Medical Emergencies and Patient Assessment Notes

Medical Emergencies Overview

  • Definition: Medical emergencies involve conditions due to diseases, while trauma emergencies are caused by physical injuries from forces applied to the body.
    • Example: Heart attack leading to a car crash or a diabetic patient falling due to low blood sugar.

Types of Medical Emergencies

  • Respiratory Emergencies: Difficulty in breathing or inadequate oxygenation.

    • Related Diseases: Asthma, emphysema, chronic bronchitis.

  • Cardiovascular Emergencies: Conditions affecting the circulatory system.

    • Example: Heart attacks and congestive heart failure.

  • Neurologic Emergencies: Issues related to the brain (e.g., seizures, strokes, fainting).

  • Gastrointestinal Emergencies: Often involve conditions like appendicitis, diverticulitis, pancreatitis.

  • Urologic Emergencies: Commonly involve kidney stones.

  • Endocrine Emergencies: Mostly complications of diabetes mellitus.

  • Hematologic Emergencies: Result from blood disorders like sickle cell disease, hemophilia.

  • Immunologic Emergencies: Allergic reactions to foreign substances, ranging from mild to severe.

  • Toxicologic Emergencies: Involves poisoning or substance abuse cases.

  • Behavioral Emergencies: Patients may exhibit psychological conditions, complicating assessments.

  • Gynecologic Emergencies: Involves emergencies related to the female reproductive system.

Patient Assessment

  • Focus: Differentiates from trauma assessments by focusing on symptoms and the nature of illness (NOI).
  • History Importance: A thorough medical history can help clarify a patient’s condition.
  • Challenges: Injury distraction, tunnel vision, uncooperative patients, and avoiding bias in assessment.

1. Scene Size-Up

  • Ensure scene safety and identify the number of patients.
  • Use standard precautions (gloves, protective equipment).
  • Evaluate need for additional resources (ALS units, etc.).

2. Primary Assessment

  • Develop a general impression of the patient’s condition.
  • Assess level of consciousness using the AVPU scale.
  • Ensure airway is open and check breathing.
  • Assess circulation via pulse and skin condition.
  • Identify and address any life threats immediately.

3. History Taking

  • Gather a detailed history using OPQRST to understand patient's chief complaint.
  • Ask about previous episodes, current medications, and medical history.
  • Collect information from family, friends, or bystanders if patient is unresponsive.

4. Secondary Assessment

  • Conduct a focused examination based on chief complaint when time allows.
  • Examine head, neck, chest, abdomen, pelvis, and extremities for signs of injury.
  • Obtain vital signs.

5. Reassessment

  • Repeat primary assessment and vital signs, monitor for changes continuously throughout transport.
  • Document changes in patient's condition and any interventions taken.

Management, Transport and Destination

  • Pre-Hospital Treatment: Often symptomatic, may include administering certain medications under medical control.
  • Transport Decisions: Critical patients need rapid transport; non-critical may not require lights/sirens.
  • Destination Selection: Choose the closest appropriate ED, considering specialized facilities when needed (e.g., cardiac care).

Infectious Diseases Management

  • General Principles: Follow standard precautions while assessing potential infectious disease patients.
    • Use OPQRST for assessment, gather vital signs, especially if the patient has traveled recently.
  • Common Conditions:
    • Influenza: Transmitted through respiratory droplets; protect with PPE.
    • Herpes Simplex: Causes cold sores and can lead to pneumonia.
    • HIV: High alert for exposure; follow strict safety protocols.
    • Hepatitis: Can be contagious; various forms with different modes of transmission.
    • Meningitis: Inflammation of brain coverings, may vary in contagiousness.
    • Tuberculosis: Airborne transmission; requires N95 masks for protection.
    • Whooping Cough: Vaccine-preventable; highly contagious among children.

Conclusion: Assessment Complexity

  • Medical patients often present symptoms that are not immediately obvious; providing timely treatment may require careful assessment and handling of multiple simultaneous conditions.
  • Professionalism and calmness are key in delivering effective care to patients with diverse and sometimes overlapping medical issues.