Expert Advice: How to Avoid Holiday Mishaps

Simple tips from our emergency department
Adults raise glasses to toast and cheers with alcohol

Having an unexpected illness or injury during the holiday season is enough to turn anyone into a Scrooge. Unfortunately, between the winter “sick season,” weather-related injuries, and the emotional pressures of the season, urgent care centers and emergency rooms are often packed.

We asked two of our emergency medicine providers to offer some tips to help keep you out of the emergency department (ED) this season, as well as some guidance for times when you do have to visit.

7 Ways to Plan Ahead

  1. Wash your hands and mask when appropriate. It’s the best way to manage the spread of viruses, such as COVID, flu and RSV, according to Debbie Beach, BSN, RN, the nurse manager for the emergency department at The University of Vermont Health Network – Alice Hyde Medical Center. These simple tips are particularly important if your gathering includes any immunocompromised individuals or anyone who has been recently sick.
  2. Think small. Gary Starr, MD, the medical director for the emergency department at Alice Hyde Medical Center, says it’s a good idea to try to minimize large indoor gatherings, if possible, to reduce the spread of infections. “Getting together with family is fine,” he says, “but you might not want to have the whole block in one living room.”
  3. Keep enough medication on hand. Pharmacies may have limited hours during the holidays, and many of us are out of town and not close to our local drugstore. Plan ahead so you don’t run out of your prescriptions, because skipping or reducing doses puts you at risk. “And visiting the ED to refill a routine medication is less than ideal,” says Dr. Starr.
  4. Be aware of your, and others’, mental health. Both Beach and Dr. Starr are emphatic about this point. “As extended families spend more time together, relationship stresses may flare up,” Dr. Starr acknowledges. Both providers share they always see an increase in mental health crises during the holidays, so they encourage open conversations about your feelings. And Beach adds, “The holiday times can bring on increased anxiety for many, so it’s important to manage stress.” This could mean taking quiet time for yourself, getting regular exercise, and participating in activities you enjoy.
  5. Enjoy alcohol in moderation. Alcohol consumption can worsen existing physical and mental health conditions, from hypertension to heart failure to depression and more. Drinking also makes outdoor activities more dangerous. Dr. Starr adds, “Don’t drink alcohol before or while involved in things like driving, snowmobiling, skiing or ice fishing. Besides impairing your function and slowing your decision-making, alcohol also makes you feel warmer than you actually are, putting you at risk for frostbite.”
  6. Secure medications and firearms. If you don’t have young children, but are hosting a holiday gathering including young families, childproof your home. Lock away medications to prevent accidental ingestion. “Even very common, over-the-counter medications can be deadly,” Dr. Starr says. And always keep weapons locked and the key out of reach.
  7. Ask your specialist for guidance. If you’re under the care of a specialist, such as an OB/GYN or an oncologist, or if you’ve just brought home a newborn baby, ask your provider what warrants an ED visit, versus a call to your doctor’s office. “It helps to have a plan,” says Dr. Starr. “An otherwise healthy young child with an upper-respiratory infection and associated fever is usually not an emergency, but it’s understandable that some parents may not be familiar with the signs of a more serious illness. Ask your pediatrician for guidance if you’re unsure. We are always here to evaluate you for a medical emergency if the need arises, 24/7. If your doctor does refer you to the ED, be sure to let the ED physician know, since they probably won’t be aware of why you were told to come in.

If You Do Have an Emergency...

Dr. Starr notes that you can visit an urgent care center for minor injuries or illnesses that arise when you can’t get in to see your regular doctor. He emphasizes that you should always come to the ED if you feel that you’re in crisis or have an emergent medical condition that is more serious. It’s always better to be safe than sorry, and emergency providers are here to help. Sometimes, an urgent care provider may still send you to the ED if they worry that your condition is too complicated for the urgent care environment.

If you need to visit an ED or urgent care clinic, here are some things to keep in mind:

You may have to wait, and the wait may be longer during the holidays

When you make an unplanned visit to a health care center, it’s probably not going to be a quick in-and-out. “We’re staffed appropriately for the overall volume of patients we see, but it’s not possible to see every patient right away, especially when a trauma patient or a complicated medical emergency arrives at the same time,” Dr. Starr explains. This is the reason all patients are triaged – or assessed and prioritized according to the severity of their condition. “It is not first-come, first-served,” he says. And because of patient privacy, you won’t be aware of who else is there, and how serious their conditions are – so it may feel like others have cut you in line. “We do care about your ankle injury, for example, but we also care about your neighbor, who’s having a heart attack, and who needs to be treated first,” Dr. Starr advises.

It’s possible that you’re not having an emergency

While this is great news, these fortunate situations can leave some patients feeling like they didn’t get any treatment. For example, if you come in with symptoms of high blood pressure, the ED providers will make sure you’re not having a heart attack, stroke or other organ damage. If your exam and any test results are reassuring, the doctor may release you without completely fixing your blood pressure. While that can feel frustrating, Dr. Starr explains, “The emergency department is not the best place to fine-tune chronic conditions, like hypertension, once we’ve assessed for any related damage. The outpatient care setting is the most appropriate place to follow your progress or your responses to medication for chronic conditions over time. That’s why it’s important to follow up with your primary care doctor after an ED visit where we’ve ruled out an emergency condition.”

You may be referred somewhere else 

Just like the urgent care center may send you to the ED after their initial assessment, the ED may refer you to an outpatient specialist or even recommend transfer and admission to another hospital for certain conditions. “Some situations are too complex for treatment locally and will require a particular disease specialist either in consult, or during an outpatient follow up appointment,” Dr. Starr explains. While it may feel frustrating to have to start over with another triage nurse or be referred to a specialist who is not close by, rest assured you were referred for good reason, and providers are trying to find the best place to treat you.

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