Medical emergency
Encyclopedia
A medical emergency is an injury
or illness
that is acute
and poses an immediate risk to a person's life or long term health. These emergencies may require assistance from another person, who should ideally be suitably qualified to do so, although some of these emergencies can be dealt with by the victim themselves. Dependent on the severity of the emergency, and the quality of any treatment given, it may require the involvement of multiple levels of care, from a first aid
er to an emergency physician
through to specialist surgeon
s.
Any response to an emergency medical situation will depend strongly on the situation, the patient
involved and availability of resources to help them. It will also vary depending on whether the emergency occurs whilst in hospital under medical care, or outside of medical care (for instance, in the street or alone at home).
(usually an ambulance
), by calling for help
using the appropriate local emergency telephone number
, such as 999, 911
, 111
, 112
or 000
. After determining that the incident is a medical emergency (as opposed to, for example, a police call), the emergency dispatchers will generally run through a questioning system such as AMPDS
in order to assess the priority level of the call, along with the caller's name and location.
Those trained to perform first aid
can act within the bounds of the knowledge they have, whilst awaiting the next level of definitive care. Those who are not able to perform first aid can also assist by remaining calm and staying with the injured or ill person. A common complaint of emergency service personnel is the propensity of people to crowd around the scene of victim, as it is generally unhelpful, making the patient more stressed, and obstructing the smooth working of the emergency services. If possible, first responders should designate a specific person to ensure that the emergency services are called. Another bystander should be sent to wait for their arrival and direct them to the proper location. Additional bystanders can be helpful in ensuring that crowds are moved away from the ill or injured patient, allowing the responder adequate space to work.
Many states of the USA have "Good Samaritan law
s" which protect civilian responders who choose to assist in an emergency. Responders acting within the scope of their knowledge and training as a "reasonable person" in the same situation would act are often immune to liability in emergency situations. Usually, once care has begun, a first responder or first aid provider may not leave the patient or terminate care until a responder of equal or higher training (e.g., fire department or emergency medical technicians) assumes care. This can constitute abandonment of the patient, and may subject the responder to legal liability. Care must be continued until the patient is transferred to a higher level of care, the situation becomes too unsafe to continue, or the responder is physically unable to continue due to exhaustion or hazards.
The principles of the chain of survival
apply to medical emergencies where the patient has an absence of breathing and heartbeat. This involves the four stages of Early access, Early CPR
, Early defibrillation and Early advanced life support
Unless the situation is particularly hazardous, and is likely to further endanger the patient, evacuating an injured victim requires special skills, and should be left to the professionals of the emergency medical and fire service.
physicians have training to deal with most medical emergencies, and maintain CPR
and ACLS
certifications. In disasters or complex emergencies, most hospitals have protocols to summon on-site and off-site staff rapidly.
Both emergency room and inpatient medical emergencies follow the basic protocol of Advanced Cardiac Life Support. Irrespective of the nature of the emergency, adequate blood pressure
and oxygenation
are required before the cause of the emergency can be eliminated. Possible exceptions include the clamping of arteries
in severe hemorrhage.
is a trauma treatment concept, two emergency medical conditions have well-documented time-critical treatment considerations: stroke
and myocardial infarction
(heart attack). In the case of stroke, there is a window of three hours within which the benefit of thrombolytic drug
s outweighs the risk of major bleeding. In the case of a heart attack, rapid stabilization of fatal arrhythmias can prevent sudden cardiac arrest. In addition, there is a direct relationship between time-to-treatment and the success of reperfusion (restoration of blood flow to the heart), including a time dependent reduction in the mortality and morbidity.
Injury
-By cause:*Traumatic injury, a body wound or shock produced by sudden physical injury, as from violence or accident*Other injuries from external physical causes, such as radiation injury, burn injury or frostbite*Injury from infection...
or illness
Illness
Illness is a state of poor health. Illness is sometimes considered another word for disease. Others maintain that fine distinctions exist...
that is acute
Acute (medicine)
In medicine, an acute disease is a disease with either or both of:# a rapid onset, as in acute infection# a short course ....
and poses an immediate risk to a person's life or long term health. These emergencies may require assistance from another person, who should ideally be suitably qualified to do so, although some of these emergencies can be dealt with by the victim themselves. Dependent on the severity of the emergency, and the quality of any treatment given, it may require the involvement of multiple levels of care, from a first aid
First aid
First aid is the provision of initial care for an illness or injury. It is usually performed by non-expert, but trained personnel to a sick or injured person until definitive medical treatment can be accessed. Certain self-limiting illnesses or minor injuries may not require further medical care...
er to an emergency physician
Emergency medicine
Emergency medicine is a medical specialty in which physicians care for patients with acute illnesses or injuries which require immediate medical attention. While not usually providing long-term or continuing care, emergency medicine physicians diagnose a variety of illnesses and undertake acute...
through to specialist surgeon
Surgeon
In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...
s.
Any response to an emergency medical situation will depend strongly on the situation, the patient
Patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....
involved and availability of resources to help them. It will also vary depending on whether the emergency occurs whilst in hospital under medical care, or outside of medical care (for instance, in the street or alone at home).
Response
For emergencies starting outside of medical care, a key component of providing proper care is to summon the emergency medical servicesEmergency medical services
Emergency medical services are a type of emergency service dedicated to providing out-of-hospital acute medical care and/or transport to definitive care, to patients with illnesses and injuries which the patient, or the medical practitioner, believes constitutes a medical emergency...
(usually an ambulance
Ambulance
An ambulance is a vehicle for transportation of sick or injured people to, from or between places of treatment for an illness or injury, and in some instances will also provide out of hospital medical care to the patient...
), by calling for help
Call for Help
Call for Help, also known as CFH, was a computer-themed television program that first aired exclusively on TechTV , a cable and satellite television network focused on technology, and then aired on G4techTV Canada and the HOW TO Channel in Australia...
using the appropriate local emergency telephone number
Emergency telephone number
Many countries' public telephone networks have a single emergency telephone number, sometimes known as the universal emergency telephone number or occasionally the emergency services number, that allows a caller to contact local emergency services for assistance. The emergency telephone number may...
, such as 999, 911
9-1-1
9-1-1 is the emergency telephone number for the North American Numbering Plan .It is one of eight N11 codes.The use of this number is for emergency circumstances only, and to use it for any other purpose can be a crime.-History:In the earliest days of telephone technology, prior to the...
, 111
1-1-1
111 is the emergency telephone number in New Zealand. It was first implemented in Masterton and Carterton on 29 September 1958, and was progressively rolled out nationwide with the last exchanges converting in 1988...
, 112
1-1-2
112 is the principal emergency telephone number that can be dialed free of charge from any telephone or any mobile phone in order to reach emergency services in the European Union , its candidates for accession, members of the EEA agreement, as well as several other countries in the world...
or 000
000 emergency
Triple Zero is the primary national emergency number in Australia. The Emergency Call Service is operated by Telstra a condition of its telecommunications licence, and is intended only for use in life-threatening or time-critical emergencies...
. After determining that the incident is a medical emergency (as opposed to, for example, a police call), the emergency dispatchers will generally run through a questioning system such as AMPDS
Advanced Medical Priority Dispatch System
The Advanced Medical Priority Dispatch System , is an Emergency Medical Dispatch system developed and marketed by Priority Dispatch Corporation. AMPDS is primarily used in the United Kingdom, where it is medically approved...
in order to assess the priority level of the call, along with the caller's name and location.
Those trained to perform first aid
First aid
First aid is the provision of initial care for an illness or injury. It is usually performed by non-expert, but trained personnel to a sick or injured person until definitive medical treatment can be accessed. Certain self-limiting illnesses or minor injuries may not require further medical care...
can act within the bounds of the knowledge they have, whilst awaiting the next level of definitive care. Those who are not able to perform first aid can also assist by remaining calm and staying with the injured or ill person. A common complaint of emergency service personnel is the propensity of people to crowd around the scene of victim, as it is generally unhelpful, making the patient more stressed, and obstructing the smooth working of the emergency services. If possible, first responders should designate a specific person to ensure that the emergency services are called. Another bystander should be sent to wait for their arrival and direct them to the proper location. Additional bystanders can be helpful in ensuring that crowds are moved away from the ill or injured patient, allowing the responder adequate space to work.
Many states of the USA have "Good Samaritan law
Good Samaritan law
Good Samaritan laws are laws or acts protecting those who choose to serve and tend to others who are injured or ill. They are intended to reduce bystanders' hesitation to assist, for fear of being sued or prosecuted for unintentional injury or wrongful death...
s" which protect civilian responders who choose to assist in an emergency. Responders acting within the scope of their knowledge and training as a "reasonable person" in the same situation would act are often immune to liability in emergency situations. Usually, once care has begun, a first responder or first aid provider may not leave the patient or terminate care until a responder of equal or higher training (e.g., fire department or emergency medical technicians) assumes care. This can constitute abandonment of the patient, and may subject the responder to legal liability. Care must be continued until the patient is transferred to a higher level of care, the situation becomes too unsafe to continue, or the responder is physically unable to continue due to exhaustion or hazards.
The principles of the chain of survival
Chain of survival
The chain of survival refers to a series of actions that, when put into motion, reduce the mortality associated with cardiac arrest. Like any chain, the chain of survival is only as strong as its weakest link...
apply to medical emergencies where the patient has an absence of breathing and heartbeat. This involves the four stages of Early access, Early CPR
Cardiopulmonary resuscitation
Cardiopulmonary resuscitation is an emergency procedure which is performed in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person in cardiac arrest. It is indicated in those who are unresponsive...
, Early defibrillation and Early advanced life support
Unless the situation is particularly hazardous, and is likely to further endanger the patient, evacuating an injured victim requires special skills, and should be left to the professionals of the emergency medical and fire service.
Clinical response
Within hospital settings, an adequate staff is generally present to deal with the average emergency situation. Emergency medicineEmergency medicine
Emergency medicine is a medical specialty in which physicians care for patients with acute illnesses or injuries which require immediate medical attention. While not usually providing long-term or continuing care, emergency medicine physicians diagnose a variety of illnesses and undertake acute...
physicians have training to deal with most medical emergencies, and maintain CPR
Cardiopulmonary resuscitation
Cardiopulmonary resuscitation is an emergency procedure which is performed in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person in cardiac arrest. It is indicated in those who are unresponsive...
and ACLS
Advanced cardiac life support
Advanced cardiac life support or Advanced Cardiovascular Life Support refers to a set of clinical interventions for the urgent treatment of cardiac arrest and other life threatening medical emergencies, as well as the knowledge and skills to deploy those interventions.Extensive medical knowledge...
certifications. In disasters or complex emergencies, most hospitals have protocols to summon on-site and off-site staff rapidly.
Both emergency room and inpatient medical emergencies follow the basic protocol of Advanced Cardiac Life Support. Irrespective of the nature of the emergency, adequate blood pressure
Blood pressure
Blood pressure is the pressure exerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. When used without further specification, "blood pressure" usually refers to the arterial pressure of the systemic circulation. During each heartbeat, BP varies...
and oxygenation
Oxygenation (medical)
Oxygenation occurs when oxygen molecules enter the tissues of the body. For example, blood is oxygenated in the lungs, where oxygen molecules travel from the air and into the blood...
are required before the cause of the emergency can be eliminated. Possible exceptions include the clamping of arteries
Artery
Arteries are blood vessels that carry blood away from the heart. This blood is normally oxygenated, exceptions made for the pulmonary and umbilical arteries....
in severe hemorrhage.
Non-trauma emergencies
While the golden hourGolden hour (medicine)
In emergency medicine, the golden hour refers to a time period lasting from a few minutes to several hours following traumatic injury being sustained by a casualty, during which there is the highest likelihood that prompt medical treatment will prevent death...
is a trauma treatment concept, two emergency medical conditions have well-documented time-critical treatment considerations: stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
and myocardial infarction
Myocardial infarction
Myocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...
(heart attack). In the case of stroke, there is a window of three hours within which the benefit of thrombolytic drug
Thrombolytic drug
Thrombolytic drugs are used in medicine to dissolve blood clots in a procedure termed thrombolysis. They limit the damage caused by the blockage of the blood vessel.-Uses:...
s outweighs the risk of major bleeding. In the case of a heart attack, rapid stabilization of fatal arrhythmias can prevent sudden cardiac arrest. In addition, there is a direct relationship between time-to-treatment and the success of reperfusion (restoration of blood flow to the heart), including a time dependent reduction in the mortality and morbidity.