Medihub - Medical Information - Emergency Medicine

Introduction

Despite repeated warnings and harsh penalties, daily many calls are still being placed to the emergency services which are unnecessary and may deprive a real emergency situation of timely aid.

Panic often causes people to activate the ambulance in a medical crisis, while others may delay getting help as they are not sure if their symptoms are serious enough.

In Singapore, there are 2 lines for ambulances- 995 activates the Emergency Ambulance Service operated by the Singapore Civil Defence Force (SCDF) and is strictly for life-threatening medical emergencies and 1777 for non-SCDF ambulances provided by private operators.

What is a non-emergency?

A non-emergency, on the other hand, does not end in death or serious complication if it is not treated immediately. These could include one of the following:

Toothache
Slight abdominal pain e.g. gastric
Slight fever, coughs and colds
Aches and pains which have been present for a long time
Minor bruises, slight cuts or broken skin
Slight burns or scalds
Mild vomiting, diarrhoea or constipation
Medical check-up or hospital follow-up

What is an emergency?

An emergency is an illness or injury that could end in death or serious complication if it is not treated immediately. The following is a guide to cases classified as emergencies:

Drowsiness or unconsciousness where the person cannot be roused
Difficulty in breathing or choking
Sudden or severe chest pain
Sudden or severe abdominal pain that will not go away
Dislocated or broken bones
Deep cuts or wounds with profuse bleeding
Head injuries that are followed by drowsiness, vomiting, bleeding (from the ears, nose or mouth) or unusual behaviour
Injuries to chest, abdomen, pelvis or spine (neck and backbone)
Fall from heights
Poisoning e.g. inhalation of toxic gases or drug overdose resulting in unconsciousness and respiratory distress
Crushed injuries
Severe allergy
Drowning
Burns and scalds -deep with white or charred skin or covering a large area bigger than the size of a hand, or covering the face
Any burn caused by electric shock or by lightning

When to call 995 and what to do while waiting

The following details when it is necessary to call 995 without delay and what to do- and not do- while waiting for help to arrive.

1. A suspected heart attack

Symptoms include chest pain or pressure, severe palpitations, sudden profound weakness, profuse perspiration and sudden shortness of breath, although chest pain may not always be present- especially in women. Heart attack risk is greater when there is a previous history of cardiac trouble, or if the person is 40 years of age or older, has a personal or family history of vascular diseases, or other risk factors such as smoking, diabetes, elevated blood pressure or high cholesterol.

While waiting: Take (or give) aspirin in whatever dose that you have on hand immediately.

2. A suspected stroke

A stroke is marked by a sudden, overall weakness or dizziness, trouble speaking or responding, feeling weak in an arm or leg or has a seizure. Take note if these symptoms are accompanied by a new headache.

While waiting: It is important to note when the first stroke symptom appeared and provide that information to emergency medical personnel. That’s because 80% of strokes are caused by blockage to one or more cerebral arteries, which can be opened to prevent permanent damage to the brain with early intervention.

3. Severe pain or bleeding

Seek help when there is obvious weakness or drowsiness even after the bleeding has stopped as a doctor may need to sew up the wound to prevent further infections.

While waiting: Keep the victim warm and comfortable and prevent moving him/her (doing so can make matters worse) or transporting him or her to the hospital. In cases of severe bleeding, elevate the affected area and apply pressure to the site. Do not try to use a tourniquet (to constrict blood flow to the limb) unless the bleeding is unmanageable.

4. Choking

It is important to alert the medical emergencies especially if the victim is unconscious.

While waiting: If the person is still coughing, encourage more coughing. But if he or she is unable to cough, speak or breathe—and but is still conscious—Perform subdiaphragmatic abdominal thrusts (the Heimlich maneuver) until the foreign body is expelled or the victim becomes unconscious. (Or in case of extreme obesity or late pregnancy, give chest thrusts). CPR will have to be performed on unconscious victims.

5. Serious Burns

Any burns that needs quick attention should be larger than 2 to 3 inches in diameter; is located on the hands, feet, face, groin or buttocks, or around a major joint; involves all layers of skin; or appears black, or dry and white.

While waiting: Cover the area with a sterile bandage, or a clean, moist cloth. Do not remove the burned clothing, apply ice or immerse the burn in cold water.

6. A severe allergic reaction or asthma attack.

While waiting: Check if the person has an EpiPen (which is a syringe containing epinephrine (adrenaline) and inject him/her with it. During an asthma attack, reassure the person that help is on the way.

7. Poisoning

It is only necessary to call 995 if the victim is having difficulty breathing or is comatose.

While waiting: Do not try to induce vomiting.

References:

1. Singapore Civil Defence Force

http://www.scdf.gov.sg/General/Information/emergency_ambulance_service.html