12 Medical Emergencies You Need to Address Right Away
You’re talking with your father and his speech suddenly slurs. Your usually energetic mother complains of fatigue and mysterious arm pains. Your allergic friend just got stung by a bee. Your toddler is playing with a now-empty pill vial. You have sharp abdominal pains or the most excruciating headache ever. Any of these situations could represent an emergency in which time is of the utmost importance. Calling or heading to the nearest emergency room is often your safest course. Emergency medicine experts pinpoint common health crises and how you can help as a bystander.
1. Stroke: Facial droop, weak arms, slurred speech
Public awareness of stroke symptoms has improved thanks to educational efforts, says Dr. Rade Vukmir, a spokesman for the American College of Emergency Physicians and a clinical adjunct professor of emergency medicine at Temple University in Philadelphia.
The FAST acronym is an easy way to recognize urgent stroke symptoms:
- Face: One-sided facial drooping, or a crooked smile
- Arm Weakness: Difficulty holding up an arm
- Speech: Strange-sounding or slurred speech
- Time: Call the emergency land line8 right away because “time is brain.”
However, people sometimes dismiss potential stroke symptoms, Vukmir says. If patients have an episode of weakness or numbness in a hand or arm that lasts a couple of hours, they may tend to brush it off, he says, or ignore a second episode a few weeks later. Take these symptoms seriously, he advises, particularly if you have predisposing stroke risk factors including older age, diabetes, high blood pressure, pregnancy, oral contraceptive use and smoking. “If you have an episode [of] numbness or difficulty with function that lasts more than a few seconds, certainly that’s something that needs to be reviewed with a provider, whether that be your primary care physician and then, in a lot of cases, the emergency department,” Vukmir says. “We’re always there.”
2. Swallowing toxic substances
Kids – and sometimes adults – may accidentally consume anything from household cleaning chemicals to medications not meant for them. Children are quick and they’re curious. Karen Wiley, a past president of the Emergency Nurses Association board of directors, describes the case of a mother who handed a closed bottle of iron-containing vitamin supplements to her small restless kids in the back seat of the car as a makeshift rattle. Unbeknownst to the parents, the kids unscrewed the top of the bottle, which was temporarily forgotten. “Iron in vitamins is deadly to children,” says Wiley, who most recently worked in the emergency department at CHI Health Immanuel in Omaha, Nebraska. “It’s very toxic. They brought those children into the ER because they had a decrease in level of consciousness.” The parents eventually searched and found the empty bottle in the car.
3. Choking on food or foreign objects
A bystander’s response to choking depends on whether the victim is an adult, child or infant and whether he or she is unconscious. The American Heart Association and ACEP developed choking guidelines to help you determine whether an obstruction is life-endangering, such as when a person can’t speak, cough or breathe, or becomes unconscious, and when the Heimlich maneuver is indicated. The guidelines also address what to do if you are the person choking and you’re alone. Consider printing or bookmarking these guidelines as immediate resources during choking emergencies, in addition to calling for help.
4. Breathing difficulty
Persistent shortness of breath, when someone can’t recover their normal breathing, is a problem. Causes range from chronic lung conditions to severe seasonal allergies. Prescription treatments for asthma or chronic obstructive pulmonary disease aren’t always enough. In addition, children with serious infections like respiratory syncytial virus, or RSV, can have trouble breathing. Flumay quickly become dangerous for kids and older adults. People withCOPD may experience worsening symptoms, or exacerbations. How do parents differentiate between standard asthma symptoms and something more urgent? “When it comes to breathing, the kids are struggling more,” Wiley says. “The breathing treatments they’re giving their child, or their inhalers, aren’t helping.” Then, she says, it’s time to call emergency land line or take children to the emergency department.
5. Heart attack: crushing chest pain or subtle signs
“Like an elephant sitting on my chest.” In general, the public is pretty well tuned-in to heart attack signs such as chest pain and crushing chest pressure, Vukmir says. Feelings of tightness, squeezing or aching in the chest and arms, which can spread to the neck, jaw or back, are “classic” heart-attack symptoms. Nausea, heartburn, cold sweat, shortness of breath, fatigue, dizziness or lightheadedness can also signal a heart attack. However, heart attack symptoms aren’t always dramatic or obvious. Heart attack presentation can be “atypical” for many people. “Not really pain, but fatigue or weakness in the elderly,” he says. “There are clearly different gender-based presentations. Women sometimes have more of an abdominal pain or complaint – more indigestion or sickness compared to just strict chest pain.” Seemingly healthy young women can have heart attacks due to a condition called spontaneous coronary artery dissection, or SCAD. When heart attack is a possibility, calling emergency care unit means advanced cardiac life support can begin in the ambulance before the patient even reaches the hospital.
6. Visceral pain: stomach and other organs
Sharp pains in your gut, back or pelvis serve as medical warning signals. Likewise, visceral pain – deep, dull pain within the abdomen, back or pelvis – can indicate a variety of medical conditions. Appendicitis is one reason for acute right-sided abdominal pain. Malaise, fever, nausea and poor appetite can be early appendicitis signs, Vukmir says. Gallbladder disease causes pain slightly higher in the right abdomen and back. Kidney stone pain often arises in the back. “The pain is severe,” he says. “The body is trying to move an obstruction through the system.” That pain may follow a day or so of symptoms such as irritation while urinating and blood in the urine. Sudden, excruciating back or belly pain could arise from trauma to the aorta – the large vessel that supplies blood to the body. Abdominal aortic disorders including aneurysms (a weakened, bulging aorta) and dissections (tears) can be life-threatening emergencies. Seek medical help to sort out causes of organ pain and determine how to treat it.
7. Seizures: kids and adults
Seizures are frightening to witness. Parents of children with seizure disorders like epilepsy learn to recognize when help is required. “There are children out there who have severe versions of seizures and parents may need to call the emergency care unit system, because that child could stop breathing or not come out of their seizure,” Wiley says. “Usually, parents have medications to help them break the seizure. But that may not work.” In other cases, high fever may lead to a pediatric seizure in an otherwise healthy baby or small child. The emergency room triage nurse can quickly pick up signs of an ongoing seizure and start treatment. Adults also have unexpected seizures. As a bystander, “I would protect that person from injury,” Wiley says. “So, if their head is bounding on the floor or on the cement, if you have something soft, just slip it under their head to protect it.” You could gently turn the person to the side to prevent them from choking on their saliva, she adds. “you should call emergency care unit when you see it happening,” she emphasizes. “you should call emergency care unit first.”
8. Collapse: sudden cardiac arrest
When someone unexpectedly collapses and has no pulse, is not breathing and is unconscious, that person is in sudden cardiac arrest. This abrupt loss of heart function is caused by a malfunction in the heart’s electrical system. An irregular heart rhythm called ventricular fibrillation is a common culprit in cardiac arrest, according to the American Heart Association. Sudden cardiac arrest sometimes follows symptoms such as fainting, blackouts, shortness of breath or heart palpitations, but it can also occur without any warning. If you witness a possible sudden cardiac arrest, seek help immediately. Call for help or call emergency care unit if you’re alone. Check if the person is breathing and start CPR if not. Using an automated external defibrillator or AED improves chances of survival in victims of sudden cardiac arrest. AEDs are located in apartment complexes, workplaces, schools, gyms, malls and other public spaces. “Know where AEDs are, because they are there,” Vukmir says. “AED training is really pretty minimal – and that saves lives.”
9. Suicidal thoughts or attempts
If someone tells you they recently attempted suicide – or if you have thoughts of taking your own life – get help. Suicide causes are complex, often arising from a combination of stressors and unrecognized or untreated mental health issues, such as depression or substance use disorders. Suicide warning signs include a person talking about killing themselves, having no reason to live, being a burden to others and feeling trapped or hopeless, according to the American Foundation for Suicide Prevention. Especially after a painful loss or event, behaviors such as increased drinking or drug use, online searches for suicide methods, withdrawal and isolation, making a point of goodbye calls or visits to family members and friends and giving away prized possessions may also signal risk, according to AFSP. Mood changes including depression, anxiety, agitation and loss of interest are also troubling signs. Show the person that you’re concerned, be there to listen, locate mental health help.
10. Headache: sudden, severe
The sudden onset of an extraordinarily severe headache might indicate the dire emergency of brain bleeding, or hemorrhage. “The worst headache they’ve ever had in their life is how [patients] describe it,” Wiley says. One cause of a spontaneous cerebral bleed is a brain aneurysm, which involves areas in the blood vessel walls that have weakened, swollen and burst. Chronic, untreated high blood pressure can result in brain bleeds. Trauma to the head from a car or motorcycle accident could also be the cause. In some cases, an older adult who takes anti-clotting medication like Coumadin has a fall and bumps his or her head. “Then, several hours later, they complain of a headache that’s becoming worse,” she says. “We do the CT scan and we see the bleed.” Possible signs of a brain bleed include a new-onset seizure, arm or leg weakness, vision changes, nausea or vomiting and lethargy. When a severe or rapidly worsening headache strikes, seek medical help.
11. Allergic reaction: anaphylaxis
Whether it’s caused by exposure to peanuts, shellfish, a medication, insect venom or other triggers, an anaphylactic reaction can be lethal. Hives, facial flushing and swelling, difficulty breathing, throat tightness and loss of consciousness are symptoms of anaphylaxis. If untreated, a steep drop in blood pressure can lead to anaphylactic shock. Food allergies are the leading cause of anaphylaxis outside the hospital setting, according to the American College of Allergy, Asthma & Immunology. Fortunately, anaphylaxis is rare and people at risk can carry epinephrine auto-injectors – small prefilled syringes used to quickly reverse this severe allergic reaction. Available by prescription, a generic versionof EpiPen auto-injectors was approved by the Food and Drug Administration on Aug. 16, 2018. According to ACAAI, people with food allergies should carry their epinephrine auto-injector with them at all times.
12. Trauma: heavy bleeding
Trauma – such as a severed limb, blast injury or gushing head gash – is an obvious emergency. “Free-flowing blood, spurting blood or a lot of blood” from deep lacerations require immediate care, Wiley says. Scalp bleeding that doesn’t slow when you apply direct pressure needs medical attention. Check for the following, she says: “Is the skull open? Can you see that there’s not much skin protecting the bony part of the skull? Is there any loss of consciousness? Did they fall?” For instance, she says, a child who falls from the top of a slide and is unconscious and bleeding could have a skull fracture. Call emergency care unit and stay with the child, she says. If you don’t have your cellphone handy, she adds, leave to make the call if necessary. ACEP is part of the ongoing “Stop the Bleed” campaign, a nationwide effort that offers free training for the general public on dealing with life-threatening bleeding.