What to do in a Medical Emergency.

It is essential to know how to recognize the signs of a medical emergency – because correctly interpreting and acting on these signs could potentially save the life of a loved one — or your own life — one day. Many people experience the symptoms of an emergency, such as a stroke or a heart attack, but for various reasons (such as fear), delay seeking care right away. For many medical emergencies, time is of the essence, and delays in treatment can often lead to more serious consequences.


Emergency physicians believe it is the responsibility of every individual to learn to recognize the warning signs of a medical emergency. The following signs and symptoms and are not intended to represent every kind of medical emergency, but rather to provide examples of common issues.

Preparing for Emergencies

One of the most important factors in preparing for medical emergencies is to do everything you can to prevent them. Always put safety first by practicing caution and common sense and following safety instructions when given. Take care of yourself by following a sensible diet, exercising regularly and getting an annual physical. Work with your doctor to determine whether you or your family members are at risk for any potentially life-threatening conditions that may be linked to genetics or lifestyle and then follow your doctor’s advice in reducing the risk factors.

In addition:

  • Identify and eliminate the safety hazards in your home.
  • Buckle up in motor vehicles.
  • Never drink and drive.
  • If you drink alcohol, drink only in moderation.
  • Wear a helmet and safety pads when bicycling.
  • Use recommended safety gear and equipment when participating in sports and recreational activities.
  • Don’t smoke.
  • Develop a plan for medical emergencies - make sure everyone in your family knows what to do in specific circumstances, such as a flood or a fire.

To prepare for medical emergencies, it is recommended that you:

  • Organize your family’s medical information. Complete medical history forms on each family member and keep up to date copies in your home, car, first aid kits and wallet. Take the forms you need when you go to the emergency department.
  • Complete consent to treat forms for each child. (Separate forms are available for special needs children.) Provide copies to all caregivers (e.g., babysitters, relatives, school nurses, and teachers). This form will allow caregivers to authorize treatment in an emergency situation when you’re away from your child.
  • Keep well stocked first aid kits in your home and car.
  • Post emergency numbers on all your telephones and make sure your children know how to call for help. They should be able to call 911 or the local emergency number, and give their names, address, and a brief description of the problem. Always leave your written contact phone number(s), including your cell phone number, with any temporary caregivers to give to the emergency department staff. This may help an emergency physician get important information quickly about your child’s health.
  • Take a first aid class and learn CPR (cardiopulmonary resuscitation). Your local hospital, Red Cross or American Heart Association may conduct courses in your area or can guide you to organizations that do offer training.
  • Learn the warning signs of medical emergencies, and seek emergency care when they occur.

Should You Drive or Call an Ambulance?

If you answer “yes” to any of the following questions about a person experiencing a medical emergency, or if you are unsure, it’s best to call an ambulance, even if you think you can get to the hospital faster by driving yourself.

  • Does the person’s condition appear life-threatening?
  • Could the person’s condition worsen and become life-threatening on the way to the hospital?
  • Could moving the person cause further injury?
  • Does the person need the skills or equipment employed by paramedics or emergency medical technicians?
  • Would distance or traffic conditions cause a delay in getting the person to the hospital?

If you drive to the hospital, know the location and the fastest route to the nearest emergency department. In addition:

  • Don’t delay care by driving to a more distant hospital emergency department.
  • In many cases, you or the affected person will be treated in the community hospital emergency department, which is staffed and equipped to provide life-saving emergency care for patients of any age.
  • If necessary, a patient may be transferred to a hospital with special capabilities, such as a regional trauma or pediatric center.

If you call an ambulance, keep in mind that even though the 911 system was introduced in 1968, the network still does not completely cover some rural areas of the United States and Canada. Find out if your community is covered, and if not, get the telephone number for the local Emergency Medical Services and post it by your phone. When traveling, check for local EMS numbers in the areas where you will be, so you have this information before you begin your journey.

Also, be aware it is important for people calling 911 from wireless phones to tell the emergency operator the location of the emergency, because a cell tower provides only very general information about the location of a caller. Some cars now are equipped with “smart” technologies that use global positioning system satellites and cellular technology to link vehicles to direct emergency help, but many are not.

When you call for help, remember to:

  • Speak calmly and clearly.
  • Give the name, address, phone number, and location of the person in need (e.g., upstairs in the bedroom), and describe the nature of the problem.
  • Don’t hang up until the dispatcher tells you to. The dispatcher may need more information.
  • Teach your children how to place an emergency call, in case you are seriously ill or injured.
  • For highway emergencies, know the nearest highway marker number, and if dealing with a wreck, know how to identify the lanes (e.g., northbound) on the highway so you can give that information to the dispatcher.

Warning Signs and Symptoms

  • Difficulty breathing, shortness of breath
  • Chest or upper abdominal pain or pressure lasting two minutes or more
  • Fainting, sudden dizziness, weakness
  • Changes in vision
  • Difficulty speaking
  • Confusion or changes in mental status, unusual behavior, difficulty waking
  • Any sudden or severe pain
  • Uncontrolled bleeding
  • Severe or persistent vomiting or diarrhea
  • Coughing or vomiting blood
  • Suicidal or homicidal feelings
  • Unusual abdominal pain

You also can learn to recognize - and act on - emergency warning signs by taking a first aid class and learning CPR (cardiopulmonary resuscitation).

 

What to Expect in the Emergency Department

 If you are unconscious or come to an emergency department by ambulance, you will be assessed and treated right away. If you walk in to the emergency department or someone else drives you, you will first come into the waiting room where you will be assessed by a triage staff member, usually a nurse.

Triage

The triage nurse will assess your symptoms to determine whether you need to be treated right away, based on the severity of your condition. Your vital signs — such as temperature, heart rate, blood pressure, and breathing - will be checked, and medical chart information will be gathered, including details on allergies, any medications you are taking, and your medical history. It’s a good idea to bring a medical history form or wallet card, so you can quickly provide this information.

Registration

If you need to be treated right away, you will be assigned a bed in the treatment area. If you don’t need to be treated right away, and the emergency department is busy, you may be directed to a registration area where you will be asked for basic information, such as your name, age, address, and the name of your health insurance company. By law, you cannot be denied emergency medical care regardless of your ability to pay or lack of insurance coverage. 

The Waiting Room

If your condition is not life- or limb-threatening, you may be directed to sit in the waiting room, because the most critically ill and injured patients are treated first in an emergency department. (It’s not first come, first served, and having health insurance does not mean you will be seen quicker.) If you are in the waiting room, it’s important to let the triage nurse know right away if your pain or condition gets worse while you are waiting.

Why Am I Waiting So Long?

Emergency physicians are committed to providing high-quality emergency care as quickly as possible to all patients, but if you’ve been to a hospital emergency department lately, you most likely know that many of America’s ERs are overcrowded.

There are two kinds of waiting - in the waiting room and for a hospital inpatient bed. While the average time people spent in emergency departments (door to discharge) was 3.3 hours, according to the Centers for Disease Control and Prevention (2005), many patients who have been admitted to the hospital lie in gurneys along the halls, waiting hours - sometimes days - to be moved to inpatient beds, a practice known as “boarding.” 

Boarding means emergency staff can’t care for additional patients from the waiting room or from an ambulance, which also leads to ambulance diversion. Boarding is the primary cause of gridlock in our nation’s emergency departments - not the myth that too many people are coming with non-urgent medical conditions. Boarding and emergency department crowding are dangerous because they can jeopardize a patient’s ability to receive high-quality, lifesaving medical care in a timely manner and interfere with the ability of emergency departments to respond to a potential pandemic illness or terrorist attack.

Many hospitals have stopped “boarding” patients in emergency departments and instead, once they are admitted to the hospital, move them directly to the floors to which they are admitted. This spreads the burden of overcrowding throughout the hospital and often results in beds becoming more quickly available. ACEP advocates on behalf of emergency patients and has developed effective solutions to overcrowding. In addition, ACEP is working at the state and national levels, in urging decision makers and policymakers to implement these solutions to help emergency patients and to improve our health care system as a whole. 

Medical Examination

Once you are in an examination area, an emergency physician will examine you, monitor your vital signs and possibly order tests (e.g., x-ray, blood, electrocardiogram). For certain tests, you may need to avoid eating or drinking. Nurses and other medical professionals also will assist you during your visit. Family members may or may not be able to stay with you, depending on the hospital’s policy, your condition and the level of crowding in the emergency department.

During your visit, be proactive and ask questions about anything you don’t understand. If you have concerns, ask to speak again with the emergency physician. If your concerns still are not addressed, most hospitals have patient advocates available to help you.
If you are critically ill or require constant intravenous medications or fluids, you may be admitted to the hospital. Otherwise, an emergency physician will discuss your diagnosis and treatment plan with you before you are discharged. You also may receive written instructions regarding medications, medical restrictions or symptoms to watch out for that could require a return visit. In addition, you may be instructed to follow up with your family doctor.

When Your Child Has an Emergency

Nothing is more terrifying to parents than when their child has a medical emergency. Unintentional injuries are the leading cause of death in children and teens ages 1 to 21 in the U.S. The most common injuries are related to motor vehicle crashes, drowning, fires and burns, suffocation, choking, unintentional firearm injuries, falls and poisoning. However, parents can take an active role in protecting their children by providing good care and practicing injury prevention.

To prepare for a childhood medical emergency, become familiar with the signs and symptoms of childhood emergencies, work with your pediatrician to complete a medical history form for your child and develop a plan in case of a medical emergency. Ask when you should go directly to an emergency department, when you should call an ambulance, and what to do when the pediatrician’s office is closed. In addition, become familiar with the policies of emergency departments in your community - for example, some allow parents to be with their children during invasive medical procedures, and some do not.

If you take your child to an emergency department, bring your child’s medications in their original containers, as well as his or her medical history form. If you suspect your child has swallowed poison or any potentially harmful medications, call poison control first , and then bring the suspected poisons or medications with your child to the emergency department.

In a medical emergency, go to the nearest emergency department, unless directed to another nearby hospital by the child’s physician or emergency services personnel. An ambulance may transport the child to the nearest emergency department or to a nearby specialty center, if appropriate. If necessary, after stabilization, your child may be transferred to a hospital with advanced pediatric capabilities.

Since hospitals can be frightening places for children, try to bring along a favorite toy, blanket or book to help make your child less anxious.

When a child experiences a medical emergency, it’s important to stay calm and to call for help. Although this may be difficult, it is the responsibility of the parent or caretaker to do so - and remaining calm can help save the child’s life.

  • If you need immediate help, call 911 (or your local emergency services number).
  • If needed and you know how, start rescue breathing or CPR (cardiopulmonary resuscitation).
  • If you have learned first aid, apply the techniques to stop serious bleeding, manage shock, handle fractures and control a fever, until help arrives. In addition, if needed and you know how, perform basic choking-rescue procedures for infants and children.
  • If the child is having a seizure, place him or her on a carpeted floor with the child’s head turned to the side. Stay with your child until help arrives. Check to make sure that nothing is in the mouth or interfering with the child’s ability to breathe. Do not place anything in the child’s mouth when he or she is actively seizing. Placing your finger in the child’s mouth could place you at risk of being bitten and cause the child to vomit and aspirate (breathe in vomit).

If you take a child to the emergency department, help calm him or her by explaining what to expect once you arrive:

  • Listen. Give permission to ask questions, cry and talk about feelings. Let the child know it’s okay to be afraid and to say something hurts.
  • Be comforting, but honest, including when giving information about procedures that may be painful.
  • Share your feelings but remain calm; children sense when adults are anxious. Staying calm under stressful circumstances can save the child’s life.

More than 30 million children receive emergency care each year. If you are feeling anxious, be reassured by the fact that emergency physicians have special expertise in childhood emergencies and in identifying life threatening problems. They are trained in pediatric airway management, resuscitation and emergency trauma care.

Emergency physicians also play an active role in developing innovative systems that revolutionize children’s emergency care. Emergency medicine residency programs provide comprehensive training in caring for childhood emergencies.

In addition, emergency physicians have led the way to improve the standards and quality of emergency care of children around the world. Many have devoted their careers to improving emergency care of children through research and training, and through the development of clinical policies, and public education initiatives geared toward preventing injury and illness.

Symptoms of Childhood Emergencies

Because their bodies are not finished growing and developing, children’s medical problems often differ from those of adults. In addition, they may display different signs and symptoms from adults when they become injured or sick, and their treatments may differ too. For example, symptoms that are serious for a child, particularly a young child or an infant, may not be serious for an adult and vice versa. Additionally, an infant or child may not be able to communicate what’s wrong, which means the parent must try to interpret the symptom or medical problem.

Seek immediate medical help if your child exhibits any of the following warning signs of a medical emergency:

  • Any significant change from normal behavior
    • Confusion or delirium
    • ecreasing responsiveness or alertness
    • Excessive sleepiness
    • Irritability
    • Seizure
    • Strange or withdrawn behavior
  • Severe headache or vomiting, especially following a head injury
  • Uncontrolled bleeding
  • Inability to stand up or unsteady walking
  • Unconsciousness
  • Abnormal or difficult breathing
  • Skin or lips that look blue or purple (gray for darker-skinned children)
  • Feeding or eating difficulties
  • Increasing or severe, persistent pain
  • Fever accompanied by change in behavior (especially with a severe, sudden headache accompanied by mental changes, neck/back stiffness, or rashes)
  • Severe or persistent vomiting or diarrhea

These symptoms are not intended to represent every kind of childhood medical emergency.  Again, you also can learn to recognize childhood emergency warning signs - and act on them - by taking a first aid class and learning CPR (cardiopulmonary resuscitation).

What to do

Adverse Drug Reactions

Many drugs cause side effects, and certain medicines can trigger life-threatening reactions -  allergic and non-allergic -  in some people. Some medicines also interact with other medications and cause adverse drug reactions. People who take three or four medications each day are more likely to have reactions to drugs. In addition, the use of herbal supplements and alternative medicines, such as St. John’s Wort, can interact with certain drugs and cause health problems.

Adverse drug reactions can occur within minutes or within hours of exposure. They are a leading cause of death in the United States, resulting in more than 100,000 deaths each year.

The most common symptoms of allergic reactions to drugs are:

  • Skin rash or hives
  • Itchy skin
  • Wheezing or other breathing problems
  • Swelling
  • Diarrhea or constipation

The most common drug that can cause problems is penicillin. Antibiotics, sulfa drugs, barbiturates, and insulin also can cause adverse drug reactions. Some medicines trigger a response from the immune system in people with drug hypersensitivity. The body’s immune system perceives the substance as attacking the body, so it attacks the system.

More than 90 percent of adverse drug reactions do not involve an allergic immune system response. Instead, these reactions may produce a range of symptoms involving virtually any system or part of the body - which often makes them difficult to recognize.

Reactions to drugs may range from mild, such as upset stomach or drowsiness, to severe, life-threatening conditions, such as anaphylaxis. These reactions can occur with prescription medications, over-the-counter medications and supplements or herbal remedies.

Always tell your doctor if you have adverse reactions to medications and wear an identifying bracelet or jewelry such as a MedicAlert® bracelet.

lthough asthma and allergies are two separate conditions - asthma is a chronic disease of the bronchial airtubes, whereas allergies involve an overreaction of the body’s disease-fighting immune system - the two conditions can be intertwined and often overlap. 

For example, because most people with asthma also have allergies, asthma attacks (sometimes referred to as “exacerbations”) can be triggered by exposure to allergens, such as pollen, mold or animal dander. This type of asthma is known as allergic asthma, and it is one of several types of asthma.

In addition, asthma and certain allergic conditions, such as hay fever and peanut allergy, share the potential to be life threatening. Allergies can be life-threatening when they lead to anaphylaxis. Asthma can be fatal when a severe asthma attack does not respond to inhaled bronchodilators and leads to symptoms of respiratory failure, a condition known “status asthmaticus.”

Finally, since many of the symptoms of asthma are the same as they are for allergies, physicians may use some of the same medications to treat both.

Here you will find information about asthma, allergies, precautions and preventions, and preventing attacks while traveling.

Asthma

Asthma is a chronic lung disease that results in 1.8 million emergency visits and about 4,000 deaths each year. There are several types of asthma, and although the disease can be controlled, there is not yet a cure, which means that asthma patients must manage their condition on a daily basis. Moreover, it is estimated that about half of asthma sufferers do not have their condition under control, making it more likely that these patients will end up in an emergency department as a result of an asthma attack. When poorly controlled, asthma is potentially life-threatening.

The characteristics of asthma include inflammation (swelling and irritation) of the airways and bronchoconstriction (tightening of the muscles surrounding the airways). Often worse at night, these problems shrink the airways, making it more difficult to breathe. The often-missed warning signs of poorly controlled asthma are:

  • Waking at night wheezing and/or coughing
  • Requiring a quick-relief inhaler more than twice a week
  • Missing school or work
  • Being unable to participate in everyday activities
  • Requiring emergency or urgent care in order to breathe properly

Respiratory infections, such as the common cold or flu, are common triggers of asthma exacerbations, (which is why persons with asthma are advised to get a flu shot each fall when the vaccine becomes available). Other triggers include exercise, laughing or crying hard, cold air and irritants, such as poor air quality (e.g., Code Red ozone pollution days in the summer), chemicals, smoke, perfume and air fresheners. Some allergens also can serve as triggers. Common inhaled allergens include dust, pollen, mold or animal dander.

The symptoms of asthma include:

  • Difficulty breathing
  • Tightness in the chest
  • Coughing and wheezing

Asthma attacks that appear to be severe or that do not respond to the patient’s normal medication require immediate medical attention. Less serious attacks or an increasing frequency of asthma attacks should be evaluated by a visit to one’s doctor. In some cases, the patient may seek the advice of an asthma care specialist - such as an allergist or pulmonologist.

Asthma patients should go to the emergency department if they have severe asthma symptoms, especially if these symptoms are accompanied by severe sweating, faintness, nausea, panting, rapid pulse rate, and pale, cold, moist skin. (These may be signs of shock or a potentially life-threatening drop in blood pressure.) These patients may be experiencing a potentially fatal asthma attack, known as “status asthmaticus.”

Seek immediate medical attention for the following symptoms and warning signs associated with this potentially life-threatening condition:

  • Persistent shortness of breath or breathlessness experienced even while lying in bed.
  • An asthma attack that is not relived by a usually effective rescue inhalers.
  • Lips or fingernails are turning blue (or gray in persons with dark complexions).
  • Straining to breathe or the inability to complete a sentence without pausing for breath.
  • A feeling of chest tightness.
  • Feelings of agitation, confusion or an inability to concentrate.
  • Hunching of shoulders, straining of abdominal and neck muscles or sitting or standing to breathe more easily

These are all signs of impending respiratory system failure, a potentially fatal condition. Be aware also that fatal asthma attacks often occur with few warning signals, and that they can come on quickly, leading rapidly to asphyxiation and death. Fatal asthma attacks are more common among persons who have poor control of allergens or asthma triggers in their daily environments and an infrequent history of using peak flow monitors and inhalers as aids in controlling their asthma.

Finally, it is important to note that extremely severe, potentially fatal asthma attacks may not feature more wheezing and coughing - thus making such symptoms unreliable in judging the severity of asthma attacks. In such cases, the breathing airways have become so restricted that there is not enough air going in and out of the lungs to cause wheezing or coughing. (In addition, wheezing also can be a sign of other health conditions, such as respiratory infection and heart failure, so it is important to seek prompt medical attention if these other serious conditions are suspected.)

Emergency department treatment of asthma typically includes oxygen, inhaled bronchodilators (such as albuterol), and systemic corticosteroids (such as prednisone). Long-term asthma treatment includes inflammation “controllers,” such as inhaled corticosteroids, and symptom “relievers” such as inhaled bronchodilators.

Since the key to preventing asthma attacks is controlling them, it is important to seek out proper medical care, take medication as directed and become educated as to how best avoid previously described “asthma triggers.”

Allergies

Allergies involve an overreaction of the body’s immune system, which is responsible for fighting infections. There are many types of allergies, including seasonal allergies (which involve allergic reactions to pollens, grasses and weeds), perennial allergies (which last for 9 or more months out of the year), chronic allergies (to allergens such as dust and mold), food allergies, medicine allergies, insect venom allergies, and animal allergies, among others. In addition, some people develop a potentially life-threatening allergy to latex, which is found in rubber gloves, while others can become “sensitized” to substances they have been repeatedly exposed to at work, a condition known as “occupational allergy.”

Allergic responses range from mild to life threatening. Common mildly annoying allergy symptoms include sneezing, congestion, runny nose, watery eyes, headache and fatigue. However, exposure to some allergens, such as peanuts, shellfish, insect stings, medications, and latex can quickly progress to severe life-threatening reactions or anaphylaxis. For that reason, seek emergency care right away if you experience a mix of some of the following symptoms:

  • Difficulty breathing
  • Wheezing (along with high-pitched breathing sounds)
  • Confusion
  • Anxiety, fear, apprehension
  • Slurred speech
  • Swelling of the face, eyes, tongue or extremities
  • Trouble swallowing
  • Severe sweating
  • Faintness, lightheadedness, dizziness
  • Heart palpitations (feeling one’s heart beat)
  • Nausea and vomiting
  • Diarrhea
  • Abdominal pain, cramping
  • Panting
  • Rapid or weak pulse rate
  • Pale, cold, moist skin or skin redness
  • Blueness of skin, including lips or nail beds (or grayish for darker complexions)
  • Loss of consciousness

To help prevent the need for emergency care for allergy attacks, you can take the following preventive measures:

  • Visit your physician regularly. The continuing advice of a doctor is crucial to the long-term treatment of allergic conditions. Your physician may refer you to a medical specialist, known as an allergist/immunologist, who has received special training in diagnosing and treating allergic diseases. This type of specialist can recommend certain drug therapies or desensitization treatments (also known as “allergy shots”).
  • Know your allergies. If you and your physician suspect you have allergies, you may be tested to determine what is triggering your symptoms.
  • Avoid allergens. Once you know what you are allergic to, avoid the allergen. For example:
    • If you are allergic to shellfish, don’t eat it; your first reaction may be mild but additional exposures can quickly lead to life-threatening reactions.
    • If cats make you break out in hives, don’t pet them or keep them in your home.
    • If you are allergic to insect venom, take precautions when going out of doors, particularly at certain times of year when such insects are more prevalent or aggressive, or when picnicking or in wooded environments. Persons with insect-venom allergies should also carry self-injectable epinephrine (EpiPen or TwinJect), diphenihydramine or a bee-sting kit (per a health provider’s instructions); injectable epinephrine should be used only on the person for whom it has been prescribed.
    • If you are allergic to pollen or mold, avoid the outdoors on windy days or when you begin to notice symptoms. The wind often stirs up pollen and mold and carries it through the air. Also, don’t hang laundry out to dry. Pollen and molds can collect on sheets and clothing And minimize activity outdoors at dawn (5 a.m. to 10 a.m.) when pollen is usually emitted into the air. -To minimize exposure to outdoor allergens, keep car windows closed when you drive, and consider using air conditioning when your seasonal allergy symptoms are at their worst, both in your car and at home (provided the system is regularly cleaned and maintained and filters are frequently changed).
    • If you are allergic to grass or molds, do not cut your grass and avoid the outdoors when others are mowing their lawns.
    • If you are allergic to mold (or have an allergic asthmatic reaction to it) and experience heightened allergic symptoms in your everyday home or work environment, consider hiring someone to investigate and address the problem. (Do not attempt to remove moldy insulation and other items from your home yourself; doing so can cause an intense allergic reaction.)

Additional Precautions and Prevention

People with allergies and asthma, which are often related, should always carry medications with them and ask their doctors about wearing medical alert bracelets or jewelry.

More specifically, individuals with asthma should always carry a quick-relief inhaler (bronchodilator), such as albuterol, and avoid known asthma triggers when possible. Individuals at risk of anaphylaxis, for whom a doctor has prescribed self-injectable epinephrine (such as an EpiPen or TwinJect), should carry it at all times and know how to use it in an emergency. Show your family and friends how to use it on you as well.

Persons with allergic asthma and related allergies should avoid exposure to pollution from poor air quality or tobacco smoke. If you live in a city that measures and forecasts air quality, stay indoors as much as possible when the forecast is poor (e.g., “Code Red,” Code Orange”). If you are prone to exercise-induced asthma, be aware of your limitations, especially if you do strenuous activity in polluted or high-pollen areas (e.g., places that have a lot of trees, grass, weeds).

Injectable epinephrine should not be used on persons other than the person for whom it has been prescribed (e.g., asthmatics or persons allergic to insect venom). Some people may have underlying health conditions that could be adversely affected by this drug.

Preventing Attacks While Traveling

  • Take all necessary medications with you in their original prescription bottles, in case you need to refill prescriptions while away. Pack extra quantities of medications to make sure you don’t run out. Do not pack medications in checked luggage in case your luggage is lost; keep it in a carry-on bag.
  • Carry topical hydrocortisone cream and antihistamine medication with you - if you are using an over-the-counter medication, make sure you have used it before and that it is effective.
  • If using a nebulizer for delivering anti-asthma medication, don’t forget to take it on vacation, along with an electrical current converter for it if traveling abroad; portable nebulizers that are plugged into auto cigarette lighter receptacles are also available.
  • If your doctor requests that you use a peak flow meter and record chart, be sure to take these items with you.
  • Bring your allergy-proof pillow or bedding to guard against dust mites.
  • If staying in a hotel or bed and breakfast, check ahead of time to find out whether perfumed air fresheners, deodorizers or other scented products will be used. (Scented carpet cleaning agents also may be a problem.)
  • In hotels, ask for a nonsmoking room, preferably on a nonsmoking floor.
  • If sensitive to mold, call ahead to determine whether this might be a problem, particularly if you are staying in a cabin or a beach bungalow. If driving, check your vehicle for mold and mildew problems, and if camping, check tents and other mold-prone items.
  • If sensitive to sulfites, when eating out check with the restaurant staff to find out whether this additive has been used as a food preservative. If so, ask if your meals can be prepared without it. (Sulfites are commonly used as a preservative in wine, dried fruits and dried potato products. They also occur naturally in wine.)
  • If food allergies are a significant problem, pack snacks at home you can eat while traveling - in case you find yourself without access to “safe” foods.
  • If allergic to pollens (e.g., trees, grass, weeds), check the pollen counts in the area you are traveling to by calling the local Chamber of Commerce or the National Allergy Bureau at 1-800-9-POLLEN. Also, call 1-800-7-ASTHMA for local support group contacts who may be able to offer useful local information.
  • Check with your insurer on coverage limitations and policies regarding out-of-state or out-of-network coverage.

 

Bites and Stings

Most bites and stings are easily treatable and non-threatening. However, some insects, snakes, jellyfish - and even humans - can bite or break the skin and potentially introduce disease into your body.

Animal Bites

Animal bites can be frightening, and in some cases, are medical emergencies. The most common animal bites in the United States are from household pets, with dogs and cats causing the most injury. Cat bites and scratches are especially prone to infection. Human or animal bites can become infected or transmit illnesses such as rabies. A tetanus shot may be required if you have not had one within 10 years; if you are not sure when you had your last tetanus shot, and you’ve been bitten, you should get one within 72 hours after your injury.

If bitten, but the bleeding is minor, cleanse and treat the wound as you would a minor wound. Wash the area thoroughly with soap and water, apply an antibiotic ointment (unless the person has allergies or sensitivities to antibiotics) and cover with a clean bandage.

If the bite creates a deep puncture or the skin is badly torn and bleeding, apply direct pressure to stop the bleeding and get medical attention right away. If you develop a fever or other signs of infection - swelling, redness, pain, a bad smell or fluid draining from the area - see a physician immediately.

If an animal acts strangely and bites you, go to an emergency department or see your doctor immediately, because the animal may have rabies. This is especially true for bats, skunks, raccoons and foxes. If possible, capture the animal, if it is safe to do so, so it can be checked for rabies, which is fatal in humans if left untreated. If the animal is dead, wear gloves or use a shovel to move it into a plastic bag. Do not damage the animal’s head, since rabies testing is done on the brain, and do not freeze the animal. Clean the area and any tools used to remove the animal with a bleach solution. Some people avoid seeking treatment, because they fear it will involve a series of painful shots to the abdomen. This used to be true, but a simpler, less painful treatment is now involved.

Strange animal behavior may be a sign of rabies and typically includes an unprovoked attack. For example, if normally shy nocturnal (night) animals bite during the day, they may be infected. Rabies is rare in dogs, cats, rodents and plant-eating animals. Other signs of rabies in animals include drooling, running in circles, appearing paralyzed or exhibiting unusual or aggressive behaviors.

To prevent children from getting animal bites, including from those that may have rabies:

  • Teach children to avoid unfamiliar animals, particularly wild animals, and to understand that any animal may bite when it is frightened, ill or injured. Even pets that are normally friendly may bite when startled by sudden noises or motions, or disturbed when sleeping or eating.
  • Never leave young children unattended with animals.
  • Make sure your child has had a tetanus shot.

Insect Stings

Most people have mild reactions to insect bites, but some have severe allergic reasons that require emergency treatment. In addition, some insects carry disease, such as West Nile Virus or encephalitis, although this is rare.

Insect bites or stings that cause severe pain and swelling at the site of the bite, a generalized rash or any swelling of the face or difficulty breathing, require immediate medical evaluation.

If you are stung by an insect, such as a bee, treat the area by:

  • Removing the stinger. Scrape or flick it out with something stiff like a credit card, or even grasp it with tweezers and pull it straight out, to avoid squeezing more venom into the wound.
  • Washing the wound with soap and water.
  • Using cold compresses or ice to help reduce any swelling and relieve pain.
  • Monitoring for signs of severe allergic reaction.

If a bite or sting wound remains or worsens over several days, seek medical treatment for possible infection. Get immediate medical attention if you have been bitten or stung and you exhibit signs of an extreme allergic reaction or anaphylaxis.

Symptoms of an allergic reaction include:

  • Hives, itching or rash at the site or even away from the bite area
  • Swollen lips or eyelids
  • Swelling of the throat
  • Difficult or noisy breathing (wheezing)
  • Loss of consciousness

While it’s nearly impossible to prevent all insect bites and stings, these are steps you can take to minimize the risks:

  • Use insect repellent. Repellents with DEET are effective in preventing bites by mosquitoes, ticks, fleas, chiggers, and biting flies. Repellents for children should contain no more than 10 percent DEET. Do not use DEET on babies. “ Don’t use scented soaps, perfumes, hair sprays, or sunscreens, which can attract bugs.
  • Avoid going outdoors during peak hours when insects are out - dusk and dawn.
  • Avoid areas where insects nest or gather, such as stagnant pools of water, garbage cans, and orchards and gardens where flowers are in bloom.
  • Don’t leave food, drinks, or garbage out and uncovered.
  • When outdoors in wooded, floral or grassy areas, or in areas infested with ticks or mosquitoes, wear long-sleeved shirts and pants and protective shoes. Dress in light colors, if possible (so insects will be easier to detect) and void dressing in bright colors or flowery prints, which attract some insects. Don’t wear baggy clothing, which can trap bugs.
  • Check yourself and your children for ticks after leaving infested areas. If you find one, and you know how to remove it, do so. If not, see “How to Remove a Tick.”
  • If you have removed a tick, keep an eye on the area and check for signs of Lyme disease or Rocky Mountain Spotted Fever, and call your physician if symptoms are present. 
  • Children and adults who are highly allergic should wear medical identification bracelets, and adrenaline auto-injectors (epi pens) should be available at all times.

Spider Bites and Scorpion Stings

Most spiders are not dangerous. For most bites, wash the wound with soap and water and apply an antibiotic ointment. The bite may cause some irritation or itching, but should heal in five to seven days. Some bites can lead to local skin infections, which are easily treated with antibiotics.

Two of the most poisonous spiders in the United States (more common in southern states) are the black widow (which is shiny with a red hourglass marking on belly) and the brown recluse (has a violin-shaped marking on top, and is about one-inch long). Always seek emergency care if you are bitten by one of these types of spiders.

Black widows release a toxin when they bite that can damage the human nervous system. Reactions to a black widow bite can include pain at the bite site, nausea, severe abdominal pain or muscle cramping.

Venom from a brown recluse can cause tissue damage. Reactions from its bite may include fever, nausea, headache, burning, pain or itching, or a deep blue or purple area around the bite, surrounded by a whitish ring and then a red ring (similar to a bull’s eye)

If you are bitten by either one of these poisonous spiders: 

  • Call-911 and explain what has happened.
  • Wash the area with soap and water and cover with gauze and a cold pack.

Scorpions in the United States typically are found in Arizona, New Mexico and in California. Scorpion stings are most dangerous to the very young and the very old. If you are stung by a scorpion, you will feel immediate pain or burning.

Scorpion stings usually occur at night. Stings may cause bite marks, swelling and pain, which can be treated with medication. You also might apply ice to help with pain. Seek immediate medical care for more serious symptoms, such as nausea, vomiting, rise in blood pressure, diarrhea, or allergic reactions.

Jellyfish and Stingray Stings

Most jellyfish stings are harmless and occur by accident when people come in contact with the tentacles. Some varieties of jellyfish are more poisonous than others, such as the box jellyfish from Australia. Most stingray injuries require emergency care. To prevent injury, avoid swimming in areas where there are sightings of jellyfish or stingrays.

The tentacles of a jellyfish release a poison that results in a skin eruption, in the form of a painful red rash that itches. The sting usually causes a sting mark, pain and swelling, which may last several days to  several weeks. Both jellyfish and stingray stings also can cause life-threatening shock and allergic reactions.

The sting of a stingray causes a bleeding wound that may become swollen and turn blue or red. It causes excruciating pain and can result in death. Severe symptoms may include nausea, fever, muscle cramps, paralysis, elevated heart rate and seizures.

If stung by a jellyfish or stingray:

  • Carefully remove any tentacles or stingers still on the body. Make sure to cover your hand - do not directly touch the tentacles or you will be injured.
  • Soak jellyfish stings in salt water or vinegar (fresh water will increase pain and may release more of the toxin).
  • Soak stingray stings in hot (but not scalding) water until the pain diminishes.
  • Wash and bandage.
  •  For stingray stings, apply pressure to stop the bleeding. If necessary, and you are trained to do so, perform CPR
  • If an allergic or life-threatening reaction is observed, call 911 or your local emergency number immediately.

Snake Bites

Snake bites can be life-threatening if the snake is poisonous. Poisonous snakes found in the United States include rattlesnakes, copperheads, cottonmouth water moccasins and coral snakes. If you see a snake, do not touch it, but instead, back away from it slowly.

If you are bitten, remember the color and shape of the snake. This information will help medical providers treat you. If you are walking in high water, and you are not sure you have been bitten by a snake, look for a pair of puncture marks at the wound and for redness and swelling, as well as severe pain.

If bitten by a pit viper (rattlesnake, copperhead, cottonmouth):

  • Call 911 or your local emergency number immediately.
  • Cleanse the wound, but do not try to cut around the fang marks and suck out the venom. People who do this often do more damage than good.
  • Immobilize the bitten area and keep it at the same level as the heart. Do not try to apply a tourniquet.
  • It’s important for the victim to remain calm and move as little as possible. That will help prevent the spread of the poison through the body.
  • Do not apply ice or flush the wound with water.

If bitten by an elapid snake (coral snake):

  • Take an additional step of wrapping the area in an elastic roller bandage so that it is snug but not tight; the point farthest from the heart should be wrapped first.
  • Check the area for sensation, increased skin temperature and redness before and after bandaging.
  • Minor swelling and itching can be treated with cool compresses, over-the-counter oral antihistamines or hydrocortisone creams. Use only as directed.

Tick Bites (Lyme Disease and Rocky Mountain Spotted Fever)

Tick bites can cause Lyme disease or Rocky Mountain spotted fever, which must be treated by a physician. Ticks cause 20,000 new cases of Lyme disease in the United States each year, especially in the northeast, mid-Atlantic and north-central states. Several hundred to more than one thousand new cases of Rocky Mountain spotted fever are reported each year, although it is likely that many cases go unreported.

Lyme Disease.-Lyme disease is usually treated easily when caught early enough. Early symptoms of Lyme disease usually appear within a few weeks of infection and include:

  • A bull’s-eye-shaped rash - white in the center and bright red on the outside; but this is not true in all cases.
  • Flu-like symptoms, such as a feeling of weakness or discomfort, sore throat, dry cough, stiff neck, headache swollen glands and fatigue.
  • Photosensitivity (light sensitivity to the eyes or skin).

Left untreated, Lyme disease may spread to the heart, brain and nervous system. Later-stage symptoms of Lyme disease are more serious and can include:

  • Arthritis, particularly in the knees, which can become chronic if the infection goes untreated
  • Severe headaches
  • Abnormal heartbeats
  • Bell’s palsy (a condition that causes facial muscles to weaken or become paralyzed)
  • Cognitive difficulties
  • Memory loss
  • Numbness and tingling or coordination problems
  • Extreme fatigue
  • Chronic or extreme muscle pain

Rocky Mountain Spotted Fever.- Rocky Mountain spotted fever is the most severe of the tick-borne illnesses. After an incubation period of about 5 to 10 days, people with Rocky Mountain spotted fever have signs and symptoms that include:

  • Sudden onset of fever
  • Headache
  • Muscle pain
  • Rash on hands and feet

The disease can be difficult to diagnose in the early stages, and without prompt and appropriate treatment it can be fatal. Antibiotic treatment is effective if it begins early enough. 

Preventing Tick Bites.-To avoid exposure to disease-carrying ticks, ACEP recommends taking the following preventative measures:

  • Cover up when you are outside, especially near wooded areas or grasslands; wear a hat and long-sleeved, light-colored clothing; and tuck pants into socks so that ticks will be easier to spot.
  • Avoid wooded areas, piles of leaves and tall grasses, and, if hiking, stay on wide, clear trails.
  • Use insect repellents, such as those containing DEET (no more than a 10 percent formula for children), on clothing and skin.
  • Check yourself regularly for ticks, and shower or bathe after potential exposure.
  • Use tick repellents on your pets, and check their fur, ears and paws for ticks, which can drop off once inside and lurk in carpeting and upholstery.
  • If bitten, remove the tick by pulling it straight up with a tweezers (or between your fingertips if tweezers are not available). Avoid twisting the tick, which may cause its body parts to remain embedded underneath the skin, often causing infection.
  • Get tested for Lyme disease if a tick bite is detected, or if Lyme disease symptoms develop.

How To Remove a Tick. - Adult deer ticks are approximately the size of a sesame seed, but nymph ticks are much smaller - about the size of a speck of dirt - and more difficult to detect. Avoid removing a tick with your bare hands, and do not crush the tick because it may contain fluids infected with disease. To remove a tick:

  • Use tweezers to grasp it as close to the skin as possible.
  • Pull outward with steady pressure.
  • Do not twist, which can cause parts of it to remain in the skin.
  • After removal, disinfect the area and wash your hands with soap and water.
  • Save the tick for identification in case you become ill - put in a sealable plastic bag in your freezer.

Mosquito Bites (West Nile Virus)

First reported in the United States in 1999, West Nile Virus has since spread rapidly. It typically appears in the summer until fall.

For 20 percent of those who become infected, the virus causes a mild, flu-like illness. It is considered a public health concern because there is a risk of contracting a potentially fatal brain infection in about one percent of cases. The severity of the virus is greater for persons over age 50 and for persons whose immune systems are compromised.
West Nile Virus is transmitted by mosquitoes, which means the best way to reduce your chance of becoming infected is to avoid getting bitten. Here’s how:

  • When you are outside, use insect repellent such as DEET (no more than 10 percent formula for children; not intended for use on infants under two months old) or natural oil of lemon eucalyptus (not intended for use on children under age three) on clothing and skin.
  • Eliminate mosquito breeding sites by draining sources of standing water, inserting mosquito larvae pellets in drains, maintaining clean gutters and keeping fountain waters flowing.
  • Cover up as much as possible when you are outdoors; wear long-sleeve shirts and pants.
  • Stay inside between sunset and sunrise, when mosquitoes are more active.
  • Install or repair screens on doors and windows to keep mosquitoes out.
  • Never handle dead birds with your bare hands (precautionary measure to prevent disease).
  • Investigate and support your community’s mosquito-control program. Many communities practice integrated pest management.

Identifying Mild and Severe Symptoms

  • About one in five persons who become infected show any signs of illness, and usually these symptoms are mild. Most infected people will experience fever, headache, fatigue, aches and pains and, in some cases, swollen lymph nodes and a skin rash on the trunk of the body.
  • These symptoms generally last for a few days, but in some cases can linger for a few weeks.
  • Symptoms of serious infection include headache, high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness and paralysis.
  • Symptoms of the most severe infections include West Nile encephalitis (inflammation of the brain), meningitis (inflammation of the tissue surrounding the brain and spinal cord) and West Nile poliomyelitis (inflammation of the spinal cord that causes sudden weakness and/or paralysis in the limbs and/or breathing muscles).

Broken Bones

Broken bones (also called fractures) are a common injury for adults and children. They may be caused by falls, motor vehicle crashes, direct blows and even intentional injuries, such as violence and child abuse.

Broken bones are a common injury for children under age 10. Children have additional risks associated with breaking bones, because their bones are still growing; this includes damage to growth plates and growth at wrong angles. Women who have gone through menopause also are at increased risk because they lose bone mass and their bones become weaker. Bones can be strengthened throughout life, however, through weight-bearing exercise and calcium diet supplements. 

Symptoms of a broken bone include swelling, bruising and being unable to put weight on it or use it for normal movement. Do not move a person with a broken bone unless you are in a life-threatening situation involving further potential harm to the injured person (such as a car accident that results in a car fire), especially someone with a head, neck or back injury or a hip or pelvis fracture.  

If it becomes necessary to move someone with a broken bone, immobilize the injured area first with a splint. If you don’t have a splint, make one using a folded newspaper, board or rolled up piece of clothing.  In addition:

  • Splint the injury in the position it was found in.
  • Splint above and below the fracture site. Pad the splints to reduce discomfort.
  • Do not try to realign the body part. However, if circulation is poor and the skin is turning pale, and no medical assistance is available, gently moving the injured part back into its normal position may improve circulation.
  • Avoid making the splint too tight, which can cut off circulation. Check for circulation, numbness, warmth and skin color.
  • If the bone is sticking out from the skin (open fracture), do not try to push it back in. Use a clean, dry cloth or bandage to cover it until medical help arrives.
  • Apply ice pack to reduce swelling (except for small children and not directly on the skin).
  • Stop any bleeding by gently applying pressure to the wound with a sterile bandage or clean cloth.
  • Prevent shock.

Tips for specific body parts:

  • If a finger appears to be broken or dislocated, tape the injured finger to the finger next to it. For an injured thumb, a splint may be used.
  • For a broken leg, use a triangular bandage to bind the injured leg to the uninjured leg.
  • For a broken ankle/foot, use a soft splint (a pillow or a heavy towel) to immobilize the area. The person’s shoe should not be removed.
  • Most rib fractures heal on their own within two months. However, in rare instances, broken ribs can puncture the lungs and cause internal bleeding. If you suspect someone has a rib fracture, position a pillow or folded blanket between the area where pain is occurring and the arm, then bind the arm to the body to support the injured rib area.

Burns

About 4,000 people die each year in the United States from fire and burn injuries. Burns are one of the leading causes of childhood injury. They can be caused by scalding from hot liquids or cooking oils, contact with flames, or from overexposure to the sun. Burn also can be electrical (e.g., when a child bites an electrical cord) or chemical (e.g., resulting from swallowing or spilling bleach on your skin).

Here you will find information about minor burns, and chemical and electrical burns.

Minor Burns

For minor burns:

  • Remove the person from the heat source and remove any burned clothing, except clothing imbedded in the burn.
  • Run cool - not cold - water over the burn or hold a clean, cold compress on it until the pain subsides. Do not use ice. Do not use not butter or other types of grease.
  • Remove jewelry or tight clothing from around burned areas, and apply a clean bandage. You can also apply antibiotic cream.

Seek emergency care for more serious burns and for any burns to the eyes, mouth, hands, and genital areas, even if mild. If the burn covers a large area, get medical attention immediately. Get immediate medical attention if you have any of the following symptoms related to a burn:

  • Fever
  • Puss-like or foul-smelling drainage
  • Excessive swelling
  • Redness of the skin
  • A blister filled with greenish or brownish fluid
  • A burn that doesn’t heal in 10 days to two weeks

Never break blisters from a burn, and remember not to remove clothing stuck to burned skin. If you are helping someone with a serious burn, keep the burned areas elevated to reduce swelling.

In addition, know what to do in case you or your clothing catches fire: stop (don’t run), drop (to the floor, immediately), and roll (cover your face and hands while rolling over to smother the flames).
If you are helping someone else who has been burned, remove the person from danger first, unless doing so puts you in danger as well.

Chemical and Electrical Burns

For chemical and electrical burns, call 911 or your local emergency number. Assess the situation to make sure you (and the victim) will not be in contact with the burn source. For electrical injuries, DO NOT approach an injured person until you know the power source has been turned off.

For chemical burns:

  • Dry chemicals should be brushed off the skin by a person wearing gloves.
  • Remove the person’s clothing and jewelry and rinse chemicals off the skin by placing the person in a shower for 15 to 20 minutes. (Be careful to protect your eyes and the eyes of the injured person.)
  • Wet chemicals should be flushed off affected areas with cool running water for 20 minutes or longer or until emergency help arrives.
  • If you or someone else has swallowed a chemical substance or an object that could be harmful (e.g., watch battery) call poison control first (1-800-222-1222) and then 911. It is helpful to know what chemical product has been swallowed. Take it with you to the hospital.

Minor electrical burns can be treated with cool (not cold or ice) compresses. After cleansing, a mild antibiotic ointment and bandage may be applied. A tetanus shot is also recommended, especially if the person has not had one in more than 10 years.

For more serious electrical burns:

  • Check for breathing. If the person is not breathing, start rescue breathing if you know how.
  • Raise burned arms and legs higher than the person’s heart.
  • Cover the person with cool, wet cloths. Do not use butter, ointments or any other home remedy. Do not break the blisters or remove burned skin.

Sunburns with extensive blistering or general symptoms of nausea, vomiting, weakness or chills, are more serious and need physician evaluation.

Prevent burns by following safety precautions:

  • Install smoke detectors on every floor and check to make sure they are working and/or replace batteries every six months.
  • Teach children to avoid hot substances and chemicals. If you have young children, use safety latches in your home
  • When cooking, keep pot handles turned toward the rear of the stove, and never leave pans unattended.
  • Do not leave hot cups of coffee on tables or counter edges.
  • Do not carry hot liquids or food near your child or while holding your child.
  • Always mix and stir then check the temperature of food or beverages before serving a child, especially foods or liquids heated in a microwave.
  • Keep matches and lighters out of children’s reach in a locked cabinet. Use only child-resistant lighters.
  • Prevent scalding by keeping your water heater set at 120º to 125º F; test bath water before putting a child in the bathtub.
  • Cover unused electric outlets with safety caps, and replace damaged, frayed or brittle electrical cords.
  • Keep fire extinguishers on every floor of your house, especially in the kitchen, and know how to use them.
  • Do not put water on a grease fire - it can spread the fire.

 

Choking (Heimlich Maneuver)

The Heimlich Maneuver may be employed only when a person is choking and his or her life is endangered by a windpipe obstruction. Choking is signaled by an inability to speak, cough or breathe, and may result in a loss of consciousness and death. Avoid using excessive force in employing the Heimlich Maneuver to avoid injury to the ribs or internal organs. Given the potentially life-or-death nature of the situation, use your best judgment.

In the event of choking, the American Heart Association and ACEP offer the following guidelines:

Conscious Adult

  • In the event of choking, rescuers should take action if they see signs of severe airway obstructions (including poor air exchange and increased breathing difficulty, a silent cough, cyanosis or if the person is unable to speak or breathe).
  • To differentiate between mild airway obstruction and severe airway obstruction, the rescuer should ask, “Are you choking?” If the victim nods yes, assistance is needed. Choking also often is indicated by the Universal Distress Signal (hands clutching the throat).
  • If the person can speak, cough or breathe, do not interfere.
  • If the person cannot speak, cough or breathe, give abdominal thrusts known as the Heimlich Maneuver.
  • To employ the Heimlich Maneuver, reach around the person’s waist. Position one clenched fist above the navel and below the rib cage. Grasp your fist with your other hand. Pull the clenched fist sharply and directly backward and upward under the rib cage six to 10 times quickly.
  • In case of obesity or late pregnancy, give chest thrusts.
  • Continue uninterrupted until the obstruction is relieved or advanced life support is available. In either case, the person should be examined by a physician as soon as possible.

Unconscious Adult

  • Position the person on his or her back, arms by side.
  • Shout for help. Call 911 or the local emergency number.
  • Perform a finger sweep to try to remove any foreign body from the mouth. Only remove an object you can see and easily extricate.
  • Listen for breathing and watch for the chest to rise and fall. If the person is not breathing, perform rescue breathing. If unsuccessful, give six to 10 abdominal thrusts (the Heimlich Maneuver). To perform abdominal thrusts on an unconscious person, kneel over the person and place the heel of one hand on the person’s abdomen, slightly above the navel. Next, place your other hand on top of the first. Press into the abdomen with quick, upward thrusts.
  • Repeat sequence: Perform finger sweep, attempt rescue breathing, perform abdominal thrusts, until successful.
  • Continue uninterrupted until the obstruction is removed or advanced life support is available. When successful, have the person examined by a physician as soon as possible.
  • After the obstruction is removed, begin CPR, if necessary.

Conscious Infant (Under one year old)

  • Support head and neck with one hand. Place the infant face down over your forearm, head lower than torso, supported on your thigh.
  • Deliver up to five back blows, forcefully, between the infant’s shoulder blades using the heel of your hand.
  • While supporting the head, turn the infant face up, head lower than torso.
  • Using two or three fingers, deliver up to five thrusts in the sternal (breastbone) region. Depress the sternum ½ to 1 inch for each thrust. Avoid the tip of the sternum.
  • Repeat both back blows and chest thrusts until the foreign body is expelled or the infant becomes unconscious.
  • Do not perform blind finger sweeps or abdominal thrusts on infants.
  • Alternative method: Lay the infant face down on your lap, head lower than torso and firmly supported. Perform up to five back blows. Turn the infant on his or her back as a unit and perform up to five chest thrusts.

Unconscious Infant (Under one year old)

  • Shout for help. Call 911 or the local emergency number.
  • Perform the tongue-jaw lift. (Grip on the jaw by placing your thumb in the infant’s mouth and grasping the lower incisor teeth or gums; the jaw then lifts upward.) If you see the foreign body, remove it.
  • If trained to do so, begin rescue breathing.
  • Perform the sequence of back blows and chest thrusts as described for a conscious infant.
  • After each sequence of back blows and chest thrusts, look for the foreign body and, if visible, remove it.
  • Resume rescue breathing.
  • Continue with the sequence of back blows and chest thrusts, and, after each sequence continue to check for the foreign body, which should be removed.
  • If the foreign body is removed and the infant is not breathing, begin CPR.

Conscious Child (Over one year old)

To dislodge an object from the airway of a child:

  • Perform abdominal thrusts (the Heimlich Maneuver) as described for adults. Avoid being overly forceful in order to avert injury to ribs and internal organs (use your best judgment).

Unconscious Child (Over one year old)

  • If the child becomes unconscious, continue as for an adult, except:
  • Do not perform a blind finger sweep in children up to 8 years old. Instead, perform a tongue-jaw lift and remove the foreign body only if you can see it.

If you are choking and are alone:

  • Do not panic; if possible, take slow breaths.
  • Call 911 or the local emergency number immediately (even if you cannot speak); the dispatcher should be able to recognize that an emergency is occurring. If you are using a land-line, in some (but not all) areas, he or she may then be able to trace the call and send emergency personnel to you. (Cell phone calls may not be traceable to an exact location.)
  • If available, lean over the back of a chair and press hard on your abdomen and chest to expel the object or attempt to use your fists to give yourself abdominal thrusts (Heimlich Maneuver).
  • To employ the Heimlich Maneuver, position one clenched fist above the navel and below the rib cage. Grasp your fist with your other hand. Pull the clenched fist sharply and directly backward and upward under the rib cage six to 10 times quickly.
  • In case of obesity or late pregnancy, give chest thrusts.
  • Continue uninterrupted until the obstruction is expelled or advanced life support is available. In either case, you should be examined by a physician as soon as possible.

Cuts and Abrasions

 Most cuts are minor, but it’s still important to care for them. Most can be treated by cleaning with soap and water and applying a clean bandage. You also may want to treat the cut with an antibiotic ointment. If you delay care for only a few hours, even a minor wound can build enough bacteria to cause a serious infection and increase your risk of a noticeable scar.

Puncture wounds may not seem very serious, but because germs and debris are carried deep into the tissues, a physician evaluation may be needed. In addition, antibiotics or a tetanus shot may be required.

Seek medical attention for a cut or a wound that shows any of the following signs:

  • Long or deep cuts that need stitches
  • Cuts over a joint
  • Cuts from an animal or human bite
  • Cuts that may impair function of a body area, such as an eyelid or lip
  • Cuts that remove all the layers of the skin, like slicing off the tip of a finger
  • Cuts caused by metal objects or puncture wound
  • Cuts over a possible broken bone
  • Cuts that are deep, jagged or “gaping” open
  • Cuts that have damaged underling nerves, tendons or joints
  • Cuts that have foreign materials, such as dirt, glass, metal or chemicals embedded in them
  • Cuts that show signs of infection, such as fever, swelling, redness, a pungent smell, pus or fluid draining from the area
  • Cuts that include problems with movement or sensation, or increased pain 

Seek emergency care if:

  • The wound is still bleeding after a few minutes of steady, firm pressure with a cloth or bandage
  • Signs of shock occur
  • Breathing is difficult because of a cut to the neck or chest
  • There is a cut to the eyeball
  • There is a cut that amputates or partially amputates an extremity
  • There is a deep cut to the abdomen that causes moderate to severe pain

A tetanus shot may be required if you have not had one within 10 years or if you are unsure of when you last had one. Tetanus is a bacterial infection that affects the nervous system and is often fatal. Although most people are aware that stepping on a rusty nail or a puncture wound can cause a tetanus infection, most people do not know that tetanus bacteria can also enter the body even through a tiny pinprick, a scratch from an animal, splinters, bug bites and even burns that break the skin.

Diabetic Emergencies

It is estimated that more than 20 million people in the United States have diabetes, with an estimated six million people being unaware they have it. The best way to prevent diabetic emergencies is to effectively manage the disease through making health food choices, exercise and frequently checking blood glucose levels.

Diabetics may experience life-threatening emergencies from too much or too little insulin in their bodies. Too much insulin can cause a low sugar level (hypoglycemia), which can lead to insulin shock. Not enough insulin can cause a high level of sugar (hyperglycemia), which can cause a diabetic coma. 

Symptoms of insulin shock include:

  • Weakness, drowsiness
  • Rapid pulse
  • Fast breathing
  • Pale, sweaty skin
  • Headache, trembling
  • Odorless breath
  • Numbness in hands or feet
  • Hunger

Symptoms of diabetic coma include:

  • Weak and rapid pulse
  • Nausea
  • Deep, sighing breaths
  • Unsteady gait
  • Confusion
  • Flushed, warm, dry skin
  • Odor of nail polish or sweet apple
  • Drowsiness, gradual loss of consciousness

First aid for both conditions is the same:

  • If the person is unconscious or unresponsive, call 911 or your local emergency number immediately.
  • If an unconscious person exhibits life-threatening conditions, place the person horizontally on a flat surface, check breathing, pulse and circulation, and administer CPR while waiting for professional medical assistance
  • If the person is conscious, alert and can assess the situation, assist him or her with getting sugar or necessary prescription medication.
  • If the person appears confused or disoriented, give him or her something to eat or drink and seek immediate medical assistance.

 

Drowning

Drowning occurs most often among small children and people who can’t swim, but even experienced swimmers may be susceptible, depending on weather conditions, water currents, their health and other circumstances.

Drowning is one of the leading causes of death among children ages one to four years of age. It only takes a few seconds for a child to drown, and small children can drown in just a few inches of water - in a bathtub, a toilet or a bucket.

Parents need to keep a close eye on their children when they are near any water sources, especially pools or at the beach or a lake. In addition, parents need to know the limits of their child’s ability to swim and to set firm ground rules for play around the water, and to never leave kids unsupervised. For every child who drowns, more than 10 children are treated in emergency departments for near drowning. Keep in mind the following safety precautions:

  • Teach your children to swim.
  • Never swim alone.
  • Only swim in places that are supervised. Never allow children to swim without adult supervision.
  • Install safety fences with child-proof latches around swimming pools.
  • Never dive into unfamiliar water.

If you’re at the beach:

  • Always swim near a lifeguard tower and never swim alone.
  • Wear sunscreen, with at least a level 15 sun protection factor, to protect against burns.
  • Check with lifeguards about surf and beach conditions before going in the water. Obey warning signs in dangerous areas.
  • Don’t overestimate your swimming ability. Never depend on flotation devices for your safety.
  • Never drink alcohol and swim.
  • Always swim or surf in designated areas.
  • Avoid cliff edges, stay behind fences and obey warning signs.
  • Never run and dive in the water. Even if you have previously checked current conditions, those conditions can change rapidly.

In addition, boating accidents can also result in drowning. While life jacket use has increased, according to the Centers for Disease Control and Prevention, 90 percent of people who died in boating accidents were not wearing any kind of flotation device. Just because you know how to swim doesn’t mean you should go boating without a life jacket. Wearing a life jacket is important for anyone who goes out on water.

  • Always wear your life jacket and carry first aid equipment in the boat.
  • Tell someone when you’re going, who is with you and how long you’ll be away.
  • When changing seats, stay low and near the center line of a small boat.
  • On sailboats, keep alert to wind and sail activity and stay low to avoid getting hit by the sail “boom.”
  • Monitor the weather carefully for signs of a storm.
  • Take a marine radio with you to call for assistance in case there are any problems. (Cell phones frequently do not work off-shore.)
  • Never drink alcoholic beverages on a boat. Being “tipsy” can result in falling overboard. Your ability to swim safely or call for help is greatly reduced by alcohol use.

If a person appears to be drowning (e.g., is flailing in the water, yelling for help, coughing or going under, or appears to be unconscious or floating in the water), check the area, alert a lifeguard if one is nearby, then call 911 or your local emergency number. In addition:

  • Do not attempt to rescue a drowning person while in the water yourself unless you are trained to do so and have lifesaving equipment. People who are drowning may panic and pull you underwater with them; dangerous circumstances - such as strong currents or rip tides - may also endanger you.
  • If possible, reach out with or throw an object that floats to the person from a secure out-of-water position, such as a boat, a swimming pool ladder or a dock.
  • For a person pulled from the water, tilt the head back, lift the chin and check for breathing and other signs of life. Expel fluid or other objects from the mouth.
    • If the person is not breathing, give two slow rescue breaths. If rescue breaths go in, give CPR. If rescue breaths do not go in, reposition the airway and reattempt.
    • If the person is still not breathing after rescue breaths are administered, see Unconscious Choking.

Electrical Injury-Shock

Causes of electrical injury and shock include accidental exposure to household or appliance wiring, arcs from power lines, the severing of an electrical cord or sticking of foreign objects into an outlet (typically in the case of a young child), faulty machinery and occupational accidents. (Lightning is a separate topic with a unique set of injuries (see the link below).

An electrical injury to the skin or internal organ can occur by accidental exposure to an electrical current. Although the external burn may appear minor, severe or fatal internal damage still may have occurred, especially to the heart, muscles or brain. Electrical injury can cause cardiac arrest (from the electrical impact to the heart), muscle and nerve destruction and thermal burns.

Approximately 3 percent to 4 percent of patients admitted to burn centers in the United States are victims of electrical injuries; serious electrical burns carry a 40 percent chance of death. The two most common age groups for electrical injury are children under six (e.g., exploring toddlers) and young adults (electrical workers and construction workers in particular). Electrical injury is the fifth leading cause of occupational death in the United States.

Symptoms of electrical injury or resulting shock may include:

  • Skin burns
  • Numbness, tingling
  • Weakness
  • Muscle contraction or pain
  • Bone fractures
  • Headache 
  • Hearing impairment
  • Seizures
  • Irregular heart rhythms
  • Cardiac arrest
  • Respiratory failure
  • Unconsciousness

Whether a person survives an electric shock depends on the type of circuit (AC or DC current), level of the voltage, level of amperage, the way in which the current entered the body, the duration of exposure, the victim’s general health, and the timing and adequacy of treatment. Seeking immediate emergency assistance is vital in such situations.
To assist someone with an electrical injury:

Check to see if the person is still in contact with the electric current. If so, don’t touch the person, and find another way to shut off the power, such as at the circuit or breaker box. A victim in contact with an AC current (household current) may not be able to let go of the point of contact because their muscles contract strongly in response to the electricity.

  • Check breathing and pulse.
  • Call 911 or emergency number.

Heart Attack

Dr. Greg Henry, emergency physician and clinical professor at the University of Michigan Medical Center in Ann Arbor, Michigan

Heart attack (myocardial infarction) remains the leading killer of both men and women in the United States. More than 400,000 Americans die from heart attacks each year. Getting emergency medical help immediately can dramatically increase your chances of survival and recovery.

A heart attack is not always a sudden, deadly event. Often it is an evolving process during which a clot forms in an artery of the heart, depriving the heart of blood and oxygen. The longer the heart attack process continues, the more permanent damage is done to otherwise healthy heart muscle.

Many people ignore the warning signs of a heart attack or wait until their symptoms become unbearable before seeking medical help. Others wait until they are absolutely sure it’s a heart attack because they worry they will look foolish if it is a false alarm. These reactions can result in dangerous delays.

Only skilled medical professionals can determine if someone is having a heart attack. Your responsibility is to recognize the warning signs and act quickly. If you are having a heart attack, you may be moved from the emergency department to a catheterization lab to receive angioplasty or a stent, or possibly heart bypass surgery. In addition, hospitals have lifesaving medications that are designed to stop a heart attack by dissolving the clot and restoring blood flow to the heart, although these medications work best when given within the first one or two hours after the onset of heart attack symptoms, when the damage is still limited.  

People often will experience some, but not all, of the following symptoms, which may come and go:

  • Uncomfortable pressure, fullness, squeezing sensation or pain in the center of the chest, lasting more than a few minutes, or it goes away and comes back.
  • Pain that spreads to the shoulders, neck, jaw, arms or back.
  • Chest discomfort accompanied by lightheadedness, fainting, sweating, nausea or shortness of breath.

Some less common warning signs of heart attack that should be taken seriously - especially if they accompany any of the above symptoms - include:

  • Shortness of breath and difficulty breathing.
  • Abnormal chest pain (angina), stomach, or abdominal pain. (Symptoms may feel like indigestion or heartburn.)
  • Nausea or dizziness.
  • Unexplained anxiety, weakness, or fatigue.
  • Palpitations, cold sweat or paleness.

As with men, women’s most common heart attack symptom is chest pain or discomfort. Women are more likely than men to experience shortness of breath, nausea/vomiting and back or jaw pain.
If you suspect someone is having a heart attack:

  • Call 911 or your emergency services number immediately. Stay with the person until the ambulance arrives. Do not attempt to drive the person to the hospital; if his or her condition should worsen, there is nothing you can do to help while driving.
  • After 911 is called, the EMS dispatcher will likely give pre-arrival instructions (when appropriate) for the administration of aspirin (not acetaminophen, ibuprofen or naproxen) and nitroglycerin (if prescribed) while emergency-response units are enroute to the scene The ideal aspirin dose in such instances is two to four baby aspirin or one full or extra strength tablet (325 or 500mg), and chewing helps get the aspirin into the bloodstream faster than swallowing it whole. (The patient should not be given aspirin if his or her physician has advised otherwise, e.g., because of allergies or possible harmful interactions with other medications or known disease complications).
  • If the person is conscious, keep the person calm and help him or her into a comfortable position. The victim should stop all physical activity, lie down, loosen clothing around the chest area, and remain calm until the ambulance arrives.
  • If the person becomes unconscious, make sure the person is lying on his or her back. Clear the airway and loosen clothing at the neck, chest and waist. Check for breathing and pulse; if absent, and if trained to do so, begin cardiopulmonary resuscitation (CPR).

If you think you may be having a heart attack:

  • If you are with someone, tell that person you may be having a heart attack and want to get to the hospital immediately. Have the person call 911 or the emergency services number.
  • If you are alone, call 911 or the emergency services number immediately. Do not drive yourself to the hospital.
  • Once you have called 911, you likely will be instructed to chew and swallow an aspirin unless your physician has advised you otherwise (e.g., because of allergies or contraindications, including possible harmful interactions with other medications or known disease complications). Keep in mind that chewing helps get the aspirin into the bloodstream faster than swallowing it whole.

Here you will find information about automated external defibrillators (AEDs) and heart attack prevention.

Automated External Defibrillators (AEDs)

Lay rescuers can be trained to operate portable, computerized, automated external defibrillators (AEDs) used to apply electric shock to restart a heart that has developed a chaotic rhythm called ventricular fibrillation, the most common cause of sudden cardiac arrest. Survival is directly linked to the amount of time between the onset of sudden cardiac arrest and the treatment with an electric shock to stop the abnormal heart rhythm. If an AED is available where you work or live, ACEP recommends taking a training course to learn to use it. In September 2004, the U.S. Food and Drug Administration approved over-the-counter sales of AEDs, available for use in the home and without a prescription.

Heart Attack Prevention

The major risk factors for coronary heart disease are:

  • Increasing age. About four out of five people who die of coronary heart disease are ages 65 or older.
  • Gender. Men have a greater risk of heart attack than women, and they have attacks earlier in life. At older ages, women who have heart attacks are twice as likely as men to die from them within a few weeks.
  • Heredity (including race). Children of parents with heart disease are more likely to develop it themselves. African Americans have more severe hypertension than whites and consequently, are at greater risk.
  • Smoking. A smoker’s risk of heart attack is more than twice that of non-smokers.
  • High cholesterol. The risk of coronary heart disease rises as blood cholesterol levels rise.
  • Physical inactivity. Regular, moderate-to-vigorous exercise plays a significant role in preventing heart and blood vessel disease.
  • Body weight. People with excess body fat are more likely to develop heart disease and stroke, even if they have no other risk factors.
  • Diabetes. This condition seriously increases the risk of developing cardiovascular disease.

You can reduce your chances of having a heart attack by quitting smoking, and nonsmokers should not start. People can also lose excess weight, exercise regularly, eat a low cholesterol diet, and take medications to reduce cholesterol if prescribed. It’s also important to maintain a healthy blood pressure, control diabetes, and avoid excessive alcohol consumption. Talk to your physician about taking aspirin if you have major risk factors for heart disease. Get regular checkups, and if you have a family history of heart disease, it’s especially important that you maintain a healthy lifestyle.

Nosebleeds

A nosebleed, especially one that arises spontaneously in a child, can be alarming, but most nosebleeds are not serious and often look much worse than they really are.

Nosebleeds most often are caused by dry or thin mucous membranes in the nose (which may be linked to indoor heat in the winter), sinusitis, and nose picking. Less often nosebleeds result from colds, allergies, injuries, sticking small objects up the nose or cocaine use. In older persons, they may be linked to atherosclerosis (“hardening of the arteries”), high blood pressure, blood-clotting disorders or infections, or sometimes they are caused by aspirin and other drugs that interfere with blood clotting. In rare instances, frequent nosebleeds may be linked to a serious illness or disease.
 
To stop a nosebleed:

  • Sit with head forward while pinching the nostrils together continuously for at least 5 minutes, or if bleeding persists, for 10 minutes. Do not tilt head back (so as to avoid swallowing blood, which may cause nausea, vomiting and diarrhea).
  • Stop pinching the nose if it becomes particularly uncomfortable, or the bleeding is not easily controlled by this technique.
  • If the nosebleed is the result of an injury or blow to the nose, placing a cold compress or ice pack across the bridge of the nose may help alleviate some swelling and discomfort.

If a nosebleed occurs after a fall or car crash, seek immediate medical attention; this could be a sign of internal bleeding. If bleeding persists for more than 15 minutes, seek a medical assistance. If bleeding persists and is related to a blow to the face, head or nose, physician evaluation is needed to determine whether the person has a broken nose or a facial or head fracture.

Puncture Wounds

Most cuts are minor, but it is still important to properly care for them. Sometimes it’s hard to determine what wounds can be treated at home and which require a trip to the emergency department.

Wounds that need emergency medical care are:

  • Those that will not stop bleeding after a few minutes of applying direct pressure.
  • Deep, gaping, jagged or potentially disfiguring cuts, to avoid the formation of scar tissue.
  • Long or deep cuts that need stitches.
  • Cuts over a joint.
  • Cuts that may impair function of a body area such as an eyelid or lip.
  • Cuts that remove all of the layers of the skin like those from slicing off the tip of a finger.
  • Cuts from an animal or human bite.
  • Cuts that have damaged underlying nerves, tendons, or joints.
  • Cuts over a possible broken bone.
  • Cuts caused by a crushing injury.
  • Cuts with an object embedded in them.
  • Cuts caused by a metal object or a puncture wound.

Also call 911 or emergency services immediately if:

  • Bleeding from the cut does not slow during the first few minutes of steady direct pressure.
  • Signs of shock occur.
  • Breathing is difficult because the cut is in the neck or chest.
  • The wound is a deep cut to the abdomen that causes moderate to severe pain.
  • The wound is a cut to the eyeball.
  • The cut amputates or partially amputates an extremity.

To help stop the bleeding:

  • Apply firm, direct pressure over a bleeding wound with clean cloth or sterile bandage. (Don’t use heavy pressure if the wound is on the person’s head.) Maintain pressure until bleeding subsides, or (if an ambulance has been called) until trained medical help arrives.
  • If bleeding is occurring in a limb, keep applying pressure and elevate the limb above the heart, unless you suspect the limb is broken.
  • Deep cuts should not be cleansed. Do not apply antiseptic, as it could damage healthy tissue. If blood soaks through, do not remove bandages (as removal may interfere with clotting); instead apply more bandages directly on top.
  • For wounds that are still bleeding after applying steady, firm pressure for more than five minutes, call 911 immediately. Continue applying firm, direct pressure over the wound with a clean cloth or sterile bandage. Maintain pressure until trained medical help arrives.
  • If bleeding is severe, and you think the person’s life is in danger, wrap a 3? wide tourniquet above the wound area and pull tightly.
  • If the person has been impaled (by a knife, pole or other similar object), do not pull the offending object out of the wound. (Doing so may cause uncontrolled bleeding or organ damage.)
  • A tetanus shot may be recommended as follow-up, especially if the person has not had one in more than 10 years.

Be aware that injuries that cause bleeding may also cause shock.

 

Seizures

Seizures involve sudden involuntary alterations in behavior or consciousness resulting from excessive electrical activity in the brain. Seizures are common in persons who have epilepsy and normally last two to three minutes. In other cases, seizures may be caused by head injuries, brain tumors, lead poisoning, inadequate brain development, genetic deficiencies, infectious disease and fevers. Seizures may also be caused by alcohol abuse and alcoholism, Alzheimer’s Disease, lupus, kidney failure, stroke and other illnesses. In approximately 50 percent of seizures, no cause can be identified.

In persons with epilepsy, there are two types of seizures: generalized seizures, which include tonic-clonic seizures (also known as grand mal seizures); and partial seizures, which affect only part of the brain. Anti-seizure medications are available for person’s diagnosed with epilepsy.

In the case of most epileptic seizures, it is usually not necessary to call 911 or the local emergency number. However, it is important to keep the person away from harmful objects and to make sure his or her airway remains clear.

The symptoms of a seizure includes:

  • A preceding warning or aura (in some cases).
  • A complex partial seizure or a convulsion involving rhythmic jerking.
  • A loss of responsiveness or alertness, with the eyes generally remaining open.
  • Barely detectable breathing during the seizure followed by deep breathing during recovery.
  • Incontinence or loss of urine (in some cases).
  • A transition back to the person’s normal state known as the “post-ictal period”; this is a recovery period for the brain, which may last anywhere from a few seconds to several hours and may involve combativeness.

In some cases, seizures may also involve isolated abnormal movements of a limb, periods of staring or abnormal stiffening without rhythmic jerking.

Take the following actions if someone is having a seizure:

  • Move harmful objects out of the way, cushion the head and protect the person from falling.
  • Loosen ties, scarves or other neckware.
  • Do not put anything in the person’s mouth.
  • Do not attempt to restrain the convulsions.
  • After the convulsion ceases or if the person is vomiting, roll the person onto his or her left side to protect the airway and to help drain away any mouth secretions.
  • Make sure the airway is clear and the person is breathing. If not, start rescue breathing and seek immediate medical attention.
  • Observe the length of the seizure, the movements involved, direction of head and eye movements and the time it takes to return to full consciousness and alertness, so you can report this information to a medical professional.

Call 911 or the local emergency number immediately if:

  • The seizure lasts five minutes or longer, or is repeated.
  • Injuries have resulted from the seizure.
  • The person experiences persistent breathing difficulty.
  • The person having the seizure also has a fever.
  • The person experiences persistent confusion or remains unconscious.
  • The person is pregnant, is a diabetic, is injured or appears to have life-threatening conditions.
  • This is the first time the person has had a seizure, or, in the case of an established epileptic, the seizure represents a marked change from the type or duration of seizure typically experienced.

 

Stroke

Stroke is a life-threatening condition that constitutes a medical emergency. It is the third leading cause of death in the nation. Stroke occurs when blood flow to the brain is interrupted by a clogged or burst artery. The interruption deprives the brain of blood and oxygen, and causes brain cells to die. Seek emergency care immediately if a stroke is suspected.

Stroke symptoms in general include:

  • Sudden numbness, weakness or paralysis and drooping of the face, arm or leg, especially on one side of the body.
  • Suddenly blurred or decreased vision in one or both eyes.
  • Slurred speech, difficulty speaking or inability to understand or be understood.
  • Loss of balance or coordination.

Some people may have additional, nontraditional (sometimes non-neurological) symptoms, including severe headache, especially if the onset is abrupt or if accompanied by other symptoms (such as a change in consciousness), in which case a brain hemorrhage may be a cause for concern.

Stroke symptoms that last for only a few minutes and then subside may indicate a “mini-stroke,” or a transient ischemic attack (TIA). TIAs are serious medical events and require treatment; they are also a warning sign that a more dangerous stroke may occur in the future.

It is important to know that stroke often goes unrecognized; people often wait to see if their symptoms improve and unknowingly put themselves in greater danger. However, because stroke can incapacitate or kill within minutes, doctors recommend treating a suspected stroke as a medical emergency and seeking immediate medical care.

If stroke is suspected, it should be communicated directly immediately. Call 911 and tell the dispatcher or the triage nurse or doctor, “I think this is a stroke.”

How to Reduce Your Risk of Stroke

  • Control your blood pressure.
  • Don’t smoke.
  • Eat a healthful diet that is low in sodium and fat.
  • Have your cholesterol checked; if it is high follow your doctor’s instructions on how to control it.
  • Exercise regularly.
  • Control diabetes.
  • Manage heart disease. Be aware of your family’s medical history of stroke.
  • Promptly report warning signs to your doctor.