The “stomach bug” or “stomach flu” is actually gastroenteritis, which is not the same as the influenza virus. Influenza or “flu” usually does not cause symptoms such as vomiting or diarrhea. So, what is gastroenteritis and what causes this distress?

Gastroenteritis is an inflammation of the stomach and small and large intestines. Symptoms are diarrhea, nausea or vomiting, abdominal cramps, and often a fever. Gastroenteritis is caused by viruses, bacteria or parasites.

Causes

Viral — Individuals who have viral gastroenteritis have contracted the illness primarily through infected fecal matter. Two common types of viral gastroenteritis are norovirus and rotavirus.

• Norovirus — These viruses are found in the vomit and stool of infected people. You can get it by: eating food or drinking liquids that are contaminated with norovirus, touching surfaces or objects contaminated with norovirus and then putting your hand or fingers in your mouth, or by having direct contact with a person who is infected with norovirus (for example, when caring for someone with norovirus or sharing foods or eating utensils with them).
  • People with norovirus illness are contagious from the moment they begin feeling sick until at least 3 days after they recover. But, some people may be contagious for even longer
  • When wide-spread infections occur on cruise ships or in school systems, norovirus is a common culprit.
• Rotavirus — Rotavirus is contracted directly through infected fecal matter and occurs predominantly in winter and spring. In the US, contagious outbreaks are common in childcare centers, hospitals, and nursing homes.
  • Frequent hand washing is the best tool to limit the spread of rotavirus infection, as well as vaccination which is now offered in the routine line up of infant immunizations

Bacterial — When improperly handled food or water containing bacteria is consumed, this may result in bacterial gastroenteritis. Undercooked meats, unclean utensils, untreated water, raw foods, and unwashed hands can all cause different strains of bacteria in what we eat or drink. Two of the most commonly known bacteria that cause gastroenteritis are E.coli and Salmonella.

E.coli — Although E.coli bacteria normally live in intestines, certain strains can cause inflammation of the small intestine and mild to severe food poisoning. When dangerous forms of E.coli are present in food and beverage products and distributed through the supply chain, there are often product recalls to prevent further illness and even death in individuals who have consumed the products.

Salmonella — Salmonella bacteria causes an infection of the lining of the small intestine. Salmonella outbreaks are also caused by unclean food equipment and improperly prepared food, particularly undercooked poultry and eggs. Salmonella can also be contracted from certain reptile pets, such as turtles, lizards, and snakes, which can carry the bacteria.

Parasitic — Gastroenteritis can also be caused by parasites such as protozoa, nematodes, and amoeba. Which can be spread on dirty hands, on the soiled surfaces of toys or bathrooms or through contaminated drinking or swimming water.

• Giardia is the most common cause of parasitic gastroenteritis in the United States.

Prevention

• Wash hands often and thoroughly.
• Avoid potentially contaminated water and food.
• Avoid contact with infected individuals when possible.
• Cook food thoroughly. When in doubt, throw it out.
• Clean kitchen surfaces and equipment thoroughly.
• Do research before swimming. Has the water been tested?
• When sick, stay home so others do not become infected.

What is Urgent Care?

As defined by the Urgent Care Association of America, Urgent Care is healthcare provided on a walk-in, no-appointment basis for acute illness or injury that is not life or limb threatening, and is beyond the scope or availability of the typical primary care practice or retail clinic.

Urgent Care centers provide walk-in, extended-hour care for illnesses and injuries that do not belong in an emergency room. Typical urgent care services include physicals, immunizations, xrays, blood and urine tests, fracture and laceration care, EKG’s, oxygen and intravenous fluids. They are owned by physicians, groups of physicians, hospitals and corporations and are staffed with qualified and experienced physicians, physician assistants and nurse practitioners.

Did You Know?

• Urgent Care Centers have been open in the U.S. for over 30 years.
• Since the 1990’s the number of Urgent Care Centers increased from 4,000 to 9,000.
• The U.S. healthcare system faces increased patient needs, decreased access to care, rising costs, and growing demands on primary care and emergency care systems.
• Independent studies show that Urgent Care improves access and lowers cost, but no global review has been done at a legislative level.
• The current healthcare reform dialogue emphasizes use of advanced primary care and primary care physicians as the solution for lowering costs.
• There is no inclusion of Urgent Care in any of the recent federal healthcare legislation.
• Urgent Care’s role to help our healthcare system has not yet been examined.Access to Care
• As of June 2011, according to the Department of Health and Human Services, there are over 66 million people living in a primary care health professional shortage area.
• In 2007 that number was at 56 million.
• Only 57% of Americans report having same or next-day access to primary care.
• 63% have difficulty finding care evenings, weekends or holidays. The ER is the only option. In 2010 20% of adults reported waiting six days or more to see a doctor.

Projected Physician Access

• By 2020, there will be 45,000 too few primary care physicians.
• By 2025 the over-65 population will grow to 80 million.
• The Patient Protection and Affordable Care Act will provide healthcare coverage for a new group of 32 million individuals, which will add to the physician access shortfall.
• The demanding role of primary care physicians includes extensive patient education, diagnosis, treatment, and follow up, limiting time for new and limited access patients. Enhanced Primary Care Physician Options
• Primary Care Physicians can expand their hours to add more unscheduled patients, but this does not address the projected shortfall in primary care physicians in ten years.
• Urgent Care centers can handle episodic urgent patient visits in a collaborative and mutually supportive manner with primary care physicians.
• Partnering with an urgent care center, which already has extended hours, can costeffectively absorb primary care overflow patients.

Emergency Department Realities

• Emergency departments are overcrowded and high-cost for non-emergency care.
• Crowded ERs threatens timely patient care, resulting in prolonged pain and suffering.
• The number of emergency departments is falling and visits are increasing.
• ERs provide a disproportionate share of services to Medicaid and uninsured patients.Increasing rates of ER visits by the elderly in an aging population can lead to “catastrophic overcrowding.”
• Average ER wait times are approximately 4 hours.
• Contributing to over-crowded ERs is non-emergency care in the ER department.
• Urgent care centers can help lower cost of non-emergency care.
• For hospitals and ERs, high costs will continue to rise.
• The population will continue to age and require more care.

Measuring and Lowering Costs

• Cost savings for an urgent care visit versus an emergency room visit for the same diagnosis ranges from $228 – $583.
• At 31.64 million non-emergency visits, the cost savings of using an urgent care center instead of an ER could range from 7.22 – 18.45 billion dollars annually.
• This difference in cost is the most significant issue with the use of the emergency department as a panacea.
• By its nature, most non-emergency care can wait until morning. Pilot Programs for Lowering Costs
• Some insurance payers already recognize the cost-savings that urgent care represents and are educating patients about their alternatives for non-emergency treatment.
• One of Wellpoint’s health plans, Anthem Blue Cross and Blue Shield in Virginia, reviewed their visit data and found that more than 60% of ER visits for members were for diagnoses that could have been treated at urgent care centers.
• After launching a patient education initiative, Anthem saw a 14% decrease in ER visits in one year among members who were part of its program.

Current and Future Roles for Urgent Care

• With the industry’s growth, urgent care is available in more communities and can now be considered as part of the solution to lowering U.S. healthcare costs.
• The viability of urgent care centers for creating access while keeping cost low is in their existing capacity to absorb episodic primary care visits and non-emergency ER visits.
• Even without concerted federal or state efforts, use of urgent care centers is rising.
• Current access and capacity in communities with urgent care centers is successful based on an average patient wait time of approximately 20 minutes for 74% of patients.The growth rate of urgent care centers indicates continued building of capacity to absorb additional visits.
• What is missing is national discussion of this capacity and its potential to save billions of dollars to the U.S. healthcare system.
• In the future, urgent care centers could be considered as key sites for non-emergency treatment in a disaster. If hospitals are overwhelmed with serious injuries, urgent care centers could be designated as treatment sites for less critical patients.
• Community officials could establish a network of the centers in their areas and include them in public notifications of disaster planning programs.

How YOU Can Help

• Find the nearest urgent care center to where you live and use it for acute, but nonemergency visits when you do not have access to your primary care physician.
• Write to your local, state, and federal legislators and emphasize that urgent care must be considered as part of the national U.S. healthcare reform.
• Educate family, friends and neighbors about urgent care and how important it is to use these facilities and ask them to write to their legislators as well.

For more information, visit the Urgent Care Association of America website at: www.ucaoa.org

This document was extracted by Urgent Care of Connecticut from The Case of Urgent Care, UCAOA, September 1, 2011 in an effort to generate awareness of the importance of urgent care and the impact it could have on reducing cost in our healthcare system. Urgent Care of Connecticut has four locations in Southbury, Brookfield, Norwalk and Ridgefield and is growing and added approximately 100 jobs to Connecticut. For more information about Urgent Care of Connecticut visit our website at www.ucofconnecticut.com.

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The company’s goal is to exceed patient expectations with every visit and provide a more pleasant experience than an emergency room, from a more inviting decor, to a cheerful and engaged staff and shorter wait times.

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You’re back to school and that means shared classroom space and public areas can become breeding grounds for illnesses and injuries. Although ailments cannot always be avoided, the following tips can help you stay well physically and mentally. I wish all students a very safe and healthy school year.

• Get Enough Sleep – Settle down before bed with a relaxing routine. Turn off the TV and electronic games. Take a warm shower or bath. Sit up in a chair and read a magazine or good story until you’re sleepy. When going to bed, prevent a morning headache by adjusting your pillow to avoid neck strain. The amount of sleep an individual needs varies with age and individual needs, but ranges between 8 and 12 hours. You should wake up feeling rested and refreshed.
• Eat a Healthy Diet - This is so important for your brain development and immune system. Eat balanced daily meals with whole grains, lean proteins, colorful fruits, veggies, dairy products and healthy snacks. Limit fats, sugars and processed foods. Hydrate by drinking enough water throughout the day.
• Ease Morning Stress – After dinner, put books and completed homework into your backpack. Select an outfit and find weather-appropriate outerwear for the bus stop in the morning. Write a brief “to do” list in your daily planner for the next day. Staying organized helps clear your mind of the small stuff to help you maximize your learning potential. This can also assist you with getting quality sleep.
• Be Keen and Clean - Clean clothes, brushed teeth and combed hair helps you feel your best. When in the classroom – or anywhere – cough and sneeze into your sleeve and not on your neighbors. Do not borrow combs and hats. This can put you at risk for head lice. To prevent cold germs from spreading, use hand sanitizer, wash your hands, and keep your hands off your face.
• Just Talk About It – Do you feel anxious at times? Talk to a parent, teacher, guidance counselor or friend about what’s on your mind. Learning to express yourself is so important to keep butterflies at bay. Take some deep breaths. Get up and stretch. Keeping your feelings bottled up can take a toll on your physical and mental health.
• Get Fit – Physical activity such as sports, dance, and martial arts builds friendships, self-confidence and helps you perform better in school. To avoid injuries, follow the rules for safety, don’t overdo it, and use good sportsmanship. Also, lighten up your backpack and adjust the straps to take care of that spine.
• Derail that Bully – If you encounter a bully, stand tall, turn and walk away. If the bully is persistent, get help from a guidance counselor, teacher or parent. The consequences of bullying can be devastating. Have a pact among your friends and peers to help victims of bullying. Go together to a school official or parent so appropriate action can be taken to stop the bully.
• Take Care of Yourself – Avoid toxic people and toxic substances. Drug and alcohol abuse leads to poor performance in school, mood disorders, fatigue, and health problems. Do not drive under the influence or get into a car if you think the driver has been abusing substances. Surround yourself with fun, positive friends. Share your talents in art, music, sports. Try new hobbies or activities together.

Here are some websites that have more valuable information about these tips:

kidshealth.org

fit.webmd.com

Everyone loves summer, and there is nothing more fun than being out in the sun on a hot summer day. However, the sun can also be dangerous. Prolonged exposure to the sun is the most preventable risk factor for skin cancer. Sun exposure can also cause retina damage, cataracts, and even immune suppression. The main hazard of sunlight comes from its ultraviolet rays, specifically the UVA and UVB rays. UVA leads to aging, and UVB leads to burning.

A sensible combination of sunscreen, shade and proper clothing will allow us to get the most out of the sun and at the same time, minimize our risk. First, sunscreen should always be used when you are going to be outside this summer. The American Academy of Pediatrics advocates use for children greater than 6 months of age. It should be rated SPF 15 or more and protect against both UVA and UVB rays. It should be generously applied to all exposed areas including the ears, back, shoulders, and the back of the knees and legs. Remember to protect your lips with lip balm containing sunscreen. Apply 30 minutes before exposure to the sun to allow sufficient time to interact with the skin, and reapply at least every 2 hours. If you’ve been swimming or sweating, apply sunscreen even more frequently. Adults should use about 35ml or 1oz of sunscreen to cover their entire body. That’s the same amount that would fit into a shot glass. Find a sunscreen that fits your budget so that you use it frequently and freely. Just because a product is expensive, doesn’t mean it works better.

Second, spend as much time in the shade as possible. This is especially important between 10AM and 4PM, when the sun’s rays are the strongest. If your shadow is shorter than you, it is time to move to the shade.

Third, the proper clothing will also help protect you. A hat should have a wide brim to protect your face, neck and ears from the sun. Wear sunglasses to protect your eyes from the sun. Choose sunglasses that block both UVA and UVB. Clothing should be tightly woven and loose fitting, and cover as much exposed skin as possible. Just because it is cloudy does not mean that the dangers of the sun are not shining through. At least 40% of the sun’s harmful rays penetrate the clouds. Cloudy days can actually be more dangerous, since people may not be as careful to protect themselves well.
Be careful, and you’ll safely enjoy the summer rays!

Concussions are a temporary loss of brain function, which can be mild to severe. Symptoms that are serious include loss of consciousness, amnesia, nausea and vomiting, extreme headache, poor concentration, coordination or balance, slurred speech, confusion, and sleepiness. When these symptoms occur after a head injury, seek medical attention immediately.

When no obvious symptoms are noticeable after a head injury, your son or daughter should still be monitored closely for several days. If he or she develops a headache, dizziness, vision changes, personality changes, poor concentration and forgetfulness go to a doctor for a thorough examination. The doctor may need to rule out a brain bleed, which can be detected on a CT scan.

It is important that your son or daughter is “benched” until a doctor gives clearance to return to play. The brain needs time to heal after a concussion or else it is vulnerable to further injury. If recurring, concussions can lead to permanent brain injury.

When an athlete returns to play too soon and suffers a second brain injury it can lead to “Second Impact Syndrome” and possibly cause sudden death. Because of this risk, the athlete should not be allowed to play until he or she is completely symptom free, both at rest and during exertion. An athlete who has too many concussions in too short a time may need to be “benched” for the season.

The NFL recently initiated a research focus about the long-term risk of recurring concussions. The research found that a number of former athletes suffered brain damage leading to early dementia and other neurological problems. As a result, the NFL mandates that players be completely asymptomatic and pass a series of neurologic tests before they return to play. The NFL’s new culture no longer glorifies players who play injured, and instead considers this irresponsible.

To help prevent concussions, young athletes need to wear proper equipment including helmets and to follow the coach’s rules for safety, proper technical form, and good sportsmanship. They also need to be honest about their symptoms and not feel that it is a “badge of honor” to play injured.

When your child suffers a head injury, take it seriously. Watch for symptoms that may indicate a concussion. Bring your child to the doctor for an evaluation and follow the doctor’s orders about returning to play. Remember, it is better to miss one game than to suffer a more serious injury and miss the whole season.

Some Guidelines for Parents

A child with a fever causes worry for most parents. Please allow me to provide some advice to ease your mind when a young person in your household has a fever. First, remember that almost all fevers are caused by infections. If you have a fever, it means your body is fighting an infection. Teething in infants probably does not cause fever. It’s best to focus on the fever rather than the teething so you are not distracted from what is really going on with your child.

How Sick is My Child?

First, get an accurate temperature reading. Keep in mind that the height of the fever does not determine how sick your child is. A serious illness can occur with either a low fever or a high fever. A mild viral illness can also occur with either a high or low fever. When evaluating a fever, carefully look at your child’s behavior for signs of serious illness. Is your child paying attention to you and to what is going on in the room? Is your child active and interested in playing? Check your child’s color. Also, carefully look at his or her breathing pattern. Is your child breathing fast or working hard to breathe? This assessment is as important, if not more important, than how high the fever is.

What type of thermometer shall I use?

Newborns and Young Children – Use a rectal, non-mercury thermometer only. Never use a mercury thermometer. If the glass breaks, toxic mercury will be released and inhaled by anyone standing nearby.

Children Over Age One – Axillary, or under the arm-pit, thermometers are acceptable and are almost as accurate as rectal thermometers.

Older Children – Oral mouth thermometers can be used. Your child should be able to comfortably hold the thermometer in his or her mouth with closed lips. Use a simple digital thermometer. Ear and forehead thermometers are not reliable and should not be used in children.

What kind of medicine should I give my child, and how much?

Fever medications may be given to make the child more comfortable. Either acetaminophen or ibuprofen may be used. Do not give any medicine to babies who are younger than 3 months of age without first talking to your doctor.

Acetaminophen (one brand name: Children’s or Infants’ Tylenol) relieves pain and lowers fever. The correct dosage depends on your child’s weight and age.

Ibuprofen (two brand names: Children’s Advil, Children’s Motrin) is another medicine that can be used to lower a fever in children older than 6 months of age. Talk to your doctor before giving ibuprofen to your child. Again, the correct dose depends on your child’s weight and age.

Can I give my child aspirin to lower his or her fever?

No. In rare cases, aspirin can cause Reye’s syndrome in children. Reye’s syndrome is a serious illness that can lead to death. We recommend that parents not give aspirin to children younger than age 18

What else can I do to help my child feel better?

In older children, a warm sponge bath is also a great way to both lower the temperature and to observe the child for signs of serious illness. The child must be old enough to sit unassisted in the tub and always be observed by a parent.

• Give your child plenty of fluids to drink to prevent dehydration (not enough fluid in the body) and help the body cool itself. Water, clear soups, popsicles and flavored jell-o are good choices.
• If your child is getting enough fluids, don’t force him or her to eat if he or she doesn’t feel like it.
• Make sure your child gets plenty of rest.
• Keep the room temperature at about 70°F to 74°F.
• Dress your child in loose cotton clothing. Overdressing can trap body heat and cause your child’s temperature to rise.
• If your child has chills, give him or her an extra blanket. Remove it when the chills stop.

When should I call the doctor or make sure that my child is seen?

If your child has any of the following warning signs:

• Constant vomiting or diarrhea
• Dry mouth
• Earache or ear pulling
• Fever comes and goes over several days
• High-pitched crying
• Irritability
• No appetite
• Pale appearance
• Seizures
• Severe headache
• Skin rash
• Sore or swollen joints
• Sore throat
• Stiff neck
• Stomach pain
• Swelling of the “soft spot” on an infant’s head
• Unresponsiveness or limpness
• Wheezing or problems breathing
• Whimpering

3 months of age or younger - call or be seen right away if your baby’s rectal temperature is 100.4°F (38°C) or higher even if your child doesn’t seem sick. Babies this young can get very sick quickly.

3 to 6 months of age - call or be seen if your baby has a temperature of 101°F (38.3°C) or higher, even if your baby doesn’t seem sick.

6 months and older and has a fever of 102°F (38.8°C) to 102.9°F (39.4°C), watch how he or she acts. Call or be seen if the fever rises or lasts for more than 2 days.

6 months and older and has a fever of 103°F (39.4°C) or higher, call or be seen even if your child seems to feel fine.

Trust your instincts as a parent. If you think something is wrong, call you doctor or go to your local urgent care center. You and your doctor will be glad you did.