Hamma

Bala Francis Hamma submitted 2017-08-15

Emergency medical care

Emergencies and disasters are an unfortunate part of life. During an emergency situation, how you react, and how you care for an injured individual, can make a difference between life and death. The delivery of emergency care and advance cardiac life support (ACLS) requires trained and dedicated personnel that can carry out emergency life-saving procedures.

Emergency medical care involves care for undifferentiated, unscheduled patients with acute illnesses or injuries that require immediate attention. Although emergency physicians do not usually provide long-term or continuing care, they carry out urgent and rapid investigations and interventions to resuscitate and stabilize patients.

The aetiology of medical emergencies are multi-systemic. They include:

• Cardio-vascular emergencies: cardiac arrest, hypertension, acute coronary syndrome, acute heart failure, disorders of cardiac rhythm, acute deep vein thrombosis (DVT) and acute pulmonary embolism.
• Respiratory emergencies: respiratory arrest, oxygen therapy in acute illness, asthma and spontaneous pneumothorax.
• Gastro-intestinal emergencies: acute gastro-intestinal bleeding, bleeding oesophageal varices and acute bloody diarrhea.
• Diabetic and endocrine emergencies: diabetic ketoacidosis (DKA) and hypoglycaemia.
• Neurology emergencies: acute stroke and status epilepticus.
• Renal emergencies: acute kidney injury (AKI).
• Electrolyte disturbances: hypokalaemia, hyperkalaemia, hypocalcaemia, hypercalcaemia, hyponatraemia and hypernatraemia.
• Sickle cell crisis, drug over-dosage/acute poisoning, decompensated liver disease, acute painful joints and acute psychiatric emergencies.

Medical emergencies can be frightening. However, it is essential to know how to recognize an emergency complication. Medical emergencies often come with serious signs and symptoms that are life threatening. These may include:

• Shortness of breath—when the body lacks sufficient air supply to provide the vital organs and cells with oxygen for life.
• No breath or pulse—if the victim is not breathing nor has pulse.
• Chest or upper-abdominal pain or pressure — Chest or upper-abdominal pain or pressure can be a sign of a serious life-threatening issue especially if the pain spreads to the neck, arms, and jaw. In fact, these are classic signs of a heart attack. A heart attack occurs when blood flow to a portion of the heart is restricted. Seeking emergency medical attention immediately is vital if an individual is suffering from these symptoms.

Other signs and symptoms of medical emergency include; unconsciousness, possible spinal or neck injury, disorientation, sudden severe pain, bleeding that can’t be controlled, severe or persistent vomiting, coughing or vomiting blood, major injury or trauma, feeling of impending doom, sudden vision changes or loss, suicidal or homicidal feelings, fainting, sudden dizziness, weakness, changes in vision, difficulty in speaking and confusion or changes in mental status.

The approach to save lives from such life threatening situations is termed “emergency medical care”.

I consider emergency care providers as the most unique individuals in the medical profession with an unquenched passion for life-saving; providing patients with Basic Life Support care that is thorough, qualitative, flexible and caring.

The technique employed for emergency care depends on the medical emergency condition in question. Emergency care begins with a critical assessment and evaluation of the victims’ airway, breathing, and circulation. (ABCs of resuscitation).

By their very nature, medical emergencies happen quickly and without warning. Having an action plan, the right tools and resources, and arming yourself with key pieces of knowledge can make a difference between life and death where every second counts. The emergency action plan should include three key elements; preparation, recognition, and decision-making. At this point, mental and physical preparations are very important.

As a student, I see the need for not just me, but all emergency care providers to continually prepare both mentally and physically before approaching a life-threatening situation. There is also a need to be alert, calm but quick in such situations, as it has always been said that early preparation produces good result.

Most times, emergency presentations may appear complicated, but early preparation and planning will help better manage the situation. Effective emergency care requires a detailed knowledge and recognition of the particular condition and associated tell-tale signs.

Mental preparation involves thinking on how to improve team based skills, performance, patients’ safety and how to minimize medical errors and provide possible solutions for anticipated recurrences. It also includes pondering on questions like; what will it look like? What obstacles should I anticipate? How can I manage the challenges that might occur?

Furthermore, mental preparation also includes; constant practice and revision of the emergency action plan, establishing team goals, defining priorities and creating awareness on the possible emergencies that can be encountered, so that the emergency care team can be prepared for even the most complex and challenging emergency situation. It also requires self-composure and evaluation of the case. Its needs or demands, careful decision on the right technique to be used for the condition and developing skills for team-work with good communication skills. Maintaining absolute focus with excellent technique co-ordination is also important.

However, physical preparation involves:

• Wearing safety and infection control equipment: Items that can reduce the chances of exposure to bodily fluids (e.g. disposable gloves, eye protection, face shield or pocket mask).
• Checking the scene and the victim (i.e. assessing the scene for the victims’ safety).
• Confirmation of the total number of victims at the scene.
• Self-care (hand washing before and after a procedure, feeding on dietary or nutritional foods, proper rest and stress management).
• Developing time based skills for active participation in the team and making sure that all the equipment needed for the performance are available.

In conclusion, my advice to students aspiring to join the medical profession is that they should make life-saving a priority and the driving force behind their interest for the profession. Working as a medical practitioner or emergency care provider is beyond just the good pay and benefits. Thus, they should commit themselves to hard-work, learning and diligence, for it takes hard-work to accomplish success.

They should always remember that their reactions, decisions and how they administer care towards a patient can make the difference between life and death.

Posted: August 15, 2017