When You Are Undergoing Emergency Surgery

An emergency surgery is a one that must be performed immediately and without which a person might die be permanently harmed.


Intake Assessment Begins

Three doctors pushing patient on gurney in hospital

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Upon arriving at the emergency room, the emergency staff will begin to assess the person’s condition. This will include taking vital signs, reviewing symptoms, performing a physical exam, and taking a history of the person's past and present illnesses, allergies, and medication use.

If the patient is critically ill, treatment may begin immediately alongside the intake assessment. If needed, the person may be stabilized with medications, transfusions, intravenous fluids, other types of emergency interventions.

In most cases, the nursing staff will initiate venous access (inserting an IV line into a vein) to enable the rapid delivery of medications.


Diagnostic Testing Before Surgery

Electrocardiogram ECG
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Once the physical assessment is complete and the patient has been stabilized, diagnostic tests may be ordered including X-rays, lab work, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, electrocardiograms (ECGs) to assess heart health, electroencephalograms (EEGs) to assess brain injury.

If the tests confirm the need for surgery, a surgeon will be immediately consulted. In larger hospitals, a trauma or general surgeon is usually available 24 hours a day and will typically perform their own assessment in the emergency room.


Emergency Transfer to Another Facility

paramedics taking patient to helicopter

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Depending on the type of hospital a person is taken to, a transfer to another facility may be needed. Small or rural hospitals often do not have either the specialists or technical capabilities to perform certain surgeries.

In such a case, the emergency room will coordinate a transfer once the patient is stabilized, typically within an hour or less. Transportation may involve an ambulance or helicopter with trained staff onboard to help facilitate the safe transfer.


Preparing for Surgery

Anesthesiologist in operating room

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General anesthesia is usually given during emergency surgeries to fully sedate the individual and temporarily paralyze his or her muscles. To do this, medication is delivered by IV to relax the patient while the physician places an ​endotracheal tube in the windpipe. The tube is connected to a ventilator which takes over respiration for the patient during surgery.

Other medications are then given to prevent any movement and to ensure the person sleeps through the entire procedure. The anesthesiologist will remain on hand to continuously monitor vital signs.

If necessary, the anesthesiologist will place either additional IV lines or a single larger line (called a ​central line) into the patient's neck or groin to deliver different medications simultaneously.


Undergoing Surgery

Two surgeons working on a patient

Once the general anesthesia has taken effect, the emergency surgery will begin. The area of the body to be operated upon will be cleansed thoroughly and surrounded by sterile drapes to ensure the area remains germ-free.

The nature of the surgery and illness will dictate how many surgeons are needed and how long the operation will take. If needed, transfusions may be ordered to better stabilize the patient during the procedure. Typically, IV fluids are given during the surgery to compensate for any loss of blood and body fluids.


Recovery After Surgery

Doctors talking to patient in hospital ICU

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When the surgery is completed, the person will be transported to the post-anesthesia care unit (PACU) if they are stable. The patient will typically be groggy until the anesthesia wears off. During this recovery phase, the person's vital signs will be closely monitored and pain medication prescribed as needed.

Once the patient is alert and the anesthesia has worn off, he or she will be transported to a hospital room to begin healing. Those who are unstable or in need of constant monitoring will be taken to the intensive care unit (ICU).

Individuals with critical injuries may need to remain on the ventilator until they are strong enough to breathe on their own. Others may require additional surgeries or medical procedures.


Rehabilitation and Discharge

Patient in wheelchair in hospital corridor
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Recovery times can vary and may include rehabilitation therapy. Those in ICU will remain there until they are able to breathe without assistance. Antibiotics may be prescribed to prevent infection and various pain medications may be used to help control pain.

For patients too sick to eat, nutrition may be delivered by IV or through a feeding tube inserted into the stomach or small intestine. When strong enough to do, the patient will begin by sipping small amounts of clear liquids and gradually progress to a normal diet.

For those able to do do, recovery will begin by asking the person to sit on the edge of the bed and walk to the bathroom. As the person improves, the walking distances will be increased with or without mobility aids.

The nursing staff will provide incision care during the hospital stay and teach the patient how to properly care for the wound once he or she is home. The hospital discharge procedure will begin once the physician is assured that the person is amply recovered. If needed, home health care will be ordered to assist with the transition or to provide ongoing care.

By Jennifer Whitlock, RN, MSN, FN
Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.