Urgent conditions are severe disorders of vital functions that pose a threat to the patient’s life and require emergency care, including with the help of intensive care and resuscitation methods. Such critical conditions include both acute pathologies (poisoning, asphyxia, traumatic shock) and complications of long-term chronic diseases (hypertensive crisis, asthmatic status, diabetic coma, etc.). Emergency physicians are engaged in the relief of emergency conditions. However, the basics and principles of resuscitation measures are owned by all senior and middle-level medical workers.
Life-threatening conditions differ in their causes and leading mechanism. Knowledge and consideration of the etiopathogenesis of critical life disorders are extremely important, because they allow you to build the right algorithm for providing medical care. Depending on the damaging factor , emergency conditions are divided into three groups:
- Injuries. Occur when the body is exposed to extreme factors: thermal, chemical, mechanical, etc. They include burns, frostbite, electrical trauma, fractures, internal injuries and bleeding. They are recognized on the basis of an external examination and assessment of the main processes of vital activity.
- Poisoning and allergies. They develop with inhalation, enteral, parenteral, contact entry of poisons / allergens into the body. This group of urgent conditions includes poisoning with mushrooms, plant poisons, alcohol, psychoactive substances, chemical compounds, drug overdose, venomous snake and insect bites, anaphylactic shock, etc. There are no visible injuries in many intoxications, and severe disorders occur at the cellular level.
- Diseases of internal organs. These include acute functional disorders and decompensation states of chronic processes (myocardial infarction, cerebral stroke, PE, pulmonary edema, hypertensive crisis and a number of others). They are diagnosed using clinical, laboratory and instrumental methods.
The most common emergency conditions are found in surgery, traumatology, cardiology, neurology, and infectious diseases. In urology, renal colic, acute kidney failure, priapism, acute urinary retention require immediate help. In obstetrics and gynecology, urgent cases include uterine bleeding, eclampsia of pregnant women, childbirth outside a medical institution. In endocrinology, these are lactic acidosis, ketoacidosis, hypo- and hyperglycemia, thyrotoxic, addisonic, hypocalcemic, catecholamine crises. Specific urgent conditions of childhood are false croup, convulsive and hyperthermic syndromes, abortive SIDS.
A patient in critical condition can be recognized at the first examination by assessing his position, facial expression, color and moisture of the skin, heart rate, frequency, type and nature of breathing, blood pressure level. The severity of the patient’s condition in intensive care is determined by the degree and speed of violation of vital functions: consciousness, hemodynamics, external respiration. In addition, urgent conditions can occur with fever, pain, intoxication syndrome, dehydration, mental disorders. Symptoms that should alert relatives and those around the patient are sharp weakness and lethargy, loss of consciousness, speech disorders, profuse external bleeding, pallor or cyanosis of the skin, suffocation, convulsions, repeated vomiting, severe pain.
The strategy of treating emergency conditions consists of pre-medical care, which can be provided to the victim by nearby people, and the actual medical measures carried out by professional physicians. First aid depends on the nature of the disorder and the patient’s condition; it may include termination of the damaging factor, giving the patient an optimal body position (with a raised headboard or leg end), temporary immobilization of the limb, providing oxygen access, applying cold or warming the patient, applying a hemostatic tourniquet. In all cases, an ambulance should be called immediately.
Upon arrival of doctors, emergency care begins with the relief of the leading syndrome, which poses the greatest danger to the patient (respiratory disorders, circulatory disorders, shock manifestations). For this purpose, infusion solutions, hemostatic, narcotic, vasotonic and other drugs can be administered to the patient, therapeutic blockades can be carried out. In the absence of spontaneous breathing, tracheal intubation is performed (or a tracheostomy is applied) and a ventilator is adjusted; when cardiac activity stops, adrenaline is injected intracardiacally, external heart massage or defibrillation is performed.
The outcome of emergency conditions depends on the timeliness, volume and quality of emergency care provided. Cardiopulmonary resuscitation is continued for 30 minutes. The criterion of its effectiveness is the restoration of vital functions, in this case, after the stabilization of the patient’s condition, they are hospitalized in a hospital for further treatment of the underlying disease. If after the specified time there are no signs of revival of the body, then resuscitation measures are stopped and biological death is stated. In the online directory “Medic Journal” you will find a detailed description of emergency conditions, as well as professional recommendations for first aid to people in critical condition.