A medical emergency is an acute

injury An injury is any physiological damage to living tissue caused by immediate physical stress. An injury can occur intentionally or unintentionally and may be caused by blunt trauma, penetrating trauma, burning, toxic exposure, asphyxiation, or ...

or illness 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.AAOS 10th Edition Orange Book Dependent on the severity of the emergency, and the quality of any treatment given, it may require the involvement of multiple levels of care, from first aiders through

emergency medical technician An emergency medical technician (EMT), also known as an ambulance technician, is a health professional that provides emergency medical services. EMTs are most commonly found working in ambulances. In English-speaking countries, paramedics a ...

paramedic A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research. Not all ambulance personnel are p ...

s, emergency physicians and anesthesiologists. Any response to an emergency medical situation will depend strongly on the situation, the patient 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).

Response

Summoning emergency services

Emergency_telephone_numbers_in_the_world

For emergencies starting outside medical care, a key component of providing proper care is to summon the

emergency medical services Emergency medical services (EMS), also known as ambulance services or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care. ...

(usually an

ambulance An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medi ...

), by calling for help using the appropriate local

emergency telephone number Most public switched telephone networks have a single emergency telephone number (sometimes known as the universal emergency telephone number or the emergency services number) that allows a caller to contact local emergency services for assista ...

, such as 999, 911,

111 111 may refer to: *111 (number) *111 BC *AD 111 *111 (emergency telephone number) *111 (Australian TV channel) * Swissair Flight 111 * ''111'' (Her Majesty & the Wolves album) * ''111'' (Željko Joksimović album) * NHS 111 *(111) a Miller index fo ...

, 112 or 000. 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 as

AMPDS The Medical Priority Dispatch System (MPDS), sometimes referred to as the Advanced Medical Priority Dispatch System (AMPDS) is a unified system used to dispatch appropriate aid to medical emergencies including systematized caller interrogation and ...

in order to assess the priority level of the call, along with the caller's name and location.

First aid and assisting emergency services

Those who are trained to perform first 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.

Legal protections for responders

To prevent the delay of life-saving aid from bystanders, many states of the USA have "

Good Samaritan law Good Samaritan laws offer legal protection to people who give reasonable assistance to those who are, or whom they believe to be injured, ill, in peril, or otherwise incapacitated.liability 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 either expressed or implied: * If a patient is able to make decisions, they must give expressed,

informed consent Informed consent is a principle in medical ethics and medical law, that a patient must have sufficient information and understanding before making decisions about their medical care. Pertinent information may include risks and benefits of treatm ...

before aid is given. * However, if a patient is too injured or ill to make decisions – for example, if they are unconscious, have an

altered mental status An altered level of consciousness is any measure of arousal other than normal. Level of consciousness (LOC) is a measurement of a person's arousability and responsiveness to stimuli from the environment. A mildly depressed level of consciousne ...

, or cannot communicate - implied consent applies. Implied consent means that treatment can be given, because it is assumed that the patient would want that care. Usually, once care has begun, a first responder or first aid provider ''may not'' leave the patient or terminate care until a responder of equal or higher training (such as an

) 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.

The chain of survival

The principles of the

chain of survival The chain of survival refers to a series of actions that, properly executed, reduce the mortality associated with sudden cardiac arrest. Like any chain, the chain of survival is only as strong as its weakest link. The six interdependent links in the ...

apply to medical emergencies where the patient is not breathing and has no

pulse In medicine, a pulse represents the tactile arterial palpation of the cardiac cycle (heartbeat) by trained fingertips. The pulse may be palpated in any place that allows an artery to be compressed near the surface of the body, such as at the ...

. This involves four stages: # Early access # Early

cardiopulmonary resuscitation Cardiopulmonary resuscitation (CPR) is an emergency procedure consisting of chest compressions often combined with artificial ventilation in an effort to manually preserve intact brain function until further measures are taken to restore spon ...

(CPR) # Early

defibrillation Defibrillation is a treatment for life-threatening cardiac arrhythmias, specifically ventricular fibrillation (V-Fib) and non-perfusing ventricular tachycardia (V-Tach). A defibrillator delivers a dose of electric current (often called a ''coun ...

# Early

advanced life support Advanced Life Support (ALS) is a set of life saving protocols and skills that extend basic life support to further support the circulation and provide an open airway and adequate ventilation (breathing). Components These include: * Tracheal i ...

(ALS)

Clinical response

Within hospital settings, an adequate staff is generally present to deal with the average emergency situation.

Emergency medicine Emergency medicine is the medical speciality concerned with the care of illnesses or injuries requiring immediate medical attention. Emergency physicians (often called “ER doctors” in the United States) continuously learn to care for un ...

physicians and

anaesthesiologists Anesthesiology, anaesthesiology, or anaesthesia is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medi ...

have training to deal with most medical emergencies, and maintain CPR and

Advanced Cardiac Life Support Advanced cardiac life support, advanced cardiovascular life support (ACLS) refers to a set of clinical guidelines for the urgent and emergent treatment of life-threatening cardiovascular conditions that will cause or have caused cardiac arrest, ...

(ACLS) certifications. In disasters or complex emergencies, most hospitals have protocols to summon on-site and off-site staff rapidly. Both emergency department and

inpatient A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other healt ...

medical emergencies follow the basic protocol of Advanced Cardiac Life Support. Irrespective of the nature of the emergency, adequate

blood pressure Blood pressure (BP) is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term "blood pressur ...

and oxygenation are required before the cause of the emergency can be eliminated. Possible exceptions include the clamping of

arteries An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts of the body (tissues, lungs, brain etc.). Most arteries carry oxygenated blood; the two exceptions are the pul ...

in severe

hemorrhage Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vag ...

Non-trauma emergencies

While the golden hour is a trauma treatment concept, two emergency medical conditions have well-documented time-critical treatment considerations: stroke and

myocardial infarction A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which ...

(heart attack). In the case of stroke, there is a window of three hours within which the benefit of thrombolytic drugs outweighs the risk of major bleeding. In the case of a heart attack, rapid stabilization of fatal

arrhythmias Arrhythmias, also known as cardiac arrhythmias, heart arrhythmias, or dysrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. A resting heart rate that is too fast – above 100 beats per minute in adults ...

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 the mortality and

morbidity A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that ...

References

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