24-Hour Emergency Medical Care for Acute Illness, Injury & Life-Threatening Conditions

The Emergency Department at AS Medical Complex provides 24-hour assessment and emergency care for patients experiencing sudden illness, injury, severe symptoms, or potentially life-threatening medical conditions.

Emergency medicine focuses on the rapid recognition, assessment, stabilization, investigation, and initial treatment of patients who cannot safely wait for a routine outpatient appointment.

Emergency conditions may involve:

• Heart

• Brain and nervous system

• Lungs and breathing

• Severe infection

• Injuries and trauma

• Abdomen

• Kidneys and urinary system

• Severe allergic reactions

• Poisoning

• Burns

• Children

• Pregnancy-related emergencies

• Surgical conditions

• Other acute medical problems

The World Health Organization describes emergency care as an integrated system for providing timely treatment to acutely ill or injured patients, including patients with injuries, sepsis, heart attacks, strokes, asthma, and acute complications of pregnancy.

The goal of the Emergency Department is not simply to identify a diagnosis.

Emergency care may involve:

• Identifying immediate threats to life

• Stabilizing airway, breathing and circulation

• Controlling severe symptoms

• Performing urgent investigations

• Beginning time-sensitive treatment

• Monitoring the patient

• Obtaining specialist consultation

• Arranging hospital admission where necessary

• Arranging transfer or referral when required

• Safely discharging suitable patients with instructions and follow-up

At AS Medical Complex, patients should be assessed according to the severity and urgency of their condition, rather than only according to the order in which they arrive.

WHO describes acuity-based triage as the process of prioritizing patients according to how urgently medical intervention is required.

Our Emergency Department Services

Depending on the patient's condition, clinical indication, hospital resources and specialist availability, Emergency services at AS Medical Complex may include:

• 24-hour Emergency assessment

• Emergency medical evaluation

• Emergency nursing assessment

• Triage and prioritization

• Vital-sign assessment

• Oxygen-saturation monitoring

• Rapid assessment of critically ill patients

• Resuscitation

• Airway assessment

• Breathing assessment

• Circulation assessment

• Neurological assessment

• Cardiac monitoring where clinically required

• ECG

• Blood-glucose testing

• Emergency Laboratory investigations

• Emergency X-Ray

• Emergency Ultrasound where clinically appropriate

• Portable Ultrasound where appropriate

• CT Scan where clinically indicated and available

• Other urgent imaging where appropriate

• Intravenous access

• IV fluids where clinically indicated

• Emergency medication

• Pain management

• Fever management

• Treatment of selected asthma and respiratory emergencies

• Initial management of chest pain

• Initial assessment of suspected heart attack

• Initial assessment of stroke symptoms

• Seizure assessment

• Severe infection and sepsis assessment

• Trauma and injury assessment

• Fracture and dislocation assessment

• Wound assessment

• Bleeding control

• Burn assessment

• Acute abdominal-pain assessment

• Vomiting and dehydration assessment

• Severe allergic-reaction assessment

• Poisoning assessment

• Acute urinary-problem assessment

• Pediatric emergency assessment

• Acute pregnancy-related emergency assessment

• Emergency specialist consultation where required

• Observation and reassessment

• Hospital admission where clinically required

• Referral to higher or specialized care when necessary

• Emergency discharge planning and follow-up instructions

The exact emergency treatment provided depends on the patient's condition and the hospital's available specialist, diagnostic, procedural, critical-care and surgical resources.

What Is an Emergency Department?

An Emergency Department is a hospital service designed for patients with acute illness or injury requiring timely medical assessment.

Patients may arrive because of:

• Sudden symptoms

• Significant injury

• Rapid deterioration of an existing illness

• Severe pain

• Abnormal consciousness

• Difficulty breathing

• Significant bleeding

• Other urgent medical concerns

Emergency Departments must be able to recognize which patients require immediate treatment and which patients can safely wait for further evaluation.

WHO's emergency-care framework emphasizes early recognition, resuscitation, treatment, monitoring and appropriate continuation of care for acutely ill and injured patients.

What Is Triage?

Triage is the process used to determine how urgently a patient needs medical attention.

Patients are assessed according to the seriousness of their condition.

WHO defines acuity-based triage as sorting and prioritizing patients according to the estimated urgency for intervention.

This means that a critically ill patient who arrives after another patient may appropriately be treated first.

Triage may consider factors such as:

• Main complaint

• Breathing

• Pulse

• Blood pressure

• Oxygen level

• Temperature

• Consciousness

• Severe pain

• Bleeding

• Neurological symptoms

• Mechanism of injury

• Age

• Pregnancy

• Other high-risk features

Triage is intended to identify patients who cannot safely wait.

Emergency Patients Are Not Always Seen in Arrival Order

Emergency care is different from a routine clinic queue.

A patient with:

• Cardiac arrest

• Severe breathing difficulty

• Shock

• Major bleeding

• Stroke symptoms

• Severe trauma

• Loss of consciousness

may require immediate treatment even if other patients arrived earlier.

WHO's triage guidance specifically prioritizes patients based on acuity, with the most seriously ill requiring immediate attention.

Patients whose conditions are less urgent may therefore sometimes experience a longer wait.

Initial Emergency Assessment

The first stage of emergency assessment focuses on identifying immediate threats to life.

A structured assessment may consider:

• Airway

• Breathing

• Circulation

• Neurological status

• Exposure for injury or other abnormalities

WHO Basic Emergency Care training promotes a systematic ABCDE approach to rapidly assess and resuscitate acutely ill or injured patients.

Further assessment then focuses on:

• Symptoms

• Medical history

• Medication

• Allergies

• Previous illnesses

• Physical examination

• Required diagnostic investigations

Resuscitation

A critically ill patient may require immediate resuscitation before a complete diagnosis is established.

Depending on the emergency, early treatment may involve:

• Airway support

• Oxygen where clinically indicated

• Assisted breathing where required

• IV access

• Circulatory support

• Control of severe bleeding

• Emergency medications

• Cardiac monitoring

• Defibrillation where indicated

• Other lifesaving interventions

WHO's Emergency Care Toolkit specifically includes medical and trauma resuscitation algorithms designed to support timely lifesaving treatment and onward referral.

Cardiac Arrest

Cardiac arrest occurs when the heart suddenly stops pumping blood effectively.

A person may:

• Collapse

• Become unresponsive

• Stop breathing normally

• Have no effective circulation

This requires immediate resuscitation.

Emergency response may include:

• Cardiopulmonary resuscitation – CPR

• Defibrillation where appropriate

• Airway and breathing support

• Emergency medication

• Identification and treatment of reversible causes

Cardiac arrest is different from a heart attack, although a heart attack can sometimes lead to cardiac arrest.

Chest Pain

Chest pain can have many possible causes.

Some are relatively minor, while others can be life-threatening.

Possible serious causes include:

• Heart attack

• Acute coronary syndrome

• Pulmonary embolism

• Aortic disease

• Pneumothorax

• Severe infection

• Other cardiac or pulmonary conditions

Patients with new severe or unexplained chest pain should receive prompt medical assessment.

Heart Attack Symptoms

A heart attack may cause:

• Chest pressure

• Chest squeezing

• Chest fullness

• Chest pain

• Pain spreading to one or both arms

• Back pain

• Neck pain

• Jaw pain

• Shortness of breath

• Nausea

• Sweating

• Lightheadedness

• Other symptoms

The American Heart Association emphasizes that symptoms can vary and that chest discomfort and shortness of breath are important warning signs.

A patient with suspected heart attack requires urgent assessment.

Emergency Assessment of Chest Pain

Depending on clinical findings, chest-pain assessment may include:

• Vital signs

• Clinical examination

• ECG

• Cardiac biomarkers such as troponin

• Blood tests

• Chest X-Ray

• Echocardiography where indicated

• CT imaging in selected conditions

• Cardiology consultation

• Other investigations

Not every patient with chest pain is having a heart attack.

However, serious causes should be considered before symptoms are dismissed as:

• Gas

• Acidity

• Muscle pain

• Anxiety

without appropriate clinical assessment.

ECG in Emergency Care

An Electrocardiogram – ECG records the electrical activity of the heart.

It may be particularly important for patients with:

• Chest pain

• Palpitations

• Fainting

• Suspected heart attack

• Abnormal heart rhythm

• Other cardiac symptoms

ECG results are interpreted together with:

• Symptoms

• Examination

• Laboratory tests

• Previous ECGs

• Other investigations

An apparently normal ECG does not exclude every cardiac condition.

Stroke Emergency

Stroke occurs when blood supply to part of the brain is interrupted or when bleeding occurs within or around the brain.

Stroke requires urgent assessment because some treatments are highly time-sensitive.

CDC identifies major stroke warning symptoms including sudden:

• Weakness or numbness of the face, arm or leg, particularly on one side

• Confusion

• Difficulty speaking

• Difficulty understanding speech

• Vision problems

• Difficulty walking

• Dizziness

• Loss of coordination

• Severe headache without a known cause

Do Not Wait for Stroke Symptoms to Improve

Some neurological symptoms may disappear after a short time.

This can occur during a Transient Ischemic Attack – TIA.

However, a TIA is still an emergency warning sign.

CDC specifically states that stroke and TIA symptoms require emergency assessment and that it may not initially be possible to know whether the event is a TIA or a major stroke.

A patient should not simply wait at home to see whether weakness or speech difficulty improves.

Emergency Stroke Assessment

Emergency stroke assessment may involve:

• Neurological examination

• Blood glucose

• Blood pressure

• ECG

• Laboratory testing

• CT Brain

• CT angiography in selected patients

• MRI in selected circumstances

• Neurology consultation

• Other investigations

The appropriate imaging pathway depends on:

• Symptoms

• Time of onset

• Clinical stability

• Available imaging

• Suspected type of stroke

Severe Breathing Difficulty

Breathing difficulty can become life-threatening.

Emergency causes may include:

• Severe asthma

• Pneumonia

• Pulmonary edema

• Pulmonary embolism

• Pneumothorax

• Severe allergic reaction

• Airway obstruction

• Heart failure

• Severe infection

• Other respiratory conditions

Patients with severe respiratory distress require immediate medical assessment.

Asthma Emergency

Asthma can cause:

• Wheezing

• Shortness of breath

• Chest tightness

• Cough

WHO notes that asthma involves inflammation and narrowing of the airways and can produce combinations of these symptoms.

An asthma attack becomes particularly concerning when the patient has:

• Severe breathlessness

• Difficulty speaking

• Increasing exhaustion

• Reduced consciousness

• Poor response to usual reliever medication

• Other signs of significant respiratory distress

Such patients require urgent assessment.

Low Oxygen Level

Oxygen saturation may be checked using a pulse oximeter.

A low reading can occur because of conditions involving:

• Lungs

• Heart

• Circulation

• Severe infection

• Other medical problems

The significance of an oxygen reading depends on:

• Patient's baseline

• Symptoms

• Underlying lung disease

• Circulatory status

• Measurement quality

The reading should therefore be interpreted clinically rather than treated as an isolated number.

Severe Allergic Reaction

A severe systemic allergic reaction is known as anaphylaxis.

It can involve:

• Swelling of the tongue or throat

• Difficulty breathing

• Wheezing

• Circulatory problems

• Collapse

• Widespread allergic symptoms

WHO describes anaphylaxis as a systemic allergic reaction that can cause serious airway, breathing or circulation problems.

Anaphylaxis requires emergency treatment.

Sepsis

Sepsis is a life-threatening response to infection that can lead to organ dysfunction, shock and death.

Possible signs may include:

• Fever

• Rapid heart rate

• Rapid breathing

• Confusion

• Severe weakness

• Significant body pain

• Low blood pressure

• Reduced urine output

• Other signs of serious illness

WHO states that sepsis is a medical emergency requiring timely clinical care, including appropriate antimicrobials, fluids and other measures according to the patient's condition.

Sepsis Assessment

Depending on clinical findings, emergency assessment may include:

• Vital signs

• Blood pressure

• Oxygen saturation

• Mental status

• Laboratory investigations

• Blood cultures where appropriate

• Urine testing

• Chest imaging

• Other imaging

• Assessment of the possible infection source

Treatment should not be unnecessarily delayed in a critically ill patient while waiting for every test result.

WHO emphasizes early recognition, emergency care, antimicrobial treatment, source control and monitoring as important elements of sepsis management.

Fever

Fever can occur with many illnesses.

Most fever does not automatically represent an emergency.

However, urgent assessment may be needed when fever is associated with:

• Severe breathing difficulty

• Confusion

• Very low blood pressure

• Seizure

• Severe dehydration

• Stiff neck

• Severe weakness

• Rapid deterioration

• Significant immune suppression

• Other concerning symptoms

The Emergency team evaluates the entire clinical presentation rather than temperature alone.

Seizures

A seizure can occur because of:

• Epilepsy

• Low blood glucose

• Fever in selected children

• Brain disease

• Stroke

• Infection

• Electrolyte abnormalities

• Medication

• Drug or alcohol-related conditions

• Other causes

Emergency assessment may be needed when:

• It is the first seizure.

• The seizure is prolonged.

• Seizures repeat without recovery.

• The patient remains unconscious.

• Significant injury occurred.

• The patient is pregnant.

• Another serious medical condition is suspected.

Loss of Consciousness

Loss of consciousness can result from many conditions, including:

• Fainting

• Heart-rhythm problems

• Low blood pressure

• Low blood glucose

• Seizure

• Stroke

• Head injury

• Severe infection

• Poisoning

• Other conditions

A patient who remains unconscious or has persistent abnormal consciousness requires urgent medical assessment.

Low Blood Sugar

Severe hypoglycemia can lead to:

• Sweating

• Trembling

• Confusion

• Abnormal behavior

• Seizure

• Loss of consciousness

Emergency assessment may be necessary when severe symptoms are present.

Blood glucose is often checked rapidly in patients with unexplained:

• Confusion

• Neurological symptoms

• Seizure

• Reduced consciousness

because glucose abnormalities can mimic other neurological emergencies.

Very High Blood Sugar

Severely elevated blood glucose can sometimes lead to serious metabolic emergencies.

Warning symptoms may include:

• Severe thirst

• Frequent urination

• Vomiting

• Abdominal pain

• Dehydration

• Deep or abnormal breathing

• Confusion

• Reduced consciousness

Patients with diabetes who develop significant deterioration should seek urgent medical assessment.

Trauma & Injuries

Emergency trauma care may be required after:

• Road traffic accident

• Fall

• Workplace injury

• Sports injury

• Assault

• Significant blunt injury

• Penetrating injury

• Other accidents

Emergency assessment focuses first on identifying injuries that threaten:

• Airway

• Breathing

• Circulation

• Brain and nervous system

• Major organs

WHO emergency-care training uses a systematic ABCDE approach for injured patients so that immediately life-threatening conditions can be identified and treated quickly.

Major Trauma

Major trauma can involve more than one body system.

Possible injuries include:

• Head injury

• Chest injury

• Abdominal injury

• Pelvic injury

• Spinal injury

• Major fractures

• Internal bleeding

• Vascular injury

Depending on the patient, emergency assessment may require:

• X-Ray

• Ultrasound

• CT Scan

• Laboratory investigations

• Surgical consultation

• Orthopedic consultation

• Neurosurgical consultation

• Other specialist assessment

The exact pathway depends on hospital capability and patient stability.

Head Injury

Head injury can range from mild to life-threatening.

Urgent assessment is particularly important when there is:

• Loss of consciousness

• Persistent vomiting

• Severe worsening headache

• Seizure

• Confusion

• Weakness

• Abnormal behavior

• Significant mechanism of injury

• Use of blood-thinning medication

• Other concerning neurological features

CT Brain may be required in selected patients.

Not every minor head injury requires CT.

Clinical assessment determines when imaging is appropriate.

Spinal Injury

Possible spinal injury should be considered after significant trauma, especially when there is:

• Neck pain

• Back pain

• Limb weakness

• Numbness

• Paralysis

• Loss of sensation

• Significant fall

• High-energy accident

Selected patients may require:

• X-Ray

• CT

• MRI

• Orthopedic or Neurosurgical assessment

depending on the suspected injury.

Fractures

A suspected fracture may cause:

• Severe pain

• Swelling

• Bruising

• Deformity

• Inability to move the limb normally

• Inability to bear weight

Emergency assessment may involve:

• Examination

• X-Ray

• Pain relief

• Splinting or immobilization

• Orthopedic consultation

• Additional CT or MRI in selected cases

Open Fracture

An open fracture occurs when a fracture communicates with an external wound.

This requires urgent medical and orthopedic assessment because of risks including:

• Infection

• Bleeding

• Soft-tissue injury

• Damage to nerves or blood vessels

Treatment may involve:

• Wound care

• Appropriate antibiotics

• Tetanus assessment

• Imaging

• Surgery

• Other orthopedic treatment

depending on the injury.

Joint Dislocation

A dislocation occurs when the normal surfaces of a joint become displaced.

It may affect:

• Shoulder

• Finger

• Elbow

• Hip

• Knee

• Other joints

Emergency treatment may involve:

• Pain management

• Imaging

• Reduction

• Post-reduction imaging

• Immobilization

• Orthopedic follow-up

Patients should not attempt forceful self-reduction of a major joint dislocation.

Severe Bleeding

Significant external bleeding requires rapid assessment and control.

Severe bleeding can lead to:

• Low blood pressure

• Shock

• Loss of consciousness

• Organ injury

Emergency management may involve:

• Direct bleeding control

• IV access

• Laboratory investigations

• Blood-group testing

• Blood products where clinically indicated and available

• Surgical evaluation

• Other treatment

Internal Bleeding

Internal bleeding may occur after:

• Trauma

• Gastrointestinal bleeding

• Ruptured blood vessel

• Pregnancy complication

• Other conditions

Symptoms can include:

• Weakness

• Dizziness

• Fainting

• Abdominal pain

• Blood in vomit or stool

• Low blood pressure

• Rapid pulse

• Other signs of shock

Emergency imaging and specialist assessment may be necessary.

Wounds & Cuts

Emergency wound assessment may include:

• Controlling bleeding

• Examining wound depth

• Looking for foreign material

• Assessing nerve function

• Assessing blood supply

• Cleaning

• Closure where appropriate

• Tetanus assessment

• Antibiotics where medically indicated

Not every wound requires stitches.

The appropriate treatment depends on:

• Location

• Depth

• Contamination

• Time since injury

• Tissue damage

• Other factors

Burns

Burns can result from:

• Flame

• Hot liquids

• Hot surfaces

• Electricity

• Chemicals

• Other causes

Emergency assessment considers:

• Burn depth

• Percentage of body involved

• Location

• Airway involvement

• Age

• Associated injuries

• Medical conditions

More serious burns may require specialized referral according to severity and hospital capability.

Electrical Injury

Electrical injuries can sometimes cause significant internal damage even when the external burn appears small.

Possible complications can involve:

• Heart rhythm

• Muscles

• Nerves

• Tissue damage

Patients with significant electrical injury may require Emergency assessment, ECG or other monitoring depending on the exposure and symptoms.

Acute Abdominal Pain

Severe abdominal pain can have many possible causes.

Emergency conditions may include:

• Appendicitis

• Bowel obstruction

• Perforation

• Gallbladder inflammation

• Pancreatitis

• Kidney stones

• Internal bleeding

• Ectopic pregnancy

• Other surgical or medical conditions

Assessment may involve:

• Examination

• Laboratory tests

• Urine testing

• Ultrasound

• CT Scan

• Pregnancy testing where appropriate

• Surgical or specialist consultation

Appendicitis

Appendicitis can cause:

• Abdominal pain

• Pain moving toward the right lower abdomen

• Fever

• Nausea

• Vomiting

• Reduced appetite

Diagnosis may involve:

• Clinical examination

• Laboratory tests

• Ultrasound

• CT

depending on age and clinical circumstances.

Patients with suspected appendicitis may require General Surgery assessment.

Bowel Obstruction

Possible symptoms of bowel obstruction include:

• Abdominal pain

• Abdominal swelling

• Vomiting

• Inability to pass stool

• Inability to pass gas

A significant bowel obstruction can become a surgical emergency.

Assessment may involve:

• Examination

• Laboratory testing

• X-Ray

• CT Scan

• General Surgery consultation

Severe Vomiting & Dehydration

Persistent vomiting can result in:

• Dehydration

• Electrolyte abnormalities

• Kidney dysfunction

• Low blood pressure

Emergency assessment may be particularly important when vomiting is associated with:

• Severe abdominal pain

• Blood

• Confusion

• Reduced urine output

• Significant weakness

• Pregnancy-related complications

• Other serious symptoms

Gastrointestinal Bleeding

Gastrointestinal bleeding may appear as:

• Vomiting blood

• Black tar-like stool

• Red blood in stool

• Other signs of bleeding

Significant bleeding can become life-threatening.

Emergency assessment may include:

• Vital signs

• Laboratory tests

• IV access

• Blood-group testing

• Gastroenterology or surgical assessment

• Endoscopy where clinically indicated and available

• Other treatment

Kidney Stones

Kidney stones can cause severe pain, commonly involving:

• Side

• Back

• Lower abdomen

• Groin

Assessment may involve:

• Urine testing

• Kidney-function testing

• Ultrasound

• CT Scan

• Pain management

A stone associated with urinary obstruction and infection can become particularly serious and may require urgent Urology treatment.

Acute Urinary Retention

Acute urinary retention occurs when the bladder cannot empty.

Symptoms may include:

• Inability to pass urine

• Severe lower abdominal discomfort

• Bladder swelling

Emergency treatment may require:

• Examination

• Bladder assessment

• Catheterization

• Laboratory testing

• Urology consultation

depending on the cause.

Poisoning & Overdose

Emergency assessment is appropriate after suspected:

• Medication overdose

• Chemical ingestion

• Toxic exposure

• Pesticide exposure

• Drug poisoning

• Other potentially harmful substances

WHO recognizes poisoning management as an important part of acute clinical care and highlights the role of specialist poison-information services where available.

Whenever possible, family members should bring:

• Medicine packaging

• Chemical container

• Product name

• Estimated amount

• Approximate exposure time

without exposing themselves to additional danger.

Do Not Induce Vomiting After Poisoning Unless Specifically Advised

Different poisons require different treatment.

Inducing vomiting can be dangerous after certain exposures.

Management depends on:

• Substance

• Amount

• Time

• Route of exposure

• Symptoms

• Patient age

• Other medical factors

Emergency clinical guidance should be obtained rather than relying on a general home remedy.

Pediatric Emergencies

Children can deteriorate differently from adults and require age-appropriate assessment.

Emergency evaluation may be necessary for children with:

• Severe breathing difficulty

• Persistent seizure

• Significant dehydration

• Severe infection

• Major trauma

• Altered consciousness

• Poisoning

• Other serious symptoms

WHO has dedicated pediatric emergency triage and treatment guidance emphasizing rapid recognition and immediate treatment when emergency signs are identified.

Fever in Children

Fever is common in children.

The urgency depends on:

• Age

• Temperature

• General appearance

• Breathing

• Hydration

• Consciousness

• Rash

• Seizures

• Other symptoms

Parents should seek urgent assessment when the child appears significantly unwell or has other concerning signs rather than judging severity from temperature alone.

Pediatric Breathing Difficulty

Urgent assessment is particularly important when a child has:

• Marked breathing difficulty

• Severe chest retractions

• Blue discoloration

• Reduced responsiveness

• Exhaustion

• Other signs of respiratory distress

Children can deteriorate quickly, so significant breathing difficulty should not be managed through a routine outpatient appointment.

Obstetric & Pregnancy-Related Emergencies

Pregnancy-related emergencies may require urgent assessment.

Examples include:

• Significant vaginal bleeding

• Severe abdominal or pelvic pain

• Suspected ectopic pregnancy

• Severe hypertension-related symptoms

• Seizures during pregnancy

• Significant trauma during pregnancy

• Other acute obstetric concerns

WHO includes acute pregnancy complications among conditions requiring effective emergency-care systems.

The Emergency team may coordinate care with Gynecology and Obstetrics according to the patient's condition.

Suspected Ectopic Pregnancy

An ectopic pregnancy develops outside the normal uterine cavity.

If rupture occurs, severe internal bleeding can result.

Concerning symptoms may include:

• One-sided pelvic pain

• Vaginal bleeding

• Dizziness

• Fainting

• Shoulder-tip pain

• Collapse

Urgent assessment may involve:

• Pregnancy testing

• Ultrasound

• Laboratory testing

• Gynecology consultation

A hemodynamically unstable patient requires immediate treatment rather than waiting for routine imaging.

Severe Headache

Most headaches are not caused by a life-threatening condition.

However, urgent assessment may be necessary for:

• Sudden severe headache

• Headache after significant injury

• Headache with neurological weakness

• Headache with confusion

• Headache with seizure

• Headache with fever and concerning neurological symptoms

• Other major changes from the patient's usual pattern

Depending on clinical findings, investigation may involve:

• CT

• MRI

• Laboratory testing

• Other neurological assessment

Severe Dizziness or Fainting

Dizziness and fainting can occur from many causes.

Possible causes include:

• Dehydration

• Low blood pressure

• Heart-rhythm problems

• Blood loss

• Low glucose

• Neurological disease

• Medication

• Other conditions

Emergency assessment may be necessary when fainting is associated with:

• Chest pain

• Severe breathlessness

• Injury

• Neurological symptoms

• Significant bleeding

• Repeated episodes

• Other high-risk features

High Blood Pressure

A high blood-pressure reading by itself does not always mean that an emergency is present.

However, very high blood pressure accompanied by signs of acute organ injury can require urgent treatment.

Concerning symptoms may include:

• Chest pain

• Severe breathing difficulty

• Neurological weakness

• Confusion

• Other serious symptoms

The Emergency team assesses the patient, not only the blood-pressure number.

Emergency Laboratory Testing

Laboratory investigations may help evaluate urgent conditions.

Depending on symptoms, testing may include:

• Complete Blood Count

• Hemoglobin

• Blood glucose

• Kidney function

• Electrolytes

• Liver-related tests

• Cardiac biomarkers

• Coagulation studies

• Infection-related investigations

• Pregnancy testing

• Urinalysis

• Other clinically appropriate tests

Tests should be chosen according to the emergency problem rather than automatically performing every laboratory investigation.

Emergency Imaging

Emergency imaging may include:

• X-Ray

• Ultrasound

• Portable Ultrasound

• CT Scan

• MRI in selected circumstances

• Other specialized imaging

The appropriate examination depends on:

• Clinical condition

• Urgency

• Body area

• Patient stability

• Pregnancy

• Available imaging resources

CT can be particularly important for selected emergency conditions because it can rapidly provide detailed cross-sectional information.

Emergency X-Ray

X-Ray may be used for selected:

• Fractures

• Dislocations

• Chest conditions

• Foreign bodies

• Other emergency problems

More complex conditions may require:

• CT

• MRI

• Ultrasound

after or instead of routine X-Ray.

Emergency Ultrasound

Ultrasound may be useful for selected:

• Abdominal conditions

• Pregnancy-related emergencies

• Gallbladder problems

• Kidney or urinary problems

• Free abdominal fluid

• Other acute conditions

Point-of-care or portable ultrasound may also help trained clinicians answer focused bedside questions.

A normal ultrasound does not exclude every emergency condition.

Emergency CT Scan

CT may be particularly useful for selected:

• Head injury

• Brain bleeding

• Stroke assessment

• Major trauma

• Chest disease

• Severe abdominal pain

• Kidney stones

• Internal bleeding

• Other emergencies

The Emergency and Radiology teams determine when CT is required.

MRI in Emergency Care

MRI provides excellent soft-tissue detail and does not use ionizing radiation.

However, MRI examinations generally take longer than CT and require additional safety screening.

MRI may therefore be selected for particular emergencies rather than automatically being the first investigation for every acute patient.

Specialist Consultation

Emergency patients may require review from another specialty.

Depending on the condition and specialist availability, this may include:

• Cardiology

• Neurology

• Neurosurgery

• General Medicine

• General & Laparoscopic Surgery

• Orthopedics

• Ortho & Spine Surgery

• Urology

• Gynecology

• Pediatrics

• Gastroenterology

• Pulmonology

• Nephrology

• ENT

• Other specialties

The Emergency Department provides the initial acute-care pathway and coordinates onward management according to clinical need.

Emergency Department & Cardiology

Cardiology may be involved in patients with:

• Suspected heart attack

• Significant arrhythmia

• Acute cardiac failure

• Other serious cardiac conditions

Initial Emergency assessment may include:

• ECG

• Cardiac biomarkers

• Monitoring

• Other investigations

Further treatment depends on diagnosis and available cardiac services.

Emergency Department & Neurology

Neurology may become involved for:

• Stroke

• Seizures

• Severe neurological weakness

• Other acute neurological conditions

Emergency imaging and time-sensitive assessment may be required before definitive specialist treatment.

Emergency Department & Neurosurgery

Neurosurgery may be required for selected:

• Intracranial bleeding

• Severe head injury

• Spinal-cord compression

• Other neurosurgical emergencies

Where definitive treatment cannot be provided onsite, stabilization and appropriate referral or transfer may be necessary.

Emergency Department & General Surgery

General Surgery may assess emergency conditions such as:

• Appendicitis

• Bowel obstruction

• Perforation

• Internal abdominal bleeding

• Acute gallbladder complications

• Other surgical emergencies

Investigation can include:

• Laboratory testing

• Ultrasound

• CT

• Other imaging

before the final surgical plan is determined.

Emergency Department & Orthopedics

Orthopedic emergencies may include:

• Fracture

• Dislocation

• Open fracture

• Significant limb injury

• Joint injury

Treatment may require:

• Imaging

• Immobilization

• Reduction

• Surgery

• Follow-up

depending on the injury.

Emergency Department & Urology

Urological emergency consultation may be required for selected:

• Urinary obstruction

• Infected obstructed kidney

• Acute urinary retention

• Testicular torsion

• Significant urinary trauma

• Other conditions

Sudden severe testicular pain requires urgent assessment because some causes are time-sensitive.

Emergency Department & Gynecology

Gynecology may be involved in:

• Ectopic pregnancy

• Severe vaginal bleeding

• Acute pelvic pain

• Pregnancy-related complications

• Other gynecological emergencies

Pregnancy testing and ultrasound may form part of assessment when clinically appropriate.

Emergency Department & Pediatrics

Children presenting with acute illness or injury should receive age-appropriate assessment and treatment.

The Pediatrics team may become involved in selected:

• Severe infections

• Respiratory conditions

• Seizures

• Dehydration

• Other pediatric emergencies

according to clinical need.

Emergency Department & ICU / Higher-Acuity Care

Some patients remain critically ill despite initial Emergency treatment.

They may require:

• Continuous monitoring

• Organ support

• Intensive nursing

• Advanced medical treatment

WHO distinguishes critical care as ongoing intensive management for life-threatening illness or injury requiring close monitoring and support.

Depending on the patient's condition and available facilities, the next step may be:

• ICU

• HDU

• Operating theatre

• Inpatient ward

• Specialist referral

• Transfer to another appropriate facility

Observation & Reassessment

Not every Emergency diagnosis can be established immediately.

Some patients require a period of:

• Observation

• Repeat vital signs

• Repeat examination

• Repeat ECG

• Repeat Laboratory tests

• Monitoring of symptoms

• Other reassessment

This can help determine whether the patient:

• Can safely go home

• Requires admission

• Requires specialist review

• Requires additional investigation

Emergency Department Admission

Patients may require hospital admission when:

• Ongoing treatment is required.

• Symptoms remain severe.

• Monitoring is necessary.

• Surgery is required.

• Serious infection is present.

• Significant cardiac or neurological disease is suspected.

• The patient cannot safely recover at home.

• Other clinical concerns are present.

Admission does not depend solely on one test result.

The full clinical condition is considered.

Transfer to Another Facility

Sometimes a patient requires treatment or expertise beyond what is immediately available at the presenting hospital.

In such circumstances, the clinical team may need to:

• Stabilize the patient

• Communicate with the receiving service

• Arrange appropriate transport

• Transfer relevant medical information

WHO's emergency-care framework includes continuity from first contact through transport, emergency-unit care and onward inpatient or specialized care.

Emergency Discharge

Many patients are safely discharged after Emergency assessment and treatment.

Before discharge, patients may receive:

• Diagnosis or provisional diagnosis

• Medication instructions

• Wound-care instructions

• Activity restrictions

• Follow-up advice

• Warning symptoms

• Referral instructions

AHRQ emphasizes the importance of a clear Emergency Department discharge process because inadequate discharge preparation can contribute to treatment failure and return visits.

Follow-Up After Emergency Care

Emergency care addresses the acute problem.

Further treatment may require follow-up with:

• General Medicine

• Cardiology

• Neurology

• Surgery

• Orthopedics

• Urology

• Gynecology

• Pediatrics

• Another specialist

• Primary care

Patients should follow the discharge instructions even if symptoms improve.

Return to Emergency If Symptoms Worsen

Patients discharged from the Emergency Department should return for urgent reassessment if they develop:

• Worsening symptoms

• New breathing difficulty

• Chest pain

• Weakness or speech difficulty

• Loss of consciousness

• Severe bleeding

• Persistent vomiting

• Severe uncontrolled pain

• Confusion

• Other warning symptoms specified at discharge

An earlier diagnosis should not prevent reassessment if the clinical condition changes.

What Information Should You Bring to Emergency?

Whenever possible, patients or family members should provide:

• Identification

• Medication list

• Known allergies

• Existing medical conditions

• Previous operations

• Recent test reports

• Recent imaging

• Pregnancy status

• Details of the event or injury

• Approximate time symptoms started

However, do not delay emergency treatment simply because documents are unavailable.

Bring Your Medication List

Medication information can be particularly important for patients taking:

• Blood thinners

• Insulin

• Diabetes medicine

• Blood-pressure medicine

• Heart medicine

• Anti-seizure medicine

• Steroids

• Other significant treatment

The Emergency team needs accurate medication information to help avoid interactions and understand possible causes of symptoms.

Medication Allergies

Tell Emergency staff about:

• Medication allergies

• Previous severe allergic reactions

• Contrast reactions

• Other important allergies

If the exact medicine is unknown, describe the previous reaction where possible.

Do Not Eat or Drink in Some Emergencies

Depending on the condition, patients may temporarily be asked not to eat or drink.

This can be relevant when:

• Emergency surgery may be required

• Sedation may be required

• Certain imaging or procedures are planned

• Swallowing is unsafe

The Emergency team should provide specific instructions.

Infection Prevention in the Emergency Department

Emergency Departments care for patients with many different illnesses.

Infection-prevention practices may include:

• Hand hygiene

• Appropriate personal protective equipment

• Respiratory precautions

• Environmental cleaning

• Safe sharps handling

• Isolation measures where clinically required

Emergency-care systems also play an important role in early recognition of outbreaks and communicable disease.

Patient Identification & Safety

Emergency patients may undergo multiple:

• Tests

• Medicines

• Procedures

• Transfers between clinical areas

Correct patient identification is therefore important throughout care.

Safety systems may include confirming identifiers before:

• Medication

• Blood collection

• Imaging

• Procedures

• Admission

• Transfer

Emergency Care for Older Adults

Older adults may present differently from younger patients.

A serious illness may sometimes appear as:

• Confusion

• Fall

• Weakness

• Reduced appetite

• Functional decline

rather than a classic symptom.

Medication use and multiple chronic diseases can also complicate assessment.

The clinical team should consider these factors during Emergency evaluation.

Falls in Older Adults

A fall may cause:

• Hip fracture

• Head injury

• Wrist fracture

• Other trauma

It may also occur because of another underlying medical problem such as:

• Low blood pressure

• Infection

• Heart-rhythm abnormality

• Medication

• Neurological illness

Emergency assessment should therefore consider both the injury and the possible reason for the fall.

Mental Health Emergencies

Some patients may require urgent assessment because of:

• Severe agitation

• Acute confusion

• Severe behavioral disturbance

• Risk of self-harm

• Risk to others

• Other acute psychiatric symptoms

Emergency management should prioritize:

• Immediate physical safety

• Medical causes

• Appropriate clinical assessment

• Psychiatric consultation where available and indicated

Sudden behavioral change can sometimes be caused by physical illness rather than a primary psychiatric condition.

Emergency Care Is Different From Routine OPD Care

The Emergency Department is primarily intended for:

• Acute illness

• Significant injury

• Rapid deterioration

• Potentially serious symptoms

Routine issues such as:

• Stable chronic disease follow-up

• Prescription refills

• Long-standing minor symptoms

• Routine health screening

• Non-urgent specialist review

may be better managed through an appropriate outpatient clinic when no emergency warning signs are present.

However, patients who are uncertain whether symptoms are dangerous should not ignore significant acute deterioration.

When Should You Visit the Emergency Department?

Seek Emergency medical assessment for symptoms such as:

• Severe chest pain

• Severe breathing difficulty

• Sudden weakness or numbness

• Sudden speech difficulty

• Loss of consciousness

• Severe allergic reaction

• Persistent seizure

• Major trauma

• Significant head injury

• Severe uncontrolled bleeding

• Open fracture

• Severe abdominal pain

• Suspected internal bleeding

• Severe dehydration

• Suspected poisoning

• Severe infection with deterioration

• Sudden severe testicular pain

• Severe pregnancy-related bleeding or pain

• Other rapidly worsening or potentially life-threatening conditions

WHO emphasizes that emergency care is intended for time-sensitive acute illness and injury requiring prompt recognition and treatment.

When Should You Call for Emergency Medical Transport?

When available, emergency medical transport may be more appropriate than attempting to drive a critically ill patient privately when there is:

• Cardiac arrest

• Suspected heart attack

• Suspected stroke

• Severe breathing difficulty

• Major trauma

• Severe bleeding

• Unconsciousness

• Other immediately life-threatening conditions

Prehospital emergency care can provide assessment, stabilization and communication during transport. WHO's emergency-care framework includes prehospital care and transport as important components of the emergency-care system.

Do Not Drive Yourself During a Serious Emergency

A patient with:

• Severe chest pain

• Significant dizziness

• Stroke symptoms

• Severe breathing difficulty

• Reduced consciousness

should generally not attempt to drive themselves.

The condition can deteriorate suddenly.

Appropriate emergency transport or assistance should be arranged where possible.

Time Matters in Medical Emergencies

Many emergency treatments are time-dependent.

WHO emphasizes that emergency-care systems are designed to support timely recognition and treatment of acute illness and injury.

Patients should therefore not delay seeking emergency assessment because they are:

• Waiting for symptoms to become unbearable

• Waiting until morning

• Waiting for an outpatient appointment

• Trying repeated home remedies

when serious warning symptoms are present.