Medical emergencies

Opiate overdose is a medical emergency that can result in respiratory and CNS depression. The opioid receptor antagonist naloxone immediately reverses cardiorespiratory depression. However, repeated naloxone administration is required, since the effects of naloxone last for 30 min, while opioid agonists can remain at potentially lethal blood levels for several hours. 

Acute bronchospasm causes severe respiratory distress and wheezing from the forceful expiration of air and is considered a medical emergency, ft is characterized by severe respiratory distress, dyspnea, forceful expiration, and wheezing. The nurse must report these symptoms to the primary health care provider immediately. 

Basic aspects of the proteins of the blood coagulation system and of fibrinolysis are described in this chapter. Some fundamental aspects of platelet biology are also presented. Hemorrhagic and thrombotic states can cause serious medical emergencies, and thromboses in the coronary and cerebral arteries are major causes of death in many parts of the world. Rational management of these conditions requires a clear understanding of the bases of blood clotting and fibrinolysis. 

The PCP abuser poses unique problems for law enforcement agencies and the judicial system. McCarron et al. (1981), in reviewing medical and behavioral characteristics of 1,000 PCP episodes observed in medical emergency rooms, have noted the extremely high incidence (35 percent) of violence and rage reactions. Possibly... 

Acute stroke is considered to be an acute medical emergency. Identification of the time and manner of stroke onset is an important determinant in treatment. The time the patient was last without symptoms is used as the time of stroke onset. Since patients typically do not experience pain, determining the onset time can be difficult. It is also important to document risk factors and previous functional status of the patient to assess current disability due to the stroke. 

Many of the electrolyte disturbances discussed in the remainder of this chapter represent medical emergencies that call for... 

It is critical to differentiate acute and chronic respiratory acidosis, as the acute form is often a medical emergency that requires intubation and mechanical ventilation, whereas the chronic form is typically a stable condition. The blood gases in Case Study 2 came from a patient with advanced emphysema who is a "C02 retainer" due to ineffective ventilation. Because this patient s disease is chronic, the elevated PaC02 developed very slowly and allowed for metabolic compensation. 

The results of these surveys indicate that substance abuse is wide ranging, begins early, and is associated with a considerable number of medical emergencies. 

Acute primary angle-closure glaucoma is a medical emergency and requires laser or surgical intervention. 

Medical emergency due to high risk of vision loss. 

Signs and symptoms Prepubertal children often present with stuttering priapism. Older males can present with prolonged episodes that last for days and should be managed as medical emergencies. Urinary obstruction can occur in severe cases. 

Falciparum malaria must be considered a life-threatening medical emergency. 

Malaria is transmitted by the bites of the Anopheles mosquitoes which introduce into the bloodstream one of four species of sporozoites of the plasmodia (Plasmodium falciparum, P. ovale, P. vivax or P. malariae). Initial symptoms of malaria are nonspecific and may resemble influenza and include chills, headache, fatigue, muscle pain, rigors, and nausea. The onset of the symptoms is between 1 to 3 weeks following exposure. Fever may appear 2 to 3 days after initial symptoms and may follow a pattern and occur every 2 or 3 days (P. vivax, P. ovale and P. malariae). Fever with P. falciparum can be erratic and may not follow specific patterns. It is not unusual for patients to have concomitant infections with P. vivax and P. falciparum. Falciparum malaria must always be regarded as a life-threatening medical emergency. 

Infection is a primary cause of death in acute leukemia patients. The majority of chemotherapy used to treat ALL and AML can cause severe myelosupression, placing the patient at risk for sepsis from otherwise normal bacteria. It is important to recognize that symptoms and signs of infection maybe absent in a severely immunosuppressed or neutropenic patient. Fever (greater than 38.3°C, 100.9°F) in a neutropenic patient is a medical emergency. Following chemotherapy, the period of neutropenia usually reaches its nadir approximately 14 days after the... 

Angioedema Swelling similar to urticaria (hives), but the swelling occurs beneath the skin instead of on the surface. Angioedema is characterized by deep swelling around the eyes and lips, and sometimes of the hands and feet. If it proceeds rapidly, it can lead to airway obstruction and suffocation, and it should therefore be treated as a medical emergency. 

Equipment and supply centers Medical emergency response Medical monitoring activities Sanitary facilities Supply, maintenance, and repair of communications, respiratory, and sampling equipment Maintenance and repair of vehicles Replacement of expendable supplies Storage of monitoring equipment and supplies—storage may be here or in an on-site field laboratory... 

Medical Emergency Preparedness and Planning Office Rotterdam, The Netherlands George Rusch... 

Hypercalcemic crisis and symptomatic hypercalcemia are medical emergencies requiring immediate treatment. Rehydration with normal saline followed by loop diuretics can be used in patients with normal to moderately impaired renal function. Initiate treatment with calcitonin in patients in whom saline hydration is contraindicated (Table 78-3). 

Deaths from overdoses of other types of hallucinogens are rare, but not with PCP. Poisoning with this drug is a major medical emergency and requires great skill in management. Fortunately, the means are available for successful treatment. 

Methods for treating victims exposed to contamination and addressing common medical emergencies such as burns, cuts, and heart attacks... 

In auditing various industrial workplaces, we found that this particular OSHA standard is one of the most misunderstood by employers. Based on our experience, we found that OSHA s use of the words "near proximity to" and "adequate" contribute to the vagary and ambiguity of this standard. Most employers understand the need to provide first aid supplies in the workplace, but generally think that this is the extent of their responsibilities in this regard. Moreover, many workplaces do train their personnel on basic first aid and CPR, but do not require (in written job descriptions) that the trained employees respond to a workplace medical emergency. 

We found that employers are reluctant to have employees respond to workplace medical emergencies because most employees do not want to respond. They do not want to be exposed to gore and the victim s pain. They also do not want to assume liability for trying to aid an injured victim. 

We pointed out earlier that most emergency plans address fire, medical emergencies, and the accidental release or spills of hazardous materials. Note that the development of emergency response plans should also factor in other possible emergencies— natural disasters, floods, explosions, and/or weather-related events that could occur and certainly will occur. Now, emergency response to terrorist activity or threats must also be added to the list. 

Delirium. Closely related to the previous disorders is delirium, which includes both psychosis and a fluctuating level of consciousness. The fluctuating sensorium is the key to distinguishing delirium from other causes of psychosis. Medical illnesses or drugs cause delirium it is a medical emergency that requires prompt medical treatment. 

It is extremely important to identify delirium in a timely manner. Delirium is a medical emergency because untreated, it often proves fatal. Delirium generally occurs when some external factor interferes with normal brain functioning. The most common causes of delirium are infection (e.g., pneumonia or bladder infections) and the side effect of prescribed medication or drugs of abuse. 

Suggested training for facility personnel and operations personnel who are likely to witness or discover a fire, medical emergency, or hazardous substance release should include ... 

For medical emergencies, call your regional Poison Control Center. Further Information may be obtained by calling 1-800-4PHARMA. 

Lactic acidosis is a medical emergency that must be treated in a hospital setting. In a patient with lactic acidosis who is taking metformin, immediately discontinue the drug and promptly institute general supportive measures. Because metformin is dialyzable (with a clearance of up to 170 mL/min under good hemodynamic conditions), prompt hemodialysis is recommended to correct the acidosis and remove the accumulated metformin. Such management often results in prompt reversal of symptoms and recovery. 

Note Status asthmaticus should be considered a medical emergency. 

Status asthmaticus Status asthmaticus is a medical emergency and is not rapidly responsive to usual doses of conventional bronchodilators. Oral theophylline products alone are not appropriate for status asthmaticus. 

Care of the patient s airway, respiratory support, and treatment of cardiovascular abnormalities are all part of the early support that may be required. The needs for these situations are common to all medical emergencies, though in the poisoned patient, potential interactions between therapy and suspected poison(s) must be considered. 

Excess serotonin in the central nervous system leads to a condition commonly referred to as the serotonin syndrome. There are several drug mechanisms that can cause serotonin toxicity. Serotonin toxicity can be a medical emergency characterised by rapid onset of severe hyperthermia, muscle rigidity and multiple organ failure. 

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