What is a Medical Emergency?

The response to an emergency medical situation will depend on the situation.

Prevention Is Our Number One Priority

Prevention is the best way to prepare the individual you support for a medical emergency.  Assist the individual in learning how to practice caution and common sense, and follow safety instructions when they are given.  You can assist the individual in preventing some illnesses and injuries in the following ways:

• Encourage the individual to take care of him or herself by eating a healthy diet and exercising regularly.  A healthy diet includes eating fruits and vegetables everyday.  Taking a walk everyday is a good way to get regular exercise. 
• Encourage the individual to visit the doctor regularly and to get annual checkups.  Bring a list of all the medications the individual is taking to each doctor appointment.  Call the doctor right away when the person feels ill or is injured.  If you think the individual's medicine is making them sick, help them to keep a list of how they feel and the times these feelings happen.
• Ask the doctor if the individual is at risk for any potentially life-threatening conditions.  These may be linked to genetics or lifestyle choices, such as smoking or eating poorly.  Assist the individual to follow their doctor’s advice to reduce the risk factors.
• Keep up-to-date medical records and emergency contact information available.  Inform everyone in the individual’s support network where to find this information.
• Ask the doctor about “MedicAlert” identification if the individual has any chronic medical conditions or an allergy to a food or medicine.
• Keep the home safe.  Check the individual’s home for hazards or unsafe conditions.  Eliminate hazards such as slippery floors, throw rugs, steps without a hand rail, sharp edges on counters or tables, etc.
• Enroll yourself, the individual, and people in their support network in First Aid and CPR courses sponsored by the American Red Cross or the American Heart Association.
• Keep a first aid kit handy in the home or when traveling.  Replace the contents as they are used or expire.  The kit should include adhesive bandages, antibiotic cream, aspirin, gloves, scissors, sterile gauze, thermometer, tweezers, etc.
• Add In-Case-of-Emergency (ICE) entries to the individual’s cell phone address book.  If someone arrives in the emergency department unconscious, emergency staff will check the cell phone for ICE contact information.

Is It An Emergency?

Medical emergencies can happen any place and at any time.  It is important to recognize the signs of a medical emergency.

It is also important that every individual learns to recognize the warning signs of a medical emergency.  You can help the individual you support to learn these warning signs and symptoms of some common medical emergencies listed below:

• Difficulty breathing, shortness of breath
• Chest or upper abdominal pain or pressure lasting two minutes or more
• Fainting, sudden dizziness, weakness, seizure
• Possible serious bone fractures
• Major burns
• Changes in vision
• Difficulty speaking
• Confusion or changes in mental status, unusual behavior, difficulty waking
• Any sudden or severe pain
• Head pain that lasts longer than five minutes
• Uncontrolled bleeding
• Shock symptoms, e.g., confusion, disorientation, cool/clammy, pale skin
• Severe or persistent vomiting or diarrhea
• Coughing or vomiting blood
• Unusual abdominal pain
• Suicidal or homicidal feelings

Knowing these signs and acting quickly could save the individual’s life.  Get treatment promptly.  For many medical emergencies, time is very important.  Some people experience the symptoms of an emergency, such as a stroke or a heart attack, but do not get help right away.  A delay in treatment could lead to a more serious illness.

Emergency Checklist

The following suggestions can help you respond when you are with an individual that is experiencing a medical emergency.  This list describes your priorities in an emergency situation.  Follow these steps:

1. Evaluate the situation to protect yourself and others from injury.
2. Be calm and reassuring.  Talking to yourself may help keep you calm.  It may reassure the individual needing help to hear that you are calm.
3. Do not move the individual unless the individual is in immediate danger or unless you cannot provide assistance without moving the individual.
4. Get help.  Call out for someone to call 9-1-1 or, if the individual does not need immediate assistance, make the call yourself.
5. Calmly explain the exact nature of the illness or injury.
6. State the exact location of the emergency.
7.  STAY ON THE LINE! The dispatcher will need to ask additional questions.
8. Look, listen, and feel for breathing.
9. Feel for a pulse to determine if the heart is beating.
10. Control bleeding with direct pressure by putting a bandage, cloth, or gloved hand over the spot that is bleeding.
11. Treat for shock.  Lay the individual flat.
12. If the individual is unconscious, move him or her into the recovery position. 
13. If the situation is a choking emergency, perform the abdominal thrust (Heimlich) maneuver.

When You Call 9-1-1 for Help, Remember:

• Speak calmly and clearly.
• Give the name, address, phone number, and location of the person needing help (i.e., in the bedroom).
• Describe the nature of the problem.
• Don’t hang up until the dispatcher tells you to.  The dispatcher may need more information.
• If you are using a cell phone, it is important to tell the emergency operator the location of the emergency.
• If you are calling from a highway, look for the nearest highway marker or call box, and give the number to the dispatcher. 

After you have called 9-1-1, there are several things you can do until the Emergency Responders arrive.  These simple procedures will aid the Emergency Responders and the person in need of treatment.

• Provide first aid to the best of your ability.
• Use precautions to prevent exposure to bodily fluids.
• If you determine that the individual has no pulse and/or is not breathing, and you have been trained in cardiopulmonary resuscitation (CPR), begin CPR.
• Stay calm, do not get excited.  Being calm will reassure the individual that help is on the way.
• Do not move the individual unless it is absolutely necessary for safety reasons.
• Make the individual as comfortable as possible.
• Gather the individual’s medication and medication information.  This will help the paramedics  determine the individual’s medical history.
• It is important to remember the time and sequence of events.  For example, try to remember when you last spoke with the individual, how long he or she has been unconscious, and for how long this medical condition has existed.  Write this information down if possible. 

Emergency Tips:

Follow the tips below for responding to certain emergency situations:

• Uncontrolled or Severe bleeding:  Elevate the injured area, support it, then use a sterile pad to apply pressure to the wound.  If blood seeps through the pad, place additional clean pads on top of each other.  Wear rubber gloves or place plastic bags over your hands to prevent the spread of hepatitis or HIV infection.  Call for emergency medical assistance.
• Possible serious bone fractures:  Do not move a person with a broken bone unless you are in a life-threatening situation involving further potential harm to the injured person (such as a car accident that results in a car fire).  This is especially important for someone with a head, neck or back injury or a hip or pelvis fracture.  If it becomes necessary to move someone with a broken bone, immobilize the injured area first with a splint.  If you don't have a splint, make one using a folded newspaper, board, or rolled up piece of clothing.
• Major burns:  First degree burns are red and painful but don’t have blisters.  For a first degree burn, put the injured area under cool water.  Second degree burns are deeper, painful and have blisters.  They should be washed with soap and water and treated with an antibiotic ointment. Seek medical attention if the blisters are severe and the skin looks white or charred.  Cover the burn with a non-stick sterile gauze bandage, if you have one.
  • Seek immediate emergency treatment if the burn is on the face, hands, feet or genitals; covers more than one square inch of skin; or causes respiratory problems because of smoke inhalation, indicated by coughing, wheezing, soot-tinged spit, or red sores in the mouth.
• Choking adult:  Stand up and hold the person from behind.  Wrap your arms around his or her waist and put one fist against the abdomen.  Make sure your fist is slightly above the navel but below the rib cage.  Holding your other hand over your fist, quickly thrust in and up with both hands 4 to 10 times.  Call for emergency medical help if the person continues to choke.
• Heart attack symptoms, e.g., chest pressure/pain:  If you suspect someone is having a heart attack:
  • Call 9-1-1 for emergency medical service.  Tell the dispatcher where you are.  Don't hang up until you're told to do so.
  • Give the person CPR only if you've been properly trained to do so.
  • While waiting for emergency help to arrive, give the person an aspirin if he or she is conscious and able to swallow.
  • If possible, get the person into a relaxed sitting position, with the legs up and bent at the knees, to ease strain on the heart.  Loosen tight clothing around the neck and waist.
  • Stay calm and reassuring.
  • If using an Automated External Defibrillator (AED) in the case of a heart attack or cardiac arrest, follow the instructions.  The AED will provide audible prompts at the appropriate intervals.
• Poisoning:  If someone has swallowed an unknown substance or been poisoned, call the Poison Control Center (1-800-222-1222) or 9-1-1.
  • Try to determine what the person has swallowed by finding the product container.
  • Don't induce vomiting unless instructed to do so by medical personnel.  The Poison Control Center can help you find a local poison control center that is open 24 hours a day, 7 days a week.
• Shock symptoms:  Signs of shock include:  pale, cool, clammy skin; restlessness, anxiety or agitation; drowsiness or fatigue; dizziness, light-headedness or faintness; profuse sweating, moist skin; irritability; thirst; rapid pulse; rapid, weak breathing; enlarged pupils; nausea or vomiting; blue tinge to lips or fingernails (or gray in the case of dark-complexions).  Call 9-1-1 and then lay the person down, with his or her feet elevated about 12 inches (unless there is a head, neck or back injury or if you suspect broken bones in the hips or legs); do not elevate the head.
• Stroke:  Signs of stroke include: sudden numbness, weakness or paralysis and drooping of the face, arm or leg, especially on one side of the body; sudden blurred or decreased vision in one or both eyes; slurred speech, difficulty speaking or inability to understand or be understood; loss of balance or coordination.  Call 9-1-1 or seek emergency medical help right away.

Resources:

• American College of Emergency Physicians
• The Harvard Medical School Family Health Guide
• Emergency Preparedness Guide