Relatives, Alcohol, Knives, and Other ED Thanksgiving Tales

Nov 25, 2011— -- Asked how people can avoid illness and injury on Thanksgiving Day, an emergency physician in Detroit may have said it best: "People need to minimize their alcohol consumption. But if they don't, stay away from relatives and carving knives."

During major holidays when just about everything else is closed, the local ER is the only place for people with health problems to go. And every holiday has its unique health risks, whether it be spoiled eggs at Easter, mishandled fireworks on the Fourth of July, or short-circuiting light strings at Christmas.

MedPage Today and ABC News polled emergency physicians around the country to ask about cases they've treated on Thanksgivings past, and for their suggestions for safer Turkey Days -- or other holidays -- yet to come. Here's what they told us.

Relatives and Sharp Objects

Dr. Daniel Morris of Henry Ford Hospital in Detroit supplied the advice regarding relatives and knives as well as the anecdote behind it: It began with a fight over who would carve the turkey and ended with "an intoxicated patient" transported to the ER. Morris gave no other details, but from his recommendation for avoiding future episodes, we can guess what went down.

Another story from the same hospital was told by physician assistant Judy Wagensomer. EMTs arrived at a house to find a man lying on the floor after having been stabbed, by his brother, with a carving fork. But his injury did not stop the man from "eating as much turkey as he could ... because he knew once he got to the ER he wasn't getting any more food," Wagensomer said.

Watch What You Eat

Most physicians we contacted noted that overindulgence, with pain and sometimes vomiting as the immediate sequelae, are probably the most common health events associated with Thanksgiving. Dr. Rahul Khare of Northwestern Memorial Hospital in Chicago noted in an email that eating too much can sometimes be life-threatening.

"For example, if someone has an inflammatory bowel disease such as Crohn's or ulcerative colitis, a large amount of turkey combined with gravy and mashed potatoes, along with pumpkin pie, can cause intestinal blockage," Khare said. "We definitely see an increase in emergency department visits and patients who develop intestinal blockage."

Sometimes people also ingest things not meant to be ingested. Dr. Gary Vilke, chief of staff at the University of California San Diego Medical Center, said a colleague had once treated a patient in January who was complaining of rectal pain. "She had one of the small metal skewers used to hold the turkey legs together stuck in her anus, which she recalled was missing from her turkey during her Thanksgiving dinner two months prior," Vilke said.

New Recipes, New Dangers

Deep-fried turkey has become a holiday favorite in recent years. MedPage Today has been told it's tastier than the oven-roasted variety, but it requires immersing the bird in gallons of boiling oil. Khare said his department had seen a big increase in burns in the past five years.

"The difficulty comes when the cook removes it from the boiling oil," he said. "We see a significant amount of second-degree burns due to the tipping over of the pot; handling of the hot, fried turkey just after removal from oil; and significant grease burns from the splashes. Burns can ruin that turkey meal quickly."

He also indicated that drinking while deep frying was frequently a factor in such incidents.

Travel Tragedy

The Wednesday before and the Sunday after Thanksgiving are traditionally the highest-volume traffic days of the year. Dr. Thomas Tallman of the Cleveland Clinic related a sad story from earlier in his career that actually took place on Thanksgiving day.

An elderly woman, just arrived from the U.K., was driving to her son's house hoping to surprise him. Accustomed to driving on the left, she was in the wrong lane on the highway and smashed head on into another car. "She did not survive," Tallman said.

And the driver of the other car? It was the woman's son who was running a quick errand. He was not seriously injured, but "I have never felt so badly as I did [explaining] to him and his family what had happened," Tallman said.

The Upside

Dr. Vincent Mosesso Jr. of the University of Pittsburgh said the interaction of family and holiday sometimes is beneficial.

"During the holidays many persons are cajoled, or even forced, to come to [the emergency department] by family (or friends) who haven't seen them in a long time," he told MedPage Today and ABC News in an email. "The person often seems much worse to the visitor than when last seen and there is concern for acute illness or serious deterioration of chronic disease."

This may be an overreaction or may reflect the relative's guilt at not visiting more often. But "sometimes there are real issues that do need to be addressed," Mosesso added.

He recalled one older woman who was brought in with "a large, deep, gangrenous ulcer in a breast." Not only was it infected but it was related to a malignant tumor.

"If that had gone much longer she would have become septic and most likely died. So that was one case where the out-of-town relative visit did save the day."

How to Stay Out of the ER

Recommendations from emergency physicians for next year's Thanksgiving were simple and straightforward:

Eat and drink in moderation

Drive carefully and defensively

Be extra careful with knifes and other sharp implements. "Buy bagels pre-sliced," Tallman advised.

Now the key will be remembering them for a whole year.