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Emergency Medicine/Global Medicine
Medical Emergency
What should be your first question in case a patient is referred to you?

Where is the patient now?
How old is the patient?
What is the gender of the patient?
Who is reporting this emergency?
What seems to be the problem?
How much time has elapsed from the start of the emergency until now?
Does one individual or many individuals have medical emergencies at this location?
How many individuals have medical emergencies at this location?
A medical emergency with an individual victim.
A multiple casualty incident.
Do you think this is a multiple causality incident?

If it is a multiple causality incident, the guidelines are different.

What problems, complaints, incidents, and issues need on-the-spot diagnosis and treatment?
Unconsciousness at a public location.
Sudden unconsciousness at home.
Survival Needs
Human Pregnancy Emergencies
Here are further guidelines.
Can the patient talk?
Can the patient respond to verbal questions accurately?
Can the patient do spontaneous eye opening?
Does the patient respond to painful stimulus?
Is the patient conscious, oriented in time, space, and person?

Conscious means able to see, hear, and talk.
In pediatric patients younger than six months of age, the ability to make any verbal noise or cry is equivalent to talking.

What best describes you in a medical emergency?
Doctor in a medical emergency.
Emergency responder in a medical emergency.
Emergency Call Center in a medical emergency.
Watcher, relative, or acquaintance of the victim in a medical emergency.
Victim himself or herself in a medical emergency.
The role of www.qureshiuniversity.com/medicalemergencyworld.html in a medical emergency.

What is a Medical Emergency?
Who are the people behind 911 or emergency call responders?
Ideally, an experienced competent medical doctor should be behind 911 or emergency call responders.

What is the role of www.qureshiuniversity.com/medicalemergencyworld.html in a medical emergency?
Guide the following:
Doctor in a medical emergency.
Emergency responder in a medical emergency.
Emergency call center in a medical emergency.
Watcher, relative, or acquaintance of the victim in a medical emergency.
Victim himself or herself in a medical emergency.
Guide the state department of health worldwide.
Administrative Issues
Emergency Diagnosis Code
What are various symptoms, signs, statements, questions, issues, and histories that should raise suspicion of a medical emergency?

There are at least 123 such symptoms, signs, statements, questions, issues, histories, and scenarios.
Agitated Patient (Acute stress reaction.)
Attempted suicide.
Attempted homicide.
Abdominal Pain.(Stomach pain)
Altered sensorium.
Any sudden or severe pain.
Animal bites (may require rabies or tetanus shot).
Armed Robbery.
Allergic reactions.
Breathing difficulties.
Bleeding from any orifice or any part of human body that will not stop.
Bleeding which does not stop after applying pressure.
Being beaten by someone.
Bloody Sputum
Broken bones.
Behavior-related emergencies.
Change in mental status (such as unusual behavior, confusion, and difficulty arousing).
Changes in vision.
Chest pain.
Cough with fever.
Coughing up or vomiting blood.
Confusion or changes in mental status
Cuts and abrasions.
Chest or upper abdominal pain or pressure lasting two minutes or more.
Difficulty breathing.
Difficulty speaking.
Difficulty getting up.
Difficulty in passing urine.
Difficulty in passing feces.
Domestic Violence
Dental emergencies.
Earaches and ear infections.
Electrical injury shock.
Emergency Food
Environmental factors (hostile environment).
Foreign bodies in nose or ears.
Fainting or loss of consciousness.
Fainting, sudden dizziness, weakness, seizure.
Feeling of committing suicide or murder.
Fever with breathlessness.
Functional impairment (not taking care of self. inability to gain relevant skills and knowledge relevant to age).
Head or spine injury.
Head injury.
Hypothermia - frostbite.
Head pain that lasts longer than five minutes.
Intentional enforced harms.
Loss of consciousness.
Loosening of social inhibitions.
Likely to be harmful to self or others.
Low abdominal pain.
Medicine overdose.
Major burns.
Persistent or severe vomiting.
Persistent unexplained fever even with Tylenol use.
Puncture wounds.
Personality disorders (harmful to others). Panic attacks.
Psychosis(delusions, hallucinations, catatonia, thought disorder, loss of contact with reality).
Pregnancy-related emergencies.
Possible serious bone fractures.
Survival Needs
Suicidal feelings.
Significant trauma (to the head, stomach, chest)
Sore throat & fever
Severe neck or back injury.
Sexual intercourse due to conspiracy.
Severe or persistent vomiting.
Severe or persistent vomiting or diarrhea.
Severe headache.
Severe burns.
Severe pain in any part of the body that does not subside.
Serious drug reactions with psychiatric or non-psychiatric medications.
Syncope or unconsciousness.
Sudden or severe pain.
Sudden loss of vision.
Suicidal or homicidal feelings.
Sudden asthma attack that does not stop.
Sudden numbness or not being able to move an arm, leg, or one side of the body.
Sever headache with fever or vomiting.
Sudden injury or trauma due to a motor vehicle crash, burns, smoke inhalation, near drowning, wound, etc.
Substance abuse.
Sudden severe pain anywhere in the body.
Sudden dizziness, weakness, or change in vision.
Swallowing a poisonous substance.
Shock symptoms, e.g., confusion, disorientation, cool/clammy, pale skin.
Severe or persistent vomiting or diarrhea.
Trauma with unconsciousness.
Trauma with cuts, sprains, or abrasions.
Trauma with open fracture.
Trauma with pain on mobility.
Trauma with swelling.
Unconsciousness with diabetes.
Unconsciousness at a public location.
Sudden unconsciousness at home.
Unable to move
Uncontrolled bleeding
Upper abdominal pain.
Uncontrolled bleeding.
Unusual abdominal pain.
Unusual or persistent abdominal pain.
Unexplained stupor, drowsiness or disorientation.
Violence or other rapid changes in behavior.
Vomiting or coughing blood.
Vomiting and diarrhea.
What will happen if you do not diagnose and treat a medical emergency properly?
It can lead to death.
It can lead to disability.
It can lead to other harms.
It can lead to medical malpractice.
It can lead to legal malpractice.
Number of Patients per Week

EM physicians are among the busiest doctors. In 2012, 28% saw 50-75 patients per week (in 2011, it was nearly 35%), and 24% saw 76-99 patients per week (about the same as in 2011). Among all doctors, 20% see 50-75 patients per week and 15% see 76-99 patients per week.

Hours Spent Seeing Patients per Week

The largest percentage of EM physicians spends 30-40 hours per week seeing patients. The percentage of doctors who put in that amount of time has remained constant. In both 2012 and 2011, 47% worked 30-40 hours per week. In the previous year, about 53% worked those hours. In contrast, among all physicians, the greatest percentage (30%) also worked a 30- to 40-hour week in 2012.

Hours Spent Seeing Patients in the Hospital

EM physicians, because of their specialty, spend a large portion of their time in the hospital with patients. A full 67% spend 25 hours or more per week seeing patients in the hospital.

Other specialists who spent a considerable amount of time seeing patients in the hospital were cardiologists (24% spent more than 25 hours a week in the hospital) and critical care physicians (72%). Among internists that number was 29%, and among family physicians it was only 5%.

Hours Spent per Week on Paperwork and Administrative Activity

Most jobs entail paperwork and cumbersome chores. But EM physicians were less bogged down with such tasks than were many other specialists.

More than a third of EM doctors (36%) spent 1-4 hours on paperwork and administration each week, and another 27% spent 5-9 hours. Only 12% had 20 hours or more of paperwork per week.

The Most Rewarding Part of Your Job

No matter what the public thinks, it's not all about the money. For EM physicians, there are clearly plenty of emotional rewards that still have a strong impact. Being good at the practice of medicine was the paramount reward for 40%; for physicians overall, that number was 34%.

For 31% of doctors overall, relationships with patients ranked next on the list in 2012. Among EM physicians, who tend not to have ongoing relationships with patients due to the nature of the specialty, only 15% felt the same, although it still ranked third as a factor in career satisfaction.

Good compensation ranked second in importance, with 16% of EM physicians citing it in 2012 compared with 9% of physicians overall.

Emergency Medicine Physician Compensation by Setting

In 2012, EM physicians who worked in hospitals were the top earners among various work settings, with a mean income of $277,000. EM physicians in single specialty group practices ranked next in earnings, with a mean income of $253,000, followed by those working in healthcare organizations.

Emergency Medicine Physician Compensation by Geographical Region

EM physician compensation varies by region. Doctors in the South Central region, with the highest compensation ($298,000), earned more than their colleagues in the North East, with the lowest compensation ($242,000).

Emergency Medicine Physician Compensation in 2012

Physicians have done well in 2012, and that's true for EM physicians as well. EM physicians were the 12th highest-ranked specialty, with a mean income of $270,000.