SOS: identifying emergencies

Posted on 4 November 2014

Dr Brian Gutuza, the head of the emergency centre at Mediclinic Cape Town tells us how to spot a potentially dangerous situation.

1. What are the symptoms of a dangerous bee sting?
Bee stings are not dangerous unless you are allergic to the bee venom. It is the same as being allergic to nuts or penicillin. If you experience breathing difficulty, swelling of your face or throat, or fainting or dizziness immediately after a sting you should seek immediate medical help. The main first-line treatment is adrenaline. Some people get severe swelling at the site of the sting. This is not life threatening but could cause pressure complications and infection, so you should consult a doctor for treatment.

2. If I fall off a ladder, what precautions should I take in case I have a broken bone? How do I know if I have a broken bone?
If you think you have injured your neck or spine or have a head injury you should avoid moving and ask someone else to call an ambulance so that a paramedic can assess you. The symptoms of a broken bone are pain, swelling and difficulty moving the affected part. Splinting the injured limb reduces the pain and prevents further damage. Rib and pelvis fractures can be serious and should be assessed at an emergency centre. If you suspect a fracture you should have an x-ray. It is not always possible to tell the difference between a sprain and a fracture without an x-ray. In addition, some fractures need operations to prevent permanent disability. Falling from a ladder is a preventable accident and the consequences can be very serious. You should exercise extreme caution and preferably have someone at the bottom to help steady the ladder at all times.

3. Is an electrical shock always hazardous?
Common household electricity has a relatively low voltage and causes pain or a spark when you touch it briefly. This does not require medical treatment. Prolonged contact with an electrical point will cause general body seizure movement and can cause severe burns, muscle damage, fractures and heart rhythm disturbance. If you are electrocuted in this way you must seek medical attention even if you feel well afterwards. The muscle damage could lead to kidney failure. Contact with power lines and cables at electrical substations can be fatal.

4. When is bleeding and/or bruising considered a problem?
Bruises in the mouth that appear for no reason could indicate a bleeding disorder. Bleeding into joints after minor bumps or no trauma is abnormal. Nosebleeds are very common and usually stop with first aid measures. If the nose bleeding cannot be stopped then it may indicate a clotting problem. If you cough up blood, vomit blood or pass blood in the urine or stool it is abnormal. Cut wounds can bleed a lot but can be controlled with direct pressure. Frequent bleeding episodes (such as blood in stools or excessive menstrual bleeding) can lead to anaemia and must be attended to by a doctor.

5. How do I know if chest pain is just chest pain, or if it’s something serious?
There are three factors to consider: the nature of the pain, associated symptoms and risk factors. Typical angina feels as if an elephant is sitting on your chest. It may also resemble a belt or band tightening, or a very unpleasant discomfort that is hard to pinpoint.

However, some people have silent heart attacks, with no pain. Associated symptoms are very important. Extreme tiredness or breathlessness, vomiting, sweating, fear and pain that moves to the arms or jaw are serious warning signs, as is fainting or feeling like fainting while having chest pain.

Common risk factors for heart disease are smoking, diabetes, family history of heart attacks, obesity, age over 40, cocaine use and high cholesterol.

Heart attack is not the only serious cause of chest pain. If the chest pain worries you, especially if there are associated alarm symptoms, you should call a doctor or go to the emergency centre for further assessment.

Heart disease prevention is the most important action to take if you are at risk of heart disease. Regular exercise, healthy diet and lifestyle and regular check-ups to detect conditions such as diabetes, hypertension and high cholesterol are essential. Exercise ECG tests can detect coronary artery disease (narrow heart arteries) before you get a heart attack. If you have significantly narrow coronary arteries, a stent or two could prevent permanent heart damage.

Dr Gutuza shares a few more emergencies and how to deal with them.

The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.