What We Actually See in December

We are open on the 25th, on New Year's Eve, and at 4am on a Sunday — every
day of the year, no appointment.

Emergency rooms have a December, and it is fairly predictable. This is what it
actually consists of, in rough order, with the one thing worth knowing about
each.

And the thing that matters more than any item on the list: do not postpone a
symptom because of the date. The most common December mistake is not a ladder
or a carving knife. It is deciding to deal with something after the family
leaves.

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1. Falls, mostly from ladders and roofs

The single most predictable December injury. Lights, decorations, a gutter
that needs clearing, a roof nobody goes on for the other eleven months.

What is worth knowing: if you hit your head and take a blood thinner —
including aspirin — get checked even if you feel completely fine. A bleed can
declare itself hours or days later.
Falls: what to do after one

The boring prevention that works: someone at the foot of the ladder, and
not on a roof alone. Most of these happen when nobody else is home to notice.

2. Cuts

Carving, chopping, and — increasingly — opening packaging with a knife.

Worth knowing: come in for anything that will not stop bleeding with ten
minutes of firm pressure, any cut that gapes open, anything with numbness or
loss of movement past it, and any wound with glass or grit you cannot rinse
out. We will ask when you last had a tetanus booster, so it is worth
knowing.

3. Burns

Hot oil, oven doors, boiling water, candles, fire pits, and the fireplace nobody
has used since last winter.

Worth knowing, and it is the counter-intuitive one: a burn that does not
hurt much is more worrying than one that hurts a lot, because the deepest burns
destroy the nerve endings that would report pain. Cool it under cool running
water for about twenty minutes — not ice.
Burns: how bad is it

4. Chest pain and palpitations

There is a genuine December pattern here, and it has a name.
Holiday heart ·
Chest pain: when to go to the ER

Worth knowing: this is the category where postponing costs the most. Call
911 rather than driving for chest pain.

5. Children and the things in the wrapping paper

Button batteries are the one to know about. They are in greetings cards that
play music, light-up toys and decorations, remote controls and key fobs — and a
swallowed one burns through tissue within hours while the child may look
entirely well. Come in immediately; do not wait for symptoms.

Also: magnets, small parts in new toys, and the alcohol left in glasses
overnight, which is a genuine cause of childhood presentations after a party.
Poisoning: what to do first ·
What sends children to the ER

6. Alcohol

Mostly as the reason an injury happened rather than as the presenting problem.

Worth knowing: never let someone sleep off suspected alcohol poisoning —
absorption continues after the last drink. Roll them onto their side and call
911.
Alcohol: what an ER actually sees

7. Stomach upsets

Food left out too long, a turkey that was not quite done, and a household
passing a virus around.

Worth knowing: most settle at home with fluids. Come in for blood in
vomit or stool, severe or localised abdominal pain, signs of dehydration,
inability to keep any fluid down, or anyone very young, very old or
immunosuppressed.
Abdominal pain ·
Dehydration

8. Carbon monoxide

Rarer than the rest and the most serious. Gas heaters used more in winter, a
generator, a fireplace with a blocked flue, a car left running in a garage.

The pattern: headache, nausea, dizziness and confusion affecting several
people or pets in the same building, better in fresh air. No smell, no
warning.

Get everyone outside and call 911. Do not go back in to open windows.

9. Travel, and the long drive

A long drive raises clot risk in the same way a long flight does, and in this
part of Arizona the drive is the more common version — four hours to the coast
counts.

Worth knowing: swelling, pain or warmth in one leg afterwards, or sudden
breathlessness and chest pain that sharpens when you breathe in.
Blood clots

Prevention: stop and walk about every couple of hours, drink water, move
your ankles while sitting.

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The Arizona December, briefly

Our December is other people's spring, which changes the list:

• Hiking and outdoor sport increase rather than decrease, because the
  weather is finally pleasant. So do the injuries that go with them.
• Visitors arrive unacclimatised and underestimate the sun even in winter.
• Heaters and fire pits come out for genuinely cold desert nights, which is
  where the carbon-monoxide and burn risk comes from.
• It is still dry. Dehydration does not take December off.

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What happens when you arrive here

• A physician sees you — board-certified, every visit, at every hour and on
  every date.
• CT, X-ray and a full laboratory on site. Ultrasound is called in from a mobile service.
• A critical care room here for the presentations that need one.
• Monitoring for up to 24 hours where you need watching rather than
  admitting.

If admission or hospital-level inpatient care is needed, we stabilise and
arrange the transfer. We are an emergency room, not a hospital.

Nothing about arriving on a holiday is unusual for us. It is a normal
working day here, and you are not interrupting anything.

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El Mirage ER — open 24 hours a day, 7 days a week, 365 days a year.
12000 N El Mirage Rd, El Mirage, AZ 85335 · (480) 237-4922
Poison Control: 1-800-222-1222 · If this is a medical emergency, call
911.

This article explains when to seek emergency care. It is not medical advice and
cannot account for your history, your medications, or what is happening to you
now. If you are unsure, call us or call 911.

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Sources

The guidance in this article about when to seek emergency care is drawn
from these public sources. Each one is linked so you can read it yourself.

• MedlinePlus (National Library of Medicine) — First Aid — https://medlineplus.gov/firstaid.html
• Poison Control (National Capital Poison Center) — Poison Help, 1-800-222-1222 — https://www.poison.org/

This article is general information, not a diagnosis, and it cannot account
for your history or medications. If you are unsure, call us on (480) 237-4922
or come in. If it might be an emergency, treat it as one and call 911.

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