The word ‘emergency’ is a much abused one in the context of providing healthcare in our country. It is a common scene to find a group of concerned relatives storming emergency rooms across the country’s hospitals and screaming emergency. While some of these cases are genuine emergencies, it is an over-utilized term designed to attract the prompt attention that the incoming people seek. Sometimes, it is because someone they know or have come across has developed a certain condition of sudden onset that can be considered a threat to life. At other times, it is just a ruse to cover their neglect of the ill person over a period of time. There are certain important medical conditions that are considered as emergency medical situations and some of these conditions are itemized below:
- Difficulties with breathing occurring in any person at any age including conditions like asthma.
- If some person suddenly collapses by becoming unconscious or fainting.
- Any kind of epileptic seizure or fit especially when it results in a fall or loss of consciousness.
- A stroke once it is recognized as one.
- Severe pain occurring in any part of the body.
- A heart attack.
- Any form of obvious bleeding or suspected bleeding especially from serious injuries, cuts or wounds.
- Low blood sugar level especially in those people who have diabetes.
However, it is not possible to be prepared for every conceivable kind of emergency. What is useful to know is that any situation in which waiting for normal care in a healthcare setting is likely to be dangerous to your life or part of your body, that situation will qualify as an emergency. Therefore, active labour that begins suddenly in a pregnant woman can be considered an emergency especially when the patient is taken unawares and has had no time to prepare. So also, is a severe injury or a serious illness of sudden onset otherwise described as an acute condition.
In many countries around the world, the beginning of the rendition of care to a person in a dire emergency situation often starts with the ambulance crews available within a few minutes at an address that had dialled the specific emergency code for such purposes. On paper, this service also exists in Nigeria, but you and I know that the reality is very different. In such countries and cities around the world, the crews are trained for the important work they do, and they are empowered to deliver that initial service before the victims are whisked off to the nearest hospital. To that extent, the hospitals in the area tend to have similar competences and be almost equally staffed. When additional specialized services are required, the hospitals within the vicinity can suitably direct the ambulance crews or commit to providing the important stabilizing services before referring such patients to a more advanced or more specialized hospital. In many countries, therefore, such capabilities have been advanced to include emergency air ambulance services that can take such patients very quickly to the required hospital where the necessary personnel are on standby. The meaning of this, of course, is that such hospitals possess helipads for the swift handover of such patients to hospital staff. It is sometimes laughable to see ambulances in Nigeria stuck in traffic because other motorists do not believe that they are conveying genuine patients.
But who can blame such people? There are many factors mitigating against such speedy evacuation to a hospital not the least of which is the poor state of our roads. This helps to make traffic conditions worse. The other aspect is that ambulances often become a cover for inappropriate activities because there is a consensus among the users and drivers that they are somehow immune to the requirements of observing security obligations. At other times, as yours truly has witnessed while working as a medical officer with a federal parastatal, the ambulance belonging to the staff clinic was often hijacked by the top executive management to transport all sorts of things on their behalf including live cows. It is imperative that when ordinary people see how the siren has been wrongly used to coerce them to give up their space in the road for a cow to pass unimpeded because it is riding in an ambulance, such a motorist is most unlikely to make way for another ambulance in the future. In the end, many ill people have to endure transportation in all kinds of vehicles to the hospitals closest to them, and when they arrive there, the escorts are compelled to yell EMERGENCY at the top of their lungs. They can then proceed to cause a raucous and create disorder in the emergency room as they try to compel the attending staff to abandon what they are doing in order to attend to the latest arrival. Sometimes, the opposite condition is created due to interference with the working atmosphere.
Usually, such relatives and bystanders at the scene even threaten the healthcare personnel on duty to not let the patients they have brought to die. What often happens in addition is that because of their lack of understanding that is required for them to provide the required space for the team to optimally work, more delays are encountered. In other jurisdictions where people know their rights and people stay within the confines of their professional obligations, people do not need to be told or threatened with security in order to provide such room to emergency room staff. People who are trained in first aid performance can often take charge at the scene of the incident and get the people in the vicinity to avoid crowding the scene around a victim. These days, the ubiquitous presence of the smart phone has become another problem in scenes like these as people scramble for the most vantage positions to take both still photographs and video clips for dissemination into the social media space. People ought to understand, or otherwise appreciate the fact that those people who man the emergency rooms are trained for the work they do and will always be able to distinguish between the gravely ill patients from those who are serious but in conditions you cannot describe as grave. For example, a 12-year-old child who is stooling and vomiting may be in far more serious condition that an adult who was stabbed in their back with a knife.
The young child with far less reserves than the adult can lapse into unconsciousness within a few minutes while the man with a knife forgotten in his back by a naughty fellow will need to have certain preparations made for him to go into an operating theatre before the knife can be safely removed. Both of these are emergency conditions, but relatives and friends must understand that they are not the ones to judge which one is more serious. On the face of it, the knife attack victim would appear to be the life-threatening injury but the one in real trouble is the youngster who is still losing both body salts and body water even as the sympathizers of the adult demand action over a man who can be classified as being in a stable condition. Until the users of the nation’s health facilities get to understand that there is a master in every sphere of human endeavour, many unnecessary delays in instituting treatment for those who genuinely need it will continue to be a problematic event across the nation’s emergency rooms or accident and emergency centres as it is called in some hospitals.
