From deep cuts and car accidents to dehydration and heart attacks, medical emergencies can happen anytime, anywhere. How well you are prepared and how efficiently you utilize available resources will determine how comfortable you are when handling medical emergencies.

Preparing for medical emergencies
Everybody should have an emergency plan, especially people who have chronic medical conditions. An emergency plan consists of a list of emergency contacts, personal medical records, any important prescription medication or medical equipment, emergency cash, concise steps on how to respond to unforeseen situations and regular drills. The plan should be shared with your family, ayi, driver, friends and co-workers. If you do not speak Chinese, identify two or three bilingual friends or colleagues who may be able to provide assistance, and memorize their mobile numbers and put them in your phone. Don’t forget to include the number of your family doctor or pediatrician as well.

Understanding your medical insurance policy is another important aspect of preparation. Familiarize yourself with the medical emergency facilities nearby your home, office and child’s school, and check to see if they accept your insurance. For the curious, most hospitals will provide tours and detailed information on their services and capabilities. Next, get yourself and the people around you trained in how to perform CPR and First Aid, and purchase a fist aid kit for your home, car and office.

Available medical resources
The call number for an ambulance in China is “120.” Ambulances are typically equipped with standard oxygen, IV set, EKG machine, monitor and emergency medications. The average response time, from your call until the ambulance arrives, will vary depending on your location. In most major cities, the response time is usually less than 15 minutes, but sometimes you may need to wait much longer due to traffic or a long waiting list. In many cases, taking a personal car or taxi may be a faster alternative than waiting for an ambulance.

Usually three staff are allocated to one ambulance including an emergency doctor, technician and driver. The ambulance staff and 120 line operator usually only speak very basic English. Be sure to clearly tell the operator your address and a contact method, typically your mobile phone number. You can request a specific hospital if your situation allows, but if you are having a life threatening situation and become unstable, the ambulance will bring you to the closest hospital. Ambulances accept cash only, and you pay after you arrive at the hospital. The payment amount depends on both the distance driven and treatment received, but most of the time it is only a few hundred RMB.

Emergency rooms (ERs)
For many medical emergencies, it is critical to go to an emergency room rather than a primary care facility. An ER is able to treat a broad spectrum of illnesses and injuries, including life-threatening problems that require immediate attention. Upon arrival in an ER, the triage nurse will measure vital signs and separate any infectious patients. Emergency Medicine physicians treat patients according to severity. ER doctors provide initial treatment, working to stabilize patients, diagnose emergent conditions and bring in specialists if needed. After a patient is diagnosed and stabilized by the doctor, they are then moved to an inpatient room for monitoring or recovery, transferred to another hospital if necessary, or discharged.

Many Chinese public hospitals include emergency departments with 24 hour service. They tend to be very crowded in larger cities, lacking in privacy. For international patients, these ERs may seem difficult to handle when in an emergency, as staff will likely speak only limited English, if any at all. These hospitals offer no direct billing with international insurance, meaning all patients must pay cash in advance. It is critically important to be prepared to go to such a public hospital ER in case of an emergency, as it may be essential to seek the nearest help available depending on the situation. Because banks may not be open at the time of emergency, and as ATM cards often have daily withdrawal limits, it is a good idea to set aside between RMB 10,000-20,000 in a home safe, just in case. If you are a Chinese citizen, you must bring your ID card, and if you are not Chinese, do not forget to bring your passport to the hospital as it will be required for registration.

While international medical centers offer English-speaking staff, Western-trained physicians and direct billing, many of these facilities in China do not have emergency medicine departments. For example, in Shanghai, the only international hospital with a full-service emergency room open 24 hours a day, 7 days a week is Shanghai United Family Hospital & Clinics. Thorough preparation for medical emergencies includes understanding which hospitals in your area include ER facilities.

When should I go to the ER?
You should consider going to an emergency room if you experience any of the following conditions:

• Heart attack symptoms such as chest pain or tightness, shortness of breath, sudden dizziness, weakness, or nausea
• Signs of a stroke including sudden weakness or numbness in a limb or one side of your face, speech difficulties, trouble seeing out of one or both eyes, unexpected dizziness or loss of balance, or extreme headache
• A blow to the head that results in loss of consciousness, seizure, or vomiting
• A possible broken bone manifesting as a joint looking out of shape, swelling, bruising, or being unable to bear weight
• A wound that fully penetrates the skin, impairs your ability to function, or doesn’t stop bleeding after 15 minutes of applied pressure
• A serious burn that affects a large area of skin
• Serious infection with high fever and accompanying obvious pain from some part of your body
• Exposure to a toxic substance
• A bite by an unvaccinated animal
• Any other condition that makes you feel uncomfortable, leading you to think you need to see a doctor

Preventing medical emergencies
The best way to handle medical emergencies is to prevent them from happening in the first place. Start by understanding your vaccination status and local endemic diseases, keeping you and your family members’ vaccination cards and making sure they are all up-to-date. Regularly visit your primary doctor and strictly follow medical instructions if you have chronic medical disorders like high blood pressure or diabetes. Wear a seat belt whenever driving in a car, and wear a safety helmet and other protective gear when you are cycling or doing other risky activities. With a little forethought an

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