Non-COVID-19 emergencies in pandemic times

Dr. Aslesha Sheth, Emergency medicine consultant.

Amongst the chaos of the COVID-19 pandemic across the world and in our city, as emergency physicians we find that people are delaying their visits to the hospital, thereby resulting in an increase in complications and jeopardizing their own lives.

During the lockdown, emergencies that led to serious complications could have been avoided if medical aid had been obtained on time.

One such case was a burns patient brought to the hospital after one week of self-medicating on a second degree burn, with a huge infected blister over the right palm and wrist. If the patient had availed early treatment, he could have easily avoided the complications.

People with chronic conditions such as hypertension and diabetes might need immediate care and attention if symptoms persist or heightened discomfort was experienced.

A hypertensive and diabetic patient, suffering from abdominal pain, constipation, and vomiting, was brought to the hospital after one week of self-medicating, that had led to complications in her small intestine leading to an obstructed hernia and disrupted kidney functions, which required emergency surgical intervention and treatment.

The patient had to be hospitalised and was discharged after 5 days, once she her kidney functions normalised.

The elderly are prone to infection and existing chronic conditions can cause life-threatening complications if not treated immediately. It is highly advisable for adults to not avoid any delay in availing treatment for even minor symptoms.

To cite an instance, a 70-year-old male, diabetic and hypertensive patient, was brought to our ER with multiple episodes of seizures for two days and in an unresponsive state with persistent seizures.

Extended treatment

He was found to have increased pressure within the brain cavity, which caused the fits. He had to be in the ICU for a couple of days and receive extended treatment for over a week to reach normalcy.

The list of medical and surgical emergencies is endless, these time-critical emergencies if not treated on time could be life threatening. For instance:

• Acute heart attacks are best treated with good reversibility of cardiac function if treated on time and the golden hour being one hour from onset of pain. Delay in treatment can cause complications like irreversible muscle damage leading to pumping failure, fatal abnormalities in electrical conduction of the heart, leading to very low or very high pulse rate, which can lead to sudden death if not treated on time.
• Acute onset strokes are best treated within 4.5 to 6 hours of onset of symptoms, but delay in presentation to hospital beyond this can lead to severe morbidity, disability and mortality.
• Patients with trauma at home secondary to accidental falls or RTAs — whether limb fracture or head injuries, they should be addressed on time to prevent complications.
• Any patient on dialysis needs timely intervention to ensure life-threatening complications are avoided.
• Never forget that complications of high and low blood sugar need to be addressed in time, else that could lead to various complications ending up with multi-organ dysfunction.

My only request to all would be — please don’t ignore your symptoms. Act smart, act fast. Let the fear of COVID-19 not stop people from treating what can be prevented.