Overview

Across India, severely ill and injured individuals seek care each day. The frontline healthcare providers manage patients with medical emergencies. A combined approach to early identification and revival should be prioritized that reduces the impact of the conditions. Emergency Care is a vital part of the healthcare system, and it serves as the first contact across India for everyone.

In a country with logistical or financial barriers to healthcare access, people may reach out for care only when they get hit with severe illness or injury. Early recognition and timely treatment reduces the morbidity and mortality associated with the conditions.

Pre-hospitalization and facility-based emergency care is of great impact and will prove to be a cost-effective form of prevention. Additionally, disease examination at facilities delivering emergency care is essential to guide initial prevention and outbreak response.

Definition-

Simple effective care given to a casualty or injury or illness (sudden) until more advanced care can be provided.

Goals of emergency care-

• To preserve life
• Protect unconscious casualty
• Prevent further injury / pain
• Promote recovery

In emergency situation, priority should be-

• Remove danger
• Determine casualty response if its conscious
• Ensure clear airway
• Breathing if absent, expired air resuscitation needs to be commenced immediately
• Compressions if absent, cardiopulmonary resuscitation is urgently required
• Check vital signs
• Obtain history

Sudden injury and illness comes without a warning and no one plans a trip to the Emergency Department (ED). Hence it’s important to have a deep understanding of the 5 steps of emergency care-

   1. Triage- determines the severity of a patient’s condition and patients with most severe emergencies receive a quick treatment based on priority level of condition-

Level 1- Immediate life-saving intervention
Level 2- Emergency
Level 3- Urgent
Level 4- Semi-urgent
Level 5- Non-urgent

Only one person can accompany the patient in triage area

   2. Registration- helps to get patient records and consent for emergency medical treatment.
   3. Treatment- depending on condition, t/t is started using IV line and only 2 patients are allowed in patient room
   4. Re-evaluation- Tests are performed to get into an insight into disease condition and treatment needed is planned accordingly
   5. Discharge- after health recovers, a patient is given homecare instructions and discharged.

Emergency medical condition-

A condition that manifests by itself with acute symptoms of severity, pain etc., such that a prudent layperson who possesses average knowledge of health & medicine, could reasonably expect the absence of immediate medical condition to result in-

• Placing the person’s health in serious jeopardy
• Impairment of bodily functions
• Serious dysfunction of any body part or organ

Emergency physicians give emergency medicine for treating medical emergencies. Emergency medicine is a medical specialty concerned with care of illnesses or injuries requiring immediate medical attention. Some examples of medical emergencies are burns, asthma, poisoning, traumatic injuries, bleeding, shock, strokes, severe allergic reactions, road-traffic accidents or RTA etc.

How to handle a medical emergency effectively and be safe?

• Stay calm & composed
• Call medical emergency services or at local hospital for ambulance
• Always carry a First Aid Kit
• Give CPR or cardio-pulmonary resuscitation to the patient Why is it important to handle a medical emergency?
• Medical emergency situations are always alarming so it is important to be calm and composed till medical help arrives. One should take deep breaths to calm nerves and keep anxiety at bay
• Medical supervision is important so without delay hospital authorities should be called for an ambulance. The team of technicians give BLS / ALS (Basic life support / Advanced life support) to the patient while he is transported to hospital.
• A first aid kit or medical toolbox is mandatory at every home, office, school, organization and on the go. The focus should be to give medical aid to patient without further delay and damage
• CPR is done if a patient is unable to breathe so his airways should be made unrestricted by removing all tight clothing and keeping CPR.

Emergency care physicians work day and night to save lives of people in danger as life and death situations are shared every day in emergency care in the medical world. These doctors meet and see the most critical and sickest of patients and work hard utilizing their subject knowledge and skills to treat the affected patients. They have a huge responsibility on their shoulders to make a considerable and commendable difference in lives of these critical patients to avoid casualties.

Emergency Medical System (EMS) in India but is still fragmented. Due to lack of awareness and less EMS set-ups in villages and small towns of India. It is a more realized need to build more EMS set-ups so that more lives can be saved. A collaborative effort is required at the end of the medical community, government and other agencies to reform the EMS in India. However, in other countries on the world map emergency medicine is a building block of the medical world due to more awareness, more emergency medical services, education and government initiatives. It's high time India should realize the need for emergency care and work on it.

Why is there a need for emergency care?

• To treat medical emergencies
• Saves lives of people
• Prevent trauma and deaths
• Forms frontline of medicine field
• Protecting against further damage
• Provide recovery to dying patient

5 steps of emergency response-

• Prevention
• Mitigation
• Preparedness
• Response
• Recovery

PGC Response

PGC is dedicated to strengthening the emergency care systems that serve as the first point of contact with the health system and supporting excellence, timely crisis care accessible to all.

Fact Check

• The most common medical emergencies people experience are: bleeding, breathing
difficulties, collapse, epileptic seizure, intolerable pain, heart attack, or a stroke.
• Most people in India do not have medical emergency insurance.
• Emergency care in India needs reform while it is most advanced and developed abroad.
• There are very few emergency physicians in India.
• Emergency care and medicine is a fruitful and trending career among doctors.

PGC Resolution

To prioritize emergency, trauma and acute care services. Achieve access to emergency care for all.