Call 911, it’s an emergency! or is it?

A few weeks ago, I posted some general guidelines on when parents should seek medical attention for their children, or even themselves- basically for any urgent or emergent medical situation.  But what qualifies as a bona fide emergency warranting a visit to an emergency room or calling 911?

To patients, an emergency is any medical condition which 

is new, unexpected, worse than usual, uncontrolled, of unknown origin, not responding to treatment, not going away and interrupts normal life.

However, to physicians and other health care personnel, the definition of an emergency is specific.

An emergent medical condition is one that

  • Threatens life
  • Threatens one or more limbs
  • Threatens vision/hearing/speech/mental function/ function of any major internal organ or organ system
  • Has the potential, if not treated promptly, to cause death or long term and/or permanent harm.
Minutes matter with heart emergencies
Minutes matter with heart emergencies

Some examples of conditions that meet this definition are

  • Acute changes in heart function, like a myocardial infarction (heart attack), arrhythmia (abnormal heart rate or rhythm) or congestive failure (poor pumping capacity)
  • Acute brain conditions including stroke, head trauma, seizure, psychosis
  • Pulmonary (lung) dysfunction including pulmonary embolus (blood clot), severe pneumonia, asthma or COPD
  • Multiple trauma , including large burns or trauma to any major organ
  • Significant changes in components of the blood; for example high blood sugar, low blood potassium, low platelets
  • Severe depression

When should you suspect any of these conditions?

The SYMPTOMS of an emergency  include

  • Shortness of breath, or difficulty breathing, especially if not associated with exertion
  • Uncontrollable bleeding
  • A seizure, especially in a person with no previous diagnosis of seizures
  • Sudden or severe loss or difficulty with vision, hearing , speech, or other functions such as swallowing, thinking, walking, passing urine or stool
  • Fainting, passing out, loss of consciousness
  • Hallucinations, confusion, thoughts or threats of harm to self or others
  • In a pregnant woman- any of the above plus loss of fetal movement

You notice that I did not list PAIN and FEVER. Even though these are symptoms that concern patients the most, BY THEMSELVES they do not define an  emergent condition. However, if they occur with any of the other symptoms, or are severe, then it is reasonable to call it an emergency.

Chest pain must always be taken seriously, even if mild. Although in persons under 40 years old it is less likely due to a heart attack, there are other life threatening conditions that can occur in this age group. Again, especially if it is associated with any of the other symptoms, it is emergent.

While on a mission trip to Panama, my husband had a near emergency when a board flew into his leg causing a deep gash; our medical team members took care of the injury right on the clinic site, and he recovered without permanent damage
While on a mission trip to Panama, my husband had a near emergency when a board flew into his leg causing a deep gash; a local surgeon was working with our medical team , and with their help he sutured the wound at the small rural church where we were holding clinic; his leg has healed well, just a scar to remind us of the adventure.

So assuming it is an emergency, what do you do now? You do not call your doctor’s office or answering service, your mother, your best friend, or post a question on social media (which I have seen done!)

IN AN EMERGENCY  CALL 911!

Helicopters transport of emergency patients can make the difference between life and death.

If it’s not an emergency but is urgent, then the next best options are calling your doctor’s office or going to an urgent care clinic. Posting on social media is still a bad choice. Do you really want your “friends” giving you medical advice about something they know nothing about?

Now, some doctors may disagree with this- but I think it is acceptable to go to an emergency room for problems that are serious but not emergencies. Since an emergency center is staffed 24/7, it should be utilized; there’s no reason to waste our health care resources. And sometimes it may be your only choice- if your doctor’s office is closed or the schedule full, if you are away from home, or you don’t have a primary care physician.

Just be aware if you go to an emergency room instead of an office, clinic or urgent care facility you may

Hospital sign- 5 miles to help.

That brings me to my final point. There are

10 Things to Know Before Your Next Visit to the Emergency Department

that Dr. Kristin Prentiss Ott and I want you to know. She is an emergency physician who knows exactly what an emergency is . In my career I have worked in ERs so I can attest to the accuracy of what she writes. I hope you never need to go to an emergency room, but if you do, keep her advice in mind.

Helicopter landing at a hospital to deliver a critically ill person.

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