Seconds Save Lives in Medical Emergencies

Do you know what to do in an emergency? The few minutes after an injury occurs or at the onset of a medical crisis are frequently the most important.

"The key is knowing what to do, remaining calm, and making a decision to act," said Dr. Kathleen Clem, M.D., of the American College of Emergency Physicians. "You can make a difference in critical moments by remembering four important steps: prevent, prepare, recognize, act."

Prevent emergencies. Regular exercise and medical check-ups will help protect your health and identify whether you're at risk for life-threatening conditions. Follow your doctor's advice to reduce any risk factors dangerous to your health.

Prepare for emergencies. After doing everything you can to prevent emergencies, the next step is to prepare for one. Some basic steps are:

Keep well-stocked first-aid kits at home, at work, and in your car.
Learn how to recognize emergency warning signs.
Organize family medical information.
- Make lists of medications (and dosage) taken by you and your family; include allergies. In a medical emergency, you might be unconscious or unable to speak for yourself.
Identify and eliminate safety hazards in your home.
Take a first-aid class.
Post emergency numbers near the telephone.

Learn to recognize life-threatening emergencies.

Not every cut needs stitches, nor does every burn require advanced medical treatment. If you think someone could suffer significant harm or die unless prompt care is received, that situation is an emergency, and call 9-1-1 or the local hospital for help. Get help fast when the following warning signs are seen:

Chest pain lasting 2 minutes or more.
Uncontrolled bleeding.
Sudden or severe pain.
Coughing or vomiting blood.
Difficulty breathing, shortness of breath.
Sudden dizziness, weakness, or change in vision.
Severe or persistent vomiting or diarrhea.
Change in mental status (e.g., confusion, difficulty arousing).

Decide to Act.

Be ready, willing, and able to help someone until emergency services arrive. Action can mean anything from calling paramedics, applying direct pressure on a wound, performing CPR, or splinting an injury. Never perform a medical procedure if you're unsure about how to do it.

Do not move anyone involved in a car accident, serious fall, or is found unconscious unless he or she is in immediate danger of further injury.
Do not give the victim anything to eat or drink.
Protect the victim by keeping him or her covered.
If the victim is bleeding, apply a clean cloth or sterile bandage. If possible, elevate the injury and apply direct pressure on the wound.
If the victim is not breathing or does not have a pulse, begin rescue breathing or CPR.

Tips on Recognizing and Preventing Heart Attacks

Each year, 1.1 million Americans suffer heart attacks, and nearly one-third of them don't survive. By addressing risk factors and recognizing symptoms right way, you can help lower your chance of developing or dying from a heart attack.

"A heart attack occurs when the blood supply to part of the heart muscle is severely reduced or stopped," said Dr. Elaine Josephson of the American College of Emergency Physicians. "It can be caused by a blood clot. If the blood supply is cut off severely for a long time, muscle cells suffer irreversible damage and die, depending on how much the heart muscle is damaged."

The major risk factors for coronary heart disease are:

Increasing age. About four out of five people who die of coronary heart disease are ages 65 or older.
Gender. Men have a greater risk of heart attack than women, and they have attacks earlier in life. At older ages, women who have heart attacks are twice as likely as men to die from them within a few weeks.
Heredity (including race). Children of parents with heart disease are more likely to develop it themselves. African Americans have more severe hypertension than whites and consequently, are at greater risk.
Smoking. A smoker's risk of heart attack is more than twice that of non-smokers.
High cholesterol. The risk of coronary heart disease rises as blood cholesterol levels rise.
Physical inactivity. Regular, moderate-to-vigorous exercise plays a significant role in preventing heart and blood vessel disease.
Body weight. People with excess body fat are more likely to develop heart disease and stroke, even if they have no other risk factors.
Diabetes. This condition seriously increases the risk of developing cardiovascular disease.

Only trained medical personnel can tell for sure whether chest pain is caused by a heart problem. However, the primary symptom of a heart attack is pain or a feeling of heavy pressure in the chest, which might spread to the arms, neck, jaw, or back. There may be nausea, dizziness, and/or difficulty breathing. The symptoms may feel like indigestion or heartburn.

Prompt treatment during a heart attack can dramatically reduce damage to the heart. If you or someone you're with experiences any of these warning signs, don't wait. Get immediate medical attention. Call 911 or your local emergency number for help. And chew or crush and swallow a regular aspirin table, if your doctor has recommended it.

"Know the warning signs, act immediately, and keep aspirin handy at all times," said Dr. Josephson. "People make excuses for heart attack symptoms, which can be deadly — acting fast can save your life."

The Emergency Department: What To Expect

Medical emergencies are unpredictable-people don't expect to have one. You can ease the anxiety of a visit to an emergency department by learning some basic facts.

"First, it's important to know that emergency medicine over the past 30 years has evolved into a state-of-the-art, technologically advanced, fully recognized medical specialty," said Dr. Russell Harris of the American College of Emergency Physicians. "Today's emergency physicians are highly educated and trained to handle all kinds of emergency situations and to provide the best possible care."

Arrival

If you arrive by ambulance or are unconscious you will be assigned a patient bed immediately and be treated. If someone else drives you to the emergency department, you will first enter the waiting room, where your medical condition will be assessed.

Triage

Most likely, a nurse will determine the severity of your condition, based on your symptoms, and check your vital signs, including temperature, heart rate, and blood pressure. This process is called "triage."

Additional information will also be obtained, such as your name and address and medical history, and someone will prepare a chart. Anyone who comes to an emergency department will not be turned away, regardless of their ability to pay or insurance coverage.

"There are many reasons a trip to the emergency department can take longer than a visit to the doctor's office," said Dr. Harris. Unlike a doctor's office, where appointments are spread out, many emergency patients may arrive at once. Also unlike a doctor's office, patients often must wait for the results of x-rays or tests. You can help make the time pass more quickly and speed your treatment by planning ahead. If you have children, take along a book or toys for them. If possible, bring along someone to remain at your bedside. Also, bring any up-to-date medical records, including lists of medications and allergies, and any advance directives, such as a living will.

Examination

Once you are placed in an examination area, an emergency physician will examine you, possibly ordering tests (e.g., x-ray, blood, electrocardiogram) and your vital signs will be monitored. Nurses and other assistants will also assist you during your visit.

Treatment

If you are critically ill or require constant intravenous medications or fluids, you may be admitted to the hospital. Otherwise, an emergency physician will discuss your diagnosis and treatment plan with you before you are discharged. You may also receive written instructions regarding medications, medical restrictions, or symptoms that may require a return visit.