A well established California emergency medical care provider, Zachary Lutsky, MD, maintains active membership with the American Board of Emergency Medicine. Experienced in diverse aspects of medical treatment, Dr. Zachary Lutsky has a personal interest in the overprescription of antibiotics and how this is leading to antibiotic resistance.
A recent article in Wired examined the “Catch-22” involved in this issue, with a recent article published in The New England Journal of Medicine pointing toward decreased mortality among African children from trachoma when provided with annual doses of the antibiotic azithromycin.
The issue is that, while saving lives, the practice of healthy children being given antibiotics is generally proscribed because it expedites the process of bacteria adapting to medicines and developing resistance. The question starkly presented is whether the trade-off of one child’s current survival vs. a potential future death from drug-resistant infection is worth it.
This very issue was documented within the study, with the children taking antibiotics no longer susceptible to trachoma, yet experiencing greater resistance from pathogens such as E. coli and streptococcus pneumoniae. The bottom line is that in order to minimize use of antibiotics in the developing world, aspects of health such as nutrition, sanitation, and water must be emphasized.
In 2006, Dr. Zachary Lutsky began his career as an emergency physician, and has spent most of his carereers handling the sickest of patients at Level 1 trauma centers including the Harbor-UCLA and Cedars Sinai medical centers.
In addition to calling for 911 and securing the scene of the accident or trauma, bystanders can act as first-responders and provide care until help arrives. The key to providing meaningful aid during an emergency is to obtain adequate training in advance. The actions of a trained bystander can mean life or death. First-aid courses are offered around the country at hospitals and medical centers, by public safety agencies, and by the Red Cross, to help people learn skills such as the following:
Heimlich Maneuver – This involves pressure on the abdominals from behind to dislodge an object that is blocking a choking victim’s airway. The Heimlich can also be performed alone, using a chair.
Treating Deep Wounds – The most vital step is to stop the bleeding by applying pressure and elevating the wounded area. First-aid providers should try to be as sterile as possible, using gloves and bandages if available.
Managing Shock – People can go into shock after a sudden injury. Some symptoms include sweating, confusion, and shallow breathing. Bystanders who recognize these signs in an accident victim should help him/her lie down and provide a blanket to help stabilize body temperature.
Board-certified emergency physician Zachary Lutsky has served in the emergency department at Cedars-Sinai Medical Center in Los Angeles and at Santa Clara Valley Medical Center in San Jose. In these departments, Dr. Zachary Lutsky dealt with a wide range of emergency situations, including frequently fevers in young children.
When a child has a fever, many parents assume the worst and immediately take the child to the emergency room. While this isn’t necessarily a bad thing to do, low-grade fevers are not always a cause for concern. Most fevers can be handled at home with over-the-counter medications and pediatrician follow up.
Parents should take a baby under the age of 3 months to see a physician when its temperature reaches 100.4 degrees Fahrenheit. Infants should see a doctor at this low-temperature threshold because their immune systems are not fully developed and their bodies cannot properly defend against an infection. A trip to the ER may also be needed if a fever is accompanied by vomiting, difficulty breathing, a rash, or nonstop crying.
Children between 3 months and 3 years with temperatures over 102.2 degrees may be a cause for concern, as are fevers with difficulty waking or inability to keep down fluids. When children are over the age of 3, they usually can handle a fever of 102 degrees for a few days without concern. It is most important to look at the child rather than the number on the thermometer when deciding if they need to come in emergently. A child with a high fever who is running around and playing can probably wait to their pediatrician in the office.
For more than 10 years, Dr. Zachary Lutsky served as an attending physician in the emergency department at Cedars-Sinai Medical Center in Los Angeles. During that time, Dr. Zachary Lutsky saved the lives of many patients, including a stroke victim who later returned to the hospital to thank Dr. Lutsky and the rest of the emergency department.
The early signs of stroke may be remembered by the acronym “BE FAST.” The letter “B” stands for balance. Many patients who experience a stroke suddenly lose coordination or balance before the stroke occurs. This makes it difficult for them to touch their finger to their nose and affects their ability to walk in a straight line.
The “E” stands for eyes. One of the other early signs of stroke is a rapid change in vision, such as blindness in one eye or double vision.
The symptoms represented by “FAST” are more well-known signs of stroke. “F” refers to face drooping or numbness on one side, while “A” refers to arm weakness or numbness on one side of the body.
Speech difficulties are represented by “S” and usually include slurred or unclear speech. Many people experiencing a stroke will struggle with saying “The sky is blue,” so this sentence serves as a good test.
Finally, the “T” stands for “Time to call 911.” If any of the above symptoms are shown, call 911. Callers should write down the time the symptoms started and note if any symptoms have disappeared before emergency responders arrive.