Spotting an emergency: When should you send your loved ones to the hospital?

As much as we hope to avoid medical emergencies, they can happen to anyone, at any time. Being able to spot an emergency early and knowing the right steps to take can be the difference between life and death.

Read on to learn how you can spot the early signs of a medical emergency and prepare yourself to respond quickly and appropriately to ensure the best possible outcome.

How to recognise a medical emergency

It is not uncommon for less severe symptoms such as dizziness to be overlooked or dismissed as mild discomfort. However, it could be an early sign of a medical emergency.

Common signs of a medical emergency include: 

• Sudden or severe pain: A sudden onset of chest pain can be a symptom of a heart attack, which requires immediate medical attention. Severe abdominal pain may be an indication of appendicitis or a ruptured organ, which can lead to sepsis and other complications if not treated promptly.

• Difficulty breathing or shortness of breath: This could be a sign of an asthma attack, anaphylaxis (a life-threatening allergic reaction), or a severe lung infection like pneumonia which requires immediate medical attention.

• Uncontrollable bleeding: Profuse bleeding, both externally and internally, needs prompt medical attention to prevent excessive blood loss and related complications. Uncontrolled bleeding can be due to severe injuries, such as deep cuts, or internal issues like gastrointestinal bleeding.

• Sudden disorientation or confusion: An individual who suddenly seems dazed or confused could be having a stroke, seizure, or severe infection like meningitis. Time is of the essence here as any delay can worsen brain damage and have long-term consequences.

• Sudden onset of dizziness, numbness, weakness, or changes to your vision: These symptoms may be signs of a stroke or a transient ischemic attack (TIA). Early medical intervention is essential to minimise the risk of long-term health implications.

• Coughing or vomiting blood: This indicates that there is internal bleeding, and can be a sign of severe lung or gastrointestinal problems, such as tuberculosis, lung cancer, or a bleeding ulcer.

• Persistent vomiting or diarrhoea: This usually happens when a virus or bacterial infection affects your digestive system, such as food poisoning or gastroenteritis. Delaying treatment can lead to severe dehydration and other complications.

Steps to take during an emergency

It is common to panic in the face of medical emergencies, especially if you're unprepared. However, it is crucial to stay calm so you can focus on what needs to be done.

Being prepared for an emergency can help you to stay in control of the situation and get your loved one the help they need.

If your loved one is experiencing the symptoms described above, here's what you should do:

Step 1: Call 995 immediately

The most immediate step is to dial 995 for the Singapore Civil Defence Force (SCDF). Those who are hearing- or speech-impaired can still reach out to SCDF via SMS at 70995.

Step 2: Convey key information to the emergency responders

Once you are connected to an emergency responder, stay calm and try to speak coherently over the call. Here's the most immediate information you need to let the emergency responders know:

• State your loved one's age.

• Explain the immediate medical emergency and how long the symptoms have been going on.

• Give a quick overview of your loved one's medical history.

Here is an example of how you can convey the information to emergency responders over the phone: "My 81-year-old father suddenly felt dizzy 15 minutes ago and just started to feel numbness in his left arm. He had a mild stroke two years ago."

Step 3: Administer first aid or CPR (if required)

After calling 995, administer first aid. Here are some things you can do, depending on the symptoms your loved one is experiencing.

Medical Emergency	What to Do
Burns	Stop the burning process. This may include removing contact from the hot area, putting out flames with water, fire extinguisher or a blanket. Be careful not to burn yourself in the process. For severe burns, call 995 immediately. Other steps to take: Remove any items around the burnt skin, but do not forcefully remove anything stuck to the burnt skin as it may cause more damage. Cool the area with cool or lukewarm running water for 20 minutes. Do not use ice, iced water, creams, or any greasy substances. Individuals, especially seniors and young children, may run the risk of hypothermia when cooling a large burnt area. Make sure to keep them warm with blankets and clothes but avoid putting them on the burnt area. Place a cling wrap over the burnt area, but do not wrap it around the limb. This keeps the area clean and can be easily removed for examination when you reach a medical facility. Your loved one can take paracetamol or ibuprofen to manage the pain if required, but be mindful of allergies. If possible, elevate the affected area to reduce swelling.
Fall or trauma	Assess for bleeding. If there is swelling without bleeding, ice the affected area. Do not move the person before help arrives unless necessary.
Stroke	Use the BE FAST guide to identify the early symptoms of a stroke.  If you suspect that the individual is having a stroke, take note of the time that symptoms started and perform cardiopulmonary resuscitation (CPR) if necessary. Do not give them food or drinks as it can pose a risk of choking.  Avoid self-medicating as different types of stroke require different types of treatment. Administering the wrong type of medication can do more harm than good.
Persistent high fever	For most fevers, you can administer over-the-counter fever reducers but be mindful of allergies. Ensure the person gets plenty of rest and fluids. Sponge the person's forehead, armpits, and groin with lukewarm water to help bring the temperature down. However, if the fever lasts more than three days or is accompanied by other symptoms like severe headache, stiff neck, or rash, seek medical help.
Difficulty breathing or shortness of breath	Help the individual sit upright and take slow, deep breaths. If they have medication for their breathing problem, bring it to them and help them use it.
Uncontrollable bleeding	Use a clean cloth or bandage and apply direct pressure to stop the bleeding. Elevate the affected limb if possible.
Sudden onset of disorientation, confusion, dizziness, numbness, weakness, or changes to your vision	These are often overlooked symptoms of a stroke, and in stroke treatment, time is of essence.  Call 995 immediately and provide relevant medical information to the healthcare provider. Reassure the individual and get them to sit or lie down. Help them stay calm till help arrives.
Coughing or vomiting blood	Blood may appear red, brown or black. Take note of any other symptoms such as pale skin, dizziness or blurred vision and convey it to the medical provider. You may also want to take a picture of the blood to show the doctor.
Persistent vomiting or diarrhoea	Drink plenty of fluids to prevent dehydration. Eat small, frequent meals of bland food, such as crackers, rice, or toast. If the vomiting or diarrhoea lasts more than a day, worsens, or is accompanied by other symptoms, seek medical help.
Unresponsive, unconscious, not breathing, or only gasping	After calling 995, begin CPR immediately. This involves giving chest compressions and rescue breaths. Continue giving CPR until the person shows signs of life, an AED becomes available, or medical help arrives.

For severe burns, call 995 immediately. Other steps to take:

• Remove any items around the burnt skin, but do not forcefully remove anything stuck to the burnt skin as it may cause more damage.

• Cool the area with cool or lukewarm running water for 20 minutes. Do not use ice, iced water, creams, or any greasy substances.

• Individuals, especially seniors and young children, may run the risk of hypothermia when cooling a large burnt area. Make sure to keep them warm with blankets and clothes but avoid putting them on the burnt area.

• Place a cling wrap over the burnt area, but do not wrap it around the limb. This keeps the area clean and can be easily removed for examination when you reach a medical facility.

• Your loved one can take paracetamol or ibuprofen to manage the pain if required, but be mindful of allergies.

• If possible, elevate the affected area to reduce swelling.

If you suspect that the individual is having a stroke, take note of the time that symptoms started and perform cardiopulmonary resuscitation (CPR) if necessary. Do not give them food or drinks as it can pose a risk of choking. 

Avoid self-medicating as different types of stroke require different types of treatment. Administering the wrong type of medication can do more harm than good.

However, if the fever lasts more than three days or is accompanied by other symptoms like severe headache, stiff neck, or rash, seek medical help.

Call 995 immediately and provide relevant medical information to the healthcare provider. Reassure the individual and get them to sit or lie down. Help them stay calm till help arrives.

If the vomiting or diarrhoea lasts more than a day, worsens, or is accompanied by other symptoms, seek medical help.

Please note that these are general guidelines and may not be suitable for all situations. Always seek medical help if you are unsure how to respond to a medical emergency.

Should I call an ambulance or drive to the hospital?

A common misconception is that driving your loved one to the hospital is better than calling an ambulance as it is cheaper and faster. However, that is not true. Even if the medical emergency happens at a location close to a healthcare facility, it is still better to call 911 for several reasons:

• You could be distracted or anxious while driving, endangering yourself, your loved one, and others on the road.

• Ambulances are equipped with life-saving machines and supplies such as heart monitors, pain medication and intravenous fluids.

• Paramedics are trained to assess the condition and provide advanced treatment at the location and en route.

• First responders always have the latest information about hospital statuses and capabilities to determine the best hospital for your emergency.

• Ambulance crews will alert the hospital of your loved one's needs and condition ahead of time to ensure timely treatment upon arrival.

• Emergency vehicles are given the right of way in traffic, allowing them to bypass traffic congestion and arrive at the hospital quicker.

• In cases such as a fall and traffic accident, moving the individual may worsen the condition. It is better to leave it to emergency medical services (EMS) workers who are trained to transport people safely from these situations.

What to pack to the hospital during an emergency 

Once medical help is on the way and first aid is administered, you may want to pack the right documents to bring to the hospital if there is time available. This may include:

• NRIC

• Overnight clothes

• Essential medical documents, such as current and past medical records, test results, and advance care plans (make a copy if possible)

• Insurance details (e.g. letter of guarantee)

Preparing for a medical emergency

While nobody can anticipate and be fully ready for a medical emergency, there are several things you can do to equip yourself to be better prepared for such a situation.

Learn emergency response skills

We do not need to be licensed healthcare professionals to help in the event of a medical emergency. Anyone can pick up basic first aid skills and learn how to treat minor injuries and accidents and respond to medical emergencies.

Contact the Singapore Red Cross Society to find out how you can enrol in courses on basic life support (BLS), first aid, and CPR.

Stock your first-aid kit

Having a well-stocked first aid kit in a convenient location ensures that all the necessary medical supplies are easily accessible in the event of a medical emergency, saving time and reducing stress. 

For those who do not have a first aid kit at home, you can get a pre-packed one at a pharmacy near you. Also, check your first-aid kit regularly to replace expired medications and make sure it has everything you need.

Remember the warning signs of an emergency

Recognising the signs of a medical emergency is the first step to seeking help. Now that you have read this article, you would know the signs to look out for, but it is not easy to remember all of them. 

If you have a loved one at home who is at risk of a medical emergency, you may want to write down the symptoms to look out for and place them in noticeable areas around the house like the fridge to remind yourself. Also, ensure that all caregivers and family members are aware of the warning signs too.

ALSO READ: A caregiver's guide to hygiene for the terminally ill

This article was first published in Homage.