Taking Action During Medical Emergencies in Healthcare Practices

Laura M. Cascella, MA, CPHRM

Thoroughly preparing to handle medical emergencies in healthcare practices requires time and resources but can prove invaluable in terms of outcomes. When an emergency occurs, providers and staff members who can quickly and effectively implement emergency response plans might make a crucial difference in how the scenario plays out.

Even if providers and staff are not experienced with, or highly knowledgeable of, the type of emergency taking place, the common goal is to “manage the patient’s care until he or she recovers fully or until help arrives.”¹ A dual strategy to emergency response is recommended that involves a medical response and a communication response that occur simultaneously.²

In terms of medical response, a critical aspect of managing the patient’s care is ensuring that they are receiving a sufficient supply of oxygenated blood to vital organs — a goal that is supported through the delivery of basic life support (BLS). Various emergency preparedness resources also recommend following the PABCD approach, which involves:

• P: Positioning the patient appropriately, depending on the situation
• ABC: Assessing and managing (if necessary) the patient’s airway, breathing, and circulation
• D: Considering definitive treatment, differential diagnosis, drugs, or defibrillation — but only after the previous steps have taken place³

More specific algorithms and protocols related to managing certain types of emergencies — e.g., sudden cardiac arrest, anaphylaxis, bronchospasm, swallowed or aspirated instruments or devices, chest pain, shock, and seizures — can be obtained through specialty organizations, professional associations, and state and local healthcare resources.

While the medical response is occurring, various communication activities also should take place, including promptly calling emergency medical services (EMS). The designated person who calls EMS should provide essential information, such as:

• The patient’s age and gender
• A preliminary diagnosis (e.g., a possible stroke)
• Symptoms and vital signs (e.g., whether the patient is conscious and blood pressure and heart rate)
• Details about the provision of any emergency treatment (e.g., BLS, oxygen, and/or medication)
• The practice’s phone number and address, including important identifying information about the location (e.g., names of crossroads, proximity to landmarks, specific locations within a building, etc.)⁴

The practice also should assign a staff member to meet EMS responders as they arrive and direct them to the patient’s location. Doing so will help prevent losing time that ultimately might make a difference in the patient’s outcome.

Other communications activities that should occur during the medical response include directing staff, obtaining information from family members or caregivers and providing them with updates (if applicable), calling the hospital emergency department to alert staff of the situation, and documenting the sequence of events as it takes place.⁵

Post emergency phone numbers — such as the numbers for EMS, the local hospital, and poison control — in a visible location to facilitate the response process. If the caller must dial a prefix to activate an outside line, note that information as well. Periodically, an assigned staff member should check the list of emergency numbers for accuracy.

Although the number of activities involved in an emergency response and the rapid succession with which they must occur might seem indicative of chaos, proactive planning, training, and drilling will help prepare healthcare providers and staff to react quickly and efficiently on the patient’s behalf.

To learn more about medical emergency preparedness, see Managing Medical Emergencies in Healthcare Practices.

Endnotes

¹ Haas, D. A. (2010). Preparing dental office staff members for emergencies: Developing a basic action plan. Journal of the American Dental Association, 141(Suppl 1), 8S–13S.

² Sempowski, I. P. (2002, September). Dealing with office emergencies: Stepwise approach for family medicine. Canadian Family Physician, 48, 1464–1472.

³ Haas, Preparing dental office staff members for emergencies; Haas, D. A. (2006). Management of medical emergencies in the dental office: Conditions in each country, the extent of treatment by the dentist. Anesthesia Progress, 53, 20–24; Sempowski, Dealing with office emergencies; Reed, K. L. (2010). Basic management of medical emergencies: Recognizing a patient’s distress. Journal of the American Dental Association, 141(Suppl 1), 20S–24S.

⁴ Haas, Preparing dental office staff members for emergencies.

⁵ Sempowski, Dealing with office emergencies.

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