Cochin Cardiac Club

Health Blog by Dr.Uday Nair

MEDICAL EMERGENCIES




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 aider to an emergency physician through to specialist surgeons.
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).

The following are warning signs of a medical emergency:
  • Bleeding that will not stop
  • Breathing problems (difficulty breathing, shortness of breath)
  • Change in mental status (such as unusual behavior, confusion, difficulty arousing)
  • Chest pain
  • Choking
  • Coughing up or vomiting blood
  • Fainting or loss of consciousness
  • Feeling of committing suicide or murder
  • Head or spine injury
  • Severe or persistent vomiting
  • Sudden injury due to a motor vehicle accident, burns or smoke inhalation, near drowning, deep or large wound, etc.
  • Sudden, severe pain anywhere in the body
  • Sudden dizziness, weakness, or change in vision
  • Swallowing a poisonous substance
  • Upper abdominal pain or pressure
BE PREPARED
  • Determine the location and quickest route to the nearest emergency department before an emergency happens.
  • Keep emergency phone numbers posted by the phone. Everyone in your household, including children, should know when and how to call these numbers. These numbers include:
    • Fire department
    • Police department
    • Poison control center
    • Ambulance center
    • Your doctors' phone numbers
    • Contact numbers for neighbors or nearby friends or relatives.
    • Work phone numbers
  • Know at which hospital(s) your doctor practices and, if practical, go there in an emergency.
  • Keep a medical history card if you have a chronic condition or look for one on a person who has any of the symptoms mentioned.
  • Get a personal emergency response system if you are elderly, especially if you live alone.
WHAT TO DO IF SOMEONE NEEDS HELP?
  • Remain calm, and call your local emergency number.
  • Start CPR or rescue breathing, if necessary and if you know the proper technique.
  • Place a semiconscious or unconscious person in the recovery position until the ambulance arrives. DO NOT move the person, however, if there has been or may have been a neck injury.
Upon arriving at an emergency room, the person will be immediately evaluated. Life- or limb-threatening conditions will be treated first. Persons with conditions that are not life- or limb-threatening may have to wait.

CALL YOUR LOCAL EMERGENCY NUMBER or AMBULANCE  IF:
  • The person's condition is life-threatening (for example, the person is having a heart attack or severe allergic reaction)
  • The person's condition could become life-threatening on the way to the hospital
  • Moving the person could cause further injury (for example, in case of a neck injury or motor vehicle accident)
  • The person needs the skills or equipment of paramedics
  • Traffic conditions or distance might cause a delay in getting the person to the hospital.


SOME QUICK LOOK REMEDIES FOR COMMON MEDICAL EMERGENCIES : 



MYOCARDIAL INFARCTION : 


“Heart Attack” Impairment of heart function- inadequate blood flow to the heart compared to its needs, caused by obstructive changes in the coronary circulation.
Obstruction due to 1)Thrombus 2)Plaque rupture 3)Vessel spasm.



Symptoms 


Acute central chest pain not responding to nitrates.

Pain radiating to neck/left arm ,Associated with nausea/sweating/breathlessness/palpitations/collapse.Silent MI (diabetics & elderly)



What can be done?



Give semi-sitting position,Reassure, immobilize.
Call Ambulance.
Angina medications – nitrates (sublingual tablets/sprays),Aspirin, chewable.
Monitor pulse & breathing CPR if necessary


CARDIO-PULMONARY RESUSCITATION : 


CARDIO-PULMONARY RESUSCITATION UNRESPONSIVE?? SHOUT FOR HELP.
OPEN AIRWAY BY HEAD TILT/CHIN LIFT LOOK, LISTEN, FEEL IF BREATHING.
RECOVERY POSITION FOR BREATHING IF NOT BREATHING.
CALL FOR ASSISTANCE 30 CHEST COMPRESSIONS (AT RATE OF 100/MIN) 2 RESCUE BREATHS 30 COMPRESSIONS.



STROKE:


Rapidly developed clinical signs of focal disturbance of cerebral function lasting more than 24 hrs or leading to death, with no apparent cause other than vascular origin.
Recovery within 24 hrs – TIA, no residual deficit.
Causes – Thrombus/Embolus/Hemorrhage


 Symptoms 


Sudden weakness of one side of the body (sign of paralysis).

Difficulty in speaking/ drooping mouth,Dribbling of saliva from one side of mouth,Blurred vision/ partial loss of sight / flashing lights, Confusion and disorientation,Sometimes loss of consciousness.



What to do?



If unconscious then place the person in recovery position.
If conscious, make him lie down with head and shoulders raised Monitor, Reassure, Call Ambulance,Resuscitate if necessary.







HYPOGLYCEMIA : 



Low blood sugar level.
Causes- Diabetics on Insulin Starvation, Excessive alcohol intake.
Less common causes – liver failure, sepsis, endocrine tumors


Symptoms 


History of diabetes,Excess hunger, Feeling faint or dizzy, Strange behavior – Confusion, aggression.Palpitations, tremors Pale, cold, sweaty skin .

Loss of consciousness e/o diabetes – medic alert/syringe in bag



What should be done




If conscious, give GLUCOSE orally till person feels better. If unconscious, monitor airway and breathing and seek medic help. Give glucagon inj (keep prefilled syringe in c/o diabetes) If possible, IV glucose.





SEIZURES : 


Seizure – paroxysmal event due to abnormal,excessive, hyper synchronous discharges from an aggregate of CNS neurons.
Epilepsy – a condition in which a person has recurrent seizures due to a chronic, underlying process

Symptoms 


Aura Sudden rigidity of body – tonic phase ,Collapse d/t which injuries may be sustained F/b periodic relaxation of muscles – clonic phase, Tongue bite B&B incontinence Post ictal exhaustion & confusion/headache.
Other types – absence seizure, partial seizure, secondary generalized etc


First Aid


Move person away from danger e.g. fire, water, furniture. Don’t try to restrain. Don’t insert anything in mouth. After convulsion ceases, give recovery position Ensure airway is clear. Don’t leave person alone even after seizure.Reassure, support. If seizure persists >5 min/recurs w/o regaining consciousness- call Ambulance



ASTHMA : 

Disease of airways charac. By increased responsiveness of the tracheobronchial tree to a variety of stimuli. Clinical Course – Acute exacerbations with remissions / Continuous episode (status asthmaticus)
Causes – genetic (hereditary) allergic idiopathic.

Triggers Allergens d/t weather & season change, animal fur & dander, smoke, dust Pharmacologic agents - aspirin coloring agents 
Air pollutants – ozone, nitrogen dioxide, sulfur dioxide 
Occupational asthma Infections – influenza, parainfluenza Exercise Emotional upsets

Symptoms 


Shortness of breath Cough Chest tightness 
Wheezing Associated symptoms – inability to speak, pale skin, blueness, distress, confusion Ultimately – unconscious & ceases to breathe


What you should do:


Move away from the thing that triggered the episode. Take a quick relief asthma medication Stay calm so that breathing gets better
Call Ambulance if: No response to medication Lips/fingernails turn blue or grey It is hard to talk Nasal flare Skin is pulled around the neck & ribs when person breathes Heartbeat/pulse is too fast




ROAD TRAFFIC ACCIDENTS : 


Critical four minutes: One of the most common causes of a road accident death is due to loss of oxygen supply. Normally it takes less than four minutes for a blocked airway to cause death. The 'golden hour’: The first hour after the trauma is called the 'golden hour'



What can you do? : 


Beware of further collisions and fire Alert oncoming traffic to the danger ahead.
Don’t allow anyone to smoke. Get assistance from bystanders.
Call Ambulance. Don’t move casualties who remain in their vehicles, unless they are in danger by doing so. Never remove a motorcyclist’s helmet unless deemed necessary. Avoid unnecessary movements.
Reassurance

If person responsive, ask questions/shake gently by shoulders and ensure airway is open.
If breathing but unconscious put in recovery position.
 If not responsive then start CPR In case of bleeding- check if there are any objects in the wound If the wound is clear of objects apply firm pressure over the wound If there are objects embedded in the wound do not press them, and build up padding around the object.


CARDIO-PULMONARY RESUSCITATION : 


CARDIO-PULMONARY RESUSCITATION UNRESPONSIVE?? SHOUT FOR HELP.
OPEN AIRWAY BY HEAD TILT/CHIN LIFT LOOK, LISTEN, FEEL IF BREATHING .
RECOVERY POSITION FOR BREATHING IF NOT BREATHING.
CALL FOR ASSISTANCE 30 CHEST COMPRESSIONS (AT RATE OF 100/MIN) 2 RESCUE BREATHS 30 COMPRESSIONS



 


In case of burns- Cool it by clean cold water for at least 10 mins Don’t remove anything that may be stuck to it








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