Responding to a Clinical Emergency — Practice Checklist

Step-by-Step Procedure (7 steps)

1. 1.

   Recognize the signs of a true emergency quickly (sudden loss of consciousness, difficulty breathing, chest pain, signs of anaphylaxis, an active seizure) and call for the provider/clinical team immediately.

2. 2.

   For a syncopal (fainting) episode, help the patient to the floor safely if they're falling, position them supine with legs elevated if no injury is suspected, and check responsiveness and vital signs.

3. 3.

   For suspected anaphylaxis (hives, swelling, difficulty breathing after a known trigger), prepare the epinephrine auto-injector per office protocol and call 911 — anaphylaxis is a 911-level emergency regardless of whether symptoms improve after the first dose.

4. 4.

   For chest pain, keep the patient still, monitor vital signs, and prepare for the provider's assessment and likely EMS activation per office protocol.

5. 5.

   For an active seizure, protect the patient from injury (clear the area, cushion the head) without restraining their movements or putting anything in their mouth, and time the seizure.

6. 6.

   Activate EMS (911) per office protocol for any emergency that meets the practice's criteria, and know your office's specific address/room details to give dispatch without delay.

7. 7.

   Document the event in detail immediately afterward — what was observed, what was done, and the timeline — while details are still fresh.

Quality Checkpoints (4)

Confirm each of these before considering the task complete.

• The clinical team is alerted the moment an emergency is recognized, not after trying to handle it alone first.

• Anaphylaxis is treated as a 911-level emergency every time, even if symptoms seem to improve after epinephrine.

• Nothing is placed in the mouth of a seizing patient, and the patient is not restrained.

• The event is documented in detail immediately, including the precise timeline.

Avoid These Mistakes

• ⚠

  Hesitating to call 911 for anaphylaxis because symptoms temporarily improved after epinephrine — a second wave of symptoms can follow, and EMS transport is still required.

• ⚠

  Trying to restrain a seizing patient's movements, which doesn't stop the seizure and can cause injury.

• ⚠

  Putting something in the mouth of a seizing patient "to protect their tongue," which is outdated and dangerous guidance.

• ⚠

  Delaying activation of the emergency protocol while trying to further assess the situation alone.