Navigating Medical Emergencies

You don't always have to be a medical professional to aid someone in need of help. Sometimes, a life and death situation can be resolved with just a little bit of knowledge.

Former emergency room worker Dr. Stuart Fischer says his book, "Dr. Fischer's Little Book of Big Medical Emergencies" has simple and valuable information everyone can use. Dr. Fischer visited The Early Show to demonstrate some simple procedures and share some information that could help save a life.

Fischer says there isn't a single emergency where checking for circulation is not the most important thing to do. Anyone can learn how to take a pulse on the wrist, by putting two fingers on the base. When someone has fainted or someone has had a heart attack or is unresponsive, checking for a pulse can mean the difference between life and death. If someone is in very dire straits, take the pulse in the neck.

Most emergencies do not happen in front of doctors, nurses or EMTs. When someone faints, you want to get them lying down on the ground right away. You might put their knees up, then ask the person, "Are you OK?" Tap them a few times, then check for a pulse. You're not going to do CPR on someone who's responsive, so if they're breathing, this is not the time for CPR.

Someone can be having a heart attack and feel fine. In fact, a person can be having a massive heart attack but still have a normal pulse, and they might still be breathing normally. Most heart attacks actually do not require CPR. Most should be treated by immediately calling 911. CPR is a useful skill, but it has to be done if and only if there is no pulse or no breathing. There's an orderly way of checking this:

1. First we check that the person is lying down.
2. Check a pulse in the wrist, and if there's no pulse, check the pulse in the neck.
3. If there is no pulse, then it's time to do CPR. If someone collapses with a massive heart attack and is not breathing, you must call 911 first, then come back and do CPR. If there are two people in the room, one person should call, and the other should perform CPR.
4. Choking is one of the most serious of all emergencies, and it almost never happens in front of doctors or nurses. The Heimlich maneuver is only done if the person has what's called a "total obstruction." If they look like they're choking and holding their neck in the universal choking sign, cannot talk or are making a high pitched hissing noise, you make fist under the ribcage to try and pop the object out. If the person is talking and they even sound hoarse, leave them alone, because if you try to do something and try to pull the thing out ourselves, it can be a disaster.

Fischer says seizures can be frightening to people unfamiliar with the condition. Epilepsy is not an illness that needs a medical intervention, but the complications happen because people can fall or choke. You want to make sure the person doesn't hurt themselves or choke, move them away from the street or sharp objects, but otherwise let them be. When the seizure is over, turn the body slightly to one side. The seizure itself, as bad as it looks, is not particularly damaging to the patient.

Sometimes a person can make a situation worse in an emergency by administering the wrong medical treatment. For example, a person who is burned can be helped with a few simple steps when followed correctly.

Generally, you should get the burned part of the body as cool as possible immediately. But in a severe burn, you do not cool the area because you can cut off circulation. If it's a relatively minor burn, you put on cold water and keep it clean. Leave the blisters alone, so as not to puncture the wound. You can use ice for just a little bit, but mostly use cool water, even room temperature water. You don't have to put the person's hand in the freezer. Just getting their skin temperature back to normal is important. Leaving ice on it might cut circulation down.

Fischer says it's important to take CPR courses because you need to be observed doing the specific skills. The physical way you stand over the person, particularly on a child or an infant is important.

Beyond these basic medical emergency steps, you have to use your hands and your own instincts if you don't know. This is what happens most of the time. People need to be prepared and empowered with the right information because if a life-threatening emergency happens, they'll be someone in the right place at the right time.

People make mistakes in not knowing that certain emergencies are very serious, such as a nosebleed. Fischer says he has seen people die from nosebleeds. Most people think they're very mild. If they're out of one nostril, they might be mild. If it's out of two nostrils, it's always a medical emergency.

Fischer says he has seen appendicitis described as a stomachache. If a child is not playing or talking or laughing, that could be a ruptured appendix. Every medical emergency has the potential to be mistaken for something else. If you're sure it's non-serious, call the family doctor, or arrive in a car or walk to the ER. Every emergency has the potential to be disastrous.

Many people may take allergic reactions to mean a mild intolerance to a food, but if the redness is on the neck or the lips or the tongue, the person needs a trip to the ER as soon as possible.

Some severe pain, such as sciatica or arthritis can wait. On the other hand, someone with pneumonia might just think they have the flu -- with pneumonia they have a much higher temperature, they might have a severe cough and the elderly might be extremely weak.

In every diagnosis, Fischer says he likes to be cautious. Emergencies are scary, and often people can't think straight. He says the cost can be forbidding and help might be far away, but there must be knowledge that in certain types of emergencies time is of the essence. The diagnosis must be made quickly or someone might not live. The fear aspect, the financial aspect and the human aspect often hold us back. But err on the side of caution.

Fischer reminds us of a few facts that might also be helpful in times of medical emergencies. In his book he says a hospital that provides medical care cannot reject, refuse to treat or transfer patients because they cannot pay or do not have health insurance.

Under the Emergency Medical Treatment and Active Labor Act, commonly called the Federal Patient Anti-Dumping Act, a hospital is required to give a medical screening examination to all patients who arrive at its emergency room in order to rule out that they do not have a life threatening medical condition. Screening exams and required treatment cannot be delayed to inquire about the patient's financial status or ability to pay.