Emergency medical care: diseases — симптомы, диагностика и лечение

A stroke is an acute circulatory disorder in the brain, in which a section of brain tissue stops receiving oxygen and dies. This is a condition where literally minutes count: every minute without blood flow, about two million nerve cells die. That is why the main thing that everyone should know is not the names of drugs, but how to recognize a stroke in a minute and immediately call an ambulance. Trying to “lie down,” take a blood pressure pill, or wait until the morning is the most common and most expensive mistake.

Myocardial infarction is the death of a section of the heart muscle due to cessation of blood flow through the coronary artery. As with a stroke, time is of the essence here: the sooner blood flow is restored, the less muscle will die and the better the person will live in the future. The main reason for lost time is not transport or queues, but the patient himself: they endure the pain, take antispasmodics, wait for the morning. Half of deaths from heart attacks occur in the first hour, before any medical assistance, and almost always this is a consequence of delay.

A concussion is the mildest form of traumatic brain injury in which the brain is temporarily disrupted without visible structural damage. That is why a computed tomography scan usually doesn’t find anything during a concussion, and this is normal: it is not the anatomy that suffers, but the function—the metabolism in nerve cells, the transmission of signals between them. There are more myths surrounding concussions than any other injury. The two most persistent: “a concussion occurs only with loss of consciousness” and “the victim should not be allowed to sleep.” Both are incorrect. Loss of consciousness with a concussion does not occur in most patients, and the prohibition on sleep is an outdated recommendation from an era when there was no tomography and the only way to notice a growing hematoma was to regularly wake the person. Today, the doctor makes the decision based on specific criteria, and sleep, on the contrary, helps the brain recover.

Renal colic is an attack of acute pain that occurs when there is a sudden disruption of the outflow of urine from the kidney. Most often, its cause is a stone that has descended into the ureter. The pain is so severe that the person cannot find a position in which it becomes easier. Colic is not a diagnosis, but a signal: the kidney is blocked, and you need to understand why exactly and how to quickly restore the outflow.

Acute urinary retention is a condition in which the bladder is full, the urge is painful, and it is impossible to urinate. This is a urological emergency: it is dangerous to endure, wait until the morning, or try to “get wet” with a warm bath. An overfilled bladder puts pressure on the kidneys, and overstretching it can irreversibly damage the muscle and prevent normal urination even after the cause has been eliminated.

Sudden cardiac arrest is an abrupt cessation of effective heart function, causing blood to flow to the brain and organs. A person loses consciousness in a matter of seconds, breathing disappears or becomes rare, convulsive, and the pulse cannot be detected. The most common cause is ventricular fibrillation due to a heart attack or chronic heart disease. Without help, brain cells begin to die within a few minutes, so the outcome is determined by the first minutes. Immediately calling an ambulance by number 103, chest compressions and defibrillation greatly increase the chances of survival.

Heat stroke is a condition in which the body can no longer cope with heat removal and the body temperature rises dangerously. It’s not just “overheating”: heatstroke affects the brain, kidneys, liver and muscles, so it is considered an emergency. Heat exhaustion usually develops before this, with profuse sweating, weakness and nausea, and at this stage the situation is still easy to correct. Sunstroke is a special case of overheating due to prolonged exposure to direct rays on the head. In hot climates, young children, the elderly and those who work outdoors are especially vulnerable.

Pulmonary embolism is a blockage of the pulmonary artery or its branches by a blood clot, which most often comes from the deep veins of the legs. This is one of the most dangerous and at the same time most underdiagnosed conditions: its symptoms are nonspecific - shortness of breath, chest pain, rapid heartbeat - and are easily mistaken for bronchitis, intercostal neuralgia or panic. The key to timely recognition is not the symptom itself, but the circumstances: sudden shortness of breath after a flight, surgery, prolonged bed rest, or due to swelling of one leg.

Testicular torsion is a condition in which the spermatic cord twists around its axis and completely cuts off the blood supply to the organ. This is one of the few situations in urology where time is measured literally in hours: without restoration of blood flow, the testicle dies. Most often, torsion occurs in adolescents, often at night or after physical activity, and the main mistake is trying to “endure it until the morning.”

Ovarian apoplexy is a sudden rupture of ovarian tissue with hemorrhage into its thickness and bleeding into the abdominal cavity. Most often this happens in the middle of the cycle, at the time of ovulation, or in its second half. The condition begins acutely, with sharp pain, and may be accompanied by significant blood loss, so it requires immediate attention rather than observation at home.