Emergency Medicine: How Would You React?

Have you ever wondered how you would react if you were in an emergency situation? Would you know what to do? Would you have the guts to do it? This summer, with the help of the Peter J. Eloranta Scholarship, I had the privilege of taking an incredible, hands-on three week course in emergency medicine at the Boston Leadership Institute. Not only did we in the course learn how to respond to various types of emergency situations, but we also learned and practiced many of the skills necessary to being an emergency medical services (EMS) responder. We weren’t just learning medical information, we were also learning what it meant, and how to apply it to the real world.

One of the most amazing things about the course was the sheer scope of what we covered in three weeks. All of us who took the course learned a vast amount of medical terminology, multiple procedural processes by which to handle various emergency situations, multiple methods of analyzing and diagnosing patients in a variety of contexts, and a bunch of useful skills for emergency situations. The course began with perhaps the most important element of EMS response: vitals.

During the first two days of the course, we learned and practiced taking each others’ vital signs, such as pulse oximetry levels, as the pulse oximeter takes pulse diastolic and systolic blood pressure, and respirations, and we also learned what abnormal vital signs might indicate. We also learned many useful acronyms for remembering what to consider when assessing a patient, such as OPQRST. When a patient presents with a complaint, you should begin by determining Onset: when did the symptom(s) begin? Next, Provocation should be determined: what provoked the symptom(s)? Subsequently, the EMS responder should ask the patient about the Quality of their malady, such as where they feel it and how it feels. Afterwards, Radiation: does the pain radiate from one area to another? Next, Severity: how bad is the pain/symptom(s)? Finally, the EMS responder should determine Time: How long has the patient been symptomatic? While this process may sound simple and obvious, it’s acronyms like these that help EMS responders remember what to do in stressful situations, and ultimately save lives.

After learning about the basics for the first few days, we explored a variety of advanced topics. We learned how to diagnose and treat irregular heart rhythms, water-related injuries, burns, strokes, severe internal and external bleeds, shock, fractures, various types of trauma injuries, and musculoskeletal injuries. Strokes was definitely my favorite of these units, as I gained a lot of insight into a topic that I previously knew little about.

During our strokes unit, I discovered that strokes are not one general phenomenon, but in fact there are two types of strokes: ischemic and hemorrhagic. Ischemic strokes make up the vast majority of all strokes. They’re generally caused by arterial blockage which inhibits blood flow to the brain. Few who suffer ischemic strokes emerge unscathed, but the majority of those who suffer their first ischemic stroke do survive for over a year afterward. However, hemorrhagic strokes are far more deadly. They’re caused not by arterial blockage, but by the breakage of a blood vessel or multiple blood vessels in the brain. This is far worse than arterial blockage, as instead of just inhibiting oxygen flow, a broken blood vessel can leak fluid into the rest of the brain, creating intracranial pressure and causing lasting damage. Unfortunately, there is little that can be done to treat stroke victims. The best treatment for stroke is prevention, which can be achieved through exercise and a healthy lifestyle.

Even with all the interesting material that we learned, the best part of the course was definitely how hands-on it was. After learning about the different types of bone fractures, we practiced reading real x-rays. After learning about irregular heart rhythms, we listened to heart rhythms and tried to determine which type of irregular heartbeat we were hearing.

Even more than diagnoses, we learned skills that I never expected to learn going into the course, such as suturing, phlebotomy, and CPR. Given artificial flaps of skin, needles, thread, and a very informative video, we learned how to suture a wound shut quickly without leaving an ugly scar. Using a dummy arm with fake blood inside and a syringe, we practiced phlebotomy, taking blood from the dummy’s veins safely and carefully. With an army of unfortunate dummies, we practiced giving CPR, with and without an AED, or automated external defibrillator.

After taking this course, I feel much more confident in my own ability to react in an emergency situation, and I have a much better understanding of medicine in general. I definitely recommend this course for anybody interested in a potential future medical career.