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MEDICAL EMERGENCY: How to react in Medical Emergency & Important Protocols in emergency

WHAT WILL BE YOUR STEP IF YOU SEE A BURN PERSON LYING ON ROAD, AN ACCIDENT IN WHICH PEOPLE LOSING THEIR LIFE AND CARDIAC ARREST VICTIM? here are some protocols and steps that you should take if someone is losing their life in front of you…….

The emergency is a sudden unforeseen crisis and danger that requires immediate action. It can happen anywhere and any type like car accidents, fall from buildings, cardiac arrest, altitude illness, hypothermia, road accidents, bomb blast, shock and burn traumas.

Medical emergency protocols and procedures are the moves,  guides, and plans of actions that should be conducted in a manner, in order to save life, environment, and properties.

instead, doctors, medical staff like paramedics, a health care workers who give services to patients under the supervision of physicians, they include nurses, EMT( emergency medical technician) and physician assistants, and some agencies also aware and train ambulance drivers and non-medical peoples that they also take life-saving steps if no one around 

EMERGENCY SITUATIONS WITH PLAN OF  ACTIONS:

–>IN CASE OF ROAD TRAUMA ACCIDENTS:

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Road trauma accidents are fearful and stressful experiences for both a victim and crowd, in which the victim is badly injured and bleeds that lead to death. if you are non-medical staff then what should you do?

if you are non-medical person then calm yourself and take your safety first by pulling your vehicle over and park in a safe place then turn on your headlights ( for help or for distance) then call the help and see the situation and don’t try to rescue the victim until you feel vehicle will blast or on fire, then check the breathing and pulse and if the victim is bleeding apply pressure with cloth or hand on it till the help arrive.  If the person is not breathing and the pulse is not present then do CPR if you trained.

if you are paramedical staff with emergency equipment ambulance then, start with ABCs (check airway, breathing, and circulation or compression) by applying cardiac monitor or AED  then if the victim is responded then take care of wounds and bleeding by apply for-sides dressing to any open chest or neck wound and bandage/splint on non-threatening limb injuries.

If the victim does not respond or giving signs and symptoms of tension pneumothorax with unstable vitals (SBP>100, HR<100, RR<24 and GCS<15) check back for penetrating thoracic/ abdominal injury, then contact the hospital and if no communication is made then do thoracostomy for victim sake. check vitals, oxygen and glucose level. 

things to check on every second are;

  • vitals, especially after IV fluid administration.
  • check glucose if ALOC (altered level of consciousness)
  • administrate dextrose if the victim has glucose less than 80 and ALOC, unable to determine glucose.

pain management:

  • ondansetron(Zofran): used to prevent nausea, vomiting.
  • Ketamine: used as a sedative analgesic for moderate to severe pain, in multi-system trauma.
  • Fentanyl: first-line and short-acting drug, non-sedative analgesic for severe pain.

–>SEVERE BURN TRAUMA:

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Burn injuries are often destructive and disastrous. According to WHO, there are over 300000 deaths per year from fires alone .. rule of 9 use for burns investigation.

 there are 3 types of burns; thermal burns, chemical burns and electrical burns, all three can cause severe burns if precautions are not taken. 

  • thermal burn: first protect yourself then rescue the patient from source of burn to fresh air then remove burn clothes and stop a fire and pour water on affected part of body
  • chemical burn: after protecting yourself, remove contaminated clothing and wash the affected area and documented chemical, manner and time of exposure.
  • electrical burn: protect yourself then be aware of cardiac arrhythmia.

cover the patient with dry blanket or cloth to prevent hypothermia and take to a warm environment, remove the accessories(ring, ear-rings, bangles)

then check ABCs with mental status, shock, airway burn, lung sound, and affected area how deep or how long it is ? and if you found black stung sputum, horas voice and abnormal lung sound then there is chances of carbon monoxide inhalation that later cause life-threatening lung and airway injuries.

depth of burn :

  • superficial: called a first degree and erythema only.
  • partial-thickness: called a second degree and blister and capillary refill present.
  • full-thickness: called as third degree and white or charred, firm to touch and lack of sensation, it also involves the eye, genitalia, hands, and airway.

burns with greater than 15 % are admitted to the hospitals with the documentation of degree( thickness), extent(length by using the rule of nine), mechanism of burn, the time associated with injuries with tetanus status.

wound management:

  • for small burns (<15%) debride the wound and cover with a moist sterile dressing and apply antimicrobial or bacitracin if transportation time is greater than 1 hour.
  • apply silver sulfadiazine if transportation is delayed more than 12 hours.
  • for large burns apply (>15%)  apply a dry dressing to prevent hypothermia.

–> CARDIAC ARREST:

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cardiac arrest is also called as myocardial infarction in which oxygen supply is blocked to cardiac muscles. symptoms that might be felt are; pressure and crushing pain in the chest which mostly radiates to the left shoulder, neck and arm, sweating, breathlessness, and dizziness.

First of all, call the helpline if you feel any of these symptoms and lie flat the victim on the floor, and if the victim’s heartbeat gets slow and he is not responding to you then start CPR if you are trained, until the help arrives 

To try to keep epinephrine tables with you if you are a cardiac patient and place subliminally if you feel symptoms of cardiac arrest.

–>INGESTION / POISONING:

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poisoning means to drink, inhale and inject drugs, chemicals, venomous and gases which will poison your body like some people drink acid to do suicide and its symptoms are red rashes around lips and mouth, orthopnea, drowsiness, and concussions and vomiting. 

vomiting is good if the victim drinks or eats something poisonous. ondansetron(Zofran): used to prevent nausea, vomiting.

  • Things to remember:

check vitals, mental status, pupils, vomiting on the scene, note the time of ingestion, the substance is taken, the route is taken and pay special attention to airway, lungs sound, skin signs because history is very in guiding therapy but don’t delay transport otherwise it will be fatal. 

–> VAGINAL BLEEDING :

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vaginal bleeding other than intercourse and normal menses time are not good symptoms, it can occur due to injuries in the vaginal wall, infection ( like gonorrhea, chlamydia), the lower estrogen level in pre and postmenopausal women and anatomical lesions like tumors and polyps on the cervix or vaginal wall and trauma.

20 -30 % of women face vaginal bleeding in pregnancy up to 20 weeks that occur due to implantation bleeding(egg fertilization sign), ectopic pregnancy, threatened abortion, abnormal location of the placenta and premature labor.

vaginal bleeding with abnormal vitals gives an immediate route to the hospital with documentation of vital signs, symptoms of dizziness, syncope, menstrual history and bleeding duration and amount and abdominal pain.

First assess vitals, mental status, secure airway if needed, BP and trauma, lay the person in Trendelenburg or left lateral decubitus position until the transportation has arrived.

–> CHILDBIRTH:

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child labor and childbirth is an emergency process in which safety protocols is very important because if you don’t use it, it will be very dangerous for child and mother too.

important protocols are, check vitals, and HELP the women in contractions, urge of pushes, bleeding and ruptured bag of water if the baby is in a breech position take extra consideration. Once the head of the baby is out, suction the nose and mouth with a bulb syringe prior to 1st breath.

After the delivery of the child, flick the sole of feet and back and asset the child’s breath and circulation and evaluate the APGAR score.  

pain management: 

  • oxytocin; for heavy bleeding.
  • fentanyl, morphine, Dilaudid; if severe pain and normal mental status.

GENERAL QUERIES:

Q. What will be the treatment of poison drink?

Charcoal and anti-emanating (vomiting) drugs are preferable drug treatments given to the patient. and nasogastric tube (NG tube) procedures done by which decompression of stomach and drainage of poisoning drink.

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Q. What medicine should keep with you in any situation?

medicines that should be with you are pain-relieving medicines(acetaminophen-Tylenol), anti-inflammatory drug( ibuprofen – Advil, Motrin), naproxen( Aleve), for ingestion- Maalox, Mucaine syrup, and epinephrine for cardiac arrest, fentanyl, morphine, Dilaudid; if severe pain and normal mental status.

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Q. What things should be in a first aid kit?

sterile gauze, triangular bandages, disposable sterile gloves, scissors, alcohol pads, sticky tape, thermometer, ads on forceps, surgical blade + handle,  and creams of skin rash – hydrocortisone, for burn – dermal, antiseptic cream and painkillers -paracetamol, pyridine for wound disinfectant.

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CONCLUSION:

medical emergency protocols and procedures are life-saving techniques, which we should learn and also aware of more people about it because saving one person, saving one generation. 

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