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, the infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
Please return to the ER if you have:
-fever of 100.4 or higher
-vomiting
-fainting
-shortness of breath
-new middle back pain
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 4-5 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Uveitis
You were seen for pain your eye today. We examined you and think you have inflammation of the inner part of your eye called uveitis. The Ophthalmologists (eye doctors) examined you as well and want to see you in their clinic at the included date and time. In the mean time please take the prescribed medicines, including the steroid (prednisolone or Pred Forte) and Ibuprofen as instructed:
Pred Forte:
Take 6 times per day for 2 days, then...
Take 4 times per day for 1 week, then...
Take 3 times per day for 1 week, then...
Take 2 times per day for 1 week, then...
Take 1 times per day for 1 week, then...
Stop.
Please return to the ER if you have:
-worsening pain in your eye
-redness of your eye
-changes in vision in your other eye
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Chemical Injury to Eye (small abrasion)
You were seen for pain your eye today after getting a chemical in it. We washed out your eye with fluid and examined you and found a small abrasion (scratch) on your eye. This should heal within 1-2 days. The Ophthalmologists (eye doctors) examined you as well and want to see you in their clinic tomorrow and every day until it heals.
In the meantime please use the prescribed medicines, including the antibiotic eye drop and eye ointment 4 times per day each in the affected eye. Apply the drop first and wait at least 10 minutes before applying the ointment. Or you can alternate every 3 hours: Apply the drops, waiting 3 hours, apply the ointment, wait 3 hours, apply the drops again, etc.
Please return to the ER if you have:
-worsening pain in your eye
-redness of your eye
-changes in vision in your other eye
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Shoulder dislocation
You were seen for pain in your shoulder and were found to have a shoulder dislocation. We put your shoulder back in place and placed it in a sling. Please use the sling as much at you can during the day and sleep with it. When you take it on and off, be careful not to move your shoulder too much. Please use the sling until you see an Orthopedic Surgeon for follow up in 4 weeks.
You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may even safely take double the dose indicated on the bottle. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours. It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
You may take the prescribed medication for break-through pain. The medication will make you sleepy. Please do not drive or do any other activity that requires you to be fully alert while taking the medication. If the medication contains Acetaminophen (the generic name for Tylenol), be careful taking additional over-the-counter Tylenol. Add up the amounts of Acetaminophen listed in each pill, and do not take more than 3000-4000mg in 24 hours.
Please return to the ER if you have:
-uncontrollable pain in the area
-further trauma to the area
-numbness, tingling, or weakness in that arm
-any other concerns
It's been a pleasure taking care of you and we hope you feel better.
Elbow dislocation
You were seen for pain in your elbow and were found to have an elbow dislocation. We put your elbow back in place and placed it in a sling. Please use the sling as much at you can during the day and sleep with it. When you take it on and off, be careful not to move your shoulder too much. Please use the sling until you see an Orthopedic Surgeon for follow up in 1 week.
You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may even safely take double the dose indicated on the bottle. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours. It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
Please return to the ER if you have:
-uncontrollable pain in the area
-further trauma to the area
-numbness, tingling, or weakness in that arm
-any other concerns
It's been a pleasure taking care of you and we hope you feel better.
Central Retinal Artery Occlusion (CRAO)
You were seen for loss of vision in one eye today. We examined you and think you have a blockage of the blood vessel that supplies your eye. The Ophthalmologists (eye doctors) examined you as well and want to see you in their clinic as soon as you leave today.
Please return to the ER if you have:
-pain in your eye
-rednees of your eye
-changes in vision in your other eye
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Bells Palsy
You were seen today for facial droop. We assessed you and do not think you are having a stroke. We think you have something called Bell’s Palsy, which is isolated facial paralysis on one side. We are giving you medications to take that can help this get better, but it can take a long time. Some people feel better after a few weeks, and some people take 6 months or more to feel normal. Most people recover fully.
Please use eye drops to keep your eye moist at least once per hour while you are awake (more if you feel dry). Also, it is important to tape your eye closed at night so it does not dry out. Apply the ointment to the eye before taping it shut every night. Do this until your symptoms have gone away completely.
Please return to the ER if you have any of the following:
-weakness, numbness, or tingling anywhere else in your body
-chest pain or shortness of breath
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Abrasion from fall
You were seen for a scrape on you ____ from falling. You do not seem to have any other serious injuries and the cause of your fall does not seem concerning. We cleaned your wound and dressed it. Please keep it clean and change the bandage every 24 hours (or sooner if they become dirty) until a scab is formed. You do not need antibiotics at this point.
Please return to the ER if you have:
-another fall with loss of consciousness or hit your head
-the scrap seems infected (redness, swelling, fluid leaking out)
-any other concerns
Otherwise, you should follow-up with your doctor in the clinic in the next 7 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Fall, No Injuries
You were seen after falling. You do not seem to have any serious injuries. Please take the prescribed or over-the-counter medicines to help with your pain.
Please return to the ER if you have:
-another fall with loss of consciousness or hit your head
-nausea/vomiting
-any other concerns
Otherwise, you should follow-up with your doctor in the clinic in the next 7 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Fall, Headstrike, No injuries but lac
You were seen after falling and hitting your head. You do not seem to have any other serious injuries and the cause of your fall does not seem concerning. We cleaned your wound, repaired it with ___ sutures, and dressed it. Please keep it clean and change the bandage every 24 hours (or sooner if it becomes dirty) until a scab is formed. You do not need antibiotics at this point.
Please return to the ER in 5-7 days to have the sutures removed.
Please return to the ER if you have:
-another fall with loss of consciousness or hit your head
-the scrap seems infected (redness, swelling, white fluid leaking out)
-any other concerns
Otherwise, you should follow-up with your doctor in the clinic in the next 7 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Temporal Arteritis (Giant Cell Arteritis) - Outpt f/u
You were seen for temporal and jaw pain. We are concerned you may have something called Temporal Arteritis and require a biopsy and an MRI. You have been scheduled for a biopsy on _ at _. You have also been scheduled for an MRI. It is very important you go to your scheduled appointments. Any delay could cause permanent damage, including blindness.
Please return to the ER if you have:
-worsening temporal pain
-loss of vision
-nausea and vomiting and inability to keep food or drink down
-any other concerning symptoms
Irritation Around G-tube (PEG)
You were seen for burning around your gastric tube site. We examined it and found that there might be a small infection of the skin starting. We are prescribing you antibiotics to treat it just in case. Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, the infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
Please return to the ER if you have:
-worsening pain
-abnormal discharge coming from around the tube
-any problems with the tube
-any other concerns
Otherwise, you should follow-up with your doctor in the clinic in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Priapism
You were seen today for an erection that did not go away (called priapism). You improved after treatment, but still need to follow up with a Urologist. Please call the included number to make an appointment if you do not have a Urologist already.
Please seek immediate medical attention if you have any of the following:
-worsening or return of your erection
-uncontrollable pain
-nausea and vomiting
-inability to urinate
-any other concerning symptoms
Otherwise, you should follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Homeless
You came to the hospital today because you have nowhere to stay. Our social worker gave you resources for trying to find shelter. Unfortunately, we have other patients that we need to see and treat and you cannot stay in the hospital overnight. Please contact the shelters and other resources for a bed. Many shelters begin having waiting lines in the afternoon around 4pm. Please go as soon as you can to try for a bed.
Smoke Inhalation
Today, you were seen in the ER after smoke inhalation. Your bloodwork showed signs that you the smoke entered your system but is not at a dangerous level. You other labwork was reassuring and we feel you are safe to go home.
However, things can change, and you should see your doctor or return to the ER if you have:
-chest pain
-difficulty breathing
-fainting
-worsening headache
-numbness, tingling, or weakness in arms or legs
-fever of 101 or higher
-vomiting that prevents your from drinking fluids
-any other new or concerning symptoms.
Otherwise, you should follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
SVT
You were see for having a fast heart rate called Supraventricular Tachycardia (SVT). We were able to slow your heart rate down to normal. We recommend you see a cardiologist in the office for a follow up appointment to see if you would benefit from medication to control this and prevent it from happening again. You can call the included number for an appointment as soon as available.
Please return to the ER if you have:
-chest pain
-shortness of breath
-vomiting
-fainting
-any other new or concerning symptoms
Otherwise, please see your primary doctor in about 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
AICD, Defibrillation, Cardioversion
You were see after your defibrillator discharged. We interrogated your device and you did not have a dangerous heart beat at the time. We feel it is safe for you to go home. Please follow up with your cardiologist within 1 week.
Please return to the ER if you have:
-another defibrillation
-chest pain
-shortness of breath
-vomiting
-fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Bradycardia
You were see for having a slow heart rate called bradycardia. We recommend you see a cardiologist in the office for a follow up appointment as soon as possible. You can call the included number for an appointment as soon as available.
Please return to the ER if you have:
-chest pain
-shortness of breath
-vomiting
-fainting
-any other new or concerning symptoms
Otherwise, please see also your primary doctor in about 1-2 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Lung Mass
You were see today and found to have a mass in your lungs. We do not know what this mass is and there is a possibility it may be cancer. You require further testing to determine what it is and need to follow up in the clinic for further testing. Please contact the included numbers to arrange appointments.
In the meantime, please return to the ER if you have any of the following:
- shortness of breath
-chest pain
-fever of 100.4 or higher
-fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Hematuria
You were seen for blood in your urine. We placed a catheter in your bladder (Foley catheter), which is a tube that automatically drains your urine. Please flush the tube with sterile saline (sterile salt water). Please make an appointment to see an Urologist as soon as possible.
In addition, please take the prescribed antibiotics to prevent a bladder infection. It is important you take the full course of antibiotics as instructed so that an infection does not return stronger.
Please return to the ER if you have any of the following:
-recurrent bright red blood in your urine
-abdominal pain
-nausea and vomiting preventing you from eating or drinking
-high fever (greater than 100.4 degrees F)
-any other concerning symtpoms
It's been a pleasure taking care of you and we hope you feel better.
Feeding Tube Problem
You were seen for a problem with your feeding tube. We do not feel you need to stay in the hospital and you are being discharged to follow up with your regular physician as scheduled.
Please return to the ER:
-blood coming from the tube or significant blood around the tube
-nausea and vomiting preventing you from eating or drinking
-severe abdominal pain
-the tube comes out on its own
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Deep Vein Thrombosis (DVT)
You were seen today for swelling in your leg and were found to have a DVT (Deep Vein Thrombosis) - in other words a blood clot in your leg. We are starting you on blood thinning medicine (anticoagulation) that you need to give yourself. Our nurse has shown you how to give yourself this medicine. It is important you take the medicine as directed and follow up with your primary care provider in the next few days to check your blood levels and make adjustments to your prescription.
It is very important for you to come back if you have any of the following:
-bleeding that will not stop
-you can’t get this medicine from the pharmacy
-you are unable to take the medicine
-you cannot see your primary care provider in the next few days
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Deep Vein Thrombosis (DVT) - Negative
You were seen today for swelling and redness in your ___. It seems that you have inflammation of a superficial vein. You can treat this by elevating the arm or leg (ie, waist level), use warm or cool compresses, nonsteroidal anti-inflammatory drugs (NSAIDs, like Ibuprofen or Naproxen), and possibly compression therapy (like and ACE wrap).
***You have signs of some infection of the skin. Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
It is very important for you to come back if you have any of the following:
-worsening pain, weakness, numbness, tingling
-you cannot follow up in clinic in the next few days
-shortness of breath
-chest pain
-fainting
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Frostbite
You were seen today for pain in your ________ after being exposed to cold for a long time. You were rewarmed and no other serious injuries were found. It is very important to keep the area warm and dry as it heals and to avoid exposing it to colder temperatures again. You do not require antibiotics, but your tetanus should be up to date.
If possible, soak the affected area in warm water for 30-45 minutes and gently move it around.
Taking low-dose Ibuprofen has been shown to help. Unless you have any reasons you should not take Ibuprofen or NSAID medicines, you can take Ibuprofen 400mg every 12 hours for the next week.
In addition, aloe vera ointment or lotion applied to the affected area every 6 hours can reduce inflammation.
Complete recovery can take several weeks.
Please return to the ER if you have any of the following:
-pain uncontrolled at home with over-the-counter and prescription pain medicines
-uncontrollable bleeding from injuries
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Thrombophlebitis
You were seen today for swelling in your leg. We checked you for a DVT (Deep Vein Thrombosis - blood clot in your leg) and were found not to have any on ultrasound.
It is very important for you to come back if you have any of the following:
-worsening leg pain, weakness, numbness, tingling
-you cannot see your primary care provider in the next few days
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Foot Drop
You were seen for foot drop today. We believe this is due to a compression of a nerve in your leg from either an injury or even possibly the way you slept. This should slowly get better with time, but we recommend you call the included Neurologist’s number (brain and nerve doctor) to make an appointment for further evaluation. We do not think you need to stay in the hospital today.
Please return to the ER if you have any of the following:
-worsening of your weakness or numbness
-tingling or pain in any part of your body including your foot or leg
-any other concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Weakness
Today, you were seen in the ER for your feeling of weakness. Your bloodwork, EKG, and imaging did not show any reason for these symptoms. We do not know the cause of your weakness but do not think you need to stay in the hospital today.
That said , things can change. Please return to the ER if you have:
-worsening of your weakness
-symptoms worse on one side than the other
-inability to walk
-vomiting that prevents you from drinking fluids
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Dehydration
Today, you were seen in the ER for your feeling of weakness. Your bloodwork, EKG, and imaging did not show any reason for these symptoms. We think you might have been dehydrated. We do not do not think you need to stay in the hospital today.
That said , things can change. Please return to the ER if you have:
-worsening of your symptoms
-inability to walk
-vomiting that prevents you from drinking fluids
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Angioedema (ACEI)
You were seen for swelling of your face that could have been caused by your blood pressure medication. It belongs to a class of medicines called ACE-inhibitors (drugs that end in -pril) that can cause this swelling, even in people that have taken them for years. It is important to stop taking this medication right away or you could have a more serious reaction involving you mouth and tongue. We are starting you on an alternative medication for blood pressure. Please take this until you can see your primary care provider to get a replacement medication for your blood pressure as soon as possible.
Please return to the ER if you have any of the following:
-difficulty breathing
-difficulty swallowing
-nausea or vomiting that prevents you from eating or drinking
-increased swelling in your face, tongue, or mouth
-any other concerns
It's been a pleasure taking care of you and we hope you feel better.
Easy Bleeding
You were seen for bleeding from several places on your body. We checked your blood and found that all your levels are reassuring. You should see your primary care provider within 1-2 weeks to recheck your blood levels.
Please return to the ER if you have:
-worsening of your bleeding
-fainting
-lightheadedness
-difficulty breathing
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Gun shot wound (GSW)
You were seen for having a gun shot wound to your _________. We do not see any broken bones but there might be fragments of the bullet.
*You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may even safely take double the dose indicated on the bottle. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours. It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
*You may take the prescribed medication for break-through pain. The medication will make you sleepy. Please do not drive or do any other activity that requires you to be fully alert while taking the medication. If the medication contains Acetaminophen (the generic name for Tylenol), be careful taking additional over-the-counter Tylenol. Add up the amounts of Acetaminophen listed in each pill, and do not take more than 3000-4000mg in 24 hours.
Please care for the wound according to the included instructions and make a follow up appointment with your primary care provider as soon as possible for a wound check.
Stab Wound
You were seen for having a stab wound to your _________. We found ___________.
You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may even safely take double the dose indicated on the bottle. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours. It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
You may take the prescribed medication for break-through pain. The medication will make you sleepy. Please do not drive or do any other activity that requires you to be fully alert while taking the medication. If the medication contains Acetaminophen (the generic name for Tylenol), be careful taking additional over-the-counter Tylenol. Add up the amounts of Acetaminophen listed in each pill, and do not take more than 3000-4000mg in 24 hours.
Please care for the wound according to the included instructions and make a follow up appointment with your primary care provider as soon as possible for a wound check.
Foley check
You were seen for possible urinary retention.
We did not find any retention and your urine analysis is reassuring. Please follow up with your primary care provider in 1-2 days for a recheck.
We checked your Foley catheter and scanned your bladder and kidneys and every seems to be working normally. You may take the prescribed medication for bladder spasm discomfort. Please follow up with your urologist as instructed.
Please return to the ER if you have any other concerns.
Urinary Retention
You were seen for possible urinary retention. We scanned your bladder and found that you had a significant amount of urine in your bladder that you were unable to pass. We placed a Foley catheter and and you felt better immediately and we scanned your bladder and found that it was empty afterward. We are leaving in the Foley catheter. Please follow up with your urologist within 1 week.
Please return to the ER if you have any other concerns or any of the following:
-bright red blood in your urine
-high fever
-nausea and vomiting preventing you from eating or drinking
-abdominal pain
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Urinary Incontinence (male, possible prostate, dc with Flomax)
You were seen for difficulty controlling your urination. You do not have signs of infection, but your prostate may be enlarged. Please take the prescribed medicine and follow-up with your primary care physician for further evaluation
Please return to the ER if you have any other concerns or any of the following:
-bright red blood in your urine
-pus coming from your penis
-new wounds or growths on your genitals
-high fever
-nausea and vomiting preventing you from eating or drinking
-abdominal pain
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Herpes (Male)
You were seen for wounds on your penis. There is a possibility these could be herpes sores. Please take the prescribed medicine as directed and follow-up with a Urologist for further evaluation.
Please return to the ER if you have any other concerns or any of the following:
-bright red blood in your urine
-pus coming from your penis
-new wounds or growths on your genitals
-high fever
-nausea and vomiting preventing you from eating or drinking
-abdominal pain
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
SANE Brochure for Victims
https://gallery.mailchimp.com/1f3a2d805df95ea01c0386839/files/6f7f9c7d-6892-4ac3-a726-e47c808e3d07/SANE.pdf
Swallowed Foreign Body
You were seen for swallowing a foreign body. The x-ray showed that the item has past beyond the esophagus into the stomach and should pass in your stool in the next few days without problems.
Please follow up with your primary care physician with the next 1 week.
Please return to the ER if you have any of the following:
-difficulty breathing or swallowing
-fever
-nausea/vomiting
-any other concerning symptoms
It has been a pleasure taking care of you and we hope you feel better soon.
Foreign Body in Nose
You were seen for having something stuck in your nose. We were able to remove the item.
Please follow up with your primary care physician with the next 1 week.
Please return to the ER if you have any of the following:
-difficulty breathing or swallowing
-fever
-nausea/vomiting
-any other concerning symptoms
It has been a pleasure taking care of you and we hope you feel better soon.
Foreign Body in Skin (non removal)
You were seen for having something stuck under your skin. There were no signs of infection and it seemed best to let it work its way out over time.
You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may even safely take up to 4 pills of Ibuprofen and 3 pills of Tylenol at a time. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours (about 10 pills). It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
Please follow up with your primary care physician with the next 1 week.
Please return to the ER if you have any of the following:
-uncontrollable pain
-fever
-worsening numbness, tingling, or weakness
-nausea/vomiting
-any other concerning symptoms
It has been a pleasure taking care of you and we hope you feel better soon.
Wrist Sprain
You were seen for an injury of your wrist. Your x-rays did not show any broken bones. Please use the wrist support for comfort and rest, elevate, and ice the wrist for comfort. You may use Ibuprofen and Tylenol to treat the pain.
Otherwise, please return if the pain become significantly worse, you have any trauma to the same site, or if it feels dislocated.
It's been a pleasure taking care of you and we hope you feel better.
Animal Bite, Rabies Vaccine
You were seen for an animal bite requiring rabies medicine. Please return to the emergency department to received additional vaccinations for rabies on the following days from the bite: 3 days, 7 days, and 14 days. In addition, please have someone check your wound to make sure they are healing properly.
Insect Bites
You were seen in the ER with concern for bug bites. We assessed you and did not find anything that we need to keep you in the hospital for. Please follow up with your primary care provider as needed.
However, things can change, and your child should see their doctor or return to the ER if they have:
-fever
-vomiting that prevents them from keeping down fluids
-fainting
-shortness of breath
-any other new or concerning symptoms
It's been a pleasure taking care of your child and we hope they feel better soon.
Cellulitis
You were seen today for an infection of your skin. We are prescribing you antibiotics. Please take the full course of pills until it is complete, even if you start feeling better before they are finished. Otherwise, you risk creating antibiotic resistant bacteria in the infection.
You should be feeling better after at least 2 days of starting antibiotics and you should start to see improvement after at least 3 days. If you do not, you may need a different antibiotic.
Please come back to the ER or see your primary care provider in 48 hours for someone to check your wound to make sure it is healing.
Otherwise, please return to the ER if you have any of the following:
-increasing redness and swelling
-pus or other discharge from the area
-fever, chills, nightsweats
-other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Planter Wart
You were seen for pain in the sole of your foot due to a Planter’s Wart. There is a chance that you may have an infection around the wart, but we decided not to try to remove any pus because of the increased risk of infection on the bottom of your foot, the need for you to continue applying Compound W acid for the wart, and the fact that you have another appointment with the podiatrist soon. You may want to call the podiatrist’s office to see if you can scheduled an even earlier appointment.
Please return to the ER if you have any of the following:
-redness and swelling around the wart
-pus or other discharge from the area around the wart
-fever
-other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Hypothermia
You were seen for having a low body temperature (hypothermia). We were able to warm you up to normal temperature and any bloodwork abnormalities you had went back to normal. We do not feel you need to stay in the hospital at this time.
Please return to the ER if you have any of the following:
-palpitations
-chest pain
-shortness of breath
-loss of consciousness
-unable to eat or drink
-any other concerning symptoms
Otherwise, please follow up with your primary care provider in the next 1 week for a check up.
It has been a pleasure caring for you and we hope you feel better soon.
Eczema
You were seen today for dry and itchy skin that appears to be eczema. We have prescribed you a topical steroid to help with the inflammation. Please use according to the instructions and follow up with a primary care provider and/or a dermatologist. We are giving you the number of our dermatologist so you can call to make an appointment.
Please return to the ER if you have:
-fever of 100.4 or higher
-worsening of the pain at that site
-redness spreading around the wound
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Fatigue
You were seen for feeling tired. Your exam did not show anything for which we think we need to keep you in the hospital. Please follow up with your primary care provider if your fatigue continues.
Otherwise, please return to the ER if you have any of the following:
-weakness, numbness, tingling
-loss of consciousness
-any other concerning symptoms
We hope you feel better soon.
Gallstones/Cholelithiasis
You were seen today for abdominal pain and found to have stones in your gallbladder, but no infection. Your pain has improved, but the stones can cause the pain to come back, or even cause your gallbladder to become infected in the future. Some people live with these stones their whole life, but many people have to have their gallbladder removed to prevent the pain and threat of infection from coming back. Avoid fatty foods, which can often trigger the pain, and see a surgeon to discuss removal of your gallbladder if you wish. We are including the surgeon’s number for you to call and make an appointment.
Please return to the ER if you have any of the following:
-return of your pain
-severe nausea and vomiting that prevents you from keeping anything down
-high fever with abdominal pain
-any other concerning symptoms
Otherwise, please follow up with your primary care provider in the next 1 week for a check up.
It has been a pleasure caring for you and we hope you feel better soon.
Transient Ischemic Attack
You were seen today for one or more of the following neurologic symptoms: tingling, numbness, weakness, confusion, slurred speech, difficulty finding words. One of the conditions that can cause your symptoms is something called a Transient Ischemic Attack (TIA), sometimes called a "mini stroke". Our Neurology colleagues (brain doctors) feel you can be sent home at this time, but it is important that you get further testing done in the next few days to see if you are at risk for having a full stroke. Please follow up with the directions they gave you for further testing.
Please see your primary doctor or return to the ER if you have:
-your same symptoms lasting longer than usual
-new symptoms such as weakness, slurred speech, confusion
-chest pain
-shortness of breath
-vomiting
-fainting
-any other new or concerning symptoms
Otherwise, please also see your primary doctor soon to let them know what is going on.
It's been a pleasure taking care of you and we hope you feel better.
Pneumonia
You were seen today for cough and shortness of breath. Your chest x-ray showed a pneumonia. We are giving you antibiotics and other medications for symptom relief. It is important to finish the full course of antibiotics, even if you start to feel better before the full course is completed.
You should follow-up with your primary doctor in the next 3-4 days for a recheck.
Otherwise, please return to the ER if you have:
- worsening of your shortness of breath
-chest pain
-fever of 100.4 or higher
-fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Pneumothorax
You were seen today for shortness of breath. Your chest x-ray showed a pneumothorax (air in the chest around the lung). It is small enough to just be watched. Please follow up in clinic as directed.
You should follow-up with your primary doctor in the next 3-4 days for a recheck.
Otherwise, please return to the ER if you have:
- worsening of your shortness of breath
-chest pain
-fever of 100.4 or higher
-fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Facial Pain/Swelling
Today you were seen for pain and swelling in your face. We did not find any specific area of infection and your pain improved with pain medicine here. We do not think there is any reason to keep you in the hospital, but it is important that your return right away if you have any worsening symptoms such as:
-increased swelling
-increased pain
-increased redness
-difficulty breathing
-difficulty swallowing
Otherwise, please take the anti-inflammatory medicine we are prescribing you and return or see your pirmary care provider within 24 hours if you feel the same (in other words, if there is NO improvement).
If you feel completely better and back to normal in 24 hours, you do not need to come back or see your primary care provider right away. You should schedule a check up with your primary provider soon, either way.
It's been a pleasure taking care of you and we hope you feel better.
Lab Result
You were seen for an abnormal lab result. Someone called you to come in for further evalution. We have determined you do not need to stay in the hospital right now, however please return if you have any of the following:
Please return to the ER if you have any of the following:
-high fever for several days
-uncontrollable vomiting
-uncontrollable pain
-loss of consciousness
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Impetigo
You were seen for an infection on the skin of your face. This is caused by baceteria and is treated with antibiotics. Please take the entire course of antibiotics even if you feel better before all the pills are done. Otherwise the infection may come back. It does not appear to require that we keep you in the hospital today.
Please follow up with your doctor as directed in the included instructions.
Please return to the ER if you have any of the following:
-fever, chills, nausea or vomiting
-worsening discharge of fluid from your infection
-lightheadedness
It has been a pleasure treating you and we hope you feel better soon.
Vessel Disease/PAD/Claudication
You were seen for pain in your right foot. You have disease of the blood vessels of your foot that may be getting worse. Our surgeons feel you need additional imaging tests of the blood vessels of your foot since you are having more pain and the pulse does not seem strong. We are concerned blood is not reaching all the parts of your foot, and this could lead to further damage of your foot, including the need to amputate it.
However, you did not want to stay in the hospital any longer for further testing. Please call Dr. Nevill'e's office number on Monday to schedule an appointment as soon as possible.
Please return to the ER right away if you have:
-worsening pain
-decreased feeling in your foot
-if your foot is cold
-if your foot changes color
-any other concerning symptoms
It has been a pleasure caring for you adn we hope you feel better soon.
Abortion
You were seen for vaginal bleeding during pregnancy. You lab work, exam, and ultrasound *** showed that you are likely having a miscarriage ***. We do not think you need to stay in the hospital right now. However, it is important that you follow up with your Obstetrician-Gynecologist soon to make sure you pass all the products of conception.
Please return to the ER if you have any of the following:
-repeat or worsening bleeding
-unusual vaginal discharge
-concerning belly pain
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Constipation
You were seen for constipation and were not found to need hospitalization at this time. _We are prescribing you laxatives. _You may use over-the-counter laxatives or use an enema. Please use as directed and follow up with your primary care provider at the next available appointment for reassessment.
Please return to the ER if you have any of the following:
-blood in your stool
-lightheadedness
-not passing stool or passing gas
It has been a pleasure taking care of you and we hope you feel better soon.
Hypothyroidism
You were seen today for _________. You were found to have decreased function of your thyroid gland (hypothyroidism). This is fairly common and usually can be treated by giving you medicine to replace the thyroid hormone your body is not making enough of. We are prescribing you this medication at a low starting dose.
You are also referring you to a Endocrinologist. These doctors are specialists in the hormones of the body, like the thyroid hormone. They may want to do more tests to figure out why you have hypothyroidism and also adjust the dose of your medication.
Please return to the ER if you have any of the following:
-worsening weakness
-fever
-nausea or vomiting
-any concerning symptoms
It has been a pleasure taking care of you and we hope you feel better soon.
Facial Fracture
You were seen today for a facial fracture. You were examined by emergency doctors; Ear, Nose, and Throat (ENT) doctors; and eye doctors and we did not find anything for which we need to keep you in the hospital. Please follow the below instructions and attend the follow up appointments as directed:
DO NOT:
-blow your nose (use nasal saline spray instead)
-use a straw
-put anything in your nose
-sneeze with your mouth shut (open your mouth when you sneeze)
DO:
-eat a soft diet for the next 6 weeks
-use ice to help the swelling on your face
Please see the ENT doctors in the outpatient clinic in 1 week by calling the number provided in the included paperwork.
Please return to the ER if you have any of the following:
-uncontrollable pain
-new bleeding from your wounds
-loss of vision in the injured eye
-worsening pain with eye movement
-any other concerning symptoms
We hope you feel better soon.
Hyponatremia
You were seen for your low sodium level on labs drawn 1 week ago. You level today is higher and closer to a normal value. You do not appear to be having any symptoms related to a low sodium level. We spoke with your primary care doctor who will call you tomorrow to check in on you.
If you have any of the following, please return to the ER:
-lightheadedness/feeling faint
-loss of consciousness
-seizure
-persistent vomiting and inability to keep food/drink down
-any other concerning symptoms
We hope you feel better soon.
Breast Pain
Today, you were seen in the ER for your breast pain. Your tests didn't show any explanation for your symptoms. The exact cause for your pain is unclear, but we do not feel you need to stay in the hospital at this point.
However, things can change, and you should see your doctor or return to the ER if you have:
-worsening of your pain
-unusual discharge from your breast
-changes to the skin over your breast
-fever of 100.4 or higher
-shortness of breath
-any other new or concerning symptoms
Otherwise, it is important that you see your primary doctor in 1-2 days for a recheck and to schedule a mammogram.
It's been a pleasure taking care of you and we hope you feel better.
Radiculopathy/Sciatica
You were seen for pain in your ___________. We believe this pain relates to compression of nerves in your spine. The best treatment for now is to take over-the-couter NSAIDs (non-steroidal anti-inflammatory drugs) such as Naproxen Sodium (Alleve) or Ibuprofen (Advil, Motrin) and follow up with your primary care provider. You may need to seek the help of a back specialist as well to discuss other treatment options (such as surgery).
Please return to the ER if you have:
-uncontrollable pain
-weakness in any extremity
-loss of control of bowel or bladder
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Vaginal Bleeding Pregnancy
You were seen for bleeding during early pregnancy. Your bloodwork was reassuring and your ultrasound showed a normal pregnancy. We do not think you need to stay in the hospital right now. However, it is important that you follow up with your Obstetrician-Gynecologist soon to make sure the pregnancy continues to progress healthily.
Please return to the ER if you have any of the following:
-repeat or worsening bleeding
-unusual vaginal discharge
-concerning belly pain
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Influenza
Today, you were seen in the ER for your cough. You tested positive for Influenza (Flu).This is a viral infection that your body needs to fight off and this can take up to a couple weeks. Please take the prescribed medications as directed and drink plenty of fluids.
Other over-the-counter medicines that may help your symptoms are:
Ibuprofen and Tylenol - for pain, fever, and inflammation; can be taken together or separately
Cough suppressant such as Robitussin syrup. DayQuil/NyQil - for cough suppressant, congestion, pain relief
Things can change, and you should see your doctor or return to the ER if you have:
-chest pain
-difficulty breathing
-fainting
-fever of 101 or higher
-vomiting that prevents your from drinking fluids
-any other new or concerning symptoms.
Otherwise, you should follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Beta List
You were seen for _______. Your blood work tested positive for pregnancy. The ultrasound did not show a definite normal pregnancy, though it is usually too early at this point to see one. Given your symptoms, it is important you follow up in 48 hours to have your blood drawn again to measure the "beta level". This will help us determine whether your pregnancy is progressing normally or if there are problems. Please follow the directions given to you be the Obstetrics and Gynecology team for your return visit.
If anything gets worse or you have any of the following, please return to the ER right away:
-worsening abdominal pain
-severe nausea and/or vomiting
-excessive vaginal bleeding
-any other concerning symptoms
It has been a pleasure taking care of you and we hope you feel better soon.
Cellulitis/Wound Infection
You were seen for an infection in your skin. It does not appear to require that we keep you in the hospital today. Please take the antibiotics were are prescribing you. Take the full course as instructed on the bottle until all the pills are gone.
Please follow up with your doctor as directed in the included instructions.
Please return to the ER if you have any of the following:
-fever, chills, nausea or vomiting
-worsening discharge of fluid from your infection
-lightheadedness
It has been a pleasure treating you and we hope you feel better soon.
Nose Bleed/Epistaxis
You were seen for a nose bleed. Your bleeding has stopped after treatment.
Please make an appointment as soon as possible to be evaluated by the Ear, Nose, and Throat doctors. They would like to see you in 3-5 days, so call tomorrow to make an appointment. Please leave the packing (Rhino Rocket) in place until they see you.
Please take the antibiotic medication we are prescribing you. It is important to take the full course, even if you do not feel sick, so that your nose does not get infected. Do not blow your nose and try not to sneeze or cough too hard.
Please return to the ER if you have any of the following:
-fever, chills, nausea or vomiting
-blood in your mouth or running down your throat
-lightheadedness
-swelling of your nose or face
We hope you feel better soon.
Paresthesias
You were seen for numbness or tingling in your __________. Your bloodwork and EKG did not show any reason for these symptoms currently. We do not feel you need to stay in the hospital right now.
That said , things can change. Please return to the ER if you have:
-loss of consciousness
-inability to walk
-weakness in any part of your body
-vomiting that prevents you from drinking fluids
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 1 week for a recheck.
It has been a pleasure treating you and we hope you feel better soon.
Thyroglossal Duct Cyst/Neck Mass
You were seen for a lump or mass in the front of your neck. We suspect what is called a "thyroglossal duct cyst" that has become infected. We are starting you on antibiotics. Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, the infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
In additional, please follow up in the clinic with our Ear, Nose, and Throat (ENT) doctors with the next 1-2 weeks. They will discuss with you any further treatment recommendations.
Please return to the ER if you have any of the following:
-redness around the mass
-difficulty breathing or swallowing
-fever
-nausea/vomiting
-any other concerning symptoms
It has been a pleasure taking care of you and we hope you feel better soon.
Mouth Pain/Dental
You were seen for pain in your mouth. Your pain appears to be due to your teeth or gums. Your dentist is the best person to help with this pain. Please make an appointment as soon as possible to be evaluated by the dentist.
Please return to the ER if you have any of the following:
-fever, chills, nausea or vomiting
-pus in your mouth
-excessive bleeding from your mouth
-unbearable pain
We hope you feel better soon.
Epididymitis/Orchitis/Testicular pain - abx
You were seen for pain in your testicle. We found that you have an infection of the epididymis, which is connected to the testicle. We are prescribing you antibiotics that will treat this infection and your urinary tract infection. Please take them as directed until they are finished, even if you feel better before they are done.
Please return to the ER if you have:
-worsening pain
-fever
-nausea or vomiting
-any concerning symptoms
It has been a pleasure taking care of you and we hope you feel better soon.
Epididymitis/Orchitis/Testicular pain - no abx
You were seen for pain in your testicle. We are unsure of the cause of your pain, but it does not appear to be due to twisting of the testicle, which is an emergency. You may use cold packs, scrotal elevation, and over-the-counter medicines for pain.
Please return to the ER if you have:
-worsening pain
-fever
-nausea or vomiting
-any concerning symptoms
It has been a pleasure taking care of you and we hope you feel better soon.
Pericarditis
Today, you were seen in the ER for your chest pain. Your EKG didn't show any definitie explanation for your symptoms. Your story and symptoms are consistent with pericarditis. Please take the prescribed medicine to help relieve the symptoms. We do not feel we need to keep you in the hospital right now.
However, things can change, and you should see your doctor or return to the ER if you have:
-worsening of your chest pain
-difficulty breathing
-fainting
-unusual sweating or anxiety
-any other new or concerning symptoms.
In addition, you should follow-up with your primary doctor within 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Peritonsillar abscess
Today, you were seen in the ER for your sore throat and peritonsillar abscess. We drained the abscess and you should start to feel better over the next few days. Please take the antibiotics we prescribed as directed until all the pills are gone. Take the pain medications as needed. DO NOT DRIVE WHILE TAKING THE PAIN MEDICATIONS.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Diabetes/Hyperglycemia
You were seen in the ER for your high blood sugar level. We gave you insulin and your sugar came down. It is important that you see your primary care provider as soon as possible to change your medications so that your blood sugar does not get this high. Please call them to make an appointment.
Please return to the ER if you have:
-worsening abdominal pain
-nausea/vomiting
-lightheadedness
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Anxiety/Panic
Today, you were seen in the ER for your ___________. Your bloodwork and EKG looked unconcerning. We do not know the cause of your symptoms, but does not seem to be an emergency right now. There is a chance this could be cause by anxiety or a panic attack. Please follow up with your primary care provider for further assessment of your symptoms.
That said , things can change. Please return to the ER if you have:
-loss of consciousness
-inability to walk
-weakness in any part of your body
-vomiting that prevents you from drinking fluids
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
MVC (Motor Vehicle Collision)
You were seen today after your car crash. We examined you and found ___________.
You will be sore for the next few weeks. You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may even safely take double the dose indicated on the bottle. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours. It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
Please return to the ER if you have any of the following:
-unusual bleeding
-loss of consciousness
-new severe pain
Otherwise, please see you primary care provider in clinic within 1-2 weeks for a check up.
It has been a pleasure caring for you and we hope you feel better soon.
Pedestrian hit by car (Peds struck)
You were seen today after being hit by a car. We examined you and found ___________. You will be sore for the next few weeks.
You will be sore for the next few weeks. You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may even safely take double the dose indicated on the bottle. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours. It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
Please return to the ER if you have any of the following:
-unusual bleeding
-loss of consciousness
-new severe pain
Otherwise, please see you primary care provider in clinic within 1-2 weeks for a check up.
It has been a pleasure caring for you and we hope you feel better soon.
Assault
You were seen today after being injured by another person. We examined you and found ___________. You will be sore for the next few weeks. Take over the counter pain medications like Ibuprofen and Tylenol for pain.
You may even safely take double the dose indicated on the bottle. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours. It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
Please return to the ER if you have any of the following:
-unusual bleeding
-loss of consciousness
-new severe pain
Otherwise, please see you primary care provider in clinic within 1-2 weeks for a check up.
It has been a pleasure caring for you and we hope you feel better soon.
Altered Mental Status
You were seen for being confused. Your legs were examined and the wounds were dressed. Your bloodwork did not show and reasons for your confusion and you were feeling better.
Please return to the ER if you have any of the following:
-feeling confused
-lightheadedness
-any concerning symptoms
Please see you primary care provider for a check up in the next week.
It has been a pleasure caring for you and we hope you feel better soon.
Gout
You were seen for your gout flare in your _________. We gave you pain and anti-inflammatory medicines to help. You should also use ice for comfort, and elevate it to help reduce the swelling. If your pain and swelling continues, please see your primary care provider. You may need a sample of the fluid in your joint taken out for analysis.
Please return to the ER if you have any of the following:
-worsening pain despite medications
-worsening redness and swelling of the joint
-fever
-other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Vaginal Bleeding (PCOS)
You were seen today for vaginal bleeding. The ultrasound did not show any additional reason for you bleeding (like fibroids) and did show that your have polycystic ovaries. You blood levels and urine looked completely normal. It is important that you follow up with your obstetrician-gynecologist in the next week for a check up. You may continue bleeding and they may have additional recommendations of ways to treat this.
Please return to the ER if you experience any of the following:
-lightheadedness
-loss of consciousness
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Vaginal Bleeding (nonpregnant)
You were seen today for vaginal bleeding. The ultrasound did not show any additional reason for you bleeding (like fibroids). Your blood levels and urine looked completely normal. It is important that you follow up with your obstetrician-gynecologist in the next week for a check up. You may continue bleeding and they may have additional recommendations of ways to treat this.
Please return to the ER if you experience any of the following:
-lightheadedness
-loss of consciousness
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Vaginal Bleeding (known fibroids)
You were seen today for vaginal bleeding. You blood levels were ok and you did not require a blood transfusion. It is safe for you to go home.
It is important that you follow up with your obstetrician-gynecologist in the next week for a check up. You may continue bleeding and they may have additional recommendations of ways to treat this.
Please return to the ER if you experience any of the following:
-lightheadedness
-loss of consciousness
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Vomiting
You were seen for feeling nauseous and vomiting. Your labwork looked ok and we don’t think there’s anything we need to keep you in the hospital for tonight. Hopefully you start to get better soon. You can take the prescribed medication for any more vomiting, and make an appointment with your primary care provider in the next few days for a recheck.
Vaginal Bleeding While Pregnant (Abortion)
You were seen today for bleeding during pregnancy. The ultrasound showed that the pregnancy was ended and we removed some tissue during the exam. It is important that you follow up with your obstetrician-gynecologist in the next week for a check up. You will likely continue bleeding for another week or two. Please use the prescriptions to help with pain.
Please return to the ER if you experience any of the following:
-excessive bleeding (>2 pads per hour for 2 hours)
-lightheadedness
-loss of consciousness
It has been a pleasure caring for you and we hope you feel better soon.
Vaginal Bleeding While Pregnant (No Abortion)
You were seen today for bleeding during pregnancy. The ultrasound showed that the pregnancy looks ok at the moment, and your labwork was reassuring. It does not look like you are currently having a miscarriage right now. There is still a chance you could have miscarriage, and it is important that you follow up with your obstetrician-gynecologist in the next week for a check up. If you do not have an obstetrician-gynecologist, please call the included number to make an appointment.
Please return to the ER if you experience any of the following:
-worsening bleeding
-lightheadedness
-loss of consciousness
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Abdominal Pain During Pregnancy (everything ok)
You were seen today for belly pain during pregnancy. The ultrasound showed that the pregnancy looks ok at the moment, and your labwork was reassuring. It does not look like you are currently having any complications right now. It is important that you follow up with your obstetrician-gynecologist in the next week for a check up. If you do not have an obstetrician-gynecologist, please call the included number to make an appointment.
Please return to the ER if you experience any of the following:
-worsening bleeding
-lightheadedness
-loss of consciousness
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Nausea/Vomiting during Pregnancy
You were seen today for nausea and vomiting during pregnancy. The ultrasound showed that the pregnancy looks ok at the moment, and your labwork was reassuring. It does not look like you are currently having any complications right now. It is important that you follow up with your obstetrician-gynecologist in the next week for a check up. If you do not have an obstetrician-gynecologist, please call the included number to make an appointment.
For your nausea, please take Vitamin B6 (pyridoxine) 10 to 25 mg orally every six to eight hours; the maximum treatment dose suggested for pregnant women is 200 mg/day. In addition, you can take Doxylamine (Unisom). Take one-half of the 25 mg over-the-counter tablet three to four times per day.
Please return to the ER if you experience any of the following:
-worsening bleeding
-lightheadedness
-loss of consciousness
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Allergic reaction
You were seen today for your allergic reaction. We gave you medicine to reduce the symptoms and you felt better. We are giving you some of the same medications to continue over the next few days at home to prevent the symptoms from returning. We are prescribing you an Epi-Pen (epinephrine injector) to use if this happens again and you have any shortness of breath. Please make an appointment with an allergist for further testing to find out what your allergies are.
Return to the ER if you have any of the following:
-shortness of breath
-any swelling of your mouth, lips, tongue, or throat
-any other concerning symptoms
Otherwise please follow up with your primary care physician in the next 2-3 days.
It has been a pleasure taking care of you and we hope you feel better.
Hyperemesis gravidarum
You were seen in the ER for vomiting during pregnancy. For persistent nausea and vomiting, please take the Zofran (Ondansetron) tablets as well as Reglan (Metoclopromide) with either the Diclegis (or, if your insurance will not pay for this prescription, you can take the same medicines by buying Unisom and Vitamin B6 tablets and taking 10mg of each in place of 1 pill of the Diclegis. Take 2 at night, and then add 1 in the morning if you are still nauseous and vomiting, and add another 1 the next afternoon if you do not feel better). Follow up with your obstetrician-gynecologist as soon as possible. Return to the ER if you are unable to tolerate fluids or food.
Seizure
You were seen today for having a seizure. Your bloodwork and CT scan of your head did not show any reason for your seizure and you are feeling better. We do not know the reason you had a seizure, but we do not think you need to stay in the hospital. You should make an appointment with a neurologist (brain doctor) to look into other reason you had a seizure. Please do not drive , swim, or climb anything high until you have been seen by a neurologist.
Please return to the Emergency Department if you have any of the following:
-another seizure
-loss of consciousness( fainting/falling out)
-any other concerning symptoms
Otherwise please follow up with your primary care physician in the next 2-3 days.
It has been a pleasure taking care of you and we hope you feel better.
Cannabinoid Hyperemesis Syndrome
Today, you were seen in the ER for your recurrent vomiting. This appears to be due to your cannabinoid hyperemesis syndrome from using excessive marijuana. You felt better after we gave you some medications and we will prescribe you medicine that dissolves under your tongue for further nausea. Please discontinue marijuana use and consider taking hot showers or baths to relieve your symptoms. You can also rub capsaicin lotion on your back and shoulders for relief.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1-2 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Staring Spell/ Absence Seizure
You were seen today for having a staring spell. Your bloodwork and CT scan of your head did not show any reason for your seizure and you are feeling better. We do not know the reason you had a staring spell, but we do not think you need to stay in the hospital. You should make an appointment with a neurologist (brain doctor) to look into other reason you had a staring spell. Sometimes these are something called an absence seizure.
Please return to the Emergency Department if you have any of the following:
-another episode
-loss of consciousness( fainting/falling out)
-any other concerning symptoms
Otherwise please follow up with your primary care physician in the next 2-3 days.
It has been a pleasure taking care of you and we hope you feel better.
GI Bleeding
You were seen today for blood in your stool. You blood levels were normal and your vital signs were stable and we do not feel you need to stay in the hospital at this time. We are giving you the contact information for a GI doctor. Please call their office to make an appointment.
Please return to the ER if you experience any of the following:
-large amount of bright red blood in your stool
-lightheadedness
-loss of consciousness
-any other concerning symptoms
It has been a pleasure caring for you and we hope you feel better soon.
Groin lymph node swelling
You were see today for swelling in your groin. It does not appear to be a hernia and is likely a swollen lymph node that will go away on its own. Lymph nodes can swell if there is an infection nearby, or sometimes swell for unknown reasons. If the swelling does not go away, please schedule an appointment with your primary care provider for further work up.
If anything changes or gets worse, please come back to the ER, including:
-severe pain
-high fever
-the swelling gets worse
-if you have an wounds that appear over the swollen area
It has been a pleasure taking care of you and we hope you feel better soon.
Hernia
You were see today for swelling in your groin. It appears to be a hernia but is reducible (can be pushed back in on it’s own), so does not require immediate surgery. However, it can become trapped on the outside and become non-reducible. This situation can be dangerous, so it is important you go see a surgeon soon. We have provided you with a number to call to make an appointment.
If anything changes or gets worse, please come back to the ER, including:
-severe pain
-high fever
-nausea/vomiting
-the swelling gets bigger and will not go down
It has been a pleasure taking care of you and we hope you feel better soon.
Hemorrhoid
You were seen for anal discomfort or bleeding that might be due to hemorrhoids. You can try over-the-counter medications such as Preparation H for discomfort. You can also use over-the-counter stool softeners. If your symptoms persist, you can call the included number to make an appointment with a colorectal surgeon for further management options.
Please return to the ER if you have:
-uncontrollable bleeding
-new discharge
-abdominal pain
-nausea and vomiting
-any other concerning symptoms.
Please follow up with your primary doctor for a reevaluation in the next 2 weeks.
It's been a pleasure taking care of you and we hope you feel better.
Eye pain
You were seen today for your eye pain. We found that you have a corneal ulcer, likely from your contacts. Please stop using your contacts until it clears up and use the antibiotic eyedrops we have given you every 2 hours during the day, and apply the ointment we have prescribed before bed at night. Please go to the ophthalmology clinic tomorrow for a follow up check to make sure it is healing.
Please return to the ER if you have any of the follow:
-increased eye pain/redness
-thick discharge from your eye
-worsening/blurry vision
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Subconjunctival Hemorrhage
You were seen today for redness of your eye. We found that you have a small amount of blood just under the surface of the eye. This can happen from sneezing, coughing, or straining with force. Often we do not know what caused it, but it should go away on its own and does not cause any permanent problems.
Please go to the ophthalmology clinic tomorrow for a follow up check to make sure it is healing.
Please return to the ER if you have any of the follow:
-increased eye pain/redness
-thick discharge from your eye
-worsening/blurry vision
-any other concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Facial Injury
Today you were seen for pain in your ______ after injury. Your CT scans did not show any fracture or dislocation. You will have some swelling for several days. You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may take them together if needed. Do not take more than 3000mg of Tylenol (acetaminophen in 24 hours).
Otherwise, please return if the pain become significantly worse, you have any trauma to the same site, or if it feels dislocated.
Please follow up with your primary doctor for a reevaluation in the next 2 weeks.
It's been a pleasure taking care of you and we hope you feel better.
Broken Bone/Fracture
Today you were seen for pain in your _______. Your x-ray showed a fracture of the _______. Your fracture was stablized and reduced if possible and you were put in support (a splint or cast). Please follow up with the Orthopedists by calling the attached number.
You may take the prescribed medication for break-through pain. The medication will make you sleepy. Please do not drive or do any other activity that requires you to be fully alert while taking the medication. If the medication contains Acetaminophen (the generic name for Tylenol), be careful taking additional over-the-counter Tylenol. Add up the amounts of Acetaminophen listed in each pill, and do not take more than 3000-4000mg in 24 hours.
Please return to the ER if your pain is uncontrollable, you have additional trauma to the area, or you have any other concerns.
It's been a pleasure taking care of you and we hope you feel better.
Patella Fracture (quad function ok, knee immobilizer, rest, ice, Ortho f/u)
Today you were seen for pain in your knee. Your x-ray showed a fracture of the patella (knee cap). You were put in knee immobilizer, which you should wear as much as possible for 4-6 weeks. Please follow up with the Orthopedists by calling the attached number and make an appointment for their next available time.
You may take the prescribed medication for break-through pain. The medication will make you sleepy. Please do not drive or do any other activity that requires you to be fully alert while taking the medication. If the medication contains Acetaminophen (the generic name for Tylenol), be careful taking additional over-the-counter Tylenol. Add up the amounts of Acetaminophen listed in each pill, and do not take more than 3000-4000mg in 24 hours.
Please return to the ER if your pain is uncontrollable, you have additional trauma to the area, or you have any other concerns.
It's been a pleasure taking care of you and we hope you feel better.
Joint Pain
Today you were seen for pain in your _______. Your x-ray did not show any fracture or dislocation of the joint, but is not able to show muscles, tendons, and ligaments well. If your pain continues, please see the orthopedic doctor who specializes in bones and joints and whose phone number is listed in this paperwork.
Otherwise, please return if the pain become significantly worse, you have any trauma to the same site, or if it feels dislocated.
It's been a pleasure taking care of you and we hope you feel better.
Pseudoseizure (PNES)
You were seen for weakness and seizure like activity. Your CT scan and MRI did not show evidence of a stroke or other concerning neurologic problem. We think you have what are called Psychogenic Non-Epileptic Seizures. These are not caused by a neurologic problem. You may need to see a psychiatrist if they continue.
Bursitis
Today you were seen for pain in your _______. Your x-ray did not show any fracture or dislocation of the joint, but is not able to show muscles, tendons, and ligaments well. We think you have inflammation of one of the fluid-filled spaces around your joint called a bursa. This can be due to an injury or an infection in the area. We are prescribing you antibiotics and medicines for pain. Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, the infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
*You may take Ibuprofen (Advil or Motrin) and Tylenol over-the-counter for your pain. You may even safely take double the dose indicated on the bottle. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours. It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
*You may take the prescribed medication for break-through pain. The medication will make you sleepy. Please do not drive or do any other activity that requires you to be fully alert while taking the medication. If the medication contains Acetaminophen (the generic name for Tylenol), be careful taking additional over-the-counter Tylenol. Add up the amounts of Acetaminophen listed in each pill, and do not take more than 3000-4000mg in 24 hours.
Otherwise, please return if the pain become significantly worse, you have any trauma to the same site, or if it feels dislocated.
It's been a pleasure taking care of you and we hope you feel better.
Muscle Pain
Today you were seen for pain in your ___________. Your x-ray did not show any fracture or dislocation of the joint, but is not able to show muscles, tendons, and ligaments well. Your pain seems to be from soreness in the muscle. We do not know what caused this but do not feel you need to stay in the hospital at this time. You may try the muscle relaxant prescription we are giving you, but be sure not to drive while taking it because it can make you sleepy. Please follow up with your primary care provider if you pain continues.
Otherwise, please return if the pain becomes significantly worse, you have any trauma to the same site, or if it feels dislocated.
It's been a pleasure taking care of you and we hope you feel better.
Anxiety/Panic
Today you were seen for an anxiety event/panic attack. Your symptoms went away and you felt better. We do not think there is any reason to keep you in the hospital for your symptoms right now and are discharging you. Please take the medicine prescribed by your doctor for any future episodes like this, and see your doctor in the office as needed.
Please return to the ER if you have any of the follow:
-fainting
-blurry vision
-headache
-shortness of breath
-any new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Sore Throat/Pharyngitis
Today, you were seen in the ER for your sore throat. You did not test positive for Strep throat, Flu, or Mono. These symptoms are usually caused by a viral infection in the throat and sinuses that your body will fight best on its own and antibiotics do not work on viruses. The best thing to do is drink plenty of fluids, get some rest, and use over the counter products for comfort such as Naproxen, Tylenol, NyQuil/DayQuil.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Pharyngitis (Not strep, not tested)
Today, you were seen in the ER for your sore throat. You tested positive for Strep throat and we gave you antibiotics to treat it. The best thing to do is drink plenty of fluids, get some rest, and use over the counter products for comfort such as Naproxen, Tylenol, NyQuil/DayQuil.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Kidney stone (confirmed)
Today, you were seen in the ER for your back and groin pain and were found to have a kidney stone. The size of your stone is small enough that it usually passes on its own at home. You can use over-the-counter medicines called NSAIDs: Non-steroidal Anti-Inflammatory Drugs. These include Ibuprofen (Advil, Motrin) or Naproxen Sodium (Alleve). You can safely take two times to over-the-counter dosage for a limited period of time (about 1 week).
Please take the pain medicine for break-through pain as prescribed and do not drive while taking it as it can make you drowsy.
Please call the urologist number included to make an appointment for follow up, especially if it's not passing on its own.
Please return to the ER if you have:
-fever of 100.4 or higher
-vomiting
-fainting
-shortness of breath
-new middle back pain
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 4-5 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Kidney stone (unconfirmed)
Today, you were seen in the ER for your back and groin pain and we suspect you might have a kidney stone. You can use over-the-counter medicines called NSAIDs: Non-steroidal Anti-Inflammatory Drugs. These include Ibuprofen (Advil, Motrin) or Naproxen Sodium (Alleve). You can safely take two times to over-the-counter dosage for a limited period of time (about 1 week).
Please take the pain medicine for break-through pain as prescribed and do not drive while taking it as it can make you drowsy.
Please call the urologist number included to make an appointment for follow up, especially if it's not passing on its own.
Please return to the ER if you have:
-fever of 100.4 or higher
-vomiting
-fainting
-shortness of breath
-new middle back pain
-any other new or concerning symptoms
The cause of your symptoms may be something other than a kidney stone, but teh Otherwise, please follow-up with your primary doctor in 4-5 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Chest pain (CP)
Today, you were seen in the ER for your chest pain. Your EKG, chest x-ray, and bloodwork didn't show any explanation for your symptoms. The exact cause for your pain is unclear, but we do not feel we need to keep you in the hospital right now.
However, things can change, and you should see your doctor or return to the ER if you have:
-worsening of your chest pain
-difficulty breathing
-fainting
-unusual sweating or anxiety
-any other new or concerning symptoms.
In addition, you should follow-up with your primary doctor within 1-2 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Dyspnea
Today, you were seen in the ER for your shortness of breath. Your exam, chest x-ray, and EKG did not show any reason for your symptoms. We do not know what the cause of your symptoms are, but we do not think it is an emergency or that you need to stay in the hospital at this time.
You should follow-up with your primary doctor in the next 1-2 days for a recheck.
Otherwise, please return to the ER if you have:
- worsening of your shortness of breath
-chest pain
-fever of 100.4 or higher
-fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Sleep Apnea
You were seen for having an episode where your felt like you stopped breathing while sleeping. You labs, EKG, and CXR were reassuring. We think this might have been an episode of sleep apnea. For further evaluation, you can talk to your primary care provider about arranging a sleep study.
Please return to the ER if you have:
-shortness of breath
-chest pain
-fever of 100.4 or higher
-fainting
-any other new or concerning symptoms
Otherwise, you should follow-up with your primary doctor in the next 1-2 weeks.
It's been a pleasure taking care of you and we hope you feel better.
Asthma Exacerbation
Today, you were seen in the ER for shortness of breath due to a flare up of your asthma. You received nebulizer treatments and steroids and your breathing improved. Please take the full course of steroids we are prescribing you, and continue to use your home inhalers and/or nebulizers as usual.
Please return to the ER if you have:
- worsening of your shortness of breath
-chest pain
-fever of 100.4 or higher
-fainting
-any other new or concerning symptoms
Otherwise, you should follow-up with your primary doctor in the next 1-2 weeks to see if you need an adjustment to your medications to help control your asthma.
It's been a pleasure taking care of you and we hope you feel better.
COPD Exacerbation:
Today, you were seen in the ER for shortness of breath due to a flare up of your COPD. You received oxygen, nebulizer treatments, and steroids and your breathing improved. Please take the full course of steroids we are prescribing you, and continue to use your home inhalers and/or nebulizers as usual.
_CHOOSE:
In addition, please complete the entire course of antibiotics you are prescribed.
Your chest x-ray did not show signs of pneumonia, however it is not a perfect test.
Please return to the ER if you have:
- worsening of your shortness of breath
-chest pain
-fever of 100.4 or higher
-fainting
-any other new or concerning symptoms
Otherwise, you should follow-up with your primary doctor in the next 1-2 weeks to see if you need an adjustment to your medications to help control your COPD.
It's been a pleasure taking care of you and we hope you feel better.
Cough:
Today, you were seen in the ER for your cough. Your chest x-ray and bloodwork didn't show any explanation for your symptoms. The exact cause for your cough is unclear, but these symptoms are typically caused by viral infections, which generally go away on their own after several days.
However, things can change, and you should see your doctor or return to the ER if you have:
-chest pain
-difficulty breathing
-fainting
-fever of 101 or higher
-vomiting that prevents your from drinking fluids
-any other new or concerning symptoms.
Otherwise, you should follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Upper Respiratory Infection (likely viral):
Today, you were seen in the ER for your cough. Your chest x-ray and bloodwork didn't show any explanation for your symptoms. The exact cause for your cough is unclear, but these symptoms are typically caused by viral infections, which generally go away on their own after several days.
You may take Ibuprofen (Advil or Motrin), Naproxen (Alleve) and Tylenol over-the-counter for your discomfort.. You may even safely take up to 4 pills of Ibuprofen or Naproxen and 3 pills of Tylenol at a time. Do not take more than 3000-4000 mg of Tylenol (Acetaminophen) in 24 hours (about 10 pills). It can hurt your liver beyond these levels. Check the active ingredients of any prescriptions or over-the-counter medicines you take and add up the amount of Acetaminophen.
In addition, you can take cough medicine and sore throat medicine to treat those symptoms if you have them. Again, be sure to check the amount of Acetaminophen in each product.
You can also try over-the-counter anti-histamine medications for your congestion and runny nose, like Zyrtec, Allegra, or Claritin. Benedryl can also help, but may make you sleepy.
However, things can change, and you should see your doctor or return to the ER if you have:
-chest pain
-difficulty breathing
-fainting
-fever of 101 or higher
-vomiting that prevents your from drinking fluids
-any other new or concerning symptoms.
Otherwise, you should follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Abdominal pain:
Today, you were seen in the ER for your abdominal pain. Your bloodwork and CT scan and ultrasound didn't show any explanation for your symptoms. The exact cause for your pain is unclear, but we do not think there is any reason to keep you in the hospital right now.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1-2 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Weight Loss (unexplained)
Today, you were seen in the ER for your weight loss.The exact cause for your weight loss is unclear, but we do not think there is any reason to keep you in the hospital right now.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1-2 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Diverticulitis
Today, you were seen in the ER for your abdominal pain. Your CT scan showed that you have something called diverticulitis. Diverticulosis is when you have small outpouchings of your colon. Diverticulitis is when those outpouchings become inflamed. We do not think you need to stay in the hospital at this time, but we are prescribing you antibiotics. It is important you take the full course of antibiotics as instructed even if you feel better before they are finished so that an infection does not return stronger.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1-2 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Leg swelling:
Today, you were seen in the ER for the swelling of your leg. Your ultrasound showed no signs of a blood clot in your leg, and your exam does not show any signs of infection. The exact cause of your swelling is unclear, but we do not think there is any reason to keep you in the hospital at this time.
However, things can change, and it is possible for an ultrasound to miss an early blood clot. Therefore, you should see your doctor or return to the ER if you have:
-worsening of your swelling over the next 2-3 days
-shortness of breath
-fainting or lightheadedness
-fever of 100.4 or higher
-new or spreading redness of your skin
-any other new or concerning symptoms
Otherwise, you should see your primary doctor in 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Headache:
Today, you were seen in the ER for your headache. You exam and tests were reassuring and you felt better after medicines we gave you. The exact cause for your headache is unclear, but we do not think there is any reason to keep you in the hospital at this time.
That being said, things can change, and you should see your primary doctor or return to the ER if you have:
-sudden severe headache
-vision changes
-fever of 100.4 or higher
-neck stiffness
-new rash
-weakness, numbness, tingling in arms or legs or face
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 2-3 days for a recheck. It might be helpful to keep a diary of your headaches to share with your doctor. Write down when they happen, what you were doing, how long they last, how they feel and how intense they are, any associated symptoms, and any medications you took and how the headache responded.
It's been a pleasure taking care of you and we hope you feel better.
***Caffeine***
Caffeine seemed to help your headache, so you might want to try caffeine at home. It can be found in popular drinks such as coffee and tea, in pill form over-the-counter, and is included in some over-the-counter headache medicines, such as Excedrin (which also contains Aspirin, so do not take this if there is any reason you should not take Aspirin). Excedrin for Tension Headaches does not include Aspirin.
Closed head injury/Concussion:
Today, you were seen in the ER after having a head injury. Your CT scan showed no signs of dangerous brain injury, but you may notice yourself having signs of concussion in the coming days, including headache, nausea, or difficulty focusing, among other things. In general, you should avoid activities that worsen your symptoms, and you may use over-the-counter medications for your pain.
Please return to the ER if you have:
-fainting
-weakness in any single part of your body
-vomiting that prevents you from drinking fluids
-any other new or concerning symptoms
If your symptoms continue for more than 1 weeks, please make an appointment with the Concussion Clinic. Call the Neurology number included to make an appointment. The web site is: http://www.gwdocs.com/neurology/concussion-clinic
It's been a pleasure taking care of you and we hope you feel better.
Alcohol intoxication:
Today, you were seen in the ER for your alcohol intoxication. You should be more cautious with your alcohol use, as it can lead to medical problems, accidents, and poor life decisions.
If you find that you have difficulty stopping drinking, you may benefit from seeking rehabilitation services.
Substance Abuse and Mental Health Services Administration (SAMHSA)
National Helpline: 1-800-662-HELP (4357)
Confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information.
It's been a pleasure taking care of you and we hope you feel better.
Alcohol Intoxication (Spanish):
Usted fue visto en la sala de emergencia por abuso de alcohol. Debe dejar de beber alcohol o beber con moderación, ya que esto es peligroso para su salud y puede conducir a futuros problemas de salud. Usted debe buscar un grupo alcohólico anónimo local de la reunión para ayudar a parar el usar del alcohol. Debe regresar a la sala de emergencias con cualquier actividad de convulsiones, dolor incontrolado, fiebre / escalofríos, pensamientos suicidas o síntomas relacionados con usted. Debe hacer un seguimiento con su médico de atención primaria, o usar la siguiente información para encontrar un médico de atención primaria, para ayudar a controlar su salud.
Gracias por elegir el Departamento de Emergencias de George Washington.
You were seen in the ER for alcohol abuse. You need to stop drinking alcohol or drink in moderation, as this is dangerous to your health and may lead to future health problems. You should seek out a local alcoholic anonymous meeting group to help stop using alcohol. You should return to the ER with any seizure activity, uncontrolled pain, fevers/chills, suicidal thoughts or symptoms concerning to you. You should follow up with your primary care doctor, or use the below information to find a primary care doctor, to help manage your health.
Thank you for choosing the George Washington Emergency Department.
Hypokalemia due to Anorexia/Bulemia (eating disorder)
Today, you were seen in the ER for your low potassium level. This is likely due to your eating disorder. We gave you some potassium and your repeat level was higher. Your EKG did not show any problems with your heart currently, but having a low potassium level can cause your heart to beat incorrectly and even lead to death. We do not feel we need to keep you in the hospital right now, but it is important for you to start taking potassium supplements and to follow up with your primary doctor. In addition, we gave you resources for seeking further help with dealing with your eating disorder.
However, things can change, and you should see your doctor or return to the ER if you have:
-worsening of your chest pain
-difficulty breathing
-palpitations (racing heartbeat)
-fainting
-unusual sweating or anxiety
-any other new or concerning symptoms.
It's been a pleasure taking care of you and we hope you feel better
Drug abuse:
Today, you were seen in the ER for your drug abuse. You should be very careful with your use of drugs, as it can result in medical problems, accidents, and poor life decisions. You should, in fact, stop using drugs as soon as you are able.
If you are not able to stop, you should go to a rehabilitation facility, like at Psychiatric Institute of Washington at 4228 Wisconsin Ave NW, Washington, DC 20016, which is open 24 hours a day. You can call them at (202) 885-5600.
It's been a pleasure taking care of you and we hope you feel better.
Urinary tract infection (UTI):
Today, you were seen in the ER for your pain. We found that your urine test showed signs of infection, which may have been the cause of your symptoms. You should take the antibiotic as prescribed in order to get rid of the infection. Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, the infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
Please return to the ER if you have:
-fever of 100.4 or higher
-vomiting
-fainting
-shortness of breath
-new middle back pain
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 4-5 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Pyelonephritis
Today, you were seen in the ER for your pain. We found that your urine test showed signs of infection that appears to have spread to your kidneys, which may have been the cause of your symptoms. You should take the antibiotic as prescribed in order to get rid of the infection. Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, the infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
Please return to the ER if you have:
-fever of 100.4 or higher
-vomiting
-fainting
-shortness of breath
-new middle back pain
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 4-5 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Pelvic Inflammatory Disease, STD (Chlamydia, Gonorrhea), (PID)/Vaginal Discharge:
Today, you were seen in the ER for your belly pain. We found that your urine test did not show signs of infection, but it seems like you might have an infection in your uterus and tubes which may have been the cause of your symptoms. You should take the antibiotic as prescribed in order to get rid of the infection.
Please return to the ER if you have:
-fever of 100.4 or higher
-vomiting
-fainting
-shortness of breath
-new middle back pain
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 4-5 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Vaginal Foreign Body (Condom)
Today, you were seen for suspected object in your vagina. We were able to remove the object and did not see any signs of serious complications.
Please return to the ER if you have:
-fever of 100.4 or higher
-abdominal pain
-shortness of breath
-vaginal bleeding or discharge
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 4-5 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Back pain:
Today, you were seen in the ER for your back pain. Your bloodwork and exam did not give us an explanation for your pain and we do not believe you need to stay in the hospital right now for further assessment or treatment. The exact cause of your pain is unclear, but it may be due to to inflammation of the muscles of your back. You may take the prescribed medications for your pain.
Please return to the ER if you have:
-fever of 100.4 or higher
-vomiting
-weakness of your legs or numbness of your groin
-difficulty controlling your bowels or bladder
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Hygiene
You were seen for concerns about personal hygiene. We do not think you need to stay in the hospital at this time. The best approach is to take a shower daily as much as possible and wash your clothes frequently. It is also important to brush your teeth two times per day and go to a dentist every 6 months or at least once per year.
You can call the included numbers to setup a primary care provider for regular check-ups.
It's been a pleasure taking care of you and we hope you feel better.
Palpitations:
Today, you were seen in the ER for your palpitations. Your EKG, blood work, and x-ray showed no explanation for your symptoms. We do not think there is any reason to keep you in the hospital at this time.
You should follow-up with your primary doctor in 1-2 weeks for a recheck.
Please return to the ER if you have:
-fainting
-chest pain
-shortness of breath
-worsening of your palpitations
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
AFib (paroxysmal)
Today, you were seen in the ER for your palpitations. It appeared as though you had a heart rhythm called Atrial Fibrillation (or Afib). Your EKG, blood work, and x-ray looked good and you stopped having symptoms. We do not think there is any reason to keep you in the hospital at this time.
We do recommend that you follow up with a Cardiologist (heart doctor) for a recheck with in 1 week. You can call the included number to make an appointment. You should also follow-up with your primary doctor in 1-2 weeks for a recheck.
Please return to the ER if you have:
-fainting
-chest pain
-shortness of breath
-worsening of your palpitations
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Employee Occupational Exposure to Body Fluids (Post-Exposure Prophylaxis)
You were seen after being exposed to bodily fluid while working. Labs for the source person and for you were ordered and the information was shared with you. If you chose to take the PEP regimen, please fill the prescriptions. It is recommended you stop taking the medications if the source results have a negative viral load.
Be sure to follow up with Employee Health and your primary care provider. If you have any questions please let us know.
Syncope/near syncope:
Today, you were seen in the ER for your lightheadedness or fainting. Your bloodwork and chest x-ray showed no explanation for your symptoms. The exact cause for your lightheadedness is uncertain, but we do not think there is any reason to keep you in the hospital at this time.
Please see your primary doctor or return to the ER if you have:
-chest pain
-shortness of breath
-vomiting
-fainting
-any other new or concerning symptoms
Otherwise, please see your primary doctor in about 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Off Balance / Dizzy
Today, you were seen in the ER for feeling off balance. Your bloodwork and EKG of your heart showed no explanation for your symptoms. The exact cause for your lightheadedness is uncertain, but we do not think there is any reason to keep you in the hospital at this time.
Please see your primary doctor or return to the ER if you have:
-chest pain
-shortness of breath
-vomiting
-fainting
-any other new or concerning symptoms
Otherwise, please see your primary doctor in about 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Rash (resolve in 5-7 days):
Today, you were seen in the ER for your rash. The exact cause of your rash is unclear, but it does not appear to be due to a dangerous cause at this time. The rash is likely to resolve within the next 5-7 days.
If it does not got go away at that time, you may benefit from seeing a dermatologist.
Please return to the ER if you have:
-vomiting
-pain or ulcers in your mouth or on your eyes
-fever of 100.4 or higher
-lightheadedness or fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Eczematous rash (emollient w derm referral):
Today, you were seen in the ER for your rash. The exact cause of your rash is unclear, but it could be caused by irritation of something against it. Please stop using perfumes and fragrences in your lotions and soaps. Use basic Dove soap bar and an emollient lotion over-the-counter, such as Aquaphor.
If it does not got go away at that time, you may benefit from seeing a dermatologist. You can call the included number to make an appointment.
Please return to the ER if you have:
-vomiting
-pain or ulcers in your mouth or on your eyes
-fever of 100.4 or higher
-lightheadedness or fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Ring Worm
Today, you were seen in the ER for your rash. It appears to be ring worm. You can use over-the-counter products for ring worm, athelete's foot, or jock itch such as sprays or lotions to treat it.
If it does not got go away at that time, you may benefit from seeing a dermatologist.
Please return to the ER if you have:
-vomiting
-pain or ulcers in your mouth or on your eyes
-fever of 100.4 or higher
-lightheadedness or fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Shingles:
Today, you were seen in the ER for your rash. We think the most likely cause of your rash is shingles (a rash you get if you’ve had chicken pox in the past or are exposed to someone with shingles). We are prescribing you an anti-viral medication to treat the cause of the infection. Please take the full course of the medication until completed, even if the rash gets better before you are through all the pills. The rash should begin to go away over the next week, but we recommend you see you primary care provider for a check-up in the next week to make sure it is getting better.
Please return to the ER if you have:
-vomiting
-pain or ulcers in your mouth or on your eyes
-fever of 100.4 or higher
-lightheadedness or fainting
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Rectal bleeding:
Today, you were seen in the ER for the blood in your stool. Your bleeding does not seem to be dangerous right now, and your blood count is reassuring.
You should follow-up with the Gastroenterology clinic for a further evaluation, which will likely include a colonoscopy.
Please return to the ER if you have:
-worsening of your bleeding
-fainting
-lightheadedness
-difficulty breathing
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Diarrhea:
Today, you were seen in the ER for your diarrhea. The exact cause of your diarrhea is unclear, but it does not seem to be caused by anything dangerous.
Please return to the ER if you have:
-fainting
-vomiting that prevents you from drinking fluids
-blood in your stool
-worsening abdominal pain
-fever of 100.4 or higher
-any other new or concerning symptoms
Otherwise, you may follow-up with your primary doctor in the next week for any other concerns.
It's been a pleasure taking care of you and we hope you feel better.
Sickle cell:
Today, you were seen in the ER for your body pains. It seems that your pains were due to a sickle cell pain crisis. Your exam and bloodwork showed no signs of infection or other major problems at this time.
Please follow-up with your primary doctor or hematologist within the next 2-3 days for a recheck and further recommendations on management of your sickle cell disease.
***In the meantime, you may use the prescribed pain medication. Please be cautious with the use of these medications, as they may result in drowsiness; please don't use these medications before driving, swimming, or any other potentially dangerous activities.***
Please return to the ER if you have:
-pain that is not controlled with medications
-weakness of any part of your body
-fever of 100.4 or higher
-difficulty breathing or chest pain
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Dizziness/vertigo:
Today, you were seen in the ER for your dizziness, or vertigo. Your head MRI did not show any reason for these symptoms (such as a stroke or tumor). The rest of your bloodwork and EKG looked unconcerning. We do not know the cause of your dizziness but it does not seem to be an emergency right now.
That said , things can change. Please return to the ER if you have:
-worsening of your dizziness
-inability to walk
-vomiting that prevents you from drinking fluids
-weakness in any part of your body
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 2-3 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Abscess:
Today, you were seen in the ER for your abscess. We drained the abscess, which should be enough for it to heal without antibiotics.
Please return to the ER if you have:
-fever of 100.4 or higher
-worsening of the pain at that site
-redness spreading around the wound
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 1-2 weeks for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Abscess Wound Check and Packing Removal
Today, you were seen in the ER to check on how your abscess is healing. The wound is looking healthy and we removed that packing material placed inside last time. Please change the dressing once a day and follow up as instructed.
Please return to the ER if you have:
-fever of 100.4 or higher
-worsening of the pain at that site
-redness spreading around the wound
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in 1-2 weeks for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Paronychia
You were seen today for an infection around your nail. We made a cut near your nail to try to drain the pus. This should help the body to fight off the infection. We are also starting you on antibiotics. Please take the full course of antibiotics until the last day, even if you feel better before all the pills are gone. You may notice continued discharge from the area for the next day or two. Please change the dressing at least once a day until the drainage has stopped.
Return to ED sooner if any of these occur:
-Increasing pain in the wound
-Redness, swelling, or pus coming from the wound
-Fever of 100.4ºF (38ºC) or higher, or as directed by your health care provider
-Bleeding not controlled by direct pressure
It has been a pleasure caring for you and we hope you feel better soon.
Laceration repair:
Finger Laceration
You were seen today for a finger laceration. Your wound was closed with __ nonabsorbable sutures. Keep wound clean and dry for 24 hours. Do not get wound wet AT ALL x 24 hours. After that, wash gently with soap and water and apply neosporin/antibiotic ointment (optional) and a fresh bandage 2x/day. Watch for signs of poor healing, such as bleeding, dark wound edges, redness, increased pain, fever. Follow up in the ER or any other medical facility in 7-10 days for suture removal. Return to ED sooner if any of these occur:
-Increasing pain in the wound
-Redness, swelling, or pus coming from the wound
-Fever of 100.4ºF (38ºC) or higher, or as directed by your health care provider
-If stitches or staples come apart or fall out before your next appointment
-If the surgical tape closures fall off within seven days, or the wound edges re-open
-Bleeding not controlled by direct pressure
It has been a pleasure caring for you and we hope you feel better soon.
Lip Laceration
You were seen today for a laceration in your mouth/lip. Your wound was closed with __ nonabsorbable sutures. You need to return to the ER or go to a healthcare provider to remove the sutures in 5 days. Watch for signs of poor healing, such as bleeding, dark wound edges, redness, increased pain, fever. Follow up in the ER or any other medical facility in 12-14 days for suture removal. Return to ED sooner if any of these occur:
-Increasing pain in the wound
-Redness, swelling, or pus coming from the wound
-Fever of 100.4ºF (38ºC) or higher, or as directed by your health care provider
-If stitches or staples come apart or fall out before your next appointment
-If the surgical tape closures fall off within seven days, or the wound edges re-open
-Bleeding not controlled by direct pressure
It has been a pleasure caring for you and we hope you feel better soon.
Foot Laceration
You were seen today for a laceration on your foot. Your wound was closed with __ nonabsorbable sutures. Keep wound clean and dry for 24 hours. Do not get wound wet AT ALL x 24 hours. After that, wash gently with soap and water and apply neosporin/antibiotic ointment (optional) and a fresh bandage 2x/day. Watch for signs of poor healing, such as bleeding, dark wound edges, redness, increased pain, fever. Follow up in the ER or any other medical facility in 12-14 days for suture removal. Return to ED sooner if any of these occur:
-Increasing pain in the wound
-Redness, swelling, or pus coming from the wound
-Fever of 100.4ºF (38ºC) or higher, or as directed by your health care provider
-If stitches or staples come apart or fall out before your next appointment
-If the surgical tape closures fall off within seven days, or the wound edges re-open
-Bleeding not controlled by direct pressure
It has been a pleasure caring for you and we hope you feel better soon.
Absorbable-Only Sutures
You were seen today for a laceration (cut). Your wound was closed with absorbable sutures that will absorb over the next week. You do not need to have them removed.
. Return to ED sooner if any of these occur:
-Increasing pain in the wound
-Redness, swelling, or pus coming from the wound
-Fever of 100.4ºF (38ºC) or higher, or as directed by your health care provider
-Bleeding not controlled by direct pressure
It has been a pleasure caring for you and we hope you feel better soon.
Extremity Laceration
You were seen today for a _ laceration. Your wound was closed with __ nonabsorbable sutures. Keep wound clean and dry for 24 hours. Do not get wound wet AT ALL x 24 hours. After that, wash gently with soap and water and apply neosporin/antibiotic ointment (optional) and a fresh bandage 2x/day. Watch for signs of poor healing, such as bleeding, dark wound edges, redness, increased pain, fever. Follow up in the ER or any other medical facility in 7-10 days for suture removal. Return to ED sooner if any of these occur:
-Increasing pain in the wound
-Redness, swelling, or pus coming from the wound
-Fever of 100.4ºF (38ºC) or higher, or as directed by your health care provider
-If stitches or staples come apart or fall out before your next appointment
-If the surgical tape closures fall off within seven days, or the wound edges re-open
-Bleeding not controlled by direct pressure
It has been a pleasure caring for you and we hope you feel better soon.
Head Laceration
Today, you were seen in the ER for your laceration on your head or face. We repaired the laceration with (#) stitches. These stitches should be removed in 7 days. You may return to the ER to have them removed. You may notice yourself having signs of concussion in the coming days, including headache, nausea, or difficulty focusing, among other things. In general, you should avoid activities that worsen your symptoms, and you may use over-the-counter medications for your pain.
Please return to the ER if you have:
-increasing pain at the wound site
-pus draining from the wound
-redness spreading around the wound
-fever of 100.4 or higher
-fainting
-weakness in any single part of your body
-vomiting that prevents you from drinking fluids
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Generic Laceration
Today, you were seen in the ER for your laceration. We repaired the laceration with (#) stitches. These stitches should be removed in (#-#) days.
Please return to the ER of see your doctor sooner if you have:
-increasing pain at the wound site
-pus draining from the wound
-redness spreading around the wound
--fever of 100.4 or higher
-any other new or concerning symptoms
It's been a pleasure taking care of you and we hope you feel better.
Dermabond
DERMABOND* Topical Skin Adhesive (2-octyl cyanoacrylate) is a sterile, liquid skin adhesive that holds wound edges together. The film will usually remain in place for 5 to 10 days, then naturally fall off your skin. The following will answer some of your questions and provide instructions for proper care for your wound while it is healing:
CHECK WOUND APPEARANCE • Some swelling, redness, and pain are common with all wounds and normally will go away as the wound heals. If swelling, redness, or pain increases or if the wound feels warm to the touch, contact a doctor. Also contact a doctor if the wound edges reopen or separate.
REPLACE BANDAGES • If your wound is bandaged, keep the bandage dry. • Replace the dressing daily until the adhesive film has fallen off or if the bandage should become wet, unless otherwise instructed by your physician. • When changing the dressing, do not place tape directly over the DERMABOND adhesive film, because removing the tape later may also remove the film.
AVOID TOPICAL MEDICATIONS • Do not apply liquid or ointment medications or any other product to your wound while the DERMABOND adhesive film is in place. These may loosen the film before your wound is healed.
KEEP WOUND DRY AND PROTECTED • You may occasionally and briefly wet your wound in the shower or bath. Do not soak or scrub your wound, do not swim, and avoid periods of heavy perspiration until the DERMABOND adhesive has naturally fallen off. After showering or bathing, gently blot your wound dry with a soft towel. If a protective dressing is being used, apply a fresh, dry bandage, being sure to keep the tape off the DERMABOND adhesive film. • Apply a clean, dry bandage over the wound if necessary to protect it. • Protect your wound from injury until the skin has had sufficient time to heal. • Do not scratch, rub, or pick at the DERMABOND adhesive film. This may loosen the film before your wound is healed. • Protect the wound from prolonged exposure to sunlight or tanning lamps while the film is in place.
Fall onto Tailbone (coccyx)
You fell backwards and you might have injured your tailbone. No special treatment is necessary. Time will heal the injury. Pain typically lasts four to six weeks, but with each passing week the pain is less.
Rest at home as possible. Give your body time to heal. Avoid sitting as possible. Sit on soft surfaces when necessary. A foam donut-ring apparatus can be purchased at a pharmacy or medical supply store. The donut apparatus allows sitting without pressure on the coccyx. Apply a cold pack to the coccyx off and on for two days after injury. Cold helps reduce pain and swelling. Do not apply ice directly to the coccyx if it causes discomfort. Aim for coolness, yet comfort, applying a layer or two of cloth between the cold pack and coccyx. After two days, apply heat in the form of warm soaks. Moist heat increases circulation in the tissues, promoting healing. Over-the-counter pain medications can relieve discomfort associated with a broken coccyx. Acetaminophen (Tylenol), ibuprofen, or naproxen can be taken, depending on individual preference.
Please make an appointment for a recheck with your primary care provider in 1 week to make sure things are healing properly.
Please return to the ER if you have:
-leg weakness
-losing control of your bladder or bowels
-any other concerns
It has been a pleasure taking care of you and we hope you feel better.
Occupational Exposure (Needle Stick, Body Fluid)
You were seen for being exposure to body fluid. We did initial tests on both you and the person to whom you were exposed and the screening tests for infectious diseases were negative. We do not feel that you need post-exposure prophylaxis.
Please return to the ER if you have any concerning symptoms, swelling or redness at the site of exposure, new fever or chills, nausea or vomiting preventing you from eating or drinking.
It has been a pleasure taking care of you and we hope you feel better.
Depression/Suicidal Ideation:
Today, you were seen in the ER for your depression and suicidal thoughts. You were seen by our Psychiatry team, who decided that, though you are depressed, you are safe to be discharged.
That being said things can change, and you should return to the ER if you have:
-worsening of your suicidal thoughts, especially if you find yourself in a position of truly considering killing yourself
-thoughts of hurting or killing other people
-hearing voices of people that are not present
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 1-2 days for a recheck. Also, please make an appointment with your Psychiatrist for the next available appointment.
It has been a pleasure taking care of you and we hope you feel better.
Hallucinations
Today, you were seen in the ER for your hallucinations. Your medical workup did not show any acute problems and we do not think you need to stay in the hospital today. Please follow up with a psychiatrist for further evaluation.
That being said things can change, and you should return to the ER if you have:
- suicidal thoughts, especially if you find yourself in a position of truly considering killing yourself
-thoughts of hurting or killing other people
-hearing voices of people that are not present
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 1-2 days for a recheck. Also, please make an appointment with your Psychiatrist for the next available appointment.
It has been a pleasure taking care of you and we hope you feel better.
Overdose (denying SI)
Today, you were seen in the ER for taking too many pills. You bloodwork was reassuring and we monitored you for long enough to make sure you would not have any further effects from the pills. You were also seen by our Psychiatry team, and we came up with a plan for follow up care.
That being said things can change, and you should return to the ER if you have:
-suicidal thoughts
-feeling overly sleep or losing consciousness
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 1-2 days for a recheck. Also, please make an appointment with your Psychiatrist for the next available appointment.
It has been a pleasure taking care of you and we hope you feel better.
Psychosis
Today, you were seen in the ER for your psychiatric issues. Your medical workup did not show any acute problems and we do not think you need to stay in the hospital today. Please follow up with a psychiatrist for further evaluation.
That being said things can change, and you should return to the ER if you have:
- suicidal thoughts, especially if you find yourself in a position of truly considering killing yourself
-thoughts of hurting or killing other people
-hearing voices of people that are not present
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor in the next 1-2 days for a recheck. Also, please make an appointment with your Psychiatrist for the next available appointment.
It has been a pleasure taking care of you and we hope you feel better.
Hypertension:
Today, you were seen in the ER for your high blood pressure. Your exam showed no signs of consequences of your blood pressure being elevated. We do not believe there is any reason to keep you in the hospital today. You should continue to take your blood pressure medications as prescribed and see your primary care provider for a recheck.
Please return to the ER if you have:
-new weakness
-difficulty speaking
-chest pain
-difficulty breathing
-loss of vision
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor within the next 1-2 weeks.
It's been a pleasure taking care of you and we hope you feel better.
Food Impaction
You were seen for food being stuck in your esophagus. The blockage was relieved and we do not feel you need to stay in the hospital at this time.
Please follow up with a Gastroenterologist (stomach and intestine doctor) for further evaluation within 1 week.
Please return to the ER if you have:
-difficulty swallowing
-difficulty speaking
-chest pain
-difficulty breathing
-uncontrolled nausea and/or vomiting
-uncontrolled pain
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor within the next 1-2 weeks.
It's been a pleasure taking care of you and we hope you feel better.
Pill Esophagitis
You were seen for pain in your chest that we think is most likely due to a pill being stuck in your esophagus. You should take the prescribed medication to reduce the amount of acid in your stomach and follow-up with the GI doctor in 2 weeks but calling the included number.
Please return to the ER if you have:
-difficulty swallowing
-difficulty speaking
-chest pain
-difficulty breathing
-uncontrolled nausea and/or vomiting
-uncontrolled pain
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor within the next 1-2 weeks.
It's been a pleasure taking care of you and we hope you feel better.
Hypotension
Today, you were seen in the ER for your low blood pressure. Your exam showed no signs of consequences of your blood pressure being low, and it was better here in the ER. We do not believe there is any reason to keep you in the hospital today. You should continue to take your regular medications as prescribed and see your primary care provider for a recheck.
Please return to the ER if you have:
-new weakness
-chest pain
-difficulty breathing
-loss of vision
-loss of consciousness
-bleeding
-any other new or concerning symptoms
Otherwise, please follow-up with your primary doctor within the next 1-2 weeks.
It's been a pleasure taking care of you and we hope you feel better.
Hypoglcemia (IDDM):
Today, you were seen in the ER for your lightheadedness or fainting due to a low blood sugar level. The rest of your bloodwork and tests were normal. You might have taken too much insulin for the amount of food you had today. It is better for your blood sugar level to be a little high for one day rather than be too low, which can be dangerous, so please be careful about how much insulin you take. If you choose your own dose of insulin throughout the day, be sure to measure your blood sugar level first with a monitor. If your doctor has told you how much to take, please see them soon to talk about whether the dose you are taking is the still the right amount.
Please see your primary doctor or return to the ER if you have:
-chest pain
-shortness of breath
-vomiting
-fainting
-any other new or concerning symptoms
Otherwise, please see your primary doctor in about 1 week for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Vomiting/Gastritis/Gastroenteritis (no abx):
Today, you were seen in the ER for your abdominal pain and diarrhea. Your bloodwork didn't show any explanation for your symptoms. The exact cause for your discomfort is unclear, but your pain does not seem to require you to stay at the hospital at this time.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1-2 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Vomiting/Gastritis/Gastroenteritis/Dysentery (abx):
Today, you were seen in the ER for your abdominal pain and diarrhea. We found that you have an infection in your intestines. You do not need to stay in the hospital at this time, but we are prescribing you antibiotics.
Please take the full course of antibiotics, even if your symptoms get better before you are done. Otherwise, the infection might return. If it does not go away with the antibiotics, please see your primary care provider for further assessment.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your primary doctor in 1-2 days for a recheck.
It's been a pleasure taking care of you and we hope you feel better.
Crohn’s Flare
Today, you were seen in the ER for your abdominal pain that seems to be a flare up of your Crohn’s Disease. Your bloodwork looked ok, and we do not think there is any reason to keep you in the hospital right now.
Please take the course of steroids we are prescribing. Follow the instructions on the label.
However, things can change, and you should see your doctor or return to the ER if you have:
-vomiting that prevents you from keeping down fluids
-worsening of your pain
-fever of 100.4 or higher
-fainting
-shortness of breath
-any other new or concerning symptoms
Otherwise, please see your GI doctor for a recheck.
It's been a pleasure taking care of you and we hope you feel better.