At Sterling Hospitals Gurukul are equipped to handle a wide range of medical emergencies. Any health condition that deviates from normal and has the potential to deteriorate if not addressed in a timely manner, including those that can result in death, are considered medical emergency and are treated as such.
Patients presenting with symptoms such as fever, breathing difficulty, chest pain, wheezing, urticaria, vomiting, abdominal pain, confusion, seizures, decreased urine output, muscle cramps, and others are assessed immediately upon arrival to the emergency department. We check the airway, breathing, circulation, and disability of the patient, as well as their vital signs such as heart rate, respiratory rate, saturation, blood pressure, random blood sugars, and temperature. Active interventions are initiated in cases of ABCDE compromise.
We take a thorough history and conduct a clinical examination of the patient, and perform initial tests such as ECG, ABG, and bedside 2DEcho as necessary. Based on our quick assessment, patients presenting with the above symptoms are categorized as having specific medical emergencies such as sepsis, septic shock, diabetic ketoacidosis, anaphylaxis, acute kidney injury/renal failure, pneumothorax, electrolyte imbalances like hyponatremia, status asthmaticus, status epilepticus, hypertensive emergencies, tetanus, rabies, and others.
At Sterling Hospitals Gurukul, we strive to provide the best possible care to our patients in any medical emergency situation.
Sepsis: In the case of sepsis, early recognition and prompt action are crucial. The team follows a protocol that includes measuring lactates, sending cultures for blood, urine, and endotracheal samples before antibiotic administration, ensuring appropriate antibiotics, providing adequate intravenous fluids, and reassessing lactate levels if increased. A simple screening tool called q-SOFA is used to identify patients at higher risk of mortality.
Septic shock: It is a subset of sepsis that requires additional intravenous fluid bolus therapy and initiating vasopressors if low blood pressure persists. The team ensures close monitoring and reassessment of hemodynamics.
Diabetic ketoacidosis: For diabetic ketoacidosis, the team assesses blood sugar levels, acid-base balance, volume depletion, electrolyte imbalance, and factors related to DKA such as insulin deficiency, infection, or myocardial infarction. The team monitors electrolytes, vital signs, level of consciousness, and volume status every 2 hours.
Anaphylaxis: In cases of anaphylaxis, immediate diagnosis and treatment are crucial. The team assesses if the patient meets the criteria for anaphylaxis and manages airway and oxygenation, decontamination, epinephrine administration, and intravenous fluids.
Acid-base imbalance: Acid-base imbalances require an initial diagnosis through acid-base gas analysis (ABG). Based on the results, patients are treated with intravenous fluids, bicarbonates, or non-invasive/ventilator support.
Hypertensive emergencies: These are categorized into HTN urgency (with no end-organ damage) and HTN emergency (with end-organ damage to the heart, brain, aorta, lungs, or eyes). In cases of HTN emergency, continuous blood pressure monitoring and gradual reduction of BP are done to balance hypoperfusion of the brain, heart, and kidney. Aggressive BP control is required in conditions such as aortic dissection, pheochromocytoma crisis, eclampsia, or intracranial bleed.
Status asthmaticus: It requires rapid and aggressive treatment to prevent cardiopulmonary arrest. The team administers continuous bronchodilator nebulization, steroids (inhalational and intravenous), magnesium sulfate, non-invasive ventilation, and mechanical ventilation as required.