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5 Medical Emergencies Every Doctor Should Be Prepared For

Discussion in 'Emergency Medicine' started by Mahmoud Abudeif, Sep 16, 2019.

  1. Mahmoud Abudeif

    Mahmoud Abudeif Golden Member

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    If you aren’t a primary care physician, think back on a time before you specialized in your field of choice—when you were an intern or a medical student and subject to the breadth of medicine. As a physician in training, you were undoubtedly aware of all the common medical emergencies that could befall others, and how to administer first aid in various situations.

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    This knowledge, although seemingly distant, still holds relevance today. In an emergency situation, you may be called on to help with a clinical presentation that is outside your current field of practice. Remember that you are a physician who has taken an oath to protect your patients and society. You have the power to help others and save lives!

    Let’s take a look at five common medical emergencies and how physicians can provide assistance before the cavalry (EMS) arrives.

    Stroke

    Thrombolytic therapy for stroke must be administered as quickly as possible. Anyone suspected of having a stroke must be hurried to the hospital.

    Pre-hospital providers should do the following:
    • Call 911
    • Note the time of onset of symptoms
    • As with every emergency, assess the ABCs—airway, breathing, and circulation—especially because those who have suffered a stroke may have difficulty with keeping the airway open
    • Begin oxygen therapy in patients with hypoxia, and monitor with pulse oximetry
    • Do a neurological exam, and be ready to report your findings to EMS or emergency department personnel
    • Check serum blood sugar levels because hypoglycemia can mimic stroke presentation
    heart attack

    Heart attacks usually cause chest pain lasting longer than 15 minutes, but a heart attack can be silent, too, with no presenting symptoms. With heart attack, always be on the lookout for symptoms other than chest pain, such as indigestion or persistent pain in the neck or jaw. Also, many people who experience heart attacks can have warning signs that last for hours, days, or weeks.

    Pre-hospital providers should do the following:
    • Call 911
    • Administer aspirin unless the person is allergic
    • Administer nitroglycerin if prescribed
    • Begin CPR if the person is unconscious
    • If an automated external defibrillator (AED) is in the vicinity and the person is unconscious, follow the instructions on the AED
    Seizure

    A seizure is considered an emergency when it lasts for an extended period of time, or when seizures occur in quick succession without recovery in between.

    Pre-hospital providers should take the following steps:
    • Call 911
    • Prevent choking by loosening clothing around the neck and rolling the person to the side
    • Don’t put anything—like a belt—in the person’s mouth
    • Don’t restrain or hold down the person, and ask bystanders to give the person space
    • Move any sharp or dangerous objects, such as glassware, away from the person to protect from injury
    • Find out if the person has a history of seizure and has been prescribed medications for seizures
    Asthma attack

    Symptoms of an acute asthma attack can include difficulty talking or walking due to shortness of breath. Lips or fingernails can also turn blue.

    Pre-hospital providers should take the following steps:
    • Call 911
    • Find out if the person has an asthma action plan and follow it; this action plan can include instructions on giving medication and seeking medical help
    • If the person has no asthma action plan, provide asthma first aid: sit the person upright; if the person has medication or an inhaler, provide assistance for usage; and if the person does not have an inhaler on them, use an inhaler from a first aid kit—but don’t use another person’s inhaler, as dosages and active ingredients could differ
    • If available, use an inhaler with a spacer—a tube attachment that fits onto the end of the inhaler and acts as a holding chamber where medicine sits as a fine mist until inhalation
    • Continue using the inhaler until breathing is no longer labored
    Anaphylaxis

    Anaphylaxis can lead to shock and trouble breathing. It can happen minutes after exposure to a specific allergen. Sometimes, a delayed reaction may occur without an obvious trigger.

    Pre-hospital providers should take the following steps:
    • Call 911
    • Ask the person if they are carrying an EpiPen or other epinephrine autoinjector; if so, apply the autoinjector to the thigh
    • Have the person lie supine
    • Loosen tight clothing and cover the person in a blanket
    • Don’t give the person anything to drink
    • With vomiting or bleeding from the mouth, turn the person to the side to prevent choking
    • If there are no signs of breathing, begin CPR
    Finally, it may sound like common sense, but don’t leave the person you are caring for before the paramedics arrive and care is transferred. Also, make sure to hand off care to the paramedics with a full briefing of the occurrence even if the person appears to be getting better. Don’t let the person drive off without further medical care!

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