24×7 Emergency & Critical Care

Liver and digestive emergencies do not follow office hours. Bleeding, sudden confusion, high fever or rapid yellowing of the eyes can develop at night or on holidays and need immediate attention. Our 24×7 Emergency & Critical Care service ensures that expert help is available at every hour, with specialists on call and diagnostic and treatment facilities ready.

Emergencies We Manage

Liver and digestive emergencies

• Vomiting blood or black stools from varices or ulcers
• Acute liver failure and acute-on-chronic liver failure
• Hepatic encephalopathy with confusion or drowsiness
• Fever with abdominal pain in cirrhosis (possible spontaneous bacterial peritonitis)
• Acute cholangitis and obstructive jaundice
• Severe acute pancreatitis
• Acute hepatitis with rapidly worsening jaundice
• Drug or toxin-related liver injury, including paracetamol poisoning
• Complications of liver tumours, such as bleeding or rupture

Post-procedure and post-transplant emergencies

• Bleeding or infection after surgery, endoscopy or biopsy
• Suspected graft rejection or vascular complications after transplant
• Fever or infection in immunosuppressed patients

General medical and surgical emergencies

• Chest pain, breathlessness and shock
• Abdominal emergencies requiring surgery
• Trauma including liver and spleen injuries
• Sepsis, kidney failure and metabolic emergencies

How the Emergency Pathway Works

1. Triage on arrival: A trained nurse or physician quickly assesses severity and directs the patient to the appropriate area. Life-threatening cases are seen immediately.
2. Stabilisation: Airway, breathing and circulation are secured. Oxygen, intravenous fluids, medicines and monitoring begin at once.
3. Focused evaluation: Bedside ultrasound, ECG and urgent blood tests provide fast answers.
4. Specialist involvement: Hepatologists, gastroenterologists, surgeons, intensivists or transplant physicians are called according to the problem.
5. Definitive treatment: Endoscopy, interventional radiology, surgery, dialysis or ICU admission, as needed.
6. Communication: Families are updated promptly and guided on consent, admission and next steps.

Round-the-Clock Support Services

• Laboratory: Urgent tests for blood counts, liver and kidney function, coagulation, blood gases, cultures and cardiac markers
• Imaging: Ultrasound, X-ray, CT and, where required, MRI at all hours
• Blood bank: Availability of blood and blood components, including plasma and platelets
• Endoscopy: Emergency variceal banding, haemostasis and ERCP as required
• Operation theatres: Ready for emergency surgery and transplantation
• Pharmacy: Emergency medicines and antidotes, including N-acetylcysteine
• Dialysis: For acute kidney injury

Special Focus: Variceal Bleeding

Patients with cirrhosis who vomit blood or pass black stools are treated as an emergency. The team gives resuscitation, medicines to reduce portal pressure, antibiotics and arranges urgent endoscopy, usually within 12 hours. If bleeding continues, options such as balloon tamponade as a bridge, stenting or TIPS are available with interventional radiology.

Special Focus: Acute Liver Failure

A person with jaundice who becomes drowsy or confused needs immediate hospital care. Our team tests for the cause, starts treatments such as N-acetylcysteine where indicated, protects the brain and kidneys, and assesses early for transplant. Patients are shifted to the liver ICU once stable enough for transfer.

Transfer and Referral Support

Patients from other hospitals or cities are accepted after discussion between treating doctors. Our team advises on safe transfer, including what to give before transport and what documents to carry. Emergency contact numbers help referring doctors reach a senior specialist quickly.

When Should You Go to Emergency?

Go immediately if a person with liver disease or jaundice has:

• Vomiting blood or black, tarry stools
• Confusion, unusual sleepiness or inability to wake up
• High fever with chills or abdominal pain
• Rapidly increasing yellowing of the eyes or skin
• Marked reduction in urine
• Severe abdominal pain or swelling
• Difficulty breathing
• Fainting or dizziness
• After transplant: fever, jaundice, reduced urine or severe pain

What to Bring

• Identification and insurance documents
• Previous medical reports, scans and prescriptions
• All medicine strips, including herbal and traditional products
• Details of the sequence of symptoms and what the patient has eaten or taken
• A family member who can give history and sign consent

Critical Care Continuity

When emergency treatment needs ongoing intensive care, patients move to the liver ICU or general critical care unit, with the same team reviewing progress. Patients who stabilise are shifted to wards, with clear discharge and follow-up plans.

Caring for Families

Emergencies are stressful for families. Our staff explain what is happening in simple terms, provide comfortable waiting areas and help with paperwork so families can focus on the patient. Counsellors and patient coordinators assist when decisions are difficult.

Reach Us in an Emergency

If you or a family member has a liver or digestive emergency, do not wait. Call LiverMitra's emergency helpline or come to the emergency department directly.