Emergency Medicine

A heart attack, also known as a myocardial infarction, occurs when the flow of blood to the heart is blocked, often by a buildup of fat, cholesterol, and other substances, which form a plaque in the coronary arteries. The interruption in blood flow can damage or destroy part of the heart muscle.

Symptoms of a heart attack include chest pain or discomfort, which can feel like pressure, squeezing, fullness, or pain. This discomfort may also extend to the arms, back, neck, jaw, or stomach. Other symptoms include shortness of breath, with or without chest discomfort, a cold sweat, nausea, or lightheadedness.

Immediate treatment for a heart attack includes chewing an aspirin to help prevent further clotting, administering nitroglycerin to open blood vessels and improve blood flow, and providing oxygen therapy to increase the oxygen levels in the blood. In the hospital, treatments may include thrombolytic therapy to dissolve clots, angioplasty and stenting to open blocked coronary arteries, and coronary artery bypass surgery to redirect blood around a blocked artery.

It is crucial to seek emergency care immediately if there is a sudden, severe chest pain, especially if it spreads to other parts of the body or is accompanied by shortness of breath, sweating, or fainting.

A stroke occurs when the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes. There are two main types of stroke: ischemic stroke, caused by a blockage, and hemorrhagic stroke, caused by bleeding.

Symptoms of a stroke include sudden numbness or weakness, particularly on one side of the body, confusion, trouble speaking, or understanding speech, difficulty seeing in one or both eyes, trouble walking, dizziness, loss of balance or coordination, and a severe headache with no known cause.

Immediate treatment for an ischemic stroke may involve clot-busting drugs (tPA) that need to be administered within 4.5 hours of symptom onset. Aspirin may be given to reduce the likelihood of further clotting. Endovascular procedures can physically remove the clot, while medications to control blood pressure and cholesterol and surgery may be necessary for hemorrhagic stroke. Rehabilitation therapies are essential for recovery and regaining lost skills and abilities.

Emergency care should be sought immediately if there are sudden symptoms of a stroke. The FAST acronym can help remember the signs: Face drooping, Arm weakness, Speech difficulties, and Time to call emergency services.

Cardiac arrest occurs when the heart suddenly stops beating, leading to a loss of blood flow to the brain and other vital organs. This is different from a heart attack, where the heart usually continues to beat despite a blockage.

Symptoms of cardiac arrest include sudden collapse, no pulse, no breathing, and loss of consciousness.

Immediate treatment involves performing cardiopulmonary resuscitation (CPR) to maintain blood flow to the brain and organs and using an automated external defibrillator (AED) to restore a normal heart rhythm. In the hospital, advanced cardiac life support (ACLS) will include medications and advanced airway management, and post-resuscitation care might involve cooling therapy to reduce brain damage.

Emergency services should be called immediately, and CPR should be started if a person becomes unresponsive and is not breathing or has no pulse.

An asthma attack occurs when the airways become inflamed and narrowed, leading to difficulty breathing. This can be triggered by allergens, infections, exercise, or other irritants.

Symptoms of an asthma attack include severe shortness of breath, chest tightness or pain, a wheezing or whistling sound when breathing, and persistent coughing, especially at night or early morning.

Treatment for an asthma attack includes inhaled bronchodilators to open the airways, corticosteroids to reduce inflammation, and oxygen therapy to maintain adequate oxygen levels. In severe cases, intravenous medications may be required.

Emergency care is necessary if the symptoms are not relieved by usual medications, if there is difficulty speaking or walking due to shortness of breath, or if there are signs of cyanosis (blue lips or fingernails).

COPD exacerbation refers to a worsening of symptoms in people with chronic obstructive pulmonary disease, a group of lung conditions that cause breathing difficulties, including emphysema and chronic bronchitis.

Symptoms include increased shortness of breath, more frequent and severe coughing, increased mucus production, and changes in the color of mucus.

Treatment involves inhaled bronchodilators and corticosteroids to reduce inflammation and open the airways, antibiotics if an infection is present, and oxygen therapy. Severe exacerbations may require hospitalization.

Emergency care should be sought if there is severe shortness of breath not relieved by medications, a rapid heartbeat, confusion, or signs of cyanosis.

A pulmonary embolism occurs when a blood clot gets lodged in an artery in the lung, blocking blood flow to part of the lung. This can be life-threatening and requires immediate medical attention.

Symptoms include sudden shortness of breath, chest pain that may worsen with deep breathing, a cough that may produce bloody sputum, and a rapid or irregular heartbeat.

Treatment involves anticoagulant medications to prevent clot growth, thrombolytic therapy to dissolve the clot, and surgical intervention in severe cases. Long-term anticoagulation therapy may be necessary to prevent recurrence.

Emergency care is needed for sudden, unexplained shortness of breath, sharp chest pain, especially with deep breaths, or signs of deep vein thrombosis (leg swelling or pain).

Seizures are sudden, uncontrolled electrical disturbances in the brain that can cause changes in behavior, movements, feelings, and levels of consciousness.

Symptoms of a seizure can include sudden, uncontrolled jerking movements, loss of consciousness or awareness, confusion, staring spells, and strange sensations or behaviors.

Treatment includes anti-seizure medications, addressing underlying causes (such as infections or metabolic issues), emergency medications for prolonged seizures (status epilepticus), and monitoring and supportive care.

Emergency care should be sought for a first-time seizure, prolonged or repeated seizures without recovery (status epilepticus), or a seizure occurring in water or causing injury.

Traumatic brain injury occurs when a sudden trauma causes damage to the brain. This can result from falls, vehicle collisions, or violence.

Symptoms include loss of consciousness, persistent headache, nausea or vomiting, confusion or disorientation, and seizures.

Treatment involves immediate stabilization and assessment, imaging studies (CT or MRI) to assess damage, surgery for severe cases, and rehabilitation therapies for recovery.

Emergency care is needed for head injuries with loss of consciousness or confusion, severe headache, vomiting, or seizures post-injury, and any signs of neurological deficits.

Meningitis is an inflammation of the membranes (meninges) surrounding the brain and spinal cord, usually due to an infection.

Symptoms include severe headache, stiff neck, fever, sensitivity to light, nausea, and vomiting.

Treatment includes antibiotics or antiviral medications, corticosteroids to reduce inflammation, supportive care (hydration and pain management), and isolation if contagious.

Emergency care is essential for the sudden onset of severe symptoms, suspected exposure to meningitis, and symptoms in infants or young children, such as high-pitched crying and irritability.

Acute appendicitis is the inflammation of the appendix, a small tube attached to the large intestine. If untreated, it can lead to a ruptured appendix, causing serious complications.

Symptoms include sudden pain starting around the navel and moving to the lower right abdomen, nausea and vomiting, loss of appetite, and fever.

Treatment involves surgical removal of the appendix (appendectomy), antibiotics before and after surgery, and pain management.

Emergency care is necessary for sudden, severe abdominal pain, pain worsening with movement or coughing, and accompanied by fever and vomiting.

Gastrointestinal bleeding refers to any form of bleeding that occurs in the gastrointestinal tract, which can be life-threatening.

Symptoms include vomiting blood or coffee-ground-like material, black, tarry stools, bright red blood in stool, and abdominal pain.

Treatment involves stabilization and fluid replacement, endoscopic procedures to control bleeding, medications to reduce stomach acid or treat ulcers, and surgery in severe cases.

Emergency care should be sought for significant or persistent bleeding, symptoms of shock (pale skin, rapid heartbeat, fainting), and severe abdominal pain.

Pancreatitis is inflammation of the pancreas, which can be acute or chronic. It is often caused by gallstones or chronic heavy alcohol use.

Symptoms include upper abdominal pain that may radiate to the back, nausea and vomiting, fever, and a rapid pulse.

Treatment includes fasting to rest the pancreas, pain management, intravenous fluids and nutrition, and antibiotics if an infection is present.

Emergency care is needed for severe, persistent abdominal pain, pain accompanied by vomiting and fever, and symptoms of dehydration.

A fracture is a break in the bone, which can vary in severity and type.

Symptoms include severe pain at the injury site, swelling and bruising, deformity or inability to move the limb, and bone protruding through the skin (compound fracture).

Treatment involves immobilization with splints or casts, pain management, surgery for severe fractures, and rehabilitation and physical therapy.

Emergency care is needed for suspected broken bones with severe pain or deformity, open fractures with visible bone, and loss of limb function.

Burns can range from minor to severe and are classified based on the depth and extent of skin damage.

Symptoms of burns include redness, swelling, and blistering for superficial burns, white or charred skin for deep burns, varying pain levels, and possible shock in severe cases.

Treatment involves cooling the burn with water, pain management, dressing and infection prevention, and surgery and skin grafts for severe burns.

Emergency care should be sought for burns covering large areas or major joints, deep burns, those involving the face, hands, feet, or genitals, and signs of infection or shock.

Lacerations are open cuts or tears in the skin that can vary in depth and severity.

Symptoms include bleeding, pain, and the risk of infection.

Treatment involves cleaning and disinfecting the wound, closing the wound with stitches, staples, or adhesive strips, tetanus shots if necessary, and antibiotics for infected wounds.

Emergency care is needed for deep or wide cuts, uncontrolled bleeding, and signs of infection (redness, swelling, pus).

Sepsis is a life-threatening condition that arises when the body’s response to an infection causes injury to its tissues and organs.

Symptoms include high fever or low body temperature, rapid heartbeat and breathing, confusion or disorientation, severe pain or discomfort, and clammy or sweaty skin.

Treatment involves immediate administration of antibiotics, intravenous fluids to maintain blood pressure, oxygen therapy, and medications to support organ function.

Emergency care is crucial for symptoms of infection with rapid deterioration, signs of septic shock (severe hypotension, organ dysfunction), and confusion or altered mental state.

Anaphylaxis is a severe, potentially life-threatening allergic reaction that can occur rapidly after exposure to an allergen.

Symptoms include hives, itching, or skin rash, swelling of the lips, tongue, or throat, difficulty breathing or swallowing, rapid heartbeat, dizziness, or fainting.

Treatment involves immediate administration of epinephrine (EpiPen), antihistamines and corticosteroids, oxygen therapy, and monitoring and supportive care.

Emergency care is necessary for any signs of anaphylaxis, known allergies with severe reactions, and difficulty breathing or swallowing.

High fever in children can be alarming and may indicate an underlying infection or other health issues.

Symptoms include an elevated body temperature, shivering or chills, sweating, and fatigue or weakness.

Treatment involves antipyretics (acetaminophen or ibuprofen), hydration, and monitoring for complications.

Emergency care should be sought for fever in infants younger than 3 months, fever lasting more than three days, and accompanied by severe symptoms (rash, difficulty breathing, persistent crying).

Dehydration in children occurs when they lose more fluids than they take in, which can be due to illness, heat, or inadequate intake of fluids.

Symptoms include dry mouth and tongue, no tears when crying, decreased urination, and sunken eyes and cheeks.

Treatment involves oral rehydration solutions, intravenous fluids in severe cases, and monitoring and addressing underlying causes.

Emergency care is needed for severe dehydration symptoms, inability to keep fluids down, and signs of shock (rapid heartbeat, lethargy).

Respiratory distress in children can be caused by various conditions, including infections, asthma, and foreign body aspiration.

Symptoms include rapid or labored breathing, grunting or wheezing, nasal flaring, and cyanosis (bluish color of the skin, lips, or nails).

Treatment involves supplemental oxygen, medications to open airways, treatment of underlying conditions (e.g., infections), and intensive monitoring and support.

Emergency care should be sought for severe difficulty breathing, stridor (high-pitched breathing sound), and altered mental state or unresponsiveness.

An ECG is essential in emergency medicine for monitoring heart activity and detecting cardiac events such as heart attacks and arrhythmias. This non-invasive test provides immediate results, allowing for quick diagnosis and initiation of treatment.

Blood tests are crucial for assessing a patient’s overall health and identifying abnormalities. Emergency departments commonly use complete blood counts (CBC), metabolic panels, and specific markers for cardiac events and infections to guide treatment decisions.

Imaging studies, including X-rays, CT scans, and ultrasounds, are vital for quickly diagnosing internal injuries and conditions. These tests provide detailed images of bones, organs, and soft tissues, helping to identify fractures, internal bleeding, and other critical issues.

ABG analysis measures oxygen, carbon dioxide, and pH levels in the blood, providing valuable information about a patient’s respiratory and metabolic status. This test is particularly important for patients in respiratory distress or shock.

Intubation involves inserting a tube into the trachea to secure the airway and ensure adequate ventilation in patients with respiratory failure. Effective airway management is crucial in emergency medicine to prevent hypoxia and other complications.

CPR is a life-saving technique used to maintain circulation and breathing in a person experiencing cardiac arrest. It involves chest compressions and rescue breaths, and is often combined with advanced interventions like defibrillation.

Defibrillation delivers an electrical shock to the heart to restore a normal rhythm in patients with life-threatening arrhythmias such as ventricular fibrillation. Rapid defibrillation is critical in improving survival rates during cardiac arrest.

Emergency physicians frequently manage cuts, lacerations, and other injuries through wound care and suturing. Proper wound management helps prevent infection and promotes healing.

Central line placement involves inserting a catheter into a large vein, typically in the neck, chest, or groin, to administer medications, fluids, and blood products. This procedure is essential for patients requiring intensive treatment and monitoring.

Thoracostomy, or chest tube placement, is performed to treat conditions like pneumothorax (collapsed lung) and hemothorax (blood in the chest cavity). This procedure helps re-expand the lung and restore normal breathing.

Emergency surgery is necessary for life-threatening conditions such as ruptured appendices, traumatic injuries, and severe internal bleeding. These urgent interventions are performed to stabilize patients and address critical issues promptly.

Trauma care involves the comprehensive assessment and treatment of injuries resulting from accidents, falls, and violence. Emergency departments are equipped to handle severe trauma, providing immediate interventions to save lives and reduce complications.

Rapid intervention is crucial in stroke management to restore blood flow to the brain and minimize damage. Emergency departments use clot-busting medications, advanced imaging, and specialized stroke protocols to optimize outcomes.

Emergency medicine provides immediate care for patients experiencing poisoning or drug overdoses. Treatments may include activated charcoal, antidotes, and supportive measures to stabilize the patient and prevent further harm.