Course Book : #108 - Medical Emergencies

Medical Emergencies

2 contact hours

Course # 108

 

This course is intended for the reader to be able to achieve the following objectives:

  1. How to recognize heart attack and stroke

  2. Understand citizen responder

  3. Understand diabetic emergencies

  4. Understand seizures

  5. What to do while help arrives

 

This mini introduction to basic first aid and recognizing medical emergencies is intended to be a quick over view, and is not intended to diagnose or treat any individual in need of medical attention. Always call 911 when dealing with a medical emergency!

 

This information is basic, and is intended for non-medical personnel, though the information will be found to be helpful as a simple overview of medical emergencies. This information does not go into medical pathophysiology of the symptoms of those medical emergencies listed here.

 

To many individuals, an emergency at work means an accident. But some of the emergencies you may see on the job involve common medical conditions.

A person’s life may depend upon a quick response and appropriate interventions.

The people you work with may someday need medical attention due to common medical conditions.

 

According to the latest statistics reported by the American Red Cross, over 37 million visits were made to the emergency rooms in America’s hospitals.(1998) Injuries resulted in over 90,000 deaths.

 

More than 60 million people in the United States have cardiovascular disease. Cardiovascular disease causes about one million deaths in the US every year. That accounts for about 40% of all deaths that occur annually!

Over 600,000 people have strokes every year, and an estimated 160,000 will die of a stroke every year.

Sudden cardiac arrest accounts for the lives of over 220,000 a year. That is about one cardiac arrest victim every 2 minutes!

 

Diabetes affects over 8 million people.

Asthma affects about 15 million people.

About 5,000 people choke to death every year.

 

 

Each time someone experiences a heart attack or a stroke, or any other emergency situation, someone has to help. You may find yourself in the position of having to help one day. Will you be ready? Will you know what to do? Everyone should learn what to do in an emergency. This mini course is not intended to replace first aid training. It is simply an overview of how to handle some common emergencies. Contact your local Red Cross Chapter to enroll in a First Aid Training Course.

 

Calling 911 is the most important thing someone can do in an emergency. Time is critical. Seconds turn into minutes…and minutes turn into disaster!

 

Your role has four steps:

1. Recognize an emergency

2. Decide to act

3. Call 911

4. Provide care until help arrives

 

Citizen Responder

 

A citizen responder knows how to identify different types of emergencies, and provide supportive care until professional help arrives.

It is not the role of a citizen responder to delegate medical tasks to bystanders, as many are not trained in what to do. No one should ever attempt to provide any care in which they have not been properly trained.

 

Despite the best efforts, emergencies can occur any place, at any time. The person who recognizes an emergency and begins care until help arrives is the citizen responder.

 

In any emergency, fear, panic and confusion will occur, but a citizen responder stays calm and provides vital supportive care until help arrives.

Make sure to check if the person is breathing. Maintain an adequate airway. Check for breathing and a pulse. Act upon what you find.

No breathing = breathe for them

No pulse = begin chest compressions.

 

This course is not intended to teach CPR. Contact your local Red Cross to enroll in a CPR Class, if needed.

 

 

 

Heart Attack

 

A medical emergency you may come across is a person experiencing chest pain. Any chest pain that does not resolve within 15 minutes needs prompt medical attention.

 

A heart attack occurs when the blood supply to the heart muscle is reduced or cut off and the heart muscle becomes damaged.

 

Symptoms of a heart attack include:

  • Pressure, fullness, pain or squeezing in the center of the chest

  • Chest pain that spreads to shoulders, arms or neck ( predominately left arm)

  • Chest discomfort with sweating, lightheadedness, nausea or vomiting

  • Gasping for air or difficulty breathing

  • Pale, cool and clammy skin and bluish lips

  • Anxiety and a sensation of palpitations (irregular heart beat)

 

Stroke, an acute anxiety attack, indigestion and angina can all have similar symptoms as a heart attack. Don’t take chances! Have it checked out.

 

Anytime you suspect a heart attack, call for medical help right away.

  • Do not wait to see if the pain will go away

  • Do not give the victim food or water

  • Do not allow the victim to move around or exert himself

  • Do not give the victim any medications, unless the victim has a prescription for nitroglycerin tablets.

  • In the event the victim has nitroglycerin tablets, they are to be placed under the tongue to dissolve, and not to be chewed or swallowed.

  • The victim may use one tablet every five minutes, for a total of three in 15 minutes.

  • No relief after 3 tablets, and chest pain continues at 15 minutes, the victim should go to the emergency room immediately.

  • Reassure the victim and loosen tight clothing

  • Assist the victim into a comfortable position

  • If unconscious, make sure the airway is open and check for breathing and pulse. Call 911 immediately.

 

 

AED

An AED is an Automated External Defibrillator. It is used to shock a heart rhythm back into a normal rhythm. A victim in ventricular fibrillation, a form of cardiac arrest, has no pulse and will die in minutes or suffer irreversible brain damage.

 

An AED delivers a shock to the heart that helps to restore normal heart rhythm. It is to be used only when a victim has no pulse. It is essential that 911 is activated promptly. Many lay people have been trained on how to use an AED in the community. A person does not have to have any knowledge of how the heart works, or be able to read EKG monitors in order to use an AED. It is simple to use and can increase the chances of saving a life by as much as 50 % when used early in cardiac arrest. They are now found in major shopping centers, airports, and are becoming more and more popular throughout the community. Take a class in AED training, and you will be one step ahead in being prepared on how to use one.

 

Angina

 

Angina is a form of chest pain caused by lack of oxygen to the heart muscle. It is usually brought on by exertion and is relieved by rest or the use of nitroglycerin tablets.

 

A heart attack may look like angina, or angina can progress to a heart attack. Never wait to summon help until your sure it is a heart attack. Call 911 promptly. The victim will need complex equipment and medical attention to rule out if it is a real heart attack or not.

 

 

Stroke

A stroke is a blockage or rupture of a blood vessel in the brain. This blocks off needed oxygen to the brain and damages or kills brain tissue.

First aid measures cannot cure a stroke. The damage cannot repair itself.

Never ignore symptoms of a stroke.

 

Symptoms include:

  • Sudden weakness, numbness or inability to move leg, arm, or paralysis of the face. Usually only on one side of the body.

  • Visual or communication difficulties like slurred speech or blurred vision

  • Loss of balance and coordination or sudden pain in the head.

If you suspect stroke, call 911 immediately.

  • Check airway and pulse.

  • Place an unconscious victim on his or her side and keep the upper body slightly raised.

  • Never give a victim anything to eat or drink.

 

Weakness, vision and speech problems that go away can be a warning signal that a stroke may occur and should never be ignored.

 

Choking

 

Although we think of choking as a common occurrence in children, more adults than children die each year as a result of choking. Common causes include trying to swallow large pieces of poorly chewed food, drinking alcohol before and during meals (dulls the nerves that aid in swallowing), eating while talking excessively or laughing, eating too fast, walking, playing or running with food or objects in the mouth.

 

Signals include clutching the throat with one or both hands, unable to speak, cough, or breathe, high pitched crowing or wheezing sound.

 

If the victim is coughing and coughing forcefully, stay with the victim and encourage him to cough.

If the object will not come out, call 911.

Stand behind the victim and place thumb side of fist against middle of the abdomen just above the belly button. Grasp fist with other hand, and give abdominal thrusts. Repeat until object comes out, and victim breathes on their own, or until victim becomes unconscious.

 

Always call 911 in case the victim becomes unconscious.

Take a first aid class to learn more about choking.

NEVER DO THIS TECHNIQUE ON A CHILD UNDER THE AGE OF ONE YEAR OF AGE!!

 

The airway can become blocked by the tongue falling back into the throat or by food, objects or fluid (such as blood, saliva, or vomit)

 

If a victim loses consciousness, a trained person must begin rescue breathing combined with chest thrusts while the victim is on the floor.

Under the new Emergency Critical Care guidelines, the technique for an unconscious choking victim is as follows:

(notice this technique replaces the abdominal thrusts that were previously taught)

 

  • Send someone to call 911

  • Tilt head back, lift chin, and pinch the nose shut

  • Give 2 slow rescue breathes

  • Breathe until the chest clearly rises

  • If chest does not rise while giving breathes, REPOSITON airway and attempt again

  • If breathes still do not go in, find hand placement in center of chest over breastbone

  • Position self over victim, with shoulders over hands, elbows locked

  • Give 15 chest compressions in about 10 seconds

  • Lift lower jaw and tongue, look into mouth. Do a finger sweep to check for object

  • Tilt head back, and lift chin and pinch nose. Give 2 rescue breathes

  • Continue this procedure until air goes in, object comes out, person begins to breathe on own, or ambulance arrives.

 

THIS TECHNIQUE IS FOR PEOPLE OVER THE AGE OF 8 YEARS OLD ONLY !!!

 

Asthma

Asthma is a gradual or sudden narrowing of the airway bronchial tubes in the lungs. Asthma often is triggered by an allergy and makes breathing very difficult.

Symptoms of an asthma attack include:

  • Difficulty exhaling, with a whistle or wheezing sound

  • Coughing that may be frothy or dry

  • Gasping for breath

  • Anxiety, fear or panic

  • A bluish tint to skin from lack of oxygen

Call 911 if the victim does not improve with inhalers.

Call 911 if breathing becomes very quiet, and is still very difficult.

Call 911 if the victim cannot cough or if the heart rate is over 120 beats a minute.

If a victim tries to pull up his shoulders or chin to breathe, this is an absolute emergency. Call 911 emergently.

 

A person with severe asthma can go into respiratory arrest. The signs and symptoms of impending respiratory arrest in the asthma patient are drowsiness and confusion. The respiratory pattern demonstrates a pattern of muscle fatigue and sever hyperinflation of lungs. The victim’s airways are now so obstructed that the wheeze will disappear. The pulse may slow and become bradycardic. The pulse slows because when the victim was struggling to breathe, the heart rate increases. As the victim has decreased ability to breathe, there is severe respiratory muscle fatigue. The drowsiness and lack of wheezing must not be interpreted to mean the victim is improving. At this stage, the victim is often demonstrating hypoventilation

and a build up of acid in the blood. These victims require intensive care and often are intubated and placed on mechanical ventilation.

 

Diabetic emergencies

 

Diabetes is a condition in which the proper balance of glucose in the body is difficult to maintain.

 

Hyperglycemia- Hyperglycemia comes on SLOWLY and can lead to diabetic coma.

Symptoms include:

  • Thirst

  • Frequent urination

  • Vomiting

  • Fruity breathe

  • Confused and disoriented

Hypoglycemia- Comes on QUICKLY and can lead to insulin shock, which is life threatening.

 

 

Symptoms include:

  • Excessive hunger

  • Pale skin

  • Sweating

  • Poor coordination

  • Disoriented behavior

  • Possible seizures

 

Both diabetic emergencies require medical intervention. 911 should be called. If the victim has a blood glucose machine check the blood sugar level and report this finding to EMS when they arrive.

 

Seizures

 

A seizure is a sudden, involuntary muscle contraction, usually caused by uncontrolled electrical activity in the brain. A seizure can affect the entire body or just part of the body.

 

Seizures can be caused by epilepsy, poisoning, heat stroke, fever, drug over dose, brain disorders or imbalances of glucose or minerals in the body.

 

During a seizure:

 

  • Do not restrain the victim

  • Do not move the victim, except to prevent injury

  • Loosen tight clothing, especially around the neck

  • Check for a medical alert tag

  • Do not put anything in the victim’s mouth

  • Do not try to give the victim anything to eat or drink

Call for EMS if there is no history of seizures, if the seizures repeat, or if the seizure lasts longer than 2 minutes.

 

 

 

 

Summary

 

This course is not intended to take the place of first aid training, but may be helpful to alert you to some of the more common emergencies that can become life threatening. Knowing what to do, and what NOT to do, may make the difference in the life or death of someone who needs emergency medical help. Be alert, and be prepared to deal with emergencies on the job and in the community. Seek out a training course, and learn more.

 

Knowing how to recognize warning signs is the first step in acting fast and responding well in an emergency situation. One never knows when an emergency can happen, but we can learn more and feel relieved that we could help save a life if need be.

 

 

References:

 

American Red Cross

Community First Aid and Safety, 2000

Mosby Lifeline Books

 

Mosby’s Clinical Nursing

5th edition, Thompson, McFarland, Hirsh, and Tucker

2002, St. Louis, Missouri

 

Practical clinical knowledge and teaching skills of author,

Monica Oram, RN, BSN

Certified Instructor for American Red Cross

Medical Emergencies

2 contact hours

Course # 108

 

This course is intended for the reader to be able to achieve the following objectives:

  1. How to recognize heart attack and stroke

  2. Understand citizen responder

  3. Understand diabetic emergencies

  4. Understand seizures

  5. What to do while help arrives

 

This mini introduction to basic first aid and recognizing medical emergencies is intended to be a quick over view, and is not intended to diagnose or treat any individual in need of medical attention. Always call 911 when dealing with a medical emergency!

 

This information is basic, and is intended for non-medical personnel, though the information will be found to be helpful as a simple overview of medical emergencies. This information does not go into medical pathophysiology of the symptoms of those medical emergencies listed here.

 

To many individuals, an emergency at work means an accident. But some of the emergencies you may see on the job involve common medical conditions.

A person’s life may depend upon a quick response and appropriate interventions.

The people you work with may someday need medical attention due to common medical conditions.

 

According to the latest statistics reported by the American Red Cross, over 37 million visits were made to the emergency rooms in America’s hospitals.(1998) Injuries resulted in over 90,000 deaths.

 

More than 60 million people in the United States have cardiovascular disease. Cardiovascular disease causes about one million deaths in the US every year. That accounts for about 40% of all deaths that occur annually!

Over 600,000 people have strokes every year, and an estimated 160,000 will die of a stroke every year.

Sudden cardiac arrest accounts for the lives of over 220,000 a year. That is about one cardiac arrest victim every 2 minutes!

 

Diabetes affects over 8 million people.

Asthma affects about 15 million people.

About 5,000 people choke to death every year.

 

 

Each time someone experiences a heart attack or a stroke, or any other emergency situation, someone has to help. You may find yourself in the position of having to help one day. Will you be ready? Will you know what to do? Everyone should learn what to do in an emergency. This mini course is not intended to replace first aid training. It is simply an overview of how to handle some common emergencies. Contact your local Red Cross Chapter to enroll in a First Aid Training Course.

 

Calling 911 is the most important thing someone can do in an emergency. Time is critical. Seconds turn into minutes…and minutes turn into disaster!

 

Your role has four steps:

1. Recognize an emergency

2. Decide to act

3. Call 911

4. Provide care until help arrives

 

Citizen Responder

 

A citizen responder knows how to identify different types of emergencies, and provide supportive care until professional help arrives.

It is not the role of a citizen responder to delegate medical tasks to bystanders, as many are not trained in what to do. No one should ever attempt to provide any care in which they have not been properly trained.

 

Despite the best efforts, emergencies can occur any place, at any time. The person who recognizes an emergency and begins care until help arrives is the citizen responder.

 

In any emergency, fear, panic and confusion will occur, but a citizen responder stays calm and provides vital supportive care until help arrives.

Make sure to check if the person is breathing. Maintain an adequate airway. Check for breathing and a pulse. Act upon what you find.

No breathing = breathe for them

No pulse = begin chest compressions.

 

This course is not intended to teach CPR. Contact your local Red Cross to enroll in a CPR Class, if needed.

 

 

 

Heart Attack

 

A medical emergency you may come across is a person experiencing chest pain. Any chest pain that does not resolve within 15 minutes needs prompt medical attention.

 

A heart attack occurs when the blood supply to the heart muscle is reduced or cut off and the heart muscle becomes damaged.

 

Symptoms of a heart attack include:

  • Pressure, fullness, pain or squeezing in the center of the chest

  • Chest pain that spreads to shoulders, arms or neck ( predominately left arm)

  • Chest discomfort with sweating, lightheadedness, nausea or vomiting

  • Gasping for air or difficulty breathing

  • Pale, cool and clammy skin and bluish lips

  • Anxiety and a sensation of palpitations (irregular heart beat)

 

Stroke, an acute anxiety attack, indigestion and angina can all have similar symptoms as a heart attack. Don’t take chances! Have it checked out.

 

Anytime you suspect a heart attack, call for medical help right away.

  • Do not wait to see if the pain will go away

  • Do not give the victim food or water

  • Do not allow the victim to move around or exert himself

  • Do not give the victim any medications, unless the victim has a prescription for nitroglycerin tablets.

  • In the event the victim has nitroglycerin tablets, they are to be placed under the tongue to dissolve, and not to be chewed or swallowed.

  • The victim may use one tablet every five minutes, for a total of three in 15 minutes.

  • No relief after 3 tablets, and chest pain continues at 15 minutes, the victim should go to the emergency room immediately.

  • Reassure the victim and loosen tight clothing

  • Assist the victim into a comfortable position

  • If unconscious, make sure the airway is open and check for breathing and pulse. Call 911 immediately.

 

 

AED

An AED is an Automated External Defibrillator. It is used to shock a heart rhythm back into a normal rhythm. A victim in ventricular fibrillation, a form of cardiac arrest, has no pulse and will die in minutes or suffer irreversible brain damage.

 

An AED delivers a shock to the heart that helps to restore normal heart rhythm. It is to be used only when a victim has no pulse. It is essential that 911 is activated promptly. Many lay people have been trained on how to use an AED in the community. A person does not have to have any knowledge of how the heart works, or be able to read EKG monitors in order to use an AED. It is simple to use and can increase the chances of saving a life by as much as 50 % when used early in cardiac arrest. They are now found in major shopping centers, airports, and are becoming more and more popular throughout the community. Take a class in AED training, and you will be one step ahead in being prepared on how to use one.

 

Angina

 

Angina is a form of chest pain caused by lack of oxygen to the heart muscle. It is usually brought on by exertion and is relieved by rest or the use of nitroglycerin tablets.

 

A heart attack may look like angina, or angina can progress to a heart attack. Never wait to summon help until your sure it is a heart attack. Call 911 promptly. The victim will need complex equipment and medical attention to rule out if it is a real heart attack or not.

 

 

Stroke

A stroke is a blockage or rupture of a blood vessel in the brain. This blocks off needed oxygen to the brain and damages or kills brain tissue.

First aid measures cannot cure a stroke. The damage cannot repair itself.

Never ignore symptoms of a stroke.

 

Symptoms include:

  • Sudden weakness, numbness or inability to move leg, arm, or paralysis of the face. Usually only on one side of the body.

  • Visual or communication difficulties like slurred speech or blurred vision

  • Loss of balance and coordination or sudden pain in the head.

If you suspect stroke, call 911 immediately.

  • Check airway and pulse.

  • Place an unconscious victim on his or her side and keep the upper body slightly raised.

  • Never give a victim anything to eat or drink.

 

Weakness, vision and speech problems that go away can be a warning signal that a stroke may occur and should never be ignored.

 

Choking

 

Although we think of choking as a common occurrence in children, more adults than children die each year as a result of choking. Common causes include trying to swallow large pieces of poorly chewed food, drinking alcohol before and during meals (dulls the nerves that aid in swallowing), eating while talking excessively or laughing, eating too fast, walking, playing or running with food or objects in the mouth.

 

Signals include clutching the throat with one or both hands, unable to speak, cough, or breathe, high pitched crowing or wheezing sound.

 

If the victim is coughing and coughing forcefully, stay with the victim and encourage him to cough.

If the object will not come out, call 911.

Stand behind the victim and place thumb side of fist against middle of the abdomen just above the belly button. Grasp fist with other hand, and give abdominal thrusts. Repeat until object comes out, and victim breathes on their own, or until victim becomes unconscious.

 

Always call 911 in case the victim becomes unconscious.

Take a first aid class to learn more about choking.

NEVER DO THIS TECHNIQUE ON A CHILD UNDER THE AGE OF ONE YEAR OF AGE!!

 

The airway can become blocked by the tongue falling back into the throat or by food, objects or fluid (such as blood, saliva, or vomit)

 

If a victim loses consciousness, a trained person must begin rescue breathing combined with chest thrusts while the victim is on the floor.

Under the new Emergency Critical Care guidelines, the technique for an unconscious choking victim is as follows:

(notice this technique replaces the abdominal thrusts that were previously taught)

 

  • Send someone to call 911

  • Tilt head back, lift chin, and pinch the nose shut

  • Give 2 slow rescue breathes

  • Breathe until the chest clearly rises

  • If chest does not rise while giving breathes, REPOSITON airway and attempt again

  • If breathes still do not go in, find hand placement in center of chest over breastbone

  • Position self over victim, with shoulders over hands, elbows locked

  • Give 15 chest compressions in about 10 seconds

  • Lift lower jaw and tongue, look into mouth. Do a finger sweep to check for object

  • Tilt head back, and lift chin and pinch nose. Give 2 rescue breathes

  • Continue this procedure until air goes in, object comes out, person begins to breathe on own, or ambulance arrives.

 

THIS TECHNIQUE IS FOR PEOPLE OVER THE AGE OF 8 YEARS OLD ONLY !!!

 

Asthma

Asthma is a gradual or sudden narrowing of the airway bronchial tubes in the lungs. Asthma often is triggered by an allergy and makes breathing very difficult.

Symptoms of an asthma attack include:

  • Difficulty exhaling, with a whistle or wheezing sound

  • Coughing that may be frothy or dry

  • Gasping for breath

  • Anxiety, fear or panic

  • A bluish tint to skin from lack of oxygen

Call 911 if the victim does not improve with inhalers.

Call 911 if breathing becomes very quiet, and is still very difficult.

Call 911 if the victim cannot cough or if the heart rate is over 120 beats a minute.

If a victim tries to pull up his shoulders or chin to breathe, this is an absolute emergency. Call 911 emergently.

 

A person with severe asthma can go into respiratory arrest. The signs and symptoms of impending respiratory arrest in the asthma patient are drowsiness and confusion. The respiratory pattern demonstrates a pattern of muscle fatigue and sever hyperinflation of lungs. The victim’s airways are now so obstructed that the wheeze will disappear. The pulse may slow and become bradycardic. The pulse slows because when the victim was struggling to breathe, the heart rate increases. As the victim has decreased ability to breathe, there is severe respiratory muscle fatigue. The drowsiness and lack of wheezing must not be interpreted to mean the victim is improving. At this stage, the victim is often demonstrating hypoventilation

and a build up of acid in the blood. These victims require intensive care and often are intubated and placed on mechanical ventilation.

 

Diabetic emergencies

 

Diabetes is a condition in which the proper balance of glucose in the body is difficult to maintain.

 

Hyperglycemia- Hyperglycemia comes on SLOWLY and can lead to diabetic coma.

Symptoms include:

  • Thirst

  • Frequent urination

  • Vomiting

  • Fruity breathe

  • Confused and disoriented

Hypoglycemia- Comes on QUICKLY and can lead to insulin shock, which is life threatening.

 

 

Symptoms include:

  • Excessive hunger

  • Pale skin

  • Sweating

  • Poor coordination

  • Disoriented behavior

  • Possible seizures

 

Both diabetic emergencies require medical intervention. 911 should be called. If the victim has a blood glucose machine check the blood sugar level and report this finding to EMS when they arrive.

 

Seizures

 

A seizure is a sudden, involuntary muscle contraction, usually caused by uncontrolled electrical activity in the brain. A seizure can affect the entire body or just part of the body.

 

Seizures can be caused by epilepsy, poisoning, heat stroke, fever, drug over dose, brain disorders or imbalances of glucose or minerals in the body.

 

During a seizure:

 

  • Do not restrain the victim

  • Do not move the victim, except to prevent injury

  • Loosen tight clothing, especially around the neck

  • Check for a medical alert tag

  • Do not put anything in the victim’s mouth

  • Do not try to give the victim anything to eat or drink

Call for EMS if there is no history of seizures, if the seizures repeat, or if the seizure lasts longer than 2 minutes.

 

 

 

 

Summary

 

This course is not intended to take the place of first aid training, but may be helpful to alert you to some of the more common emergencies that can become life threatening. Knowing what to do, and what NOT to do, may make the difference in the life or death of someone who needs emergency medical help. Be alert, and be prepared to deal with emergencies on the job and in the community. Seek out a training course, and learn more.

 

Knowing how to recognize warning signs is the first step in acting fast and responding well in an emergency situation. One never knows when an emergency can happen, but we can learn more and feel relieved that we could help save a life if need be.

 

 

References:

 

American Red Cross

Community First Aid and Safety, 2000

Mosby Lifeline Books

 

Mosby’s Clinical Nursing

5th edition, Thompson, McFarland, Hirsh, and Tucker

2002, St. Louis, Missouri

 

Practical clinical knowledge and teaching skills of author,

Monica Oram, RN, BSN

Certified Instructor for American Red Cross

Medical Emergencies

2 contact hours

Course # 108

 

This course is intended for the reader to be able to achieve the following objectives:

  1. How to recognize heart attack and stroke

  2. Understand citizen responder

  3. Understand diabetic emergencies

  4. Understand seizures

  5. What to do while help arrives

 

This mini introduction to basic first aid and recognizing medical emergencies is intended to be a quick over view, and is not intended to diagnose or treat any individual in need of medical attention. Always call 911 when dealing with a medical emergency!

 

This information is basic, and is intended for non-medical personnel, though the information will be found to be helpful as a simple overview of medical emergencies. This information does not go into medical pathophysiology of the symptoms of those medical emergencies listed here.

 

To many individuals, an emergency at work means an accident. But some of the emergencies you may see on the job involve common medical conditions.

A person’s life may depend upon a quick response and appropriate interventions.

The people you work with may someday need medical attention due to common medical conditions.

 

According to the latest statistics reported by the American Red Cross, over 37 million visits were made to the emergency rooms in America’s hospitals.(1998) Injuries resulted in over 90,000 deaths.

 

More than 60 million people in the United States have cardiovascular disease. Cardiovascular disease causes about one million deaths in the US every year. That accounts for about 40% of all deaths that occur annually!

Over 600,000 people have strokes every year, and an estimated 160,000 will die of a stroke every year.

Sudden cardiac arrest accounts for the lives of over 220,000 a year. That is about one cardiac arrest victim every 2 minutes!

 

Diabetes affects over 8 million people.

Asthma affects about 15 million people.

About 5,000 people choke to death every year.

 

 

Each time someone experiences a heart attack or a stroke, or any other emergency situation, someone has to help. You may find yourself in the position of having to help one day. Will you be ready? Will you know what to do? Everyone should learn what to do in an emergency. This mini course is not intended to replace first aid training. It is simply an overview of how to handle some common emergencies. Contact your local Red Cross Chapter to enroll in a First Aid Training Course.

 

Calling 911 is the most important thing someone can do in an emergency. Time is critical. Seconds turn into minutes…and minutes turn into disaster!

 

Your role has four steps:

1. Recognize an emergency

2. Decide to act

3. Call 911

4. Provide care until help arrives

 

Citizen Responder

 

A citizen responder knows how to identify different types of emergencies, and provide supportive care until professional help arrives.

It is not the role of a citizen responder to delegate medical tasks to bystanders, as many are not trained in what to do. No one should ever attempt to provide any care in which they have not been properly trained.

 

Despite the best efforts, emergencies can occur any place, at any time. The person who recognizes an emergency and begins care until help arrives is the citizen responder.

 

In any emergency, fear, panic and confusion will occur, but a citizen responder stays calm and provides vital supportive care until help arrives.

Make sure to check if the person is breathing. Maintain an adequate airway. Check for breathing and a pulse. Act upon what you find.

No breathing = breathe for them

No pulse = begin chest compressions.

 

This course is not intended to teach CPR. Contact your local Red Cross to enroll in a CPR Class, if needed.

 

 

 

Heart Attack

 

A medical emergency you may come across is a person experiencing chest pain. Any chest pain that does not resolve within 15 minutes needs prompt medical attention.

 

A heart attack occurs when the blood supply to the heart muscle is reduced or cut off and the heart muscle becomes damaged.

 

Symptoms of a heart attack include:

  • Pressure, fullness, pain or squeezing in the center of the chest

  • Chest pain that spreads to shoulders, arms or neck ( predominately left arm)

  • Chest discomfort with sweating, lightheadedness, nausea or vomiting

  • Gasping for air or difficulty breathing

  • Pale, cool and clammy skin and bluish lips

  • Anxiety and a sensation of palpitations (irregular heart beat)

 

Stroke, an acute anxiety attack, indigestion and angina can all have similar symptoms as a heart attack. Don’t take chances! Have it checked out.

 

Anytime you suspect a heart attack, call for medical help right away.

  • Do not wait to see if the pain will go away

  • Do not give the victim food or water

  • Do not allow the victim to move around or exert himself

  • Do not give the victim any medications, unless the victim has a prescription for nitroglycerin tablets.

  • In the event the victim has nitroglycerin tablets, they are to be placed under the tongue to dissolve, and not to be chewed or swallowed.

  • The victim may use one tablet every five minutes, for a total of three in 15 minutes.

  • No relief after 3 tablets, and chest pain continues at 15 minutes, the victim should go to the emergency room immediately.

  • Reassure the victim and loosen tight clothing

  • Assist the victim into a comfortable position

  • If unconscious, make sure the airway is open and check for breathing and pulse. Call 911 immediately.

 

 

AED

An AED is an Automated External Defibrillator. It is used to shock a heart rhythm back into a normal rhythm. A victim in ventricular fibrillation, a form of cardiac arrest, has no pulse and will die in minutes or suffer irreversible brain damage.

 

An AED delivers a shock to the heart that helps to restore normal heart rhythm. It is to be used only when a victim has no pulse. It is essential that 911 is activated promptly. Many lay people have been trained on how to use an AED in the community. A person does not have to have any knowledge of how the heart works, or be able to read EKG monitors in order to use an AED. It is simple to use and can increase the chances of saving a life by as much as 50 % when used early in cardiac arrest. They are now found in major shopping centers, airports, and are becoming more and more popular throughout the community. Take a class in AED training, and you will be one step ahead in being prepared on how to use one.

 

Angina

 

Angina is a form of chest pain caused by lack of oxygen to the heart muscle. It is usually brought on by exertion and is relieved by rest or the use of nitroglycerin tablets.

 

A heart attack may look like angina, or angina can progress to a heart attack. Never wait to summon help until your sure it is a heart attack. Call 911 promptly. The victim will need complex equipment and medical attention to rule out if it is a real heart attack or not.

 

 

Stroke

A stroke is a blockage or rupture of a blood vessel in the brain. This blocks off needed oxygen to the brain and damages or kills brain tissue.

First aid measures cannot cure a stroke. The damage cannot repair itself.

Never ignore symptoms of a stroke.

 

Symptoms include:

  • Sudden weakness, numbness or inability to move leg, arm, or paralysis of the face. Usually only on one side of the body.

  • Visual or communication difficulties like slurred speech or blurred vision

  • Loss of balance and coordination or sudden pain in the head.

If you suspect stroke, call 911 immediately.

  • Check airway and pulse.

  • Place an unconscious victim on his or her side and keep the upper body slightly raised.

  • Never give a victim anything to eat or drink.

 

Weakness, vision and speech problems that go away can be a warning signal that a stroke may occur and should never be ignored.

 

Choking

 

Although we think of choking as a common occurrence in children, more adults than children die each year as a result of choking. Common causes include trying to swallow large pieces of poorly chewed food, drinking alcohol before and during meals (dulls the nerves that aid in swallowing), eating while talking excessively or laughing, eating too fast, walking, playing or running with food or objects in the mouth.

 

Signals include clutching the throat with one or both hands, unable to speak, cough, or breathe, high pitched crowing or wheezing sound.

 

If the victim is coughing and coughing forcefully, stay with the victim and encourage him to cough.

If the object will not come out, call 911.

Stand behind the victim and place thumb side of fist against middle of the abdomen just above the belly button. Grasp fist with other hand, and give abdominal thrusts. Repeat until object comes out, and victim breathes on their own, or until victim becomes unconscious.

 

Always call 911 in case the victim becomes unconscious.

Take a first aid class to learn more about choking.

NEVER DO THIS TECHNIQUE ON A CHILD UNDER THE AGE OF ONE YEAR OF AGE!!

 

The airway can become blocked by the tongue falling back into the throat or by food, objects or fluid (such as blood, saliva, or vomit)

 

If a victim loses consciousness, a trained person must begin rescue breathing combined with chest thrusts while the victim is on the floor.

Under the new Emergency Critical Care guidelines, the technique for an unconscious choking victim is as follows:

(notice this technique replaces the abdominal thrusts that were previously taught)

 

  • Send someone to call 911

  • Tilt head back, lift chin, and pinch the nose shut

  • Give 2 slow rescue breathes

  • Breathe until the chest clearly rises

  • If chest does not rise while giving breathes, REPOSITON airway and attempt again

  • If breathes still do not go in, find hand placement in center of chest over breastbone

  • Position self over victim, with shoulders over hands, elbows locked

  • Give 15 chest compressions in about 10 seconds

  • Lift lower jaw and tongue, look into mouth. Do a finger sweep to check for object

  • Tilt head back, and lift chin and pinch nose. Give 2 rescue breathes

  • Continue this procedure until air goes in, object comes out, person begins to breathe on own, or ambulance arrives.

 

THIS TECHNIQUE IS FOR PEOPLE OVER THE AGE OF 8 YEARS OLD ONLY !!!

 

Asthma

Asthma is a gradual or sudden narrowing of the airway bronchial tubes in the lungs. Asthma often is triggered by an allergy and makes breathing very difficult.

Symptoms of an asthma attack include:

  • Difficulty exhaling, with a whistle or wheezing sound

  • Coughing that may be frothy or dry

  • Gasping for breath

  • Anxiety, fear or panic

  • A bluish tint to skin from lack of oxygen

Call 911 if the victim does not improve with inhalers.

Call 911 if breathing becomes very quiet, and is still very difficult.

Call 911 if the victim cannot cough or if the heart rate is over 120 beats a minute.

If a victim tries to pull up his shoulders or chin to breathe, this is an absolute emergency. Call 911 emergently.

 

A person with severe asthma can go into respiratory arrest. The signs and symptoms of impending respiratory arrest in the asthma patient are drowsiness and confusion. The respiratory pattern demonstrates a pattern of muscle fatigue and sever hyperinflation of lungs. The victim’s airways are now so obstructed that the wheeze will disappear. The pulse may slow and become bradycardic. The pulse slows because when the victim was struggling to breathe, the heart rate increases. As the victim has decreased ability to breathe, there is severe respiratory muscle fatigue. The drowsiness and lack of wheezing must not be interpreted to mean the victim is improving. At this stage, the victim is often demonstrating hypoventilation

and a build up of acid in the blood. These victims require intensive care and often are intubated and placed on mechanical ventilation.

 

Diabetic emergencies

 

Diabetes is a condition in which the proper balance of glucose in the body is difficult to maintain.

 

Hyperglycemia- Hyperglycemia comes on SLOWLY and can lead to diabetic coma.

Symptoms include:

  • Thirst

  • Frequent urination

  • Vomiting

  • Fruity breathe

  • Confused and disoriented

Hypoglycemia- Comes on QUICKLY and can lead to insulin shock, which is life threatening.

 

 

Symptoms include:

  • Excessive hunger

  • Pale skin

  • Sweating

  • Poor coordination

  • Disoriented behavior

  • Possible seizures

 

Both diabetic emergencies require medical intervention. 911 should be called. If the victim has a blood glucose machine check the blood sugar level and report this finding to EMS when they arrive.

 

Seizures

 

A seizure is a sudden, involuntary muscle contraction, usually caused by uncontrolled electrical activity in the brain. A seizure can affect the entire body or just part of the body.

 

Seizures can be caused by epilepsy, poisoning, heat stroke, fever, drug over dose, brain disorders or imbalances of glucose or minerals in the body.

 

During a seizure:

 

  • Do not restrain the victim

  • Do not move the victim, except to prevent injury

  • Loosen tight clothing, especially around the neck

  • Check for a medical alert tag

  • Do not put anything in the victim’s mouth

  • Do not try to give the victim anything to eat or drink

Call for EMS if there is no history of seizures, if the seizures repeat, or if the seizure lasts longer than 2 minutes.

 

 

 

 

Summary

 

This course is not intended to take the place of first aid training, but may be helpful to alert you to some of the more common emergencies that can become life threatening. Knowing what to do, and what NOT to do, may make the difference in the life or death of someone who needs emergency medical help. Be alert, and be prepared to deal with emergencies on the job and in the community. Seek out a training course, and learn more.

 

Knowing how to recognize warning signs is the first step in acting fast and responding well in an emergency situation. One never knows when an emergency can happen, but we can learn more and feel relieved that we could help save a life if need be.

 

 

References:

 

American Red Cross

Community First Aid and Safety, 2000

Mosby Lifeline Books

 

Mosby’s Clinical Nursing

5th edition, Thompson, McFarland, Hirsh, and Tucker

2002, St. Louis, Missouri

 

Practical clinical knowledge and teaching skills of author,

Monica Oram, RN, BSN

Certified Instructor for American Red Cross