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.

updated April 7, 2023

If you have ever had a “broken heart” (and who hasn’t?), you know the sadness and grief cause not just emotional pain, but physical pain. And since that pain is often felt in our chest, it makes sense that we call it “heart break”.

The late Elvis Presley made the expression famous with his breakout hit Heartbreak Hotel.

And a particularly gruesome battle during the Korean War occurred at a place named Heartbreak Ridge, dramatized in a movie Heartbreak Ridge.

Exploring -the HEART

We often use the term HEART DISEASE when there are many diseases that involve the heart. HEART conditions affect people from birth to death.

diagram of the human heart — Heart diseases affect any and sometimes multiple parts of the heart- the atria, ventricles, the valves, the aorta, the pulmonary artery and veins, the walls and the coronary arteries (not shown in this diagram. )

Congenital Heart disease

Heart problems that are present at birth are called congenital heart disease. Defectos cardíacos congénitos. Signs or symptoms may be not apparent for a few weeks or months.

A congenital heart defect is a problem with the structure of the heart. It is present at birth.
Congenital heart defects are the most common type of birth defect.
The defects can involve the walls of the heart, the valves of the heart, and the arteries and veins near the heart.
They can disrupt the normal flow of blood through the heart. The blood flow can slow down, go in the wrong direction or to the wrong place, or be blocked completely.

I remember how concerned I felt when my son called to tell me the doctor had found a heart murmur in my 3-week-old granddaughter- especially since they lived 2000 miles away. An echocardiogram showed a VSD, a ventricular septal defect– a hole between the two larger chambers of her heart. We were all relieved when the pediatric cardiologist said it was small and unlikely to cause her problems or to need surgery, and his prediction has been correct.

Other congenital heart conditions

CARDIOPATÍAS CONGÉNITAS

Cardiomyopathy

In a previous post I told you about my late friend Chuck who had heart disease. Chuck had developed cardiomyopathy, disease of the heart muscle, which makes up the walls of the heart. Cardiomyopathy has many causes including high blood pressure (if not controlled), ischemia (lack of blood flow), infections, toxins including alcohol, and sometimes unknown causes.

Cardiomyopathy can often be managed with medications and lifestyle but sometimes, as in Chuck’s case, requires heart transplantation.

Chuck’s wife Sara wrote about his heart condition as well as other medical issues in her memoir Trumped By Sovereignty.

Myocarditis

Miocarditis

Myocarditis was a potential complication of COVID-19, both from the virus itself as well as the mRNA vaccines against it. But the risk was higher with infection than from the vaccine, the American Heart Association reported.

Myocarditis is much less common than other heart diseases but tends to occur more often in men, and in young to middle aged persons.

Myocarditis results from the inflammation created by a variety of causes.

cancer drugs that inhibit the immune system
autoimmune disorders such as systemic lupus
vaccines-mRNA for SARS-CoV2 and smallpox vaccine
the most common cause-viruses including coronavirus, influenza, parvovirus B19, dengue

Like other forms of heart disease myocarditis can lead to heart failure and arrhythmias with a mortality rate of 1-7%. Most people have uncomplicated myocarditis and fully recover.

Ischemic Heart Disease

Enfermedad de las arterias coronarias

My late father developed diabetes mellitus which led to atherosclerosis of his coronary arteries, the arteries that carry oxygen to the heart itself. Atherosclerosis can affect any of the arteries and sclerosis means “hardening”, hence the term hardening of the arteries.

EKG tracing — In sudden cardiac death, the heart stops beating abruptly

In his case this caused a heart attack, which in medical terms is a myocardial (heart muscle) infarction(death or damage).

From the damage to his heart muscle he developed congestive heart failure; his heart could not effectively pump blood to his body.

I still remember the night I received a phone call soon after going to bed. It was an EMT from the local ambulance service telling me he was at my parents’ home. My mother called 911 after my father collapsed at home and died from sudden cardiac death.

Sudden cardiac death occurs when someone with heart disease dies suddenly and unexpectedly. But sometimes, unlike my father’s case, the victim and family didn’t know a heart condition existed. This is often the case when someone dies from a sudden and persistent irregularity of the heart rhythm, called an arrhythmia.

old photo of man in a sailor uniform — My late father served in the U.S. Navy during the Second World War

Presión arterial elevada (Hipertensión)

Hypertension

Both my husband and I have hypertension, the medical term for high blood pressure. This is probably the most common cardiovascular disease . Although not a heart condition, it can cause disease in the heart and other vital organs, as shown in this diagram .

Before you go..

Please follow any of the above links to read more about these and other heart conditions.

Please explore and follow this blog for more articles that explore the HEART of health.

Enjoy this book review of State of the Heart-how we learned to understand the way the heart works and heart and what to do when it doesn’t work the way it should

exploring the State of the Heart – a book review

Our brain controls the actions of the body’s other organs, but the heart supplies the power that keeps everything working smoothly, including the brain.

by Aletha Cress Oglesby, M.D.

Tag: COVID-19

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