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Emergency Medicine/Global Medicine
Medical Emergency
Patient assessment
Emergency Diagnosis and Treatment
What are the types of patient assessment?
Patient 60-second assessment by call center/Internet/telemedicine.
Patient 60-second on-the-spot diagnosis and treatment.
Patient 60-second assessment in trauma.
Patient 10-minutes assessment in a medical emergency room.
Patient-focused history and physical exam.
Comprehensive patient assessment.


What is a medical emergency?
If a human being has any problem, symptom, complaint, or situation listed below, it is a medical emergency.
http://www.qureshiuniversity.com/medicalemergency.html

What best describes the problem, symptom, complaint, or situation in the list?

_________________________

What type of assessment does this patient need?

_________________________

What will happen if this medical condition is left without treatment?

_________________________

The individual can die.
The individual can have a disability.
The individual can have severe pain.
The individual can have irreparable harm.

Does this situation need a doctor?

_________________________

What should be displayed on an emergency medical record?
Details of the patient.
Details of the diagnosing and treating medical doctor.


Details of the patient.

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

Patient 60-second assessment by call center/Internet/telemedicine.

Where is the patient now?

_________________________

How old is the patient?

_________________________

What is the gender of the patient?

_________________________

Who is reporting this emergency?

_________________________

What are the sources of medical history?

_________________________

Patient.
Family.
Patient not responding to medical history questions.
Community member.
Police officer.
Referral from medical doctor.
Other.

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 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.

Check vital signs, mobility, and survival needs.

Consciousness of a human being has to be included in vital signs.

Vital Signs

Consciousness, pulse, blood pressure, respiratory rate, temperature.

Consciousness is extremely essential in reaching a correct diagnosis and treatment.

What are the vital signs on the date and time of diagnosis and treatment?

Date: Time: Consciousness: Pulse: Blood pressure: Respiratory rate: Temperature:
______ ______ ______ ______ ______ ______ ______
______ ______ ______ ______ ______ ______ ______
______ ______ ______ ______ ______ ______ ______

How do you categorize the condition of the patient?

_________________________

Undetermined
Good
Fair
Serious
Critical

Is this an emergency?

_________________________

What is the category of this emergency?

_________________________

Is this a medical emergency?

_________________________

In what type of setting does this patient need treatment?

_________________________
Here are various examples.
Critical care
Coroner investigations
Emergency room health care
Emergency call center
Hospital ward
Home health care
Internet human health care services
Labor, delivery, and recovery rooms
Medicolegal cases
On-the-spot diagnosis and treatment
Operating rooms
Other


Who has the duty to manage this emergency?

_________________________

What best describes this human emergency?

_________________________

Medical emergency
Surgical emergency
Trauma emergency
Pediatric emergency
Obstetrical/gynecological emergency
Medico legal case
Patient assessment
Patient 60-second on-the-spot diagnosis and treatment.

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.
What is the reason for consultation?

_________________________

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 individuals have medical emergencies at this location?

_________________________

What best describes your problem?

_________________________

Patient Name:________________________

Referred by:_________________________

Mailing Address:_____________________

Telephone:___________________________

Your Email Address:__________________

Date of Birth:_______________________

Gender: Male Female

Primary Care Physician Name, Address and Phone:__________________

Emergency Contact Name:______________

Relationship:________________________

Phone:_______________________________

Your Height:_________________________

Your Weight:_________________________

Race::_______________________________

White
Black/African American
Hispanic/Latino
Pacific Islander
Asian
Asian/American

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.

What is the location of patient at the point of the medical emergency?
Can the patient talk relevant to age?
Can the patient walk relevant to age?
Are consciousness, pulse, blood pressure, and respiratory rate normal relevant to age?
What is the cause of the existing emergency medical scenario?

Here are further guidelines.

Here are further guidelines.

Emergency medical history

What questions should you ask in emergency medical history?
http://www.qureshiuniversity.com/medicalhistory.html

http://www.qureshiuniversity.com/vitals.html
Mobility
Survival Needs
Details of the diagnosing and treating medical doctor.

What is the name, date of birth, phone number, and other contact information of the person diagnosing and treating this patient?

_____________________________________________

What is the date and time you are diagnosing and treating this patient?

_____________________________________________

What is the location of the patient at the time you are diagnosing and treating this patient?

_____________________________________________

What best describes the location of diagnosis and treatment of this case?
1. On-the-spot diagnosis and treatment.
2. Emergency room diagnosis and treatment.
3. In the hospital diagnosis and treatment.
4. Long-distance health care advice.
5. Other
_____________________________________________
Can you reach a correct diagnosis and treatment of a human being?

_____________________________________________

What is the diagnosis of this patient?

_____________________________________________

How did your reach this diagnosis?

_____________________________________________

What is the treatment for this patient?

_____________________________________________

Does the patient need to be transferred to a medical emergency room?

_____________________________________________

In America up to February 12, 2012, most emergency medical records did not have these facts.

In what emergency medical category do you fit the condition of the patient you are diagnosing and treating on this date and time?

Undetermined, Good, Fair, Serious, Critical.

If on-the-spot diagnosis of a patient declared in serious or critical condition, arrange a bed in the Intensive Care unit.

Date of Examination:_________________________

Physician Name:_________________________

Physician Address:_________________________

Is it a Medical Emergency?

___________________________

In what type of setting does this patient need treatment?

___________________________

Do any recent causes lead to this problem; for example, trauma, missed medication, inadequate survival needs, stress, or other issue?

___________________________

What are further details?

___________________________

Does any past medical history lead to this problem?

___________________________

Is there any recent history within past few minutes or hours of any of the following:
1.Unconsciousness at a public location.
2.Sudden unconsciousness at home.
3.Trauma.
4.Survival needs issues.
5.Seizures.
6.Burns.
7.Drowning.


___________________________

If there is even one recent history of the above, on the spot diagnosis and treatment is required.

Is the victim's condition life or limb threatening?

___________________________

Could the victim's condition worsen and become life or limb-threatening on the way to the hospital?

___________________________

Could moving the victim cause further injury?

___________________________

Does the victim need the skills or equipment of paramedics or emergency medical technicians?

___________________________

Would distance or traffic conditions cause a delay in getting the victim to the hospital?

___________________________

What have been his activities for the last 10 years?

___________________________

Does the individual use or abuse any of these substances?
Alcohol.
Drugs.
Tobacco.

___________________________

Is the individual on any medication?

___________________________

Questions doctor on duty needs to answer.

Is it a medical emergency?

___________________________

What is the diagnosis?

___________________________

In what setting/location does this medical condition need treatment?
Treatment required on the spot.
Treatment required in the medical emergency room.
Treatment required in the intensive care unit.
Treatment required in the ward.
Treatment required in the operating room.
Treatment required at home.
Treatment required Internet health care.
Treatment required in OPD consultation.

___________________________

What treatment do you recommend for this patient?

___________________________

What are other treatment options for this patient?
No other treatment option.
Other treatment options are enumerated.

___________________________

Prescription
How do you do a quick assessment, diagnosis, and treatment of a conscious patient?
Are you the person reporting a medical emergency for yourself?
Emergency
How do you do a quick assessment, diagnosis, and treatment of an unconscious patient?
Are all vital signs normal? Can the person move relevant to age? Has the person been provided with survival resources? Does the person or caregiver complaint of anything? Are these justified complaints?


Medical emergencies.
What are examples of emergency relevant to an individual?
What are various symptoms, signs, statements, questions, issues, and histories that should raise suspicion of a medical emergency?

There are at least 143 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.
Behavior that is dangerous to self or others and cannot be managed.
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 or near drowning
Dental emergencies.
Emergency diagnosis and treatment in neonatal period.
Emergency diagnosis and treatment after neonatal period.
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).
Human Rights Violations
Head or spine injury.
Head injury.
Human Pregnancy Emergencies
Hypothermia - frostbite.
Head pain that lasts longer than five minutes.
Intentional enforced harms.
Involuntary admission to a psychiatric facility
Loss of consciousness.
Loss of consciousness not related to a seizure
Loosening of social inhibitions.
Likely to be harmful to self or others.
Low abdominal pain.
Medicine overdose.
Major burns.
Medicolegal cases
Nosebleeds.
No pulse
Pain.
Palpitations.
Poisoning.
Poisoning including overdoses of medication.
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).
Rape.
Pregnancy-related emergencies.
Possible serious bone fractures.
Rashes.
Survival Needs
Starvation
Suicidal feelings.
Surgical Emergencies
Significant trauma (to the head, stomach, chest)
Syncope.
Seizures.
Seizure lasting over five minutes or continuous seizures
Severe asthmatic attack when prescribed medications do not work
Severe injuries as a result of accidents such as broken bones
Severe reactions to a medication with difficulty breathing or itching.
Severe reactions to insect bites or other previously unknown allergic reactions
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.
Stroke or suspected stroke (paralysis, numbness, confusion)
Trauma with unconsciousness.
Trauma with cuts, sprains, or abrasions.
Trauma with open fracture.
Trauma with pain on mobility.
Trauma with swelling.
Unable to detect breathing
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 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.
Annual health assessment.
Here are further guidelines.
Administrative Issues
Common Medical Emergencies
Dispatching for an emergency
Emergency Diagnosis and Treatment
Emergency Diagnosis Code
Emergency medical record
Emergency Department record
Emergency medical responder
Emergency medical record
Emergency Medicine
Health Care
List of medical emergencies
Medico legal cases
Patient assessment
Surgical Emergencies
Symptoms & Signs A-Z List
State Offices and Agencies of Emergency Management
What are various symptoms, signs, statements, questions, issues, and histories that should raise suspicion of a medical emergency?
How are most patients categorized in American triage locations up to February 12, 2012?

Immediately life threatening
Urgent, but not immediately life threatening
Less urgent

How should patients be categorized around the world, including in America, in case of a medical emergency?
Undetermined, Good, Fair, Serious, Critical.

Fair, serious, or critical will always get a medical diagnosis that needs emergency treatment.

This can be only done by an emergency medical doctor able to reach the correct diagnosis and provide treatment.

Is there a difference between emergency and non-emergency medical diagnosis?
Yes, there is.

What is the difference between non-emergency and emergency medical diagnosis?
This example will make you understand.
Diabetes is a non-emergency medical diagnosis.
Diabetes with hyperosmolar coma or diabetic ketoacidosis is an emergency medical diagnosis.

What is the role of www.qureshiuniversity.com/medicalemergencyworld.html in a medical emergency?
Guide the following:
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.
Guide the state department of health worldwide.
When Is It Really an Emergency?
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?