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Amedical emergency is anacuteinjury orillness that poses an immediate risk to a person's life or long-term health, sometimes referred to as a situation risking "life or limb". These emergencies may require assistance from another, qualified person, as some of these emergencies, such as cardiovascular (heart), respiratory, and gastrointestinal cannot be dealt with by the victim themselves.[1] Dependent on the severity of the emergency, and the quality of any treatment given, it may require the involvement of multiple levels of care, fromfirst aiders throughemergency medical technicians,paramedics,emergency physicians andanesthesiologists.
Any response to an emergency medical situation will depend strongly on the situation, thepatient 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 medical care (for instance, in the street or alone at home).
For emergencies starting outside medical care, a key component of providing proper care is to summon theemergency medical services (usually anambulance), bycalling for help using the appropriate localemergency telephone number, such as999,911,111,112 or000. 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 asAMPDS in order to assess the priority level of the call, along with the caller's name and location.
Those who are trained to performfirst 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 a 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.
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To prevent the delay of life-saving aid from bystanders, many states of the USA have "Good Samaritan laws" which protect civilian responders who choose to assist in an emergency. In many situations, the general public may delay giving care due to fear ofliability should they accidentally cause harm. Good Samaritan laws often protect responders who act within the scope of their knowledge and training, as a "reasonable person" in the same situation would act.
The concept of implied consent can protect first responders in emergency situations. A first responder may not legally touch a patient without the patient's consent. However, consent may be eitherexpressed orimplied:[3]
Usually, once care has begun, a first responder or first aid providermay not leave the patient or terminate care until a responder of equal or higher training (such as anemergency medical technician) 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.
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.
During a medical emergency in which a patient isno longer breathing anddoes not have a pulse, survival is predicated on adherence to thechain of survival, which has four components:
Within hospital settings, an adequate staff is generally present to deal with the average emergency situation.Emergency medicine physicians andanaesthesiologists have training to deal with most medical emergencies, and maintain CPR andAdvanced Cardiac Life Support (ACLS) certifications. Indisasters or complex emergencies, most hospitals have protocols to summon on-site and off-site staff rapidly.
Bothemergency department andinpatient medical emergencies follow the basic protocol of Advanced Cardiac Life Support. Irrespective of the nature of the emergency, adequateblood pressure andoxygenation are required before the cause of the emergency can be eliminated. Possible exceptions include the clamping ofarteries in severehemorrhage.[citation needed]
While thegolden hour is a trauma treatment concept, two emergency medical conditions have well-documentedtime-critical treatment considerations:stroke andmyocardial infarction (heart attack). In the case of stroke, there is a window of three hours within which the benefit ofthrombolytic drugs outweighs the risk of major bleeding. In the case of a heart attack, rapid stabilization of fatalarrhythmias 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 themortality andmorbidity.[citation needed]
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