Editing Medical emergency

{{Short description|Acute injury or illness posing an immediate risk to life or long-term health}}
{{About|the medical term|the Australian television series|Medical Emergency}}
{{Medref|date=March 2022}}
A '''medical emergency''' is an [[Acute (medicine)|acute]] [[injury]] 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.<ref>AAOS 10th Edition Orange Book</ref> 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 aid]]ers through [[emergency medical technician]]s, [[paramedic]]s, [[Emergency medicine|emergency physicians]] and [[Anesthesiology|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===
[[File:Emergency_telephone_numbers_in_the_world.svg|thumb|Implementation of the two [[ITU]] approved<ref>{{Cite news|url=https://www.theverge.com/2012/12/12/3758760/itu-911-112-standard-emergency-numbers|title=911 and 112 are the world's standard emergency numbers, ITU decides|work=The Verge|access-date=2018-07-26}}</ref> emergency telephone numbers in the world:{{legend|blue|112}}{{legend|yellow|911}}{{legend|green|112 and 911}}{{legend|black|Other number, no redirection or redirection for mobile phones only}}]]
For emergencies starting outside medical care, a key component of providing proper care is to summon the [[emergency medical services]] (usually an [[ambulance]]), by [[call for help|calling for help]] using the appropriate local [[emergency telephone number]], such as [[999 (emergency telephone number)|999]], [[9-1-1|911]], [[1-1-1|111]], [[1-1-2|112]] or [[000 emergency|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 [[Advanced Medical Priority Dispatch System|AMPDS]] 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===
{{Globalize|section|US|date=August 2019}}

To prevent the delay of life-saving aid from bystanders, many states of the USA have "[[Good Samaritan law]]s" which protect civilian responders who choose to assist in an emergency. In many situations, the general public may delay giving care due to fear of [[Public liability|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 consent|expressed]] or [[implied consent|implied]]:<ref name="Caroline">{{cite book|last=Caroline|first=Nancy|year=2013|title=Emergency Care in the Streets|edition=Seventh|publisher=Jones and Bartlett Learning|pages=96–97}}</ref>
* If a patient is able to make decisions, they must give expressed, [[informed consent]] 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]], 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 [[emergency 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, [[patient evacuation|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===

During a medical emergency in which a patient is [[Respiratory arrest|no longer breathing]] and [[Cardiac arrest|does not have a pulse]], survival is predicated on adherence to the [[chain of survival]], which has four components:
# Early access to emergency care
# Early [[cardiopulmonary resuscitation]] (CPR)
# Early [[defibrillator|defibrillation]]
# Early [[advanced life support]] (ALS)

==Clinical response==
Within hospital settings, an adequate staff is generally present to deal with the average emergency situation. [[Emergency medicine]] physicians and [[anesthesiology|anaesthesiologists]] have training to deal with most medical emergencies, and maintain CPR and [[Advanced Cardiac Life Support]] (ACLS) certifications. In [[mass-casualty incident|disasters]] or complex emergencies, most hospitals have protocols to summon on-site and off-site staff rapidly.

Both [[emergency department]] and [[inpatient]] medical emergencies follow the basic protocol of Advanced Cardiac Life Support. Irrespective of the nature of the emergency, adequate [[blood pressure]] and [[Oxygenation (medical)|oxygenation]] are required before the cause of the emergency can be eliminated. Possible exceptions include the clamping of [[artery|arteries]] in severe [[hemorrhage]].{{Citation needed|date=October 2009}}

==Non-trauma emergencies==

While the [[golden hour (medicine)|golden hour]] is a trauma treatment concept, two emergency medical conditions have well-documented [[time-critical]] treatment considerations: [[stroke]] and [[myocardial infarction]] (heart attack). In the case of stroke, there is a window of three hours within which the benefit of [[thrombolytic drug]]s outweighs the risk of major bleeding. In the case of a heart attack, rapid stabilization of fatal [[Heart arrhythmia|arrhythmias]] 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 rate|mortality]] and [[morbidity]].{{Citation needed|date=October 2009}}

==See also==
* [[List of medical emergencies]]
* [[Rescue squad]]
* [[Surgical emergency]]

== References ==
{{Reflist}}

==External links==
{{Wikibooks|First Aid}}
* {{cci}}

{{Emergency medicine}}
{{Authority control}}

[[Category:Critical emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Medical emergencies| ]]