Tag Archives: Trauma

Straight, No Chaser In The News: The Life Expectancy of Americans Drops for the First Time in 20+ Years

December 9, 2016General Health and Wellness, Public Health, Health Prevention844-SMA-TALK, accidents, Behind the Curtain, Cancer, Diabetes, drug overdose, high blood pressure, Hypertension, life expectancy, National Center for Health Statistics, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Stroke, TraumaJeffrey Sterling, MD

This is not a quirk, coincidence or mistake. Accordingly to the National Center for Health Statistics, for the first time in over two decades, life expectancy for Americans declined last year. This information is as shocking as it is rare.

Death rates increased in eight of the top 10 leading causes of death, including the following:

Heart attacks
Strokes
Diabetes
Drug Overdoses
Accidents

Deaths from Alzheimer’s disease represented the largest rate increase for any disease.

Even more concerning, these findings extend across all age groups and follow a five-year trend in which improvement in death rates were among the smallest improvements seen in 40 years. Death rates increased for white men and women and Black men, roughly staying the same for Black women and Hispanics. In case you were wondering, this increase in death rates is not being reproduced in other Western nations. The message here is there is a clear recent reduction in the health of the American citizen.
Many are confused and speculating about the causes for the near global reduction in life expectancy. Instead of guessing when the answers aren’t yet clear, I’d advise you to look for answers in the reporting on the only real positive finding: cancer showed a reduction in the death rate from cancer. The public health community would agree that specific innovation increase better prevention (specifically, fewer people are smoking), earlier detection (self-exams and adherence to screening regimens) and the development of new treatments that work best with good baseline health and early detection.

Straight, No Chaser has previously published a guide on how to live longer. Use these evidence-based pointers to buck the tide. Remember, misinformation and opinions are every bit as bad as bad health habits. Be informed and empowered.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Motor Vehicle Crashes

July 9, 2016Trauma844-SMA-TALK, motor vehicle collision, motor vehicle crashes, MVA, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, TraumaJeffrey Sterling, MD

‘Tis not our task to preach but to inform. Maybe you think you’ve heard it all before, but let me lay it all out for you so you can truly be an informed consumer. Forewarned is forearmed. There’s a reason you hear so much about drinking or texting and driving, wearing seat belts/helmets and speeding. If there was such a thing as Human Shark Week, the biggest and baddest predator in the trauma world would be motor vehicle crashes.
Motor vehicle collisons are the single leading cause of death among those between ages 5-34 in the US. More than 2.3 million adult drivers and passengers were treated in ERs as the result of being injured in motor vehicle crashes in 2009. Let’s lay this out simply and review the risks, the consequences and preventative efforts you should be taking.
Risky Behavior:

Danger is enhanced by various distractions and inadequate protection. The mistake people make is not understanding that much of the danger is outside of your control – other drivers. If you’re impaired or distracted, you can’t respond effectively. I’ve seen it all.

Drinking while driving – Stop it with the “I can handle my liquor” nonsense. Someone dies every hour from drinking while driving. It’s not just drunk driving, it’s impaired driving. Your senses are altered and ability to respond diminished at any level of alcohol consumption and is incrementally more so with more consumption.
Texting while driving
Eating while driving
Reading while driving
Doing your hair/shaving/makeup while driving
Kissing and other sexual activities while driving
Motorcycle driving/riding without a helmet
Letting your children drive without a license and/or formal training: it’s all too true. Teens are most at risk for accidents and being impaired/distracted/drunk while driving.
Letting your children ride in the front of the car
Not wearing seat belts (the biggest mistake of them all)

Injuries:

I’ve seen nearly every conceivable injury from motor vehicle collisions. It doesn’t take as much effort as you’d think to have a very bad life after a crash. Consider the following possible going head to toe (and yes, the list is abbreviated)…

Traumatic Brain Injury, including intracranial bleeds, strokes, seizures, concussions, herniation and death…
Neck Injury, including fractures, strains, pinched nerves, temporary and permanent loss of motion/sensation in your extremities…
Chest wall bruising, heart and lung bruising, collapsed lungs, stab wounds to the heart and lungs, ruptured heart vessels…
Abdominal injuries, including contusions to and rupture of the liver, spleen, pancreas, diaphragm and intestines…
Genital, urinary and pelvic injuries, including the kidneys and multiple fractures…
Nervous, psychologic and musculoskeletal system injuries, including contusions, life-threatening fractures and dislocations, paralysis, facial disfigurement and other scarring, post-traumatic stress syndrome and long term pain syndromes.

Prevention:

Seat belt use reduces serious injuries and deaths in crashes by 50%. Air bags provide added protection but are not a substitute for seat belts in a crash.
Wear a seat belt every time, every trip.
Seat all kids under 12 in the back seat.
Seat backseat passengers in the middle (it’s the safest spot in the car)
Regarding any function on a smartphone, if you can’t be hands free, it can wait. If you must use your hands, pull over.
Remember designated drivers? Yes, that’s still a thing.
If you’re on a motorcycle, wear a helmet, every time, every trip.
Protect your teen. No license, no vehicle. Consider driving school.

Impaired and distracted driving will cause you harm; it’s not an “if it’ll happen” situation, it’s “when it happens.” Please consider the points I’ve mentioned and the lives of passengers/other drivers when deciding how you handle your vehicle. Good luck on the road.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Broken Noses (Nasal Fractures)

June 12, 2016Head/Eyes/Ears/Nose/Throat, Trauma844-SMA-TALK, Conditions and Diseases, nasal fracture, rhinoplasty, saddlenose deformity, septal hematoma, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, TraumaJeffrey Sterling, MD

It’s curious how many patients with broken noses come into the emergency room smiling. Usually they’re kids whose parents “just want to be sure.” In these cases not much happens. The kids love to see the pictures of their x-rayed faces, and, as long as nothing more serious has also occurred, they come back for a follow-up after the swelling has gone down.
At the other end of the spectrum, a broken nose may be part of a devastating facial injury. In that case it’s very unlikely that anyone is smiling, and there are other symptoms accompanying the nose injury.

A broken nose (aka nose fracture or nasal fracture) is the most common facial fracture, and it describes one or a combination of the following:

There’s either a break in the cartilage or bone over the bridge of the nose.
There’s a break in the structure that divides the nostrils, called the septum.
There’s a break in the sidewall of the nose.

Signs and symptoms typically include a bloodied nose, difficulty breathing through the nose, deformed nose, pain, swelling and/or bruising around the eyes.

$nasalfractureclots$

There are serious concerns that either may result from or appear together with a broken nose.

Sometimes a collection of blood forms inside the nose. Failure to identify this can lead to further destruction of nasal cartilage, an abscess developing within the nose or the development of a permanent deformity causing breathing difficulty.
The nose structure itself can collapse if not repaired, particularly in the presence of retained blood.
Due to the nature of the force involved, neck injuries are often present with nose injuries.

If you have a broken nose, none of the above serious concerns should be a surprise. You should have symptoms that suggest the possibility of dangerous complications. Thus, it becomes important for you to know how to respond in the presence of a potentially broken nose.

Breathe through your mouth.
Lean forward to keep blood from going down the back of your throat.
Apply ice packs or other cold compresses to your nose without applying excessive pressure. This will reduce swelling.
Use acetaminophen (Tylenol) for pain. Other over the counter remedies may contribute to further bleeding.
Don’t manipulate or try to straighten your nose. Doing so could dislodge blood or spinal fluid being kept in check.
If a potentially serious injury has occurred, or if the injury involved a lot of force, avoid movement. A neck injury could be worsened with additional movement.

Here are some clues that you should make your way to an emergency room after a potentially broken nose injury:

Clear fluid is draining from the nose.
You have difficulty breathing.
Neck pain is present or a large amount of force was delivered to the face.
There is significant facial or nasal deformity.
You have uncontrollable bleeding.
You see a bulge inside either nostril.

Given that noses are a prominent part of our faces, be mindful to take simple protective measures when engaged in activities that could lead to broken noses. These are simple. Use protective headgear, seat belts and car seats, and avoid bar fights (or any other type of fight for that matter). That is a small price to pay for protecting your appearance!
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Mass Trauma, Community Stress and Post-Traumatic Stress Disorder

June 2, 2016Mental Health, Public HealthBehind the Curtain, Cognitive behavioral therapy, health, mental-health, Post-Traumatic Stress Disorder, Posttraumatic stress disorder, PTSD, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Symptom, TraumaJeffrey Sterling, MD

If you’ve been following the Straight, No Chaser series on post-traumatic stress disorder, it may have occurred to you that episodes that some might be able to handle when taken in isolation can have dramatically different psychological effects on others. It gives one pause and a cause to reflect on recent episodes in the news locally and abroad through a different prism.
This is the fourth in a series on Post-Traumatic Stress Disorder (PTSD).

For an introduction to PTSD, including signs, symptoms and those at risk, click here .
For a discussion of the diagnosis and treatment of PTSD, click here.
For a discussion of the effects of PTSD in children, click here.

When entire communities are affected by a mass trauma such as a natural disaster, a terrorist attack, the effects of war or even a seemingly senseless death within the community, many can develop signs of post-traumatic stress disorder (PTSD). In these instances, symptoms tend to develop in the first few weeks after the episode. This is a normal, expected and shared community response to serious trauma. Fortunately, when communities suffer trauma, resources are more likely to become readily available, which allows many to experience a lessening of symptoms over time.
In the immediate timeframe of the event, vital measures for physical and mental wellbeing should include the following.

Getting medically evaluated and to a safe place
Securing food and water
Contacting loved ones or friends
Learning what is being done to help and either provide or receive help as needed

Unfortunately, some individuals just do not get better on their own. Although most people tend to improve with time after a community disaster, it is not uncommon for some to become more distressed and to exhibit more symptoms of PTSD, depression, and other mental health conditions. There are so many variables in play based on the type of disaster that occurred. Some people are effective at rebuilding their lives if the available resources are appropriate for the type of effect it had on them personally, but others may experience ongoing stress from loss of jobs and schools, trouble paying bills, finding housing, and getting healthcare. These types of stressors compound the effects of the disaster and may delay recovery in those affected by PTSD.
Many in the public health communities are embracing a comprehensive version of mass trauma “psychological first aid.” This complement to medical and financial resources is meant to fill existing voids in post-community disaster care delivery. Otherwise treatment approaches are generally similar to treatment of other forms of PTSD.
At the end of it all, disasters are just that. It would be a good thing for you and your family to be aware of the types of community disasters you may be exposed to and prepare before you ever need help. Having emergency numbers and other resources on your person at all times can be the difference between life and death when seconds count. Here’s hoping you either never need such assistance or you’re prepared enough during a disaster to make it through ok.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Motor Vehicle Crashes

May 26, 2015Trauma844-SMA-TALK, motor vehicle collision, motor vehicle crashes, MVA, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, TraumaJeffrey Sterling, MD

It is sad to note that John Forbes Nash Jr., the brilliant Princeton University mathematician whose life story was the subject of the film “A Beautiful Mind,” was killed with his wife Alicia this past weekend in a crash on the New Jersey Turnpike. ‘Tis not our task to preach but to inform. Maybe you think you’ve heard it all before, but let me lay it all out for you so you can truly be an informed consumer. Forewarned is forearmed. There’s a reason you hear so much about drinking or texting and driving, wearing seat belts/helmets and speeding. If there was such a thing as Human Shark Week, the biggest and baddest predator in the trauma world would be motor vehicle crashes.
Motor vehicle collisons are the single leading cause of death among those between ages 5-34 in the US. More than 2.3 million adult drivers and passengers were treated in ERs as the result of being injured in motor vehicle crashes in 2009. Let’s lay this out simply and review the risks, the consequences and preventative efforts you should be taking.
Risky Behavior:

Drinking while driving – Stop it with the “I can handle my liquor” nonsense. Someone dies every hour from drinking while driving. It’s not just drunk driving, it’s impaired driving. Your senses are altered and ability to respond diminished at any level of alcohol consumption and is incrementally more so with more consumption.
Texting while driving
Eating while driving
Reading while driving
Doing your hair/shaving/makeup while driving
Kissing and other sexual activities while driving
Motorcycle driving/riding without a helmet
Letting your children drive without a license and/or formal training: it’s all too true. Teens are most at risk for accidents and being impaired/distracted/drunk while driving.
Letting your children ride in the front of the car
Not wearing seat belts (the biggest mistake of them all)

Injuries:

Traumatic Brain Injury, including intracranial bleeds, strokes, seizures, concussions, herniation and death…
Neck Injury, including fractures, strains, pinched nerves, temporary and permanent loss of motion/sensation in your extremities…
Chest wall bruising, heart and lung bruising, collapsed lungs, stab wounds to the heart and lungs, ruptured heart vessels…
Abdominal injuries, including contusions to and rupture of the liver, spleen, pancreas, diaphragm and intestines…
Genital, urinary and pelvic injuries, including the kidneys and multiple fractures…
Nervous, psychologic and musculoskeletal system injuries, including contusions, life-threatening fractures and dislocations, paralysis, facial disfigurement and other scarring, post-traumatic stress syndrome and long term pain syndromes.

Prevention:

Seat belt use reduces serious injuries and deaths in crashes by 50%. Air bags provide added protection but are not a substitute for seat belts in a crash.
Wear a seat belt every time, every trip.
Seat all kids under 12 in the back seat.
Seat backseat passengers in the middle (it’s the safest spot in the car)
Regarding any function on a smartphone, if you can’t be hands free, it can wait. If you must use your hands, pull over.
Remember designated drivers? Yes, that’s still a thing.
If you’re on a motorcycle, wear a helmet, every time, every trip.
Protect your teen. No license, no vehicle. Consider driving school.

Straight, No Chaser: Mass Trauma, Community Stress and Post-Traumatic Stress Disorder

May 7, 2015General Health and WellnessCognitive behavioral therapy, health, mental-health, Post-Traumatic Stress Disorder, Posttraumatic stress disorder, PTSD, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Symptom, TraumaJeffrey Sterling, MD

For an introduction to PTSD, including signs, symptoms and those at risk, click here.
For a discussion of the diagnosis and treatment of PTSD, click here.
For a discussion of the effects of PTSD in children, click here.

Getting medically evaluated and to a safe place
Securing food and water
Contacting loved ones or friends
Learning what is being done to help and either provide or receive help as needed

Unfortunately, some individuals just do not get better on their own. Although most people tend to improve with time after a community disaster, it is not uncommon for some to become more distressed and to exhibit more symptoms of PTSD, depression, and other mental health conditions. There are so many variables in play based on the type of disaster that occurred. Some people are effective at rebuilding their lives if the available resources are appropriate for the type of effect it had on them personally, but others may experience ongoing stress from loss of jobs and schools, trouble paying bills, finding housing, and getting healthcare. These types of stressors compound the effects of the disaster and may delay recovery in those affected by PTSD.
Many in the public health communities are embracing a comprehensive version of mass trauma “psychological first aid.” This complement to medical and financial resources is meant to fill existing voids in post-community disaster care delivery. Otherwise treatment approaches are generally similar to treatment of other forms of PTSD.
At the end of it all, disasters are just that. It would be a good thing for you and your family to be aware of the types of community disasters you may be exposed to and prepare before you ever need help. Having emergency numbers and other resources on your person at all times can be the difference between life and death when seconds count. Here’s hoping you either never need such assistance or you’re prepared enough during a disaster to make it through ok.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2015 · Sterling Initiatives, LLC

Straight No Chaser In The News: Your Teens Have Healthier Habits Than You

June 14, 2014General Health and Wellness, Public Health, Health Prevention844-SMA-TALK, CDC, Centers for Disease Control and Prevention, health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, TraumaJeffrey Sterling, MD

Your teens are healthier than you. From the department of good health news – on some very important measures, somehow it seems as if our youth have actually received and read the memo on health. According a recent survey from the Centers for Disease Control and Prevention (CDC), several measures of health have improved significantly in the teen population – with a few important exceptions.

These improvements include the following.

Cigarette smoking. Cigarette smoking among U.S. high school students has reached an all time low. Teen smoking is down to 15.7%. It was just over 15 years ago (in 1997) that the rate was 36.4%. Unfortunately, this still translates to 2.7 million high school students who smoke.
Armed trauma. The proportion of students threatened or injured with a gun, knife or other weapon on school property has dropped to 6.9%, from a peak of 9.2% in 2003. In the presence of so many school shootings, a ray of hope exists.
Fist fights. The proportion of students involved in fist fights was reported at 25%, which is down from 42% in 1991. The number of students having had a fight at school within the last year sits at 8%, which is down from 16%.
Soda consumption. 27% of teens had at least one soda daily, down from 34% in 2007.
TV viewing. 32% watched three daily hours of TV, down from 43% in 1999.
Other: Overall, teens are drinking less alcohol and are having less sex with more birth control use by females.

And now, the not so good news…

Condom use: Condom use is declining among the sexually active, being reported at 59%, down from a peak of 63% in 2003. Remember, HIV and other sexually transmitted diseases/infections haven’t gone away at all; we’ve just gotten better in controlling them. Now is not the time to get comfortable.
Texting and driving: 41% of those who drove admitted to texting or e-mailing while driving. This is bad anyway you look at it.
Cigar and other forms of smoking: Cigars are now as popular as cigarettes with high school boys. Cigars were smoked by 23% of 12th grade boys in the month before the survey. Smokeless tobacco use hasn’t changed since 1999, holding at about 8%. Other surveys have shown increases in e-cigarette and hookah use.
Computer time: 41% of teens report using a computer for non-school reasons at least three hours a day, up from 22% in 2003. Apparently this is where the TV time has gone.

What this really means is (wait for it!) your teens are educable. Discuss these topics with them and why it’s important to make healthy decisions. Of course it helps if you model the behavior.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser In The News: Distracted Driving

June 13, 2014Public Health, Trauma844-SMA-TALK, Distracted driving, drunk driving, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, TraumaJeffrey Sterling, MD

In the news are the unfortunate events surrounding comedian Tracy Morgan’s motor vehicle crash with a truck driver allegedly impaired due to sleep deprivation. I remember driving off the road years ago while eating a greasy fast food fish sandwich (you know the one). Would you believe that more than 1,000 people are injured and almost 10 people die every day in the U.S. due to distracted drivers? Of course you would, because virtually every individual who reads this has engaged in one distracted driving behavior or another at some point.

Driving is difficult. Unfortunately, it’s not always simply our actions that lead to motor vehicle crashes. These crashes often involve more than one vehicle, and sometimes a drunk, distracted or otherwise impaired driver hits another car, the driver of which may be completely at attention. Thus, driving without distractions is about giving yourself the best opportunity to react to the conditions around you.

The Center for Disease Control and Prevention (CDC) categorizes distracting driving into three main types:

Cognitive: taking your mind off of driving
Manual: taking your hands off the wheel
Visual: taking your eyes off the road

I know it seems like virtually anything you do in a car, from having a conversation to sipping on a drink qualifies, and in the event that seems a bit overbearing, remember you don’t get to see the consequences of all the bad decisions that lead to various death and other calamities that show up in an emergency room. If nothing else, today, I’d like for you to especially consider eliminating texting while driving because it combines all three of the above forms of distraction.

Here is additional data provided by the CDC.

In 2011, 3,331 people were killed in crashes involving a distracted driver, compared to 3,267 in 2010. An additional, 387,000 people were injured in motor vehicle crashes involving a distracted driver in 2011, compared to 416,000 people injured in 2010.1
In 2010, nearly one in five crashes (18%) in which someone was injured involved distracted driving.
69% of drivers in the United States ages 18-64 reported that they had talked on their cell phone while driving within the 30 days before they were surveyed.
In Europe, this percentage ranged from 21% in the United Kingdom to 59% in Portugal.
31% of U.S. drivers ages 18-64 reported that they had read or sent text messages or email messages while driving at least once within the 30 days before they were surveyed.
In Europe, this percentage ranged from 15% in Spain to 31% in Portugal.

Many states are banning texting while driving, or using graduated driver licensing systems for teen drivers to help raise awareness about the dangers of distracted driving and to keep it from occurring. That said, at the end of the day, this isn’t going to be legislated away. Even you will or won’t reduce your individual risk, and that can be done in some very specific ways.

While driving, place your phone out of reach, or just cut it off.
While a passenger, be assertive in preventing the driver from engaging in distracted activities.

It’s up to you. The life you save may be your own. I’ll text you later.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook atSterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Broken Noses (Nasal Fractures)

May 8, 2014Head/Eyes/Ears/Nose/Throat, Trauma844-SMA-TALK, Conditions and Diseases, nasal fracture, rhinoplasty, saddlenose deformity, septal hematoma, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, TraumaJeffrey Sterling, MD

A broken nose (aka nose fracture or nasal fracture) is the most common facial fracture, and it describes one or a combination of the following:

There’s either a break in the cartilage or bone over the bridge of the nose.
There’s a break in the structure that divides the nostrils, called the septum.
There’s a break in the sidewall of the nose.

Signs and symptoms typically include a bloodied nose, difficulty breathing through the nose, deformed nose, pain, swelling and/or bruising around the eyes.

$nasalfractureclots$

There are serious concerns that either may result from or appear together with a broken nose.

Sometimes a collection of blood forms inside the nose. Failure to identify this can lead to further destruction of nasal cartilage, an abscess developing within the nose or the development of a permanent deformity causing breathing difficulty.
The nose structure itself can collapse if not repaired, particularly in the presence of retained blood.
Due to the nature of the force involved, neck injuries are often present with nose injuries.

Breathe through your mouth.
Lean forward to keep blood from going down the back of your throat.
Apply ice packs or other cold compresses to your nose without applying excessive pressure. This will reduce swelling.
Use acetaminophen (Tylenol) for pain. Other over the counter remedies may contribute to further bleeding.
Don’t manipulate or try to straighten your nose. Doing so could dislodge blood or spinal fluid being kept in check.
If a potentially serious injury has occurred, or if the injury involved a lot of force, avoid movement. A neck injury could be worsened with additional movement.

Here are some clues that you should make your way to an emergency room after a potentially broken nose injury:

Clear fluid is draining from the nose.
You have difficulty breathing.
Neck pain is present or a large amount of force was delivered to the face.
There is significant facial or nasal deformity.
You have uncontrollable bleeding.
You see a bulge inside either nostril.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA). Enjoy some of our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

Straight, No Chaser: Mass Trauma, Community Stress and Post-Traumatic Stress Disorder

December 9, 2013Mental Health, TraumaCognitive behavioral therapy, health, mental-health, Post-Traumatic Stress Disorder, Posttraumatic stress disorder, PTSD, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Symptom, TraumaJeffrey Sterling, MD

This is the fourth in a series on Post-Traumatic Stress Disorder (PTSD).

For an introduction to PTSD, including signs, symptoms and those at risk, click here.
For a discussion of the diagnosis and treatment of PTSD, click here.
For a discussion of the effects of PTSD in children, click here.

When entire communities are affected by a mass trauma such as a natural disaster, a terrorist attack or the effects of war, many can develop signs of post-traumatic stress disorder (PTSD). In these instances, symptoms tend to develop in the first few weeks after the episode. This is a normal, expected and shared community response to serious trauma. Fortunately, when communities suffer trauma, resources are more likely to become readily available, which allows many to experience a lessening of symptoms over time.
In the immediate timeframe of the event, vital measures should include the following.

Getting medically evaluated and to a safe place
Securing food and water
Contacting loved ones or friends
Learning what is being done to help and either provide or receive help as needed

Unfortunately, some just do not get better on their own. Although most people tend to improve with time after a community disaster, it is not uncommon for some to become more distressed and to exhibit more symptoms of PTSD, depression, and other mental health conditions. There are so many variables in play based on the type of disaster that occurred. Some people are effective at rebuilding their lives if the available resources are appropriate for the type of effect it had on them personally, but others may experience ongoing stress from loss of jobs and schools, trouble paying bills, finding housing, and getting healthcare. These types of stressors compound the effects of the disaster and may delay recovery in those affected by PTSD.
Many in the public health communities are embracing a comprehensive version of mass trauma “psychological first aid”. This complement to medical and financial resources is meant to fill existing voids in post-community disaster care delivery. Otherwise treatment approaches are generally similar to treatment of other forms of PTSD.
At the end of it all, disasters are just that. It would be a good thing for you and your family to be aware of the types of community disasters you may be exposed to and prepare before you ever need help. Having emergency numbers and other resources on your person at all times can be the difference between life and death when seconds count. Click here for a related Straight, No Chaser on Mass Trauma, and here’s hoping you either never need such assistance or you’re prepared enough during a disaster to make it through ok.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Mass Trauma Alert – When Disaster Strikes

October 17, 2013Public Health, Trauma, Health PreventionBrain, Disaster, Duct tape, Family, Family (biology), First aid kit, Home and Garden, Hypertension, Limited liability company, Preparedness, Shopping, Sterling, Straight No Chaser (composition), Survival kit, Trauma, WordPressJeffrey Sterling, MD

If you’ve become a regular reader of Straight, No Chaser (thank you!), you will note the recurring theme of prevention. There’s often just not enough time to act in the midst of a life-threatening emergency. Today, I’m just asking you to put together a simple contingency, emergency supplies kit for whatever disaster may befall you and your family. Should you ever need it, I suspect you’ll be glad you did. The disaster you’re preparing for could last hours or more than a few days. Depending on where you live, it could be a hurricane, tornado, blizzard, or wildfire. Or maybe you’ve just become trapped inside your home; maybe you’re trapped outside your home, and your children are trapped at home. You might not have access to food, water, or electricity. With preparation of emergency water, food, and a disaster supplies kit, you can provide for and protect your entire family.
Without getting precise or complicated, it’s a very good idea to assemble a basic collection of items in the event of any emergency or disaster. All of this should sound basic and obvious, but, unless assembled and at the ready, you might not be able to access what you need. It would be good to strategically place kits at home, work, and/or car. Also consider any unique health and medical needs of your family, and include these in your kit. Store at least a 3-day supply, and if at all possible, up to a 2-week supply that will cover each member of your family. Don’t forget to consider your pets. Here’s a list of essentials. Use it to customize and develop your kit.

Water—one gallon per person, per day. This is a must. Think one half-gallon for drinking and another for food preparation and hygiene. If you are unable to store this much, store as much as you can without making your kit too difficult to maneuver. You can conserve water and energy of water by reducing activity and staying cool.
Food—nonperishable, easy to prepare items (Don’t forget the can opener.)
First aid kit
Medications (7-day supply) and any supplies needed to administer them
Flashlight
Battery powered radio (will last longer than the charge on your smartphone)
Cell phone with chargers
Extra batteries for everything
Multipurpose tool
Sanitation and personal hygiene items
Copies of personal documents (birth certificates, insurance policies, medication list and pertinent medical information, proof of address, deed/lease to home, passports, etc.) with family and emergency contact information
Extra cash
Emergency blankets and towels
Area maps
Extra house and car keys
Protective masks
Rain gear
Work gloves
Tools/supplies for securing your home
Extra clothing, hat, and sturdy shoes
Duct tape
Something to cut with (scissors, pocket knife)
Household liquid bleach
Entertainment items and other creature comfort items to help maintain your sanity

Pack the items in easy-to-carry containers, label the containers clearly, and store them where they would be easily accessible. Rollable trash containers and backpacks are very good for this purpose. In a disaster situation, you may need access to your disaster supplies kit quickly—whether you are sheltering at home or evacuating.
So there you have it. I’ve tried to be basic. Much more detailed information is available, and I’d suggest you tailor your kit to what types of disasters are most likely in your area. Take an hour and do this. Without a good disaster plan and kit, the disaster itself will only be the first wave of trauma to hit.
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Straight, No Chaser: Orthopedics Quick Tips – Learn How to Fall – The FOOSH injury

August 10, 2013Orthopedics/BonesColles' fracture, Emergency department, health, Injury, Orthopedic surgery, Orthopedics, Trauma, WristJeffrey Sterling, MD

We use a lot a acronyms in the Emergency Room, many of which can’t be repeated in polite company. Orthopedics and Trauma seem to lend themselves to a few. There’s GTSBOOM (got the stuff beat out of me, which is an all too common occurrence) and there’s FOOSH. FOOSH stands for ‘fell on outstretched hand’.
I bring this up because you need to learn how to fall. FOOSH injuries predictably cause fractures of the distal radius and ulnar (the two bones of the forearm), usually down by the wrist. These injuries are incredibly common and avoidable. The most notable injury is the Colles fracture, which is a distal radius fracture. You’ll know you have it after a fall when your wrist assumes the typical ‘dinner-fork deformity’.
$colles-fracture1$
So next time you fall, try to make it a glancing blow and avoid placing the full weight of your body on those wrists. Try to land and roll when you hit – but be extra careful to avoid bumping your head by doing this. If you get this right, it could save you 6 weeks in a splint, cast or in some cases a trip to the operating room.

Straight, No Chaser: Trauma Quick Tips and The Week In Review

August 4, 2013Medical Treatment, Health PreventionAvulsed tooth, Carbon monoxide detector, Carbon monoxide poisoning, Conditions and Diseases, Distracted driving, Head injury, health, Hypertension, Penetrating Trauma, Permanent teeth, Straight No Chaser, Trauma, WordPressJeffrey Sterling, MD

This week in Straight, No Chaser, we reviewed multiple topics related to Trauma, the #1 cause of death between ages 1-44. Here’s the Week In Review and featured Quick Tips.
1) Over the weekend, we started with discussions of Amputations of Permanent Teeth and Fingers.

Remember, you lose 1% viability per minute for a dislodged tooth. Get help quick! https://jeffreysterlingmd.com/2013/07/27/straight-no-chaser-saturday-quick-tips-the-tooth-of-the-matter-is/
The transport of displaced fingers and teeth is vital to successful reimplantation. Never place them directly on ice! https://jeffreysterlingmd.com/2013/07/28/sunday-quick-tips-give-me-the-finger/

2) On Monday, we talked about Motor Vehicle Crashes.
https://jeffreysterlingmd.com/2013/07/29/straight-no-chaser-human-shark-week-part-1-motor-vehicle-trauma/
https://jeffreysterlingmd.com/2013/07/29/trauma-quick-tips-how-to-survive-that-motor-vehicle-crash-mvc/

Avoiding distracted driving is the most important factor in preventing crashes.
Wearing your seat beat is the most important factor in surviving crashes.
The middle back seat (while wearing a seat belt) is the safest place in the car.

3) On Tuesday, we reviewed Traumatic Brain Injuries/Concussions.
https://jeffreysterlingmd.com/2013/07/30/straight-no-chaser-heads-up-traumatic-brain-injuries-concussions-part-i/
https://jeffreysterlingmd.com/2013/07/30/straight-no-chaser-heads-up-traumatic-brain-injuries-concussion-part-ii/
https://jeffreysterlingmd.com/2013/07/30/straight-no-chaser-concussions-post-script-a-neurologists-thoughts/

Dr. Flippen, a neurologist from UCLA, reminded us that most patients will recover but never as fast as they wish.
After a head injury, expect not to be released back to sporting activity for at least two weeks.

4) On Wednesday, we reviewed Mass Disasters and talked about the importance of an Emergency Kit.
https://jeffreysterlingmd.com/2013/07/31/straight-no-chaser-when-disaster-strikes/

Remember to have access to 1 gallon per day per person, half for drinking and half for cooking/hygiene.

5) On Wednesday, we also discussed Dog, Cat and Shark Bites.
https://jeffreysterlingmd.com/2013/07/31/straight-no-chaser-who-let-the-dogs-out-animal-bites/

Cat scratches are also a major infection risk and should be evaluated.
Who’d have thought sharks were nibbling you out of curiosity instead of biting you out of hunger?

6) On Thursday, we reviewed Penetrating Trauma (Gunshot and Stab Wounds). https://jeffreysterlingmd.com/2013/08/01/straight-no-chaser-gunshot-and-stab-wounds/

Remember the ‘Golden Hour’ of Trauma and get seen as soon as possible after being stabbed or shot, just as soon as you ensure your safety.
It is very important to avoid worsening possible spinal injuries by excessive movement.

7) On Friday, we reviewed Residential Fires and its associated trauma.

In Part I, we emphasized the importance of installing smoke and carbon monoxide detectors, having an escape plan and not sticking around to fight the fire. https://jeffreysterlingmd.com/2013/08/02/straight-no-chaser-the-roof-is-on-fire-the-trauma-of-residential-fires/
In Part II, we discussed treatment of possible injuries that may occur. https://jeffreysterlingmd.com/2013/08/02/straight-no-chaser-your-questions-on-treatment-of-fire-related-injuries/
Remember if any head or neck injuries exist, try your best not to move.
Remember that if you’re feeling like you have the flu after being exposed to a fire, it could be carbon monoxide poisoning!

8) On Saturday, we reviewed Snakebites.
https://jeffreysterlingmd.com/2013/08/03/straight-no-chaser-stop-the-life-you-save-may-be-your-own-snake-bites/

We debunked the myth about sucking venom out of snakebite wounds. Don’t do it!

9) Saturday, we also reviewed Elderly Falls.
https://jeffreysterlingmd.com/2013/08/03/straight-no-chaser-ive-fallen-and-cant-get-up-quick-tips-on-elderly-falls/

We identified head injuries/bleeds, lacerations and hip fractures as injuries to guard against.
We discussed the importance of home improvements, diet, exercise and checking for osteoporosis and vision checking for maintainance of health.

Straight, No Chaser: Why is Life so Traumatic? (aka Human Shark Week!)

July 28, 2013Trauma, Health PreventionAnxiety, Centers for Disease Control and Prevention, Conditions and Diseases, health, mental-health, Post-traumatic Stress, Shark Bites, TraumaJeffrey Sterling, MD

Introduction

If there were a human equivalent to shark week, it would be TRAUMA WEEK! That’s right. Trauma has all the drama, excitement and tragedy as shark bites and often makes about as much sense as exposing yourself to a shark.

Trauma is the #1 cause of death between ages 1 and 44. In fact, according to the Centers for Disease Control and Prevention, trauma accounts for more deaths during the majority of life than all other causes combined, checking in at just over 50%. Traumatic causes of injury are so common and avoidable that it’s worth looking at the top entities separately. This week we will do just, informing you of where the danger lies and offer simple tips to keep you alive.

So buckle up (literally). We’ll get into motor vehicle collisions, brain injuries, domestic abuse, suicides and homicides, drownings and other home/recreational injuries. Trauma. Unfortunately, it’s for everyone.

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