updated January 17, 2024

During the fall and winter, hospitals see an increase in patients with respiratory illnesses due to influenza, COVID-19, and pneumonia, as well as disorders due to cold exposure and injuries due to ice and snow.

One shouldn’t go to an emergency room unless they truly need to.

But what is an emergency?

An emergency can be a medical condition which

is new, sudden, and/or unexpected,
worse than usual or uncontrolled,
of unknown origin,
not responding to treatment,
not improving or resolving,
interrupts normal life.

However, a more specific definition is

An emergent medical condition is one that, if not treated promptly

Threatens life
Threatens one or more limbs
Threatens vision/hearing/speech/mental function/ function of any major internal organ or organ system
Threatens long term and/or permanent bodily harm

Emergency Medical Treatment and Labor Act (EMTALA).

In the United States, a federal law known as EMTALA defines a medical emergency as

“a condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual’s health [or the health of an unborn child] in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of bodily organs.”

Examples of emergent conditions include

Sudden or new changes in heart function, like a myocardial infarction (heart attack), arrhythmia (abnormal heart rate or rhythm) or congestive failure (poor pumping capacity)
Brain conditions including stroke, head trauma, seizure, psychosis
Pulmonary (breathing) dysfunction including pulmonary embolus (blood clot), severe pneumonia, asthma or COPD
Multiple trauma, including extensive burns , multiple fractures, or trauma to any major organ like the liver or kidneys
Chemical changes in the blood; for example high /low blood sugar, low blood potassium, low platelets,
Severe depression and/or anxiety
Drug and alcohol overdoses

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, severe dizziness
Hallucinations, confusion, thoughts or threats of harm to self or others
In a pregnant woman- any of the above plus loss of fetal movement
Persistent/severe nausea/vomiting/diarrhea
Severe pain, especially if it prevents or inhibits body function

Persons at risk

Certain groups of people are more at risk of significant illness with any of these symptoms, so emergency care should be sought sooner rather than later. They include

infants up to age 2
elderly-most medical references still call this over age 65
pregnant women
people with suppressed immune systems as from cancer chemotherapy, HIV, malnutrition, other drugs

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.

Learn more about common heart diseases at this previous post

Exploring -when HEARTS break

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.

IN AN EMERGENCY CALL 911!

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

You should not call your doctor’s office, your mother, your best friend, or post a question on social media (which I have seen done!)

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?

We doctors don’t expect you to diagnose your condition before coming to the ER or the office, and insurance companies shouldn’t either. With using the above guidelines, if you even suspect your problem is an emergency, you are wise to seek help.

Dr. Esther Choo, an emergency physician shares

6 Tips for Getting the Most Out of Your Emergency Room Visit

a speed limit sign with an H for hospital , 5 miles — A hospital will have a full-service emergency room, although the level of services differs based on the size of the hospital.

Dr. Deborah Burton, pediatric ear, nose, and throat physician gives

5 Top Tips to Best Use Urgent Care Centers

a sign on a building -"express-urgent care" — Don’t expect an urgent care clinic to offer all the services of an emergency room.

Your definition of an emergency and your insurance company’s definition may differ-and that difference may cost you money. Read why here.

Is it an emergency? Insurer makes patients question ER visit

exploring the HEART of emergencies

Dr. Aletha

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

During Breast Cancer Awareness Month I want to remind you of physician recommendations for screening. Currently, the only test recommended for screening is mammography.

a woman having a mammogram done by a technician — image used courtesy of the Public Health Image Library, CDC

No other test has evidence that its use will decrease breast cancer deaths, although they may be useful for diagnosis in women who have breast symptoms.

These guidelines for screening apply only to women at average risk of breast cancer, which is most women. They do not apply to women who have ever been diagnosed and/or treated for breast cancer, or to women who currently have symptoms related to their breasts, such as a lump, pain, discharge, or skin changes.

Guidelines for screening come chiefly from two organizations- The American Cancer Society (ACS) and the United States Preventive Services Task Force (USPSTF). Other organizations such as the American Academy of Family Physicians (AAFP) , of which I am a member, usually follow their recommendations .

guidelines from the ACS

Offer annual screening to women age 40 to 44 years.
Perform a mammogram annually in women 45 to 54 years.
Perform a mammogram annually or every other year starting at age 55 years.
Continue screen mammography as long as a woman’s overall health is good, with a life expectancy of 10 years or longer.
Routine breast exams by either the patient or a physician are not recommended.

guidelines from the U.S. Preventive Services Task Force (USPSTF)

For ages 40-49 years, individualize the decision to screen every 2 years
For ages 50-74 years, screen every 2 years
For ages 75 years and older there is no recommendation.

Both organizations recommend that physicians discuss the decision to screen or not to screen with patients and base the decision after considering possible harms versus potential benefit.These are guidelines for physicians to apply to each individual patient, not hard and fast rules.

a mammogram image — a mammogram revealing a breast cancer image source- National Library of Medicine, Open-i

Screening guidelines are not used for high risk women- women with

a history of previous breast cancer or ovarian cancer
a suspected or confirmed genetic mutation , BRCA, known to increase breast cancer risk
a history of radiation to the chest
a close family history of breast history, usually meaning parent, sibling, child, grandparent, aunt/uncle, or first cousin.

Breast cancer in young women can be hereditary. — graphic courtesy of the CDC, U.S. Department of Health and Human Services

Screening guidelines also do not apply to women with breast symptoms suggestive of cancer.

a lump in the breast or axilla (armpit)
pain, especially in only one breast
nipple discharge
persistent rash or skin changes over the breast

These women need appropriate diagnostic testing which might include

mammography,
ultrasound,
MRI,
biopsy.

Here are sources for more information

Breast Cancer

“Both women and men can get breast cancer, though it is much more common in women. Other than skin cancer, breast cancer is the most common cancer among women in the United States.”

Mammography

“You should talk to your doctor about the benefits and drawbacks of mammograms. Together, you can decide when to start and how often to have a mammogram.”

Screening Guidelines

“Mammograms are not perfect tests. They can miss some cancers, and they can find lesions that may look like cancers but are not actually cancers (false-positive results), resulting in additional testing and procedures. They can also find very low-risk cancers that would never have caused any health problems if they were never found or treated (overdiagnosis).”

Breast cancer screening benefits and harms

“Each woman also has different personal values, especially toward the idea of unnecessary medical tests and treatments.

Talk to your doctor if you are younger than 50 years and have questions about whether you should get a mammogram.”

Get involved by sharing this information with friends and colleagues

and on social media.

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Category: Diseases and injuries

Reliable keys to recognize a medical emergency

updated January 17, 2024

An emergency can be a medical condition which

An emergent medical condition is one that, if not treated promptly