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Emergency
Emergency call centers
Emergency Communications
What is the location of the harms?

_________________________

What are the issues?

_________________________

What is your telephone number?

_________________________

What is your name?

_________________________

What is your mailing address?

_________________________

What type of emergency is it?


_________________________

Is there a danger to life or property?

_________________________

Is there a serious medical emergency?

_________________________

Is there any type of fire (building, vehicle, brush, etc?)

_________________________

Is there any crime in-progress?

_________________________

Are there any other life threatening situations (traffic accident with injuries, stuck in high water, etc?)

_________________________

Is the caller or someone else the victim of a crime?

_________________________

Can you give more details?

_________________________

What best describes this case scenario?

_________________________

Medical emergency

How do you do quick assessment, diagnosis, and treatment of the patient?
What questions should you ask in case of a medical emergency?
What questions should you ask the patient?
What questions should you ask person with or reporting for the patient?

What should be your first question in case a patient is referred to you?

Where is the patient now?

_________________________

How old is the patient?

_________________________

What is the gender of the patient?

_________________________

Who is reporting this emergency?

_________________________

What seems to be the problem?

_________________________

How much time has elapsed from the start of the emergency until now?

_________________________

Does one individual or many individuals have medical emergencies at this location?

_________________________

How many people need emergency services at this time, date, and location?

_________________________

How many individuals have medical emergencies at this location?

_________________________

A medical emergency with an individual victim.
A multiple casualty incident.
Do you think this is a multiple causality incident?

_________________________


If it is a multiple causality incident, the guidelines are different.

What problems, complaints, incidents, and issues need on-the-spot diagnosis and treatment?
Unconsciousness at a public location.
Sudden unconsciousness at home.
Trauma
Survival Needs
Seizures
Burns
Drowning
Human Pregnancy Emergencies
Here are further guidelines.
Conscious
Can the patient talk?
Can the patient respond to verbal questions accurately?
Can the patient do spontaneous eye opening?
Does the patient respond to painful stimulus?
Is the patient conscious, oriented in time, space, and person?


Conscious means able to see, hear, and talk.
In pediatric patients younger than six months of age, the ability to make any verbal noise or cry is equivalent to talking.
How do you know if you or someone else has a medical emergency?
Take a look at symptoms, signs, statements, questions, issues, and histories that should raise suspicion of a medical emergency.
If any of the entities listed below best describes your or someone else's situation, this is a medical emergency.

What are various symptoms, signs, statements, questions, issues, and histories that should raise suspicion of a medical emergency?

There are at least 123 such symptoms, signs, statements, questions, issues, histories, and scenarios.
Agitated Patient (Acute stress reaction.)
Attempted suicide.
Attempted homicide.
Abuse.
Abdominal Pain.(Stomach pain)
Altered sensorium.
Any sudden or severe pain.
Animal bites (may require rabies or tetanus shot).
Armed Robbery.
Allergic reactions.
Breathing difficulties.
Bleeding from any orifice or any part of human body that will not stop.
Bleeding which does not stop after applying pressure.
Being beaten by someone.
Burns.
Bites.
Bloody Sputum
Broken bones.
Behavior-related emergencies.
Change in mental status (such as unusual behavior, confusion, and difficulty arousing).
Changes in vision.
Chest pain.
Choking.
Cough with fever.
Coughing up or vomiting blood.
Confusion or changes in mental status
Cuts and abrasions.
Chest or upper abdominal pain or pressure lasting two minutes or more.
Difficulty breathing.
Difficulty speaking.
Disoriented.
Difficulty getting up.
Difficulty in passing urine.
Difficulty in passing feces.
Domestic Violence
Drowning.
Dental emergencies.
Earaches and ear infections.
Electrical injury shock.
Emergency Food
Environmental factors (hostile environment).
Fainting.
Fever.
Foreign bodies in nose or ears.
Fainting or loss of consciousness.
Fainting, sudden dizziness, weakness, seizure.
Feeling of committing suicide or murder.
Fever with breathlessness.
Functional impairment (not taking care of self. inability to gain relevant skills and knowledge relevant to age).
Headache
Head or spine injury.
Head injury.
Hypothermia - frostbite.
Head pain that lasts longer than five minutes.
Intentional enforced harms.
Involuntary admission to a psychiatric facility
Loss of consciousness.
Loosening of social inhibitions.
Likely to be harmful to self or others.
Low abdominal pain.
Medicine overdose.
Major burns.
Medicolegal cases.
Nosebleeds.
Pain.
Palpitations.
Poisoning.
Persistent or severe vomiting.
Persistent unexplained fever even with Tylenol use.
Puncture wounds.
Personality disorders (harmful to others). Panic attacks.
Psychosis(delusions, hallucinations, catatonia, thought disorder, loss of contact with reality).
Pregnancy-related emergencies.
Possible serious bone fractures.
Rape.
Rashes.
Survival Needs
Starvation
Suicidal feelings.
Significant trauma (to the head, stomach, chest)
Syncope.
Seizures.
Sore throat & fever
Sunburn.
Severe neck or back injury.
Sexual intercourse due to conspiracy.
Severe or persistent vomiting.
Severe or persistent vomiting or diarrhea.
Severe headache.
Severe burns.
Severe pain in any part of the body that does not subside.
Serious drug reactions with psychiatric or non-psychiatric medications.
Syncope or unconsciousness.
Sudden or severe pain.
Sudden loss of vision.
Suicidal or homicidal feelings.
Sudden asthma attack that does not stop.
Sudden numbness or not being able to move an arm, leg, or one side of the body.
Sever headache with fever or vomiting.
Sudden injury or trauma due to a motor vehicle crash, burns, smoke inhalation, near drowning, wound, etc.
Substance abuse.
Sudden severe pain anywhere in the body.
Sudden dizziness, weakness, or change in vision.
Swallowing a poisonous substance.
Shock symptoms, e.g., confusion, disorientation, cool/clammy, pale skin.
Severe or persistent vomiting or diarrhea.
Trauma with unconsciousness.
Trauma with cuts, sprains, or abrasions.
Trauma with open fracture.
Trauma with pain on mobility.
Trauma with swelling.
Unconsciousness.
Unconsciousness with diabetes.
Unconsciousness at a public location.
Sudden unconsciousness at home.
Unable to move
Uncontrolled bleeding
Upper abdominal pain.
Uncontrolled bleeding.
Unusual abdominal pain.
Unusual or persistent abdominal pain.
Unexplained stupor, drowsiness or disorientation.
Violence
Violence or other rapid changes in behavior.
Vomiting
Vomiting or coughing blood.
Vomiting and diarrhea.
What best describes you in a medical emergency?
Doctor in a medical emergency.
Emergency responder in a medical emergency.
Emergency Call Center in a medical emergency.
Watcher, relative, or acquaintance of the victim in a medical emergency.
Victim himself or herself in a medical emergency.
The role of www.qureshiuniversity.com/medicalemergencyworld.html in a medical emergency.
Here are further guidelines.
Should emergency call centers have an e-mail address?
Yes.

What are examples of emergency call centers?
911 is an example of an emergency call center.
Not all regions of the world have 911 as emergency call centers.
Control rooms in some regions receive emergency calls.

Why should emergency call centers have an e-mail address?
In certain situations, it is impossible to explain everything over the telephone.
Up to October 9, 2013, doctors were not available through emergency call centers.
The police and paramedics who respond to the situation usually do not have abilities or expertise to handle the situation properly.

What should be available in an emergency call center?
An emergency call center should have access to a doctor who will reply to emergency calls.
The person answering the telephone should be able to connect immediately to a doctor.
E-mails should be available with an emergency call center.
The emergency call center should send a doctor to the location of the emergency.
The emergency call center should notify a competent police officer who can serve without harming anyone.

Who else should supervise emergency call centers?
Every state has an emergency department or organization.
Every state emergency department or organization must be updated about every emergency call to emergency call center.
Competent doctors and other emergency professionals must be at the state emergency department.

What are examples of a state emergency department or organization?
http://www.qureshiuniversity.org/stateofficesemergencymanagement.html
What is an emergency call center?
How does an emergency call center look?
What products and services are required for an emergency call center?
How many workers are required to properly manage an emergency call center round the clock?
Who should ideally be the supervisor of an emergency call center?
How many supervisors of emergency call center should there be?
What are the duties of the supervisor of an emergency call center?
How does an emergency call work?
What is an emergency call center?
How does an emergency call center look?
How many supervisors of emergency call center should there be?
What products and services are required for an emergency call center?
Education resources to educate workers.
Competent workers.
Advanced technologies.
Proper space.

How many workers are required to properly manage an emergency call center round the clock?

Duties of supervisor of an emergency call center.

Who should ideally be the supervisor of an emergency call center?

Ideally, an experienced medical doctor with extra skills and knowledge of basic human rights, state economy, state budget, state planning, and development, advanced technologies.

What are the duties of the supervisor of an emergency call center?

Enlist all requirements of the emergency call center.
Educate emergency responders, including medical doctors, police officers, fire officers, and others.
Coordinate with other departments in the state and outside the state.
Work as a team to enhance services of the emergency call center.
Resolve all complaints.

How does an emergency call work?

At the Public Safety Answering Point (PSAP), the operator verifies the caller's location, determines the nature of the emergency, and decides which emergency response teams should be notified. The emergency dispatcher uses location information provided by the caller's telephone through enhanced 911 landlines and cellular telephone to the proper public safety agency to alert responder personnel.

What types of patients get admitted to emergency room (ER), operating Room (OR), intensive care unit (ICU), and hospital wards and need Internet health care or outpatient (OPD) health care?
Intensive care unit (ICU): 18 medical conditions
Emergency room (ER): 30 medical conditions
On-the-spot medical emergency: 7 medical conditions
Operating room (OR): 22 medical conditions
Ward: 30 medical conditions
Internet health care or OPD: 6,000-plus medical conditions.
Total: 7,007 human medical conditions.

Emergency call center
    What is an emergency call center?
    How does an emergency call center look?
    What products and services are required for an emergency call center?
    How many workers are required to properly manage an emergency call center round the clock?
    Who should ideally be the supervisor of an emergency call center?
    How many supervisors of emergency call center should there be?
    What are the duties of the supervisor of an emergency call center?
Emergency medical record
    What should an emergency medical record look like?
Duties of a medical doctor in a medical emergency room.
Duties of a nurse in a medical emergency room.
Duties of emergency medical responder.
Duties of a technician in a medical emergency room.
Emergencies as per medical specialties
    What are various emergencies as per medical specialties?
    Trauma medical emergencies
      On-the-spot emergency medical diagnosis and treatment.
      On the way to the hospital treatment.
      Emergency room treatment.
      In-hospital treatment.
      Critical care treatment.
      Outpatient follow-up treatment.
      Online treatment.
    List of Diseases A-Z
    Cardiology medical emergencies
    Pulmonary medical emergencies
    Renal medical emergencies
    Gastroenterological medical emergencies
    Neurological medical emergencies
    Opthalmologic medical emergencies
    Ear, nose & throat medical emergencies
    Pediatric medical emergencies
    Endocrinologic medical emergencies
    Psychiatric medical emergencies
    Non-traumatic orthopedic medical emergencies
    Non-traumatic surgical emergencies
    Human pregnancy medical emergencies
Emergency Patient Assessment

What should you teach medical doctors about emergency patient assessment?
Emergency Patient Categories

How should an emergency medical doctor categorize the condition of a patient?

What else should an emergency medical doctor be able to answer?
Hospital Medical Emergency Department

How should a hospital medical emergency department be organized in a state?
Hospital medical emergency staff

What staff is required for a hospital medical emergency department?
Medical Emergency responders

Who is included in medical emergency responders?
State Department of Health

What should the state department of health be able to answer?
How many hospital medical emergency departments are there in the state?

Are they able to diagnose and treat all medical emergencies?

What are their e-mail, fax, telephone, and postal addresses?
Who may utilize this program for education and reference?
1. Emergency Medical Doctor
2. Emergency Nurse
3. Physician Assistant
4. Emergency Department Technician
5. Unit Secretary
6. Physicians in Training
7. Nurse
8. Postgraduate emergency medicine doctor
9. Attending physician
10. Court worker
11. Administrator
12. Consultant in emergency medicine
13. Security officer
14. Lawyer
15. Judge
16. Hospital worker
17. Legislator
18. Maintenance worker
19. Community counseling center worker
20. Media
21. Health department worker
22. Medical student
23. Social work student
24. Medical student intern
25. Social work student
26. Social work intern
27. Social worker
28. Social work master's worker
29. Social work PhD worker
30. Parents
31. Teacher
32. Principal
33. Patient
34. General public
35. Heads of other departments
36. Therapist
37. Medical Equipment Manufacturers
38. Police
39. State Department of Health
40. Heads and deputies of all departments in the state
41. Office of Emergency Management
42. Ambulance Worker
43. Ambulance Manufacturers
44. Ground Ambulance Service
45. Air Critical Care
46. Emergency Medical Dispatcher
    What experience should an emergency medical dispatcher have?

    Ideally, an emergency medical dispatcher should be an experienced emergency medical doctor.
    Medical emergency diagnosis and treatment starts as soon as the medical emergency is reported.

    Who are the people behind 911 or emergency call responders?
    Ideally, an experienced competent medical doctor should be behind 911 or emergency call responders.
If you identify yourself with anyone on the list, this program is for you.
What best describes you in the list?
Do you think anyone else needs this program for education and reference?
What is Emergency Medicine?
How did the field of Emergency Medicine get started?
What kind of patients do emergency physicians see?
What is a medical emergency?
ER Equipment
What are various medical emergencies?
Medical emergencies as per diagnosis and treatment.
Medical emergencies as per specialties.
Medical emergencies related to symptoms, signs, statements, questions, issues, and histories that raise suspicion of a medical emergency.
Who should do diagnosis and treatment in emergency medical cases?
Who should practice cardiopulmonary resuscitation, advanced cardiac life support, advanced trauma life support, or endotracheal intubation in an emergency setting?
What are the differences in the duties and responsibilities of an emergency medical consultant, emergency medical doctor, nurse, and paramedic?

Does being any board-certified emergency physician guarantee correct diagnosis and treatment?
No, it is not.
What are various symptoms, signs, statements, questions, issues, and histories that should raise suspicion of a medical emergency?
What medical emergency diagnosis and treatment should be done within a few minutes of onset of a medical emergency at the site of emergency?
What kinds of situations should be included in an organization's emergency management plans?
What tools are available for responders?
    Who has the answer?
    Who is willing to answer?
    Who has the duty and responsibility to answer?
How do you assess preparedness, quality, competence, and infrastructure of emergency medical services in the state?
Emergency medical record
    What should an emergency medical record look like?
Where is your emergency?
Is anyone hurt or injured?
How many people are injured?
What is the number you are calling from?
What is the Emergency?
What is your name?
Is the patient conscious? (Able to talk)
Is the patient breathing NORMALLY?
Is the patient short of breath or does it hurt to breathe?
Is the patient bleeding?
Can it be controlled with pressure?
Has law enforcement been notified?

Was it a physical assault vs. sexual assault?
Is the patient bleeding?
How was the victim assaulted?
(Stabbing, gunshot or major trauma go to appropriate I card)
Where is the patient injured?
Can the patient answer your questions?

ASSAULT

Is patient alert?
Is patient breathing normally?
Where is the bleeding from?
Can it be controlled with pressure?
Can the patient answer your questions?
Is blood squirting out?
Is the patient a hemophiliac (a bleeder)?

CHEMICAL

What chemical caused the burn?
How was the patient burned?
Is the patient short of breath or does it hurt to breathe?
Is the patient having difficulty swallowing?
Where is the patient burned?

ELECTRICAL

Is the patient still in contact with the electric source?
Are they coughing?
How was patient electrocuted?
Are their nose hairs burned?
Are there burns around their mouth and nose?
Are there any other injuries?

EYE PROBLEMS / INJURIES

Is patient alert?
Is eyeball cut open or leaking fluid?
Is patient breathing normally?
Are there any other injuries?
What caused the injury?

FALL VICTIM

Is patient breathing normally?
Is the patient able to move their fingers and toes?
Is patient alert?
Is the patient bleeding?
How far did the patient fall?
What kind of surface did the patient land on?
Are there any obvious injuries? What are they?
Did the patient complain of any pain or illness just prior to the fall?

Is Rescue needed?
Is patient alert?
Does the patient respond to you and follow simple commands?
Is patient breathing normally?
What happened? Can the patient answer your questions?
What was the source of the heat or cold? Is the patient acting normal for him or her?
What was the length of exposure? If not, what is different?
Does the patient have any complaints?
Is the patient sweating profusely?
Is the patient complaining of pain? If so where? How does the patient act when he/she sits up?
Can the patient talk in full sentences?
Is the patient dizzy, weak, or feeling faint?

HEAT / COLD EXPOSURE

INDUSTRIAL ACCIDENTS

Is patient alert?
Is the patient bleeding?
Is patient breathing normally?
Are there any obvious injuries? What are they?
Do you have the amputated parts?
What part of the body has been amputated?
Can it be controlled with pressure?
Is the patient entrapped?
Is the patient able to move their fingers and toes?
Is Fire Department needed?
Is Aeromedical Evacuation needed?

STABBING/GUNSHOT/ASSAULT

When did this happen?
What part(s) of the body is injured?
Is there a weapon present?
Is there bleeding?
Is patient alert?
Is patient breathing normally?
Can it be controlled with pressure?
Is there more than one person injured?
Is there more than one wound?

TRAUMATIC INJURY

Is patient alert?
Is the patient bleeding?
Is patient breathing normally?
How was the patient injured?
Where is the patient injured?
Describe what happened.

TRAUMATIC INJURY

Are there any hazards present?
What type of vehicle(s) are involved?
Is patient alert? Describe what happened?
Is patient breathing normally?
(Consider breathing card). Are all of the patients free of the vehicle?
Did you stop or drive by?
How many patients are injured? Is anyone trapped in the vehicle?
Was anyone thrown from the vehicle?
Is Rescue needed?
Is the Fire Department needed?
Could she be pregnant?
Is patient breathing normally?
(Consider breathing Has she said she felt dizzy?
Is the pain due to an injury to the patient?
Has there been vaginal bleeding?
Has the patient vomited?
How does the patient act when he/she sits up?
Is the patient wearing a Medic Alert tag?
What is the patient complaining of?
Is the patient having difficulty swallowing?
How long ago was the patient exposed?
How does the patient act when they sit up?
Does the patient have a rash or hives? Are the symptoms getting worse?
Is the patient complaining of itching?
Is patient breathing normally?
Is the patient wearing a Medic Alert tag?
Is the pain due to an injury to the patient?
Has the patient felt dizzy or fainted?
Is the patient able to speak in full sentences?
Could the patient be having an allergic reaction?
Does the patient have to sit up to breathe?
Is the patient experiencing any other problems right now?
Has the patient ever had this problem before? them?
What was the patient doing just prior to when he/she became short of breath?
Is the patient on oxygen?

BREATHING PROBLEMS

Is patient alert?
Is patient breathing normally? (Consider breathing Is the patient sweating profusely? card)
Is the patient experiencing rapid heart rate with chest pain?
Where in the chest is the pain located?
Does the patient feel pain anywhere else? If so, where?
Does the patient have a history of rapid heart rate?
How long has the pain been present?
How does the patient act when he/she sits up?
Does the pain change when the person breathes or moves?
Is the patient weak, dizzy, or faint?
Does the patient take nitroglycerin? Have they taken it?
Has the patient ever had heart surgery or a previous heart attack?
Has the patient ever had a heart problem?
Is the patient nauseated or vomiting?

CHEST PAIN/HEART PROBLEMS

Does the patient have nitroglycerin?
If yes: Has the patient taken one?

DIABETIC PROBLEMS

Is patient alert?
Is the patient sweating profusely?
Is patient breathing normally?
Is the patient on insulin?
Is the patient complaining of any pain? Where is it How does the patient act when he/she sits up?
Are they dizzy, weak, or feeling faint?

Is patient alert?
Is patient breathing normally?
Has the patient had a recent illness or injury?
Did the headache come on suddenly or gradually?

Is patient alert?
Is the patient acting normally for him or her? If not, what is different?
Is the patient violent?
Has the patient vomited?
Is the patient having difficulty swallowing?
How old is the patient?
Is law enforcement needed?

PSYCHIATRIC/BEHAVIORAL PROBLEMS

Is patient alert?
Is patient breathing normally?
Can the patient talk to you?
Can the patient answer your questions?
Has the patient taken any drugs or alcohol?
Has the patient harmed himself?
Is patient a diabetic?
Is the patient acting in their normal manner?
Is the scene secure?
Where is the patient now?
Do you think the patient might harm himself?
Is the patient a diabetic?
Is patient alert?
Is patient breathing normally?
If child:
Describe what the patient is doing.
Has the child been sick?
Is the patient still seizing?
Does the child have a fever or feel hot?
How long has the patient been seizing? If female:
Has the patient had a seizure before?
Is the woman pregnant?
Does the patient have a medic alert bracelet on?
Is the patient a recreational drug user?
Has the patient had a recent head injury?

SICK PERSON

Is patient alert?
Is patient breathing normally?
Can I talk to the patient?
Have you checked for a medic alert tag?
If there is an alert tag, what does it say?
What is the problem?
Was the onset sudden or gradual?
Are you short of breath or is it hard to breath?
Are you feeling pain anywhere? If so where?
Do you feel light headed or dizzy?
Does the patient answer your questions?
What is the patient complaining of?
Is the patient complaining of pain?
How does the patient feel when he/she sits up?
Is the patient acting normally for him or her?
How does the patient look?
Is patient breathing normally?
What is the patient doing? Has the patient had a headache?
Has the patient had any recent injury/trauma?
Can the patient answer your questions?
How is the patient acting?
Is the patient able to speak in full sentences?
Has the patient had a stroke before?
Does the patients speech sound normal?
Is patient alert?
What was patient doing?
Is patient able to move at all?
Is patient breathing normally? (Consider breathing card)
Where exactly is the patient?
Why is the patient down?
Is patient able to talk?
Is patient alert?
Is patient breathing normally?
(Consider breathing What is the source of the contamination?
Has the patient been removed from the area or source of contamination?
Is a CO Detector activated?
What is the name of the contaminating agent?

CARDIAC ARREST

Is patient alert?
Is patient breathing normally?
Does the patient respond to you?
Does the patient move?
Are the pupils fixed and dilated?

ADULT CPR INSTRUCTIONS

Does anyone there know how to do CPR?
Do you have a cordless phone?
Is there a phone that may be closer to the patient?
Can someone there relay my instructions to you?
Do you have a cordless phone?
Is there a phone that may be closer to the patient?
Can someone there relay my instructions to you?

ARE YOU WILLING TO DO MOUTH TO MOUTH?

INFANT CPR?

Do you need help in remembering the procedures?

CHOKING

Is patient alert?
Is the patient able to speak or cry?
Is patient breathing normally?
Is the patient turning blue?
How old is the patient?
Describe the breathing.
Does the chest rise?
Does air enter freely?

Is the baby CONSCIOUS?
Is the baby breathing or crying?

INFANT CHOKING INSTRUCTIONS

Is patient alert?
Has the patient been removed from the water?
Is patient breathing normally?
Is the patient on land or in a boat?
How long was the patient under water?
What was the patient doing before the accident?
Is patient alert?
Is patient breathing normally?
(Consider breathing Is patient still in contact with the source?
Are there any other injuries? If so what are they?

PREGNANCY / CHILDBIRTH

Is patient alert?
Is patient breathing normally?
Does she feel the urge to go to the bathroom?
Is this the first pregnancy?
Was there an injury? What is it?
How far along is she? Has she had a seizure?
How long was she in labor before delivery?
Were there any complications?
How does she feel when she sits up?
Was the delivery vaginal or surgical?
Is she having cramping pains that come and go?

CHILDBIRTH INSTRUCTIONS

Has she had a baby before?
How far apart are the contractions (pains)?
How far apart are the contractions (pains)?
Less than More than More than Less than 5 Min. 5 Min. 2 Min. 2 Min.
Does she have a strong desire to push?
Does she have a strong desire to push?
Is patient alert?
Is patient breathing normally?
Did the patient have any complaints just before they became unconscious?
Is this the first time today the patient has been What were they?
How does the patient act when they sit up?
Have you or anyone else tried to wake the patient up?
Has the patient taken any medication or recreational Can the patient answer your questions?
Has the patient been drinking alcohol?
What was the patient doing before they became unconscious?
Does the patient have a medic alert tag?
Does the patient have any medical or surgical history?
What will happen if you do not diagnose and treat a medical emergency properly?
It can lead to death.
It can lead to disability.
It can lead to other harms.
It can lead to medical malpractice.
It can lead to legal malpractice.