You’re coming to the hospital to give birth.

You’ve had a hip replacement and now will have a hospital stay to complete rehabilitation.

There are a lot of things swirling through your mind, notably thoughts like “Am I going to be OK?”

Questions like “Where is my toothbrush?” are probably on the backburner. That’s why it’s a good idea to make a “hospital essential items” checklist now.

Kurt Bloomstrand, MD, sees these scenarios plenty while providing care in the emergency department at OSF HealthCare. He says a hospital will provide basic toiletries, blankets, food and clothing like a gown and socks. But some people prefer their own toiletries, clothes and snacks.

Other things to do and bring:

· Write down your health information: health insurance, medications, medical history, name of your primary care provider, allergies and legal documents like power of attorney and a do not resuscitate order. Have an identification like a driver's license, too.

“Some people in the emergency department are not able to tell us their health information given what they’re presenting for. So, it’s so valuable to have basic health information written down,” Dr. Bloomstrand says. He adds that knowing your health information allows providers to care for you properly. You can also bring legal forms to your provider anytime to be added to your medical record.

· Bring other items essential to your well-being: eyeglasses, contacts, hearing aids, dentures and a continuous positive airway pressure machine (CPAP) for sleeping. Bring cases and batteries for these items, too.

· When choosing clothes, opt for loose-fitting and short-sleeved garments.

“If you have an IV, a short-sleeved shirt is much better to access it than a long-sleeved shirt,” Dr. Bloomstrand says. “You can bring a robe to cover up.”

· For moms giving birth, bring your birth plan in written form. Pack a few pairs of clothes for you and your baby.

“Babies notoriously spit up on their clothes,” Dr. Bloomstrand says with a smirk.

The hospital can provide diapers, wipes and a breast pump. But, you can bring your own if you prefer a certain type.

“Not only can you use your breast pump, the people at the hospital can teach you how to use it,” Dr. Bloomstrand says.

What babies don’t need at the hospital: rattles, books and toys. Save those memories for home.

· Don’t overdo it with personal items and food. This can cause your room to get cluttered and create a trip hazard. Have someone who can take unneeded items home.

· Don’t bring valuable items. Dr. Bloomstrand says a phone is OK to keep in touch with loved ones. But other electronics and jewelry should stay home. Hospitals have security, but like any other place, there is a chance for theft.

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When Gordon Ramsay raises his voice, it’s usually about an undercooked dish.

But in 2024, the celebrity chef was calling for help after a scary bicycle accident.

“It really shook me,” says the avid cyclist in a June 15, 2024, Instagram post. “Honestly, I’m lucky to be here.”

Ramsay says he didn’t suffer any major injuries, but he’s bruised and on the mend. And he’s again joining health care professionals in stressing the importance of wearing a helmet and biking within your means.

“I don’t care how short the journey is,” Ramsay says.

Biking accidents in the emergency department

Kurt Bloomstrand, MD, an emergency medicine physician who sees patients at OSF HealthCare, has treated people who have fallen off a moving object. It could be a bicycle, scooter or motorcycle. Sometimes it’s a child who’s learning their way. Or it could be an adult who didn’t hit the brakes in time.

“A lot of times what happens is they fall off the bike, put their arm out to protect themselves and injure their arm,” Dr. Bloomstrand says.

“But most importantly, we also see head injuries. We know that people who get in a bike accident have better outcomes if they’re wearing a helmet. People that are not have a higher risk of head injuries and traumatic brain injuries,” he adds.

Those head injuries are not something to take lightly, Dr. Bloomstrand says. Traumatic brain injuries can result in lifelong complications or death.

“When we see people in the emergency department who have suffered from a bicycle accident, we’re going to do a rapid trauma assessment,” Dr. Bloomstrand explains. “We’re going to pay special attention to the head. We’re going to make sure there are no signs of skull fracture or neurological abnormality. Depending on the severity of the injury, we may do a CAT scan [also called a CT scan] to make sure there’s no internal injury like bleeding on the brain. Those internal injuries are life-threatening emergencies that need to be addressed quickly.”

Advice

Check these off your list the next time you get on a bicycle or something similar:

• People of all ages should wear a helmet while biking. Young kids who are learning to ride should also wear knee elbow pads.
   
• Long shirts and pants and closed toe shoes (not sandals) are better than bare skin if you fall and skid on pavement (commonly called “road rash”).
   
• Be alert when riding. Don’t ride while tired or under the influence of alcohol or drugs. If you’re listening to music, consider having one ear free so you can hear your surroundings.
   
• Don’t ride above your means. Choose a speed and terrain that fits your skills.
   
• Keep your bike in good condition and configured to match your height. Your feet should touch the ground when seated. This should be true for all ages. A child should not “grow into” a bike. 
  
  At night, a headlight, reflectors, flag and a horn help you to be seen and heard. Bright-colored clothing also helps your visibility at night.
   
• Look closely before crossing an intersection, and obey all traffic laws. This typically includes riding on the right side of the road. Use universal hand signals: left arm straight for a left turn, left arm bent up for a right turn and left arm bent down for a stop. Make eye contact with the driver of a vehicle before passing in front of them.
   
• One person should ride a bike at a time, and keep both hands on the handlebars. Put items like books in a backpack or basket. Don’t try to carry items and ride.
   
• If you or someone you’re with suffers a bike injury, call 9-1-1 immediately.

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It’s the dead of winter, and you need to run to the mailbox or let your dog out. It’s just a minute, you think. A sweater and sandals will be fine.

Not so fast, says Maddy Draper, APRN, a health care provider at OSF OnCall who sees cold weather injuries often. She says exposure to frigid temperatures can have serious consequences.

Types of cold weather injuries

• Frostnip: Draper says this is a mild form of frostbite where exposure to cold temperatures turns the skin pink or red. Your skin may feel burning or numb.

“The numbness typically goes away with rewarming,” Draper says.

• Frostbite: This is a more severe case of cold exposure. Your skin may be numb and appear yellow, white, gray or black. It may feel waxy and have blisters.
   
• Hypothermia: This is when the body’s temperature drops below 95 degrees.

“There are different stages,” Draper explains. “The first is our natural response of shivering. It gets more severe. The person may get confused and have lethargy, memory loss and slurred speech. It can lead to a coma and death.”

Inside, too?

Yes, there’s a risk for these injuries inside, too, Draper says. Notably, there have been cases of infants getting hypothermia.

“The room may be too cold, and they’re not dressed appropriately,” Draper says. “If they’re in a bassinet or crib with just a onesie and it’s cold, that can lead to hypothermia.”

Signs of infant hypothermia are bright red skin and decreased energy. Sleep experts use a thermal overall grade scale (TOG) to suggest how much clothing a baby should wear to sleep depending on the temperature of the room.

Treatment

Draper says she usually sees cases of frostbite and hypothermia sent to the emergency department. Providers will rewarm you with warm water or blankets and may provide warm liquids to drink, warmed oxygen through a mask and nasal tube or heated fluids through an intravenous line (IV) or other methods. Medication can also help with pain and blood flow.

“The hospital has more imaging resources to see the impact of the tissue damage,” compared to urgent care, Draper says.

For frostnip, you can take steps to warm up at home.

“It’s not as fast as possible. It’s not as hot as possible. It’s just that gradual warming,” Draper says. “Get off your cool or wet clothes immediately. You don’t want to stick your hands or feet into hot, steaming water. Just warm water.”

That’s because hot water can burn your skin. And if your skin is numb, you may not feel the burn before the damage is done. If water is not available, you can place your hands in your armpits. And handle the sensitive skin gently. Don’t rub or massage it. If your feet are affected, get off your feet.

Prevention

Draper says older adults, people who work or do activities outside (like hunters or hikers), unhoused people and people with medical conditions (like peripheral artery disease, diabetes and Raynaud’s disease) are at a higher risk of cold weather injuries. Getting stranded in a vehicle without proper protection is also common in the winter. Drinking alcohol or using drugs may lead to you losing consciousness outside. And smoking impacts blood circulation, putting you at a higher risk, Draper says.

Some ways to beat the cold:

• Dress in layers. You can always take a layer off, but you can’t put one on if you leave it at home. Make a hat, scarf, gloves and winter boots part of your wardrobe. Make sure the clothes aren’t too tight to allow for blood circulation. And look for water-resistant garments when buying clothes.
   
• Have winter weather supplies, like blankets, flares, a first aid kit and food, in your vehicle.
   
• Be well fed and hydrated. Body fat, though unhealthy in excess, helps us stay warm. For drinks, avoid alcohol and caffeinated beverages.
   
• During outdoor activities, take breaks and go with a buddy. Keep a close eye on kids who may not realize how cold they are. Come inside to change from wet to dry clothes. Let others know your plans and when you’ll be back. If you’re not back in time, that’s a sign you may have fallen victim to the cold, and help should be sent.

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It’s something Michael Daley, MD, sees in the emergency department often and especially this time of year: chronic obstructive pulmonary disease, or COPD.

Dr. Daley, who provides care at OSF HealthCare, says while there’s no cure for COPD, medicine has come a long way to improve your quality of life with the disease.

COPD basics

Dr. Daley says more than 300 million people suffer from COPD, and it’s is the fourth leading cause of death worldwide.

“It’s a destruction of the lung tissue in the airways. A lot of inflammation and destruction over time that causes the condition to manifest itself in people in different ways,” Dr. Daley says.

Those ways include shortness of breath, chest tightness, coughing and fever. Dr. Daley points out that those symptoms overlap with a similar disease: asthma. But each has their differences, too.

“Asthma is seen as a disease of the young. People with asthma usually have that diagnosis at a much earlier age than someone with COPD,” Dr. Daley explains. “The textbooks will tell you that you typically see COPD in the sixth decade of life. So, people in their 60s, 70s and 80s.”

Treatment

Dr. Daley says many of the people he sees know they are having a COPD flare up.

“We immediately get them into a room. We put them on oxygen. We initiate various therapies that have been shown throughout the years to work well,” he says. “We’d give them steroids, antibiotics and inhalers over the course of one to three hours. We observe them and watch them improve.”

Though Dr. Daley says it’s not frequent, people can come to the hospital with a severe COPD flare up.

“They’re not moving any air at all. They’re in extreme distress,” he says.

That person would go on a ventilator to, first and foremost, save their life, but also to get them breathing more easily again. Dr. Daley says after a few days on a ventilator, health care providers would then tap into other treatments.

Long-term, a person may go on a nebulizer. It’s a machine that delivers a mist of medicine inside your body through a mouthpiece or mask. The medicine helps your airways to relax and expand, allowing you to breathe easier. This is different from an oxygen tank.

Pulmonary rehabilitation in a hospital or clinic is also a common part of treatment. Like lifting weights to build up muscle, pulmonary rehab involves exercises to work your way back to as normal breathing as possible.

“Often they’ll do what’s called chest physiotherapy. They wear a percussion vest. That helps them cough up a lot of mucus and phlegm inside their lungs that’s preventing them from breathing [well],” Dr. Daley says. “They also do a lot of breathing exercises that will help their airways expand. That leads to a better quality of life.”

Prevention

Dr. Daley says smoking tobacco is a leading cause of COPD, especially in the United States. Worldwide, air pollution is also a trigger, whether that’s outdoor smog or indoor dust and dander.

“We’re actually seeing a much younger population presenting with COPD. People in their 30s and 40s. Just because of very heavy tobacco usage,” Dr. Daley says.

So if you’re a smoker, make a plan to stop. If you live in a smoggy area, avoid prolonged exposure. Consider wearing a mask when outside. And keep your home clean and well-ventilated.

Dr. Daley adds that respiratory viruses like influenza can make COPD worse, leading to an uptick of cases in the winter. So, take basic hygiene steps to avoid those seasonal illnesses: wash your hands, cough and sneeze into your elbow, stay home when sick and be up to date on vaccinations.

Learn more

Read more about how OSF helps people with conditions like COPD recover at home.

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“I found a lump.”

It’s the unsettling phrase providers sometimes hear from women when they are performing their monthly breast self-check for cancer signs.

But lumps are not the only thing to watch for, says Heather Thompson, an OSF HealthCare breast health navigator who is herself a breast cancer survivor.

Signs to know

Each month, keep these in mind.

• Lumps, the most talked about sign.

“A lot of women, especially younger women, have very dense breasts. Sometimes it feels like a bag of rice with little bumps. That’s just the tissue,” Thompson says. “When you feel a hard nodule, fixed in place or sometimes mobile, you definitely want to get that reviewed.”

• Skin changes. This could be an orange peel skin appearance, flaky skin, irritation or a new dimple.
   
• Unexpected release of fluid or blood from the nipple. For example, if you are not breastfeeding, a nipple discharge would be unexpected.
   
• Unexpected inversion of a nipple.
   
• One breast larger than the other, or generally, any unexpected change to breast size.
   
• Any new pain in breast area.
   
• Tenderness, swelling, pain or lumps under your armpit. This is one some women may overlook since it doesn’t deal with the breasts.

“Your lymphatic system drains to armpits,” Thompson explains. “So, if there’s anything going on in the breast, it’s going to show up in your armpit eventually.”

When and how

Thompson recommends women pick a date each month for a self-check and stick with it. The first of each month, for example. This way, you can put it on your calendar, and it’s easy to remember. And, she says the feel of your breasts will change as days go by. But, choosing the same time each month gives you a baseline feel and helps avoid false positives. Thompson also advises making your chosen date a week after your menstrual cycle ends.

Thompson says many women find it convenient to examine themselves in the shower. Regardless of where, she says a good technique is to move your fingertips in a circle from the outside to the center of the breast, pressing down and feeling for abnormalities. Then, do the same under each armpit. And also, glance in the mirror for a good look at visual signs, such as one breast larger than the other.

Some women have a trusted adult, like a spouse, also feel their breast for a second opinion. Others may take photos during their self-check to show their provider. Both ideas are acceptable, Thompson says.

“When you go to the doctor, they can look at the picture. If the abnormality has changed or gone back to normal, then we know it’s nothing to really worry about. But if the issue has increased in size or looks worse, it’s something to be concerned about,” she says.

What happens next

If you find something concerning in a self-check, call your primary care provider or OB/GYN right away and explain what you found. Thompson says the provider will likely order a diagnostic mammogram, an outpatient procedure at a doctor’s office. The radiologist should read the results on the spot. If a closer look is needed, you may undergo an ultrasound, another way to image the breast, or a biopsy, which takes a tissue sample for testing.

It's important not to panic, Thompson stresses. If you have severe pain or an abscess, you should go to the emergency department. But for abnormal findings on a self-check, that’s not necessary.

“If you go to the emergency department with a lump, they’re going to send you home, and you’re going to have to go through the process of calling your provider.

“Breast cancer is not going to change that drastically in three to four weeks,” Thompson adds. “It’s not going to make that big of a difference. However, you want to get yourself scheduled and be proactive. Don’t say ‘Oh let me watch it for a few months and see if it changes.’”

But do keep track of any changes between when you make the appointment and appointment day.

Why it’s important

Thompson says a monthly self-check goes hand-in-hand with regularly scheduled mammograms as the most important ways to prevent breast cancer. You should talk to your primary care provider or OB/GYN about what mammogram schedule is right for you.

“Typically, we do a mammogram every year to get the breast image,” Thompson says. “But during the year, things can develop that you don’t notice. Some things can develop very quickly.

“By doing a monthly exam, you learn your body. You know how it feels,” she adds. “Each month you may say ‘Well I didn’t remember that there last month.’ So you can address it right away.”

Early detection is key for a better outcome. Conversely, unchecked breast cancer is a major killer in the United States. The American Cancer Society estimates about 43,700 women will lose their life to the disease in 2023.

Learn more

Read more about breast health and breast cancer on the OSF HealthCare website.

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Growing up on a farm a couple miles from the clinic where she works, Bethany Huelskoetter, APRN, knows the importance of playing it safe in a rural setting, whether you’re young or old. With National Farm Health and Safety Week coming up, Huelskoetter, a nurse practitioner at OSF HealthCare, says now is the time to review the basics of farm safety.

• Heavy machinery: For big equipment like a tractor or auger, know how to use it before you get in the driver’s seat. Know how to shut the machine off quickly in an emergency. When behind the wheel, know your surroundings. Go slowly and be very cautious in places like driveways where kids run around. Wear fitted, not loose, clothing.

“Machines have shafts and moving parts,” Huelskoetter explains. “You don’t want to have loose sleeves or something that can get caught in that mechanism and cause a catastrophic injury.”

• Driving smaller vehicles: Children and young adults are often found whizzing around a rural property on an all-terrain vehicle or motorbike. That can go south quickly, Huelskoetter warns. A passenger could be flung from the vehicle and get injured or killed.

              Wear a helmet and buckle the seatbelt. Don’t drive too fast, and don’t make sharp turns, especially on loose gravel. Sit in the vehicles the way they are intended. Don’t hang off the back or side. And never operate after drinking alcohol.

• Toxic materials: Farmers and homeowners often handle chemicals like pesticides. Huelskoetter advises reading the label so you know what you’re touching. The label should also tell you what protective equipment to wear and whether the product is toxic to pets.

The American Association of Poison Control Centers website has a national hotline and state-by-state resources for exposure to or ingestion of toxic materials. Huelskoetter says to have that phone number in your cell phone. When you call, someone will ask you basic questions about what happened and tell you what to do. You may be able to treat the issue at home, or the hotline may advise you to go to the nearest emergency department.

• Animal bites: Kids playing in nature may encounter “all kinds of crazy things,” Huelskoetter says. Bites from spiders, snakes and raccoons can happen. The first step, she says: clean the bite thoroughly with soap and water. Then, cover it with a band aid or clean cloth and go to the hospital.

“You never want to mess around with an animal bite,” Huelskoetter says. “Animals’ mouths are very dirty. So you want to start the bitten person on antibiotics quickly.”

Huelskoetter adds that while we view dogs and cats as domesticated, you never know if they have not been vaccinated and are carrying diseases like rabies.

• Heat: Two common heat illnesses are heat exhaustion and heat stroke. Huelskoetter says heat exhaustion generally describes when you overheat. Experts advise to move to a cool place, sip water and put cool, wet cloths on your body. If symptoms don’t improve or you start vomiting, call 9-1-1. Symptoms of the more serious heat stroke include hot, red, dry or damp skin, a fast, strong pulse, headache, dizziness, nausea and confusion. Call 9-1-1 right away. Untreated cases of heat stroke can cause permanent damage to organs or death.

                Some tips to avoid heat illness: Avoid being outside in the middle of the day. Take breaks in a cool area during the day. Keep a cooler full of water and drinks with electrolytes, like Gatorade. Sugar-free sports drinks are a healthier choice                     than the regular ones. Have some healthy snacks, too, like popcorn, pretzels or nuts.

“Whenever your body is sweating, it’s depleting its calories and energy,” Huelskoetter says. “So your body doesn’t just need water. It also needs nutrients to help you keep going throughout the day.”

• Be prepared: Work or play with a buddy. That way, someone is there if you get hurt. If you must go alone, let people know your plans before you leave for the day. Where on the property will you be? When are you expected back? If you don’t return at the right time, that’s a sign for your loved ones to look for you. Keep your phone charged in case you need to make an emergency call. Take a mobile charger with you. And if an emergency happens, call 9-1-1 and take an ambulance to the hospital. Don’t drive yourself or have someone drive you.

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No one wants to go to a hospital emergency department (ED), but sometimes, there’s no avoiding it.

As OSF HealthCare joins other health systems struggling with staffing shortages, it is also seeing patients without access to primary care showing up in emergency rooms and facing long waits for less serious health issues. To meet the challenge of long wait times, OSF is turning to virtual technology to move patients through their ED experience more efficiently.

Anyone coming into the hospital emergency department at OSF HealthCare Saint Elizabeth Medical Center in either Peru or Ottawa, Illinois will be triaged to determine the seriousness of their condition or injury. Patients who qualify for this time saving option for care will be taken to one of our virtual care rooms where a nurse helps establish a video connection and assists the patient with any hands-on equipment needed for a video visit with the virtual provider.

“Our virtual physician will be able to do an assessment of each patient virtually, through the use of advanced technology and the onsite nurse. They will develop an appropriate treatment plan, coordinate prescriptions, and a follow up care plan,” says Dawn Trompeter, president of OSF Saint Elizabeth Medical Center. “We want to offer a better experience for everyone, and qualified patients can be seen more quickly and get on the road to recovery.”

Studies also reveal prolonged emergency department wait times and length of a visit reduces quality care and increases adverse events for patients with serious illnesses. “So, the goal with introducing this new model is to improve patient care as well as our patients’ experience,” Trompeter stresses.

The virtual emergency care area is located within the hospital emergency department and includes a mobile cart equipped with two-way audio and video capabilities, making it easy to have a conversation with the remote medical provider. The mobile units have high-resolution cameras to observe symptoms or injuries more closely.

A nurse or medical staff member will assist with completing the patient assessment using the advanced digital tools on the mobile units that allow the virtual doctor to hear a patient’s breath and cardiac sounds or look more closely into the patient’s eyes and ears, just as they would do if they were physically in the room.

“We will work together to take care of patients with the same high standard of care given by our in-person physicians,” says Benjamin Kemp, MD, the lead physician for virtual emergency care.

If at any time the care team thinks someone needs to be seen in person by a doctor, they can be immediately transferred to the traditional ED.

“If a patient requires care that is too complex for virtual interaction, we will easily and seamlessly work with the in-person team to get the great care patients deserve,” Dr. Kemp emphasizes.

OSF is using several innovative approaches to reduce ED wait times and improve the overall experience, including using virtual behavioral health clinicians to make sure people with mental health issues are seen within the target goal of one hour. Additionally, research is underway to see if predictive modeling using artificial intelligence can help match staffing with surge times.

B-roll of Virtual ED

We’re approaching the late summer-early fall period when respiratory illnesses begin their annual upswing. The latest news from federal health officials concerns a new variant of COVID-19, NB.1.8.1. Some people impacted have reported severe sore throats, almost like there’s a razor blade in there.

Fred Burke, MD, an emergency medicine physician who sees patients at OSF HealthCare, says illnesses like COVID, RSV and the flu will always be around. It’s just a matter of taking precautions to avoid serious illness. So, what’s the level of concern with this new COVID variant as we begin to make fall plans?

The razor’s edge

Any sore throat is an annoyance. But Dr. Burke says you should monitor severe cases closely.

“You’re less likely to want to eat or drink, which can lead to further dehydration,” he says.

You can manage sore throats at home with Tylenol or ibuprofen, chloraseptic spray, warm tea and throat lozenges. Dr. Burke says if you have trouble keeping food or fluids down, feel lightheaded or dizzy or have trouble breathing, see a health care provider right away.

COVID precautions

Dr. Burke says this new COVID variant isn’t linked to as much severe illness as other variants. But, he says it’s more easily spread.

“The average healthy person might get through it with some [figurative] bumps and bruises and little to no symptoms. For people with comorbidities or who are immunocompromised, the virus might be a little bit more detrimental,” Dr. Burke says.

Getting vaccinated and practicing good hygiene are two big tools to avoid serious illness, he adds. Wash your hands and high touch surfaces, like doorknobs, often, don’t cough or sneeze into the open air and stay home and away from others when you don’t feel well. If you’re in a crowd, especially if you have a comorbidity like diabetes, Dr. Burke says you should consider wearing a mask.

“If you’re going to have a gathering, whether at home or somewhere else, you can also recommend people take a home test to make sure they don’t have COVID prior to going,” Dr. Burke suggests. Those at-home tests can usually be found over the counter at a pharmacy.

For vaccines, recent preliminary guidance from the U.S. Food and Drug Administration recommends the shot this fall for people 65 and up. For others, the shot is recommended for people who have a compromised immune system or a comorbid condition like obesity, heart disease, high blood pressure, lung disease or depression. The website for the U.S. Centers for Disease Control and Prevention, meanwhile, has a broader recommendation. When in doubt, Dr. Burke says to talk to your primary care provider.

Learn more

Explore other resources to keep yourself safe from COVID on the OSF HealthCare website, blog and newsroom.

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A Tuberculosis (TB) outbreak in Kansas City, Kansas, has people on edge, with not much public knowledge about the disease or how to prevent it.

The Kansas Department of Health & Environment reported as of January 31, 67 people were infected in the latest outbreak. Two people died and roughly half have finished treatment and are considered cured.

What is Tuberculosis?

“TB is referred to as ‘the great mimicker,’ says Sharjeel Ahmad, MD, a staff physician of infectious disease with OSF HealthCare, meaning the signs and symptoms are like many other viruses and bacterial infections people get.

“Tuberculosis is a very contagious bacterial infection,” Dr. Ahmad says. “It’s caused by a bacterium called Mycobacterium tuberculosis. It is spread when people cough, sneeze or spit. So, if you cough, spit or sneeze, you generate tiny particles. When someone else inhales that, you can get infected by TB.”

While active TB disease cases are rare, Dr. Ahmad says it's likely that one in four people worldwide have been exposed to this bacterium. In Peoria, Illinois, OSF HealthCare Saint Francis Medical Center treated six TB patients in 2024. The bacteria can be transmitted easily, with the infectious dose being a single live bacterium sufficient to infect people. The infection is transmitted airborne, through droplets and aerosol.

Tuberculosis signs and symptoms

“Warning signs include, but are not limited to, unexplained fever, night sweats and unintentional weight loss,” Dr. Ahmad says. “The infection is spread through inhaling, so the lungs are the primary site for infection”

Lung symptoms include a chronic cough that doesn’t go away, along with vague chest aches and pains. You may have phlegm, which could sometimes have blood in it.

“The Vampire Effect”

Dr Ahmad says, "Before the Industrial Revolution, folklore often associated tuberculosis with vampires. When one member of a family died from the disease, the other infected members would lose their health slowly. People believed this was caused by the original person with TB draining the life from the other family members".

"It can be deadly if it's left untreated. It was colloquially referred to as 'the consumption,' way back when because it consumes the body, and the body can get overwhelmed by it."

Why do most people not get the TB vaccine?

There is a vaccine for TB, and 2021 marked 100 years it has been around. It's made from a weakened strain of bacteria, Dr. Ahmad says. It's called Bacille Calmette-Guérin (BCG). The rates of protection against tuberculosis infection vary widely. 

"It offers protection from getting TB of the brain/meningitis, especially in kids. It also has some protection against TB outside the lungs," Dr. Ahmad says. "There are some factors like genetics and where the patient is, which means it is not 100% protective. Estimates of protective effect vary between 20-70% for protection against TB disease.”

The TB vaccine can also interfere with a particular skin screening test for TB if the vaccination was given recently.

“Since the disease is so rare” Dr. Ahmad adds. We've opted over the years to not mess up our ability to detect known cases," he says. 

Who is most at risk?

The youngest and oldest populations are both at high-risk for TB, along with those who have been around an infected person.

"This is a disease of overcrowding and poor hygiene," Dr. Ahmad says. "It's been around in humans forever. It's transmitted from person to person via the respiratory route." 

People with a weakened immune system are also at risk of developing the disease if they are exposed to it. This could include people with diabetes or HIV. Patients who take medications that suppress the immune system – including patients with autoimmune diseases, transplants, and cancer patients are also more at risk. Patients with prior history of lung disease/damage are also at risk.

Dr. Ahmad adds that homeless shelters, correctional facilities and those with substance use disorder are also at-risk for becoming infected with TB. 

How TB is treated in the hospital

Dr. Ahmad says care teams use "airborne precautions," including rooms with special ventilation systems in the hospital. TB patients are kept in these "negative pressure rooms" away from others to prevent the spread of infection. The entire care team wears personal protective equipment, including gowns, gloves and N95 masks, while in the room with the patient.

The medication regimen for TB patients is intense. Traditionally, four different antibiotics will be used for the first two months. "Once we have the antibiotic susceptibility results, and everything looks good, we can drop the patient down to just two antibiotics until we reach six months’ duration of treatment for lung TB," Dr. Ahmad says. If TB spreads outside the lungs, treatment can be even longer.

While therapy can be initiated at the hospital, the patient does not have to stay in the hospital for the whole duration of treatment. Once a care plan has been formulated, it is coordinated with the local health department to ensure there are no gaps in care during the transition, the patient continues to have access to the medication, and they do not pose a public health risk to others. The aim is to limit the patient's interaction with others inside and outside the hospital until they are deemed non-infectious, meaning they cannot transmit the infection. The hospital infection control/prevention team and county health department also remain vigilant, ensuring any potential exposures are traced and screened.

Video Interview Clips

When it comes to ambulances and the services they provide, Lisa Reid, APRN, knows a thing or two because she’s seen a thing or two.

The family medicine provider at OSF HealthCare was an ambulance first responder for more than 15 years before moving to the nursing side of things. As such, she’s heard a lot of “Should I do this or that?” when calling an ambulance. Now, it’s time to clear up the misconceptions.

• Who’s coming to get me? Should I be concerned about their qualifications?
  
  Reid says different first responders can do different things, but you can be assured you’ll get the care you need.
  
  “Paramedics have more training in life-saving skills. They can do things like intubation [putting a tube down your throat to help breathing] and give intravenous [IV] medications," Reid explains. "Emergency medical technicians [EMTs] provide more basic care. They help stabilize the person and get them ready for transport. They also usually drive.”
   
• Where should I wait?
  
  Reid says if you’re hurt or ill, it doesn’t make sense to drag yourself to the curb to wait for the flashing lights. Changing locations could also waste precious time as the first responders look for you. So, stay where you are. If you’re inside, unlock the door if you can. If you can’t, Reid says first responders can get to you. For example, firefighters or police officers often go on medical calls and can break down doors or otherwise keep the scene safe.
   
• Do I need to share my health information and directives to get care?

Again, Reid says, do it if you can. But it won’t delay the on-scene care if you can’t.

“Some people put the information on their cell phone. Some people hang the documents on their refrigerator,” Reid says.

You can also fill out your health record with your health system in advance of an emergency – things such as allergies and advanced directives – so providers know what to do when you arrive.

• Can I expect care in my home? Will I go in the ambulance right away? Or both?
  
  Each case is different, but if the situation calls for it, ambulance workers can and will treat you on-scene.
  
  “If it’s a critical situation, they will often stabilize you and go [with you in the ambulance]. If it’s something where they can stay and do IVs and monitor you, they will," Reid says.
  
  The responders might even determine you don’t need a trip to the hospital.
   
• Vehicle rides are bumpy. How can they treat me safely in an ambulance?
  
  Reid admits the ride can be scary. You’re surrounded by equipment and noise. But EMTs and paramedics are trained to do things like give IV fluids while rolling down the road.
  
  Don’t expect to undergo surgery in the ambulance, Reid says. But she says it’s also common for responders to give medication, intubate and perform CPR in the vehicle.
  
  “It’s a mini emergency department on wheels,” she says.
   
• I arrived in an ambulance, so I must get priority when I get to the emergency department.
  
  “Not always true,” Reid says.
  
  “The ED is going to prioritize their emergencies based on the need for care. So to call an ambulance solely because you think you’ll be first in line – that won’t necessarily be true,” she adds.

Learn more

Read more about how emergency medical services serve you on the OSF HealthCare website.

Interview clips

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The $5 million expansion will add 7,000 square feet to the existing space, including one additional triage room and six additional treatment rooms. 

The expansion will enhance the ability of Mission Partners to serve patients through innovative space planning to improve efficiencies and connection throughout care delivery. 

"OSF HealthCare remains invested and dedicated to providing exceptional care for our rural communities, which is something we’ve done for over 115 years in the Galesburg community,” said Lisa DeKezel, president of OSF HealthCare St. Mary Medical Center. “This redesign is a crucial step in enhancing the quality care we deliver, elevating patient experiences, and addressing the evolving needs of our community." 

Construction is set to begin by the end of 2024 and is expected to take approximately 18 months to complete. 

During the project, the emergency department will remain open and fully operational, ensuring uninterrupted care for patients. 

However, during the initial phase, patients arriving by car may be re-routed to a nearby adjacent entrance. Signage will be posted to guide patients accordingly. 

"While there will be some inconveniences during construction, the end result will be a vastly improved experience for our patients, visitors, and Mission Partners," DeKezel said.

OSF HealthCare remains committed to “serving persons with the greatest care and love” in the spirit of Christ and following the example of Francis of Assisi. 

The OSF St. Mary Medical Center emergency department redesign reflects this mission. 

He was at a Champaign, Illinois, hospital where his five-year-old daughter Gabby was fighting for her life with what was later confirmed to be Rocky Mountain spotted fever as the result of a tick bite.

Gabby died of sepsis, a condition where your body responds improperly to an infection, three days later. The heartbreak led Tony and his family to become intimately familiar with sepsis. They’re now advocates for sepsis awareness, both ensuring health care providers are following best practices and patients are speaking up.

“I remember slamming every object around me,” in the days following Gabby’s death, Tony Galbo recalls. “I said ‘there’s gotta be a law to protect patients, especially children.’,”

Sepsis and septic shock

Many of the things the Galbo family advocates for to this day are already in place at OSF HealthCare.

Kurt Bloomstrand, MD, is chair of emergency services at OSF HealthCare Heart of Mary Medical Center in Urbana, Illinois. He says aside from following established, rigid protocol, OSF Heart of Mary is going the extra mile for sepsis prevention in a couple of ways. One, the hospital is leading the OSF Ministry in continuing sepsis screening and alerts for people after they are admitted (not just in the emergency department). And two, the facility is among the top 10% of hospitals in the country in following sepsis protocol as measured by the United States Centers for Medicare and Medicaid Services (CMS). Those CMS core measures include giving antibiotics and fluids and rechecking a person’s vital signs in a timely manner.

“We’re trying to identify a set of signs called the systemic inflammatory response syndrome, or SIRS,” Dr. Bloomstrand says. “Those include a fever, a fast heart rate, fast breathing and elevated or low white blood cell count. If someone has any two of those with a source of infection, we consider them possibly septic. We want to establish treatment for them very quickly.”

Treatment includes antibiotic medication or intravenous fluids along with continued testing to pinpoint the problem.

“We take this extremely seriously because we know time is tissue. The sooner we get the treatment, the better the outcome.” Dr. Bloomstrand adds. “Any person who comes into one of our emergency departments, no matter the cause, will be screened for sepsis right from the start. When we get your vital signs, that’s screening for sepsis. If you flag positive, there are alerts that go out to our staff. Then it walks us through a very specific sepsis algorithm for treatment.”

What you can do

Dr. Bloomstrand says young kids, older adults and people with serious health conditions like heart disease and diabetes are at a higher risk for sepsis. Your best bet to prevent sepsis is to practice healthy habits and prevent infection in the first place.

• Wash your hands frequently, especially after touching high-germ areas in public like a doorknob.
   
• Avoid touching your face.
   
• Sneeze and cough into your elbow or a tissue.
   
• Stay home when you’re sick.
   
• Treat wounds and bug bites properly, quickly and under guidance from a health care provider. Dr. Bloomstrand notes that pets can also harbor ticks that can cause serious illness.

Dr. Bloomstrand adds that hospital staff are empowered to speak up if they spot a possible sepsis case. But you can also speak up on behalf of yourself or a loved one about what sepsis surveillance is being done.

“It’s appropriate to make sure you are asking these questions just to make sure you’re keeping it at the front of the care provider’s mind,” Dr. Bloomstrand says.

“If we don’t catch sepsis soon enough, it can result in organ dysfunction,” he adds. “There may be long-term complications with their kidneys, such as needing dialysis. If their lungs fail, there may be long-term respiratory issues. There may be brain issues, so they have mental status changes long-term.”

Gabby’s Law

On August 18, 2016, then-Illinois Governor Bruce Rauner came to Presence Covenant Medical Center (now OSF Heart of Mary) to sign Gabby’s Law.

“Senate Bill 2403 requires hospitals to adopt evidence-based protocols for the early recognition and treatment of patients with sepsis, severe sepsis or septic shock that are based on generally accepted standards of care,” the Governor’s office said at the time. “It requires the protocols contain certain components, including those specific to identifying and treating adults and children.”

Tony Galbo recalls many meetings with lawmakers, health care groups and other stakeholders to get the plan the support it needed. And that wasn’t the end. He’s testified before lawmakers in other states and in Washington, D.C., and done countless interviews.

“Sepsis does not discriminate. It does not care about age,” Galbo says.

Interview clips - Tony Galbo

Interview clips - Dr. Kurt Bloomstrand

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Una gran cantidad de visitas al servicio de urgencias se debe a problemas abdominales.

Los Institutos Nacionales de Salud publicaron un estudio que confirma que las dolencias gastrointestinales representaron el 11 % del total de visitas al servicio de urgencias entre 2016 y 2019, mientras que poco menos del 17 % de esos pacientes fueron ingresados en el hospital. Esto se alinea con el porcentaje de visitas relacionadas con problemas abdominales en todas las instalaciones de OSF HealthCare. Desde el 1 de abril de 2023 hasta marzo de 2024, hubo 36,340 visitas al servicio de urgencias relacionadas con problemas abdominales, alrededor de un 9 % de las visitas totales.

El Dr. Samuel Vázquez es cirujano general en OSF HealthCare. Muchos de los pacientes que trata sufren de dolor de estómago agudo que termina siendo algo más grave.

“Las razones más comunes por las que las personas ingresan a la sala de urgencias son que están sufriendo un ataque de vesícula biliar o de apéndice”, señala el Dr. Vázquez. “Si ya ha pasado por una cirugía, corre riesgo de sufrir obstrucciones intestinales, por lo que puede sufrir dolor abdominal agudo, junto con vómitos y náuseas. Las hernias son la razón más común. La situación es que, normalmente, está levantando algo, cortando el césped, etc., y le empieza a doler, y el dolor no desaparece”.

Razones para buscar ayuda

Si tiene dolor abdominal agudo, náuseas, vómitos y fiebre, hay razones para hablar con su proveedor médico. Según la gravedad de los síntomas, podría derivar en una visita al servicio de urgencias.

No se trague el dolor, actúe rápido

El Dr. Vázquez afirma que el tiempo es esencial. Si se presentan síntomas graves, trátelos de inmediato.

“Cuando se trata de problemas quirúrgicos agudos, como hernia, obstrucción intestinal, ataques de vesícula biliar o apendicitis, el momento más fácil y mejor para atenderlo es cuando se presenta por primera vez”, indica el Dr. Vázquez. “Podemos tratarlo unos días más tarde, pero esto hace que todo sea más difícil”.

Aumento de casos durante el verano

Las temperaturas más cálidas suelen ir acompañadas de un aumento de las actividades divertidas al aire libre. Sin embargo, el Dr. Vázquez dice que también hay una correlación entre los meses de verano y el aumento de visitas al servicio de urgencias por problemas estomacales.

“Especialmente por hernias, porque todo el mundo está al aire libre haciendo trabajos de jardinería, deportes, etc.”, afirma el Dr. Vázquez. “Asimismo, durante las vacaciones, es mucho más frecuente ver patologías de la vesícula biliar porque todo el mundo come fuera de casa y no come lo que come normalmente. Tienden a tener estos ataques”.

Consejos de prevención

El Dr. Vázquez señala que hay cosas que se pueden hacer a diario para reducir las probabilidades de acudir al servicio de urgencias por problemas estomacales. Evite fumar, coma más saludable, coma menos alimentos procesados y haga ejercicio para mantener un estilo de vida saludable en general.

Aunque los ejercicios abdominales fortalecen los músculos que rodean el abdomen y la ingle, también pueden provocar hernias, sobre todo al levantar mucho peso.

Clips de entrevistas en vídeo

A significant number of emergency department (ED) visits are due to abdominal issues.

The National Institutes of Health (NIH) released a study, confirming that gastrointestinal complaints accounted for 11% of total ED visits between 2016-2019, while just under 17% of those patients were admitted to the hospital. This is on par with the percentage of abdominal-related visits at all OSF HealthCare facilities. From April 1, 2023, through March of 2024, there were 36,340 ED visits related to abdominal issues, about 9% of the total visits.

Samuel Vazquez, MD, is a general surgeon with OSF HealthCare. Many of the patients he treats are suffering from severe stomach pain that ends up being something more serious.

“The most common reasons why people need to come into the emergency room is because they’re having a gall bladder attack or appendix attack,” Dr. Vazquez says. “If you’ve had surgery before, you’re at risk for bowel obstructions so you can get pretty severe abdominal pain, along with vomiting and nausea. Hernias are the most common reason. The story is, you’re usually out lifting something, mowing the yard, etc. and you get pain, then the pain doesn’t go away.”

Reasons to be seen

If you’re experiencing severe abdominal pain, nausea, vomiting and a fever, these are reasons to speak with your medical provider. Depending on the severity of symptoms, it could lead to an ED visit.

Don’t stomach the pain, act fast

Dr. Vazquez says time is of the essence. If serious symptoms are presenting themselves, deal with them right away.

“When it comes to acute surgical issues like hernia, bowel obstruction, gall bladder attacks or appendicitis, the easiest and best time to take care of it is when it first presents itself,” Dr. Vazquez says. “We could still take care of it a couple days later, but it does make everything that much harder.”

Summer upswing

The warmer temperatures are often met with an increase in fun, outdoor activities. But Dr. Vazquez says there is also a correlation between the summer months and an increase in ED visits due to stomach issues.

“Especially for hernias because everyone is out and doing yard work, sports etc.” Dr. Vazquez says. “Likewise, during the holiday season, it’s much more common to see gall bladder pathology because everyone is eating out and not eating what they normally eat. You tend to have these attacks.”

Prevention tips

Dr. Vazquez says there are daily things you can do to decrease the chance of an ED visit due to stomach issues. Avoid smoking, eat healthier, eat fewer processed foods, and exercise to maintain a healthy overall lifestyle.

While core exercises do strengthen the muscles around the abdomen and groin, it can also lead to hernias, especially when lifting heavy weights.

Video Interview Clips

Les Mennenga, an OSF HealthCare Mission Partner (employee) and lead educator for East Central Illinois EMS (emergency medical services), runs Bryson Freehill and Andy Lubben through a scenario in a training ambulance. The patient, a manikin named Noelle, is complaining of a terrible headache. Freehill also notices a bulge in the manikin’s belly.

“Is she pregnant?” he asks.

“She is,” says Mennenga, standing by with a tablet that controls elements of the scenario.

And the men get to work.

Becoming a first responder

Mennenga oversees training for the three levels of ambulance responders – emergency medical responder, emergency medical technician basic and paramedic – plus nurses who work in the field or answer EMS calls in the emergency department.

“Anybody who wants to get into the world of EMS has to work with some sort of education facility,” Mennenga says. “We’re one of those.”

There’s no college degree requirement, but plenty of initial and continuing education is part of the job. Plus, you become familiar with medical best practices, all stored on a smartphone app you can access quickly in the field.

There’s no debating that the job is stressful, but it’s rewarding and usually well-paying, Mennenga says.

“We’re going to be on calls where it’s potentially a person’s worst day of their life. We have an opportunity to make a difference,” Mennenga says. “We may see something that’s traumatic. We need to understand who we can turn to talk about that.”

Noelle’s fate

Freehill and Lubben ended up treating Noelle for eclampsia, or high blood pressure during pregnancy, which led to a seizure. No critical errors in their treatment, Mennenga told the pair in a debriefing.

“We tend to do scenarios that are not common in the field or a call in the last year that had an issue with a real patient,” Mennenga says. “So we may find an area where there could be improvement. Now we’ll put it into practice and see if other people have the same issue. Is it something we need to include in initial education?”

If you’re interested in this line of work, Mennenga suggests contacting your local EMS agency or volunteer fire department. Before enrolling in a class, try observing one or doing an ambulance ride-along.

“See the realism of treating patients in the field,” Mennenga says.

Interview clips

B-roll

When talking about the opioid crisis in America, you don’t have to explain much to Howard Marsh.

A first responder for nearly a half century, Marsh has gone on numerous ambulance calls for a suspected overdose.

“It breaks my heart,” says the Advanced Medical Transport paramedic. “I just can’t believe people do this to their bodies.”

New federal data show nearly 108,000 people died of an overdose in 2022. That's up slightly from 2021. It’s a time to know the facts and misconceptions about overdoses, their causes and ways to reverse the deadly effects. One such way is naloxone, known under the brand name Narcan, a medication that has become more available in recent years to both first responders and everyday citizens.

“It’s really a good drug to have around,” Marsh says.

Narcan basics

Les Mennenga is lead educator for East Central Illinois Emergency Medical Services (EMS), an OSF HealthCare organization that trains ambulance workers. He describes Narcan as an opioid antagonist that helps reverse the effects of dangerous drugs like fentanyl, morphine, heroin and Tramadol.

“If we get too much of those medications in our system, they’ll bind with receptor sites in our brain. They’ll slow our breathing and pulse rate down,” Mennenga says. “They can actually stop the signal to our diaphragm and make us stop breathing.”

Conversely, he says, “Narcan gets to those receptor sites, competes with the opioid and will knock it off. It will help the person restore their breathing.”

Mennenga says Narcan does not work with methamphetamine, cocaine and other non-opioids.

At the scene of a suspected overdose, typically the first bits of information come from friends or family of the ailing person. Those people likely know if the person has a history with a certain drug, for example. First responders will also look for drug paraphernalia like needles. Mennenga says if the person is still alert and breathing, they would not qualify for Narcan.

“The only time we should be administering Narcan is if they’re having difficulty breathing,” Mennenga says. “They’ll be unresponsive, snoring-like respirations or not breathing at all.”

Blue lips are another sign, Marsh says.

There are three ways to give Narcan: through a shot into the muscle; intravenous therapy, commonly known as an IV; and the most common and simple way, Mennenga says, is a nasal spray. Mennenga adds that Narcan may be combined with cardiopulmonary resuscitation (CPR) or a bag valve mask to help restore breathing.

Mennenga says once the person comes to, they might experience withdrawal symptoms like nausea, vomiting or, in rare cases, a seizure or heart issues. First responders will provide more care as needed.

“Go to the hospital and get checked out,” Marsh advises. “We prefer we take you in case something happens in route.”

What you should know

East Central Illinois EMS has rolled out a Narcan leave behind program. The agency provides kits for first responders to leave with friends, family and others after responding to an overdose. The program serves as a reminder that this is an important issue. Experts say survivors are at high risk for repeated overdoses, and Narcan may be the only chance to save their life.

“Overdoses are quite common, unfortunately,” Mennenga says. “Nobody’s immune to the opioid crisis.”

He says if you want a supply of Narcan at home, contact your local health department for options.

Mennenga also says Narcan, shockingly, has some detractors. He says some people think opioid users need to learn the consequences the hard way. But Mennenga, a veteran of the EMS world, says many people who suffer overdoses aren’t your stereotypical drug user. Their use might have started with an injury, leading to pain medication. Or older adults often mix up pills and take too many.

“If they really want to get some help, we can give them resources like their public health department or the state public health department,” Mennenga says.

Learn more

Websites for the U.S. Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, the Illinois Department of Public Health and the Michigan Department of Health and Human Services all have information on opioid addiction, treatment and recovery. If you are in crisis, the national Suicide and Crisis Lifeline is 9-8-8.

Interview clips - Les Mennenga

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Telemedicine – seeing a provider by video from home – is a common and useful part of today’s health care landscape. But as Amer Alshekhlee, MD, points out, it’s sometimes not fast. A person will commonly book a virtual appointment days or weeks out.

So how can telemedicine play a critical role when millions of brain cells are at stake in a matter of minutes?

Enter telestroke. It’s a concept in use throughout OSF HealthCare. At OSF HealthCare Saint Anthony’s Health Center in Alton, Illinois, the strategic affiliation between OSF and SSM Health allows telestroke to be seamless. Dr. Alshekhlee, the stroke program director at DePaul Hospital in nearby Bridgeton, Missouri, is one of the doctors who sees people virtually when they come to the OSF Saint Anthony’s Emergency Department with a suspected stroke.

“We see patients quickly. We triage them from hospital to hospital. That provides very quick treatment,” Dr. Alshekhlee says.

“We’ll have a video encounter,” he adds. “We examine the patient. Talk to them and their family. Make a decision on what kind of treatment and where.”

Providers will ask about when symptoms started and their severity. They will likely have the patient demonstrate the BEFAST acronym, a standard way to spot stroke symptoms. Providers will look for problems or abnormalities in balance, eyes, face, arms and speech. The “T” in BEFAST stands for time. In other words, if there is evidence of issues in B through S, it’s “time” to take quick action.

“We have a scale. We score the person, and for example, say ‘these stroke symptoms look very bad’. Then we have to really act on that patient.”

That could mean a transfer to a hospital better equipped to treat stroke. Again, providers will tell you time is of the essence. For example, if you start treatment at the Emergency Department within 4½ hours of the onset of symptoms, you may be able to take Tenecteplase, a blood clot-busting agent that experts say could become the gold standard for stroke care.

On the flip side, for each minute a stroke goes untreated, the brain loses around 2 million cells it cannot recover. Strokes can also have life-altering consequences like vision, walking and swallowing difficulties. They can take years off your life and put you at risk of another stroke.

Learn more about stroke care on the OSF HealthCare website.

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Strokes are more common in older adults

My own car or an ambulance?

Sure, for minor cuts and bruises that require a trip to urgent care, the former may be appropriate.

But for things like heart attack symptoms, stroke symptoms or serious wounds, Kurt Bloomstrand, MD, says the choice is clear: call the ambulance.

Dr. Bloomstrand is an Emergency Department physician at OSF HealthCare and medical director for East Central Illinois EMS (emergency medical services). He and his colleagues have seen an alarming trend lately of people with suspected heart attack coming to the Emergency Department on their own.

“Ambulances and pre-hospital providers are equipped and trained to deal with these emergencies. We can deal with these emergencies at your home or wherever you called 9-1-1 at,” Dr. Bloomstrand says. “We’re bringing the equipment from the ED to you so we can get that treatment started even sooner and bring you life-saving treatment and medication immediately.”

For example, pre-hospital providers on site or in the back of the ambulance can perform an electrocardiogram (ECG or EKG for short), which takes a snapshot of how your heart is working. If problems are found, these providers can call ahead to the hospital and have the person bypass the ED and go directly to the cardiac catheterization laboratory. That’s a time-saving and life-saving step.

On the alternative: “If you drive yourself, there’s no way to monitor you. There’s no way to treat you if something happens,” Dr. Bloomstrand says.

Other possible pitfalls: you may pass out at the wheel from your initial medical event, causing a crash that endangers you, other drivers and pedestrians. If someone is driving you, they will likely be anxious and not drive carefully. That, too, could mean a wreck.

Private vehicles are legally not allowed to speed and go through stoplights and stop signs. An ambulance can safely, saving time.

And it may seem trivial, but if you are driving to the hospital with a serious wound, you will likely make a bloody mess all over your vehicle.

Dr. Bloomstrand has also heard plenty of misconceptions about taking an ambulance.

People who live in a rural area may think, “By the time the ambulance gets to me, I may be worse off, and I could have already been at the hospital if I took myself.”

Dr. Bloomstrand counters that although it might take time for the ambulance to arrive, this time is often faster than the time it would take to get treatment by driving to the Emergency Department.

Others may believe they can’t afford an ambulance. Dr. Bloomstrand says most major health insurance providers cover the care.

Some may think, “I’m not sick enough for an ambulance.”

“It’s your emergency. We’re there 24/7 to help and assist in your emergency,” Dr. Bloomstrand says. “If you feel like you’re having an emergency, you need to call 9-1-1. We can come and evaluate you. Please don’t feel like you’re burdening the ambulance system.”

Others may just fear an ambulance in general. They’re nervous about having a needle in their arm while in a fast-moving vehicle. Dr. Bloomstrand counters by reminding you that paramedics and emergency medical technicians (EMTs) are highly skilled and trained. They have been around the block – literally.

“We deal with this day in and day out. We’re trained and equipped to handle these emergencies,” Dr. Bloomstrand says.

Interview clips

B-roll

A mother is speaking out about water bead safety after her 14 month-old daughter swallowed a bead and wound up in the hospital.

Hannah Reif of Iowa tells Good Morning America that her child was vomiting, and doctors later found a one-inch water bead in the girl's small intestine.

Water beads are tactile toys that are marble-sized and water-absorbing. They are often used to reduce stress and anxiety while helping to develop focus and attention. The National Poison Control Center and the American Academy of Pediatrics say water beads can expand inside a person and cause a life-threatening intestinal blockage.

This latest incident with Reif's family is a reminder to know the signs of poisoning and choking and the steps to reverse the effects of each, says Aminat Ogun, MD, a family medicine physician at OSF HealthCare in Champaign, Illinois.

“Make sure there are no loose coins around  - no small toys they can pick up and swallow,” Dr. Ogun advises as a first step. The Consumer Product Safety Commission has a list of recalled products.

Food should be cut into small bites for kids. Chemicals, like bleach used for cleaning, should be capped and stored out of a child’s reach. Cabinet locks add an extra layer of protection.

If your child does ingest something they’re not supposed to, Dr. Ogun advises taking an ambulance to the Emergency Department of your local hospital. Health care providers will assess the child, consulting with the poison control center if necessary, and decide what to do. One option is to pump the poison out of the child’s stomach. If it’s a small object that doesn’t present a grave threat, Dr. Ogun says doctors may see if it will pass naturally in a bowel movement.

Some children may swallow a poisonous liquid and not say anything, perhaps because they don’t even know the seriousness of what they did. In this case, Dr. Ogun says to watch for changes in your child’s health, like vomiting and lethargy, and see a doctor right away.

If a child is choking, Dr. Ogun says there are life-saving steps you can take at home.

For children under one, Dr. Ogun says to lay the child face down on your lap and pat their back five times. Then turn the child over and repeat the pats on their chest.

For older kids, perform the Heimlich maneuver. Dr. Ogun says stand behind the person, wrap one arm around them and place your hand in a fist between their belly button and the bottom of their sternum. Lay your other hand flat on the fist. Then make upward thrusts.

If you’re alone, you can perform thrusts on yourself or thrust your upper abdomen against the back of a chair or the edge of a counter.

Local first responders or health care organizations may offer training on these life-saving techniques.

One word of caution: “Do not put your hand in the child’s mouth to try to get the object out,” Dr. Ogun says. “That could make it worse.”

If these steps don’t dislodge the object and get the child breathing again within a couple minutes, call an ambulance and get to the Emergency Department.

“If the person is turning blue, not able to speak or gasping, those are signs to go to the Emergency Department,” Dr. Ogun says.

Interview clips

B-Roll

Previous coverage

OSF HealthCare Library: Choking and abdominal thrusts

OSF HealthCare Library: Choking in an infant: What to do

OSF HealthCare Library: Poisons

OSF HealthCare Newsroom: Don't choke when planning for summer fun

Warmer temperatures bring the return of pesky insects, especially at dusk.

Experts say while most bug bites are not serious, there are times when you need to see a health care provider immediately.

Most bites can be treated quickly

Andrew Zasada, MD, an internal medicine physician at OSF HealthCare, says treatment of most minor bug bites (think mosquito or bee) is down to a science.

First, move away from the area so the bugs don’t bite you again. If the insect left a stinger behind, gently remove it with tweezers.

“Put some ice on the bite site. Wash it gently. Put a little calamine or hydrocortisone on it. Keep it elevated,” Dr. Zasada says.

Don’t scratch the bite site. Leave it alone and let it heal. For children who may find it difficult not to itch, put a Band-Aid over the bite. You can take an antihistamine like Benadryl, Allegra or Zyrtec for itching and ibuprofen or acetaminophen for pain.

If you notice a rapid worsening of symptoms in the 30 to 45 minutes following the bite, or if the wound is not healing over several days, it may be a sign of a more serious problem. See a health care provider.

Serious insect bites

Dr. Zasada says in the Midwest, two types of spiders come with dangerous fangs: black widow and brown recluse.

“These bites can cause tissue destruction at the bite site,” Dr. Zasada explains. “The venom is very potent. It can cause cell death. It’s very irritating.”

If the venom gets into your bloodstream, then chest pain, muscle cramps, sweating and nausea could follow. Dr. Zasada says black widow and brown recluse bites are “very rarely” fatal, but the illness they bring is quite unpleasant.

If you think you’ve been bitten by a black widow or a brown recluse, see a health care provider right away. Your local urgent care is equipped to treat insect bites, but if your symptoms have worsened, the Emergency Department at your local hospital may be the best destination.

Another serious condition to keep an eye on after a bug bite is an allergic reaction known as anaphylaxis.

Symptoms of anaphylaxis include shortness of breath, wheezing and a drop in blood pressure. Dr. Zasada says some people with known allergies may have an EpiPen handy and can inject themselves to alleviate symptoms. Regardless, immediate attention from a medical professional is still needed.

 Leave the critters alone

It’s inevitable that a stroll through the neighborhood will bring an encounter with an insect like an ant or mosquito. But Dr. Zasada says spiders that pack a punch don’t want to mess with humans. They tend to come out at night and live in wooded areas or a dark space in the back of a garage.

In other words, don’t mess with them, and they won’t mess with you.

“When you take clothing out of storage, shake it to make sure there are no spiders,” Dr. Zasada suggests. “When you clean the garage, don’t sit on anything that’s been stored there for a while. Dust it off first.”

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Summer wound care

'Tis the (tick) season

Busy days are the norm for Jill Pruitt.

The licensed practical nurse and certified oncology navigator at OSF HealthCare pores over imaging results looking for findings not related to what brought the person there in the first place. Imaging for possible lung cancer may reveal a thyroid problem and a need for a follow up appointment. She notes the appointment in her tickler file and contacts the provider later if it’s not getting scheduled.

A little firmness goes a long way in catching something that could have serious consequences.

“It’s important because if you just catch one thing, maybe that saves their life,” Pruitt says.

“It’s patient-first. I look out for all of them,” she adds.

Pruitt’s above-and-beyond efforts – unique throughout the entire OSF Ministry – shine a light on patient navigators and their importance.

What navigators do

Pruitt says a patient navigator is usually there with someone when they’re diagnosed and through their whole journey. The navigator sits in on consult appointments, helps schedule other appointments, answers questions and more.

“Basically they are the person’s go-to,” Pruitt repeats.

“Often when a person comes in and hears the word ‘cancer,’ they shut down,” Pruitt explains. “They didn’t hear about follow-up appointments, biopsies and other scans.”

That’s where a navigator comes in with a reminder. Where to go. What specialist to see. Write it down. Sometimes people just want to talk, and Pruitt obliges – day or night.

Once a person starts treatment, a nurse may become their main point of contact. But Pruitt and other navigators may still check in.

“They’re always there in my heart,” Pruitt says with a smile.

Looking closer

Pruitt says 50 to 60 imaging reports cross her desk each week. On a spreadsheet, she tracks person by person if anything else needs done. The doctor may have recommended another appointment or test. New patients or people who came through the emergency department may need to be established with a provider.

“We’re all human. Sometimes things are missed,” Pruitt says. “So if I look at the chart and see the procedure is not scheduled, I contact the physician to make sure they put the order in.”

Pruitt makes longer term checks, too.

“A patient comes in in April of 2023 and has a low-dose CT scan,” for example, she says. “Sometimes they need to come back in three, six or 12 months. That all is put into my tickler file for the next year. I go through the file monthly and check if they had the follow-up done. If not, I contact the physician again and make sure that test gets done.”

The doctors are usually grateful for the nudge, Pruitt says.

Pruitt may also notice people are no-showing or canceling the follow-up appointments. Or some people will explain that their insurance won’t cover a follow-up so soon, so they’ll just wait until their next regular visit in six months.

Not a good idea, Pruitt says. Early detection of cancer or any other ailment is key.

“Sometimes the cancer is in such an early stage. Doctors can do surgery and take it out. And then the person doesn’t need treatment,” like chemotherapy or radiation, Pruitt says. It underscores the importance of sticking to your appointments and asking your care team questions.

Learn more

Talk to your health care provider if you think a navigator would help your journey.

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You visit a health care provider for a minor ailment, and you leave with a plan to get better. It could be medication or changing habits, combined with follow-up appointments.

But the issues in the background don’t go away. You might say to yourself:

•  I don’t have a car or childcare. How am I going to get back for the important follow-up?
   
•  A gas station is the only place around me to get food. I can’t go for walks because it’s unsafe. How am I going to start living healthier?
   
•  I can’t afford a new mattress. What will stop my back from hurting in the morning?

These outside, non-medical factors are called social determinants of health. Health care providers everywhere are trained to ask people about them and link them with resources.

Lucas Edwards, PA, is a primary care provider at OSF HealthCare in Godfrey, Illinois. He sees social determinants of health come into play frequently.

“[Some] patients don’t have a car or someone they can depend on for consistent rides,” Edwards says. “They might have something that’s going on that’s medically urgent, and they can’t get to where they need to go. And so they put things off until it gets to the point where things get a little bit out of control.”

In those cases, people usually end up in the emergency department – nobody’s idea of a pleasant day and a more costly way to receive care.

To keep social determinants of health in mind, Edwards says to speak up when you make first contact with your provider’s office – whether that’s on the phone, checking in on a tablet at the front desk or with a medical assistant in an exam room. Tell the person about your circumstances and be willing to answer when asked about the same.

The provider will see you for what brought you there, of course. But they might also direct you to programs within the health system or in the community to help. For example:

•  An upcoming visit may be changed to virtual, an option that became more common during the pandemic.
   
•  You might be able to get care at a reduced cost.
   
•  You could be referred to a social worker.

Edwards also says a simple conversation may enlighten.

“Some patients may not have had the same access to education. They don’t understand that they have this wound on their leg, and if they don’t keep it clean, it can get worse,” Edwards says.

“The provider and the patient need to be on the same wavelength. They need to understand why I want them to do something,” Edwards adds.

There’s one last player in the social determinants of health world: the people responsible for a community’s infrastructure and other daily things we often take for granted.

For example, your doctor can treat an infection. But if you go home and drink the same contaminated water, you’re back to square one.

Or, things cost more at the grocery store than they used to.

“We work with patients who have financial constraints. They have a fixed income, and they can only spend X amount on some object,” Edwards explains. “You need to go to the grocery store and get your bare necessities. So a lot of times, their health care dollars they have budgeted get dwindled.”

“It takes a village,” to keep everyone healthy, Edwards adds.

OSF HealthCare is proactive on social determinants of health. An ongoing effort aims to have people coming to medical offices fill out a social determinants of health screen at least once a year, either through their online patient portal or on a tablet at the office. Among patients screened so far, around two-thirds identified a social need.

Learn more about social determinants of health on the World Health Organization website.

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OSF Newsroom stories on social determinants of health

OSF HealthCare blog: Caring for patients beyond the health care setting