Category Archives: Medical

Basic First Aid Following a Gunshot Wound

A former attending emergency medicine physician at Cedars-Sinai Medical Center in Los Angeles, California, Dr. Zachary Lutsky has been practicing medicine for more than 10 years. Over the course of his career, Dr. Zachary Lutsky has managed and treated patients suffered from a variety of traumatic injuries, including gunshot wounds.

Although many people never have to deal with a gunshot wound, knowing a few basic first aid techniques for promoting survival following such an injury is important. As soon as you or someone near you is shot, the first step is to always get to safety and call 911. Once this is done, focus on stopping the bleeding. While gunshot wounds primarily cause internal damage, external bleeding is the only aspect of the injury you can help with if you’re untrained.

With gunshot wounds, the bleeding is typically coming from a hole. Using a clean cloth, gauze, or any other fabric available when a kit is not present, place pressure directly on the wound. For wounds that are deep, pack some of the cloth into the wound. Make sure the entire wound is sealed by the fabric and do not reduce pressure until paramedics arrive on the scene. Further, don’t be scared about using your knee to provide even more pressure if the wound is still bleeding.

In addition to applying pressure directly to the wound, use a tourniquet when the wound is on a limb. Place the tourniquet about two to three inches above the wound and pull it as tight as you can. When properly placed, these devices are usually very uncomfortable and even painful, but they can be essential for stopping the bleeding from a wound. It’s important that you remember to only use a tourniquet when it’s a professional one. Since improvised tourniquets often fail, it’s better if you apply continuous pressure directly to the wound instead.

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When a Burn Is an Emergency

For more than two decades, Dr. Zachary Lutsky has practiced emergency medicine as an attending physician. Dr. Zachary Lutsky has delivered timely care to patients suffering from acute traumatic injuries, including severe burns.

Burns caused by heat, chemicals, or the sun vary in degrees of severity. First-degree burns affect the outermost layer of the skin and can be treated with first aid. However, when first-degree burns cover a large portion of the body, such as an intense sunburn, a trip to urgent care may be helpful.

Second- and third-degree burns are far more serious and always require medical attention. In a second-degree burn, a deeper layer of skin is burned, leaving large, weeping blisters. Second-degree burns are especially dangerous if they cover more than 10 percent of the body or if they appear in sensitive areas, such as the face, groin, and hands.

A third-degree burn of any size, due to the extensive tissue damage, should be treated as an emergency. Third-degree burns can make the skin appear brown or charred and are often painless because of nerve damage.

Three Factors Contributing to Antibiotic Overprescription

Zachary Lutsky
Zachary Lutsky

Zachary Lutsky, MD, has been working as an emergency medicine physician for more than a decade. During this time he has cared for patients at several institutions, including Cedars-Sinai Medical Center in Los Angeles, and earned board certification in emergency medicine. Beyond that, Zachary Lutsky, MD, has developed a professional interest in such topics as antibiotic overprescription.

According to research from the Pew Charitable Trusts and the Centers for Disease Control and Prevention (CDC), roughly one in three prescriptions of antibiotics is unnecessary. This habit of over prescribing antibiotics contributes to the increasing number of antibiotic-resistant bacteria. Following are several things driving this unnecessary antibiotic use:

Patient satisfaction

When patients visits their doctors, they often expect that they will receive a prescription, regardless of whether the prescription is necessary or not. Some patients will demand that antibiotics be prescribed, while others won’t. Still, whether it’s perceived by the physician or real, the pressure for doctors to prescribe something to patients influences their decision to prescribe antibiotics more frequently.

Safety

Physicians aren’t always sure what’s making a patient sick. Often certain conditions, such as a cold, shares remarkably similar symptoms to more serious illnesses, like pneumonia. To protect their patients from an undiagnosed or misdiagnosed illness, many doctors will prescribe antibiotics as a safeguard.

Decision fatigue

Doctors are responsible for repeatedly diagnosing and treating many of the same conditions. This ultimately leads to decision fatigue, a situation that occurs when a physician’s decision-making abilities decline due to making repetitive choices about treatment. It’s believed that decision fatigue plays a role in the inappropriate prescribing of antibiotics, and interestingly, studies have shown that physicians are more likely to prescribe antibiotics later in their workday.

Heart Attacks – Causes and Risk Factors

Zachary Lutsky
Zachary Lutsky

An experienced emergency physician, Dr. Zachary Lutsky is trained to provide lifesaving care to patients undergoing heart attacks and other urgent health events, as he did during his service at Cedars-Sinai Medical Center in Los Angeles. In preparation for his career, Dr. Zachary Lutsky underwent his emergency medicine residency at Harbor-UCLA Medical Center in nearby Torrance.

A heart attack occurs when the flow of oxygen-rich blood supplied by the coronary arteries is blocked or reduced, imperiling heart function. If enough damage occurs, the heart goes into arrest, which can quickly lead to death. Patients with coronary artery disease have a buildup on the artery wall called plaque, made up of fat, proteins and other material. When the plaque cracks, the body sends blood-clotting factors to the site. The resulting clot can interrupt blood flow to the heart, giving rise to a heart attack. Coronary artery spasms, a less common cause,also interrupt blood flow to the heart.

Some risk factors for heart attack include uncontrollable issues like age and family history. However, many other factors are related to lifestyle and can be addressed by changes in behavior, like quitting smoking, adopting a healthier diet, and exercising.