FAMILY MEDICINE
PRACTICE
PRITHA MAYA SAVITRI
EMERGENCY
An emergency is an unforeseen
occurrence or a combination of
circumstances calling for
immediate action or remedy.
An infrequent acute event in
general practice
Rapid deterioration in patients
condition
The level of required emergency
response or action by you
depends on the backup services
available, and..
The time delay to arrival of
backup
Scope of emergency care seen
in general practice
Pediatricemergencies
Cardiovascular emergencies
Gastrointestinal emergencies
Urogenital emergencies
Obsgyn emergencies
Contd....
Neuromuscular
ENT and eye
Endocrine
Forensic
Psychological or psychiatric
Delivery of Emergency Care
Appropriate preparation :
Equipment and clinic organization
Basic equipment and essential
drugs. House call bag
Clinic staff trained to recognize
emergency situations.
Contd
Priority treatment for such
patients.
Request for emergency
outofoffice calls should be
screened first by the doctor, who
will decide on time of visit.
Skills development
Doctor trained in management of
emergencies. Continuing
selfreview to maintain skills
acquired.
Clinic staff- trained in emergency
resuscitation and other
management procedures
Management Protocols
Work out in advance management
protocols for the emergencies
likely to be encountered.
Clinic staff should be familiar with
their roles in these protocols.
Acute pediatric problems
The breathless child is a common
night emergency.
The patient may be a child with
just a bad cold or he may have a
potentially serious condition such
as epiglottitis.
Careful questioning on the
telephone is essential before
making a decision about whether
or not to make an immediate visit.
Parental anxiety can be
tremendous
Loss of consciousness
May be potentially life threatening
or trivial
Immediate treatment required
e.g. hypoglycemic coma
(intravenous glucose 50%).
Urgent hospital referral required
e.g. head injuries, poisoning.
Contd......
Nonlife threatening causes e.g.
vasovagal attack ('faint') and
hysterical conversion presenting as
loss of consciousness.
Management depends on the
particular circumstances. Referral
may or may not be necessary.
Acute respiratory distress
Usually presents as difficulty in
breathing. Quick history and
clinical assessment.
Urgent stabilization before referral
e.g. acute laryngeal edema
secondary to an allergic reaction
(subcutaneous adrenaline,
intravenous hydrocortisone).
Contd.....