Getting to the ER in Time
Each year more than 500,000 people die unnecessarily because they don't get to their doctor or to an emergency room soon enough to properly treat their medical problems. Delay can be deadly. For example, in a heart attack or stroke arteries to the heart or brain must be unblocked within three hours of the beginning of symptoms. Giving medication after this time does no good.
Why don't people go to a hospital soon enough? First, people don't know the warning signs when something is seriously wrong. Frequently, they think that their symptoms will go away spontaneously. Second, people don't want to inconvenience others, especially in the middle of the night. In this regard, women are worse than men since they are usually the caretakers of the family. They want to put everything in order before they think of their own needs. Finally, people don't want to appear foolish by rushing to the ER if nothing is seriously wrong.
The lack of education on the part of the public prompted the American Heart Association to organize a campaign entitled "Act in Time" two years ago. Now, the American College of Emergency Physicians (ACEP) is promoting its "Seconds Save Lives" educational effort. ACEP wants people to recognize a problem and act immediately.
Getting to a doctor or to the ER early isn't important only in cases of heart attacks or strokes. When a child suffers from prolonged abdominal pains and doesn't see a doctor soon enough, a ruptured appendix may result causing severe abdominal infection. A woman suddenly experiencing difficulty breathing that doesn't go away quickly may be suffering from a blood clot traveling from her legs to her lung, a condition that may be fatal. The good news is that there are very clear warning signs or symptoms when immediate action needs to be taken.
What are the life-threatening warning signs that you need to recognize?
- Sudden or severe pain that doesn't quickly go away. This is especially true in the case of pain caused by a headache. If you suddenly suffer from a headache that is more severe than any you have ever experienced it could be caused by bleeding inside your head from a ruptured artery. (For migraine sufferers, it should be for sudden severe pain that is well beyond anything you previously experienced.) This symptom is more common in women than men and it is often neglected.
- This is also true with abdominal or stomach pain. If the pain is sudden or doesn't go away or gets worse, go immediately to the Emergency Room. In younger women, it could be an ectopic pregnancy or appendicitis; for older women it may be a hole in the intestine from a diverticuli. All of these are real emergencies and action needs to be taken immediately.
Chest pain that doesn't go away is another key sign. For women, the sign of a heart attack may be pain in the chest, or in the abdomen or back. Delay can be deadly.
- Difficult breathing or unusual shortness of breath. This can mean a blood clot to the lung or a hole in the lung. It may also indicate heart failure in older people. These are not the usual breathing problems that are experienced by smokers or people out of shape physically when they do normal tasks. Rather, this refers to breathing difficulties that are unusual for you.
- Sudden changes in mental status. If someone suddenly becomes confused, disoriented, or cannot be aroused, they may be suffering from a stroke, an infection, heat stroke or one of a number of serious medical problems. They should get to the ER immediately.
- Headaches with a stiff neck or fever. These are the warning signs of meningitis, an infection of the lining of the brain. If you have a headache and fever and can't touch your chin to your chest, get checked right away.
Coughing or vomiting blood. Coughing or vomiting a handful of blood can indicated internal bleeding, even a single episode.
- Uncontrolled bleeding of any kind, even nosebleeds, should not be ignored. This includes vaginal bleeding in women after menopause. This should be taken very seriously. The key word here is uncontrolled.
- Unexplained weight loss or weight gain. If you are trying to lose weight this is not a problem. But losing weight for no good reason can mean a serious illness like diabetes or cancer. Also, if you begin to gain weight without changing your exercise or eating habits, it can mean an accumulation of fluid in your abdomen. This can be a warning sign of ovarian cancer.
- The warning signs of stroke. Strokes are a true emergency requiring immediate attention. Someone experiencing paralysis of one arm or leg, slurred speech, drooping of one side of the face or confusion should get to the ER immediately. Don't wait to see if it stops.
Know your local medical facilities. Not all hospitals have the equipment or the staff to handle real emergencies like the ones mentioned above. It is important to find out if your local hospital has emergency medicine trained physicians and that they have the backup they need to treat strokes, heart attacks and other emergencies 24 hours a day. Check into this before you have an emergency so you don't waste precious time in the wrong hospital. When you get to the hospital, be sure to tell the personnel why you are there and what you think might be wrong. Your don't want to sit in a waiting room unnecessarily.
For more information:
American College of Emergency Physicians at www.acep.org
American Heart Association www.americanheart.org
