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FIRST AID 5 Sudden Medical Conditions. 2009. CANADIAN COAST GUARD AUXILIARY - PACIFIC. Introduction. Some medical conditions can cause a casualty to become extremely ill and require immediate first aid and emergency medical care. There may be no warning signals.

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First aid 5 sudden medical conditions l.jpg

FIRST AID 5 Sudden Medical Conditions

2009

CANADIAN COAST GUARD AUXILIARY - PACIFIC


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Introduction

  • Some medical conditions can cause a casualty to become extremely ill and require immediate first aid and emergency medical care.

  • There may be no warning signals.

  • In some cases the person may feel ill or feel something is wrong.


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Introduction

  • These can include:

    Diabetes

    Convulsions

    Heat Emergencies

    Hypothermia

    Childbirth??


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Diabetes


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Diabetes

  • A diabetic emergency can happen only to someone who has diabetes.

  • Diabetic emergencies are caused by an imbalance in the person’s sugar and insulin levels.

  • Any imbalance can be an emergency.


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Hyperglycemia

  • When the insulin level in the body is too low, the sugar will be come too high causing “hyperglycemia”.

  • This can then lead to a diabetic coma.


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Hypoglycemia

  • When the insulin is too high, the person will develop a low sugar level, causing hypoglycemia.

  • It is caused by the diabetic:

    1. Taking too much insulin

    2. Failing to eat enough

    3. Overexercising and burning of sugar faster than normal


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Hypoglycemia

  • The small amount of sugar is used up rapidly, and there is not enough for the brain to work.

  • This will cause the person to become unconscious.


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Signs and Symptoms of Diabetes

  • There is a difference between the signs and symptoms of hyperglycemia and hypoglycemia - however the major ones are similar.

    1. Changes in consciousness including dizziness, drowsiness and confusion, leading to coma

    2. Rapid breathing and pulse

    3. Feeling and looking ill


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First Aid for Diabetes

  • The first aid treatment for both hyperglycemia and hypoglycemia is the same.

  • Start with the emergency action principles.

  • If they tell you they are diabetic, or they are wearing a necklace or bracelet saying so, and they are displaying the signs and symptoms, suspect a diabetic emergency.

  • If the patient can take food or fluids, give them something with sugar in it.


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First Aid for Diabetes

  • If the patient already has too much sugar, the extra will not cause further harm over a short period.

  • Often the patient will know what is wrong and will ask for something for sugar in it.

  • If the person is unconscious, do not give anything to eat or drink.

  • Watch their ABCs, and maintain body temperature.


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First Aid for Diabetes

  • If the casualty is unconscious or is conscious but does not feel better within 5 minutes, transport to EHS.


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Convulsions


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Convulsions

  • Sometimes the brain is affected by injury, disease, fever infection, or unknown reasons, that causes a loss of control known as a convulsion.


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Causes of Convulsions

  • A common cause is epilepsy, which can be controlled with medicine, but the patient can still have convulsions.

  • The patients can sometimes be aware of an onset a convulsion, and take precautions.

  • Convulsions range from mild blackouts, which to others is like day dreaming, to sudden and uncontrolled shaking with unconsciousness lasting several minutes.


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First Aid for Convulsions

  • You can easily help the person.

  • Do not try to restrain to person or stop the convulsion.


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First Aid for Convulsions

  • Start with the emergency action principles.

  • The object is to stop the person hurting themselves.

    1. Move away nearby objects that may cause injury, and from fire and the water.

    2. Protect the person’s head by placing rolled up clothing underneath it.

    3. If there is saliva, blood, or vomit, place in the recovery position.


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First Aid for Convulsions

4. Do not try to place anything between the teeth.

  • After the convulsion the person will be drowsy and confused.

  • Conduct a secondary survey so see if they injured themselves during the convulsion

  • Reassure and comfort.

  • Stay with them until they are fully recovered


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First Aid for Convulsions

  • EHS should be used if:

    1. The convulsion lasts more than a few minutes

    2. The casualty has repeated convulsions

    3. The casualty appears to be injured

    4. You are uncertain about the cause of the convulsion

    5. The casualty is pregnant

    6. The casualty is a known diabetic


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First Aid for Convulsions

7. The casualty is an infant or child

8. The convulsion takes place in the water

9. The casualty fails to regain consciousness after the convulsion


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First Aid for Infant or Child with High Fever

  • A child or infact with a fever over 39°C (102°F) is at risk of convulsions.

  • A high fever can become a medical emergency and you need to lower the temperature by cooling the body.

  • Sponge with cool water.

  • Transport to EHS as soon as possible.


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Heat Emergencies


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Heat Emergencies

  • This is where the body is unable to manage extreme heat.

  • The way a person responds to heat is affected by humidity, wind, clothing, the work environment, physical activity, age and personal health.

  • Heat cramps, heat exhaustion and heat stroke are all caused by exposure to heat.


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Heat Emergencies

  • Heat cramps are the least serious but may lead to heat exhaustion and heat stroke.

  • Heat exhaustion is more serious and can lead to heat stroke.

  • Heat stroke is an emergency and can lead to coma and death if the body is not cooled.


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Heat Emergencies

  • Heat emergencies can worsen rapidly once they appear.


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Heat Emergencies

  • When the air temperature is high, the main source of cooling is the evaporation of sweat.

  • Sweating increases when the body is very warm.

  • However when the humidity is high, sweat does not evaporate as quickly and has little of no cooling effect.


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Causes of Heat Emergencies

  • Air temperature, humidity, and wind all affect body heat. Heat or activity in the hot environment increases the risk.


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Causes of Heat Cramps

  • Heat cramps, painful spasms of muscles usually in the calf or abdomen are caused by fluid and salt loss resulting from heavy exercise or work outdoors in warm or even moderate temperatures


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Causes of Heat Exhaustion

  • Heat exhaustion, the most common heat illness leading to fluid depletion, is caused by exercise or work in a hot environment.

  • Heat exhaustion affects anyone wearing heavy clothing such as cruiser suits, in a hot humid environment.


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Causes of Heat Exhaustion

  • Fluid loss from excess seating is not being adequately replaced, leading to low blood volume, and blood flow is reduced to vital organs as the body tries to give off heat by increasing blood flow to the skin.


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Causes of Heat Stroke

  • Heat stroke occurs when the symptoms of heat exhaustion are ignored.

  • The body cannot cool itself and gradually stops working.

  • Sweating stops as the body stops cooling itself and body temperature rapidly rises.

  • Body temperature soon reaches a level at which the brain, heart and kidneys cannot function properly.


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Signs and Symptoms of Heat Cramps

  • Severe muscle contractions especially in the legs or abdomen

  • Usually normal body temperatures

  • Moist skin


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Signs and Symptoms of Heat Exhaustion

  • Normal or slightly elevated body temperatures

  • Cool, moist, pale or red skin

  • Headache

  • Nausea

  • Dizziness and weakness

  • Exhaustion


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Signs and Symptoms of Heat Stroke

  • High body temperatures, often as high as 41°C (106°F)

  • Red, hot, dry skin

  • Irritable, bizarre, or combative behaviour

  • Progressive loss of consciousness

  • Rapid, weak pulse becoming irregular

  • Rapid, shallow breathing


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Treatment of Heat Emergencies

  • Start with the emergency action principles.

  • If you suspect that the casualty is suffering from overexposure to heat, follow these additional first aid steps immediately:

    1. Cool the body

    2. Give fluids if the person is conscious


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Treatment of Heat Cramps

  • Rest in a cool place

  • Lightly stretch the affected muscles.

  • Drink cool liquids.

  • Resume activity with care.


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Treatment of Heat Exhaustion

  • Move the casualty to a cool or shady place.

  • Drink cool water slowly, to replace fluids - water is less likely to cause vomiting.

  • Loosen tight clothing and remove perspiration soaked clothing.

  • Put cool water on the skin and fan to increase evaporation.

  • Monitor any changes.

  • Rest for the day.


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Treatment of Heat Stroke

  • If the heat exhaustion progresses, body temperature will climb, and the casualty’s condition will worsen, vomiting and show changes in level of consciousness, signaling heat stroke.

  • Cool the body any way you can.

  • Sponge the body with tepid or cold water, and fan to increase evaporation.

  • Use ice packs in the armpits and groin.


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Treatment of Heat Stroke

  • Get the casualty to EHS

  • Keep the airway open, and monitor ABCs.

  • Place in recovery position

  • A person in heat stroke may stop breathing or have a heart attack. Be prepared for rescue breathing or CPR.


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Hypothermia


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Hypothermia

  • Hypothermia is a general body cooling when the body cannot produce enough heat to stay warm.


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Hypothermia

  • The body reacts to cold by contracting blood vessels near the skin to move warm blood to the centre of the body.

  • This provides some conservation of body heat.

  • If heat loss continues, shivering starts and the body produces heat through muscle action.

  • Hypothermia results as the entire body cools as the warming system fails.


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Hypothermia

  • In hypothermia body temperatures fall below 35°C(95°F).

  • As the body continues to fall, the heart begins to beat unevenly and eventually stops.


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Hypothermia

  • Hypothermia is one of the major causes for problems on rescue vessels, and our own crews have to be aware of the causes.

  • Air temperature, the humidity, whether skin is wet and dry, and wind all affect how the body maintains its temperature.

  • The rapidity of onset of hypothermia is affected by the types of clothing in all layers for the skin to the outside.


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Hypothermia

  • In the marine environment, exposure to cold spray or immersion greatly increase the chances of hypothermia.

  • A body immersed will lose heat 25 times faster that in air of the same temperature.


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Prevention of Hypothermia

  • Avoid being outside in coldest part of the day.

  • Wear a hat and layers of clothing, to trap warm air against the skin.

  • Drink plenty of warm fluids to help the body maintain its temperature. No alcohol or caffeine.

  • When shivering starts, get out of the cold.

  • Avoid falling in the water.

  • If clothes become wet, change immediately.


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Signs and Symptoms of Hypothermia

  • Shivering (may stop when body gets too cold)

  • Numbness

  • Lack of coordination

  • Confused or unusual behaviour

  • Body temperature below 35°C (95°F)


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Stages of Hypothermia


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1st Stage of Hypothermia

  • Body Temperature drops by 1-2°C below normal temperature (35-37°C).

  • Mild to strong shivering.

  • The victim is unable to perform complex tasks with the hands; numb hands.

  • Breathing becomes quick and shallow.

  • Victim may feel sick to their stomach, and very tired.


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Transition to 2nd Stage of Hypothermia

  • Often casualty will experience a warm sensation, as if they have recovered.

  • A test to see if the casualty is entering stage 2 is if they are unable to touch their thumb with their little finger.

  • The casualty might start to have trouble seeing.


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2nd Stage of Hypothermia

  • Body temperature drops by 2 - 4°C below normal temperature (33-35°C).

  • Shivering more violent.

  • Muscle mis-coordination apparent.

  • Movements - slow and laboured, stumbling pace and mild confusion.

  • Casualty pale.

  • Lips, ears, fingers / toes may become blue.


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3rd Stage of Hypothermia

  • Body temperature drops below about 32°C.

  • Shivering usually stops.

  • Difficulty speaking, sluggish thinking, and amnesia start to appear

  • Inability to use hands.

  • Stumbling is also usually present.


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3rd Stage of Hypothermia

  • Below 30 °C, exposed skin is blue and puffy

  • Muscle coordination becomes very poor, walking becomes almost impossible.

  • Casualty exhibits incoherent/irrational behaviour including burrowing or stupor.

  • Pulse and respiration rates decrease

  • Fast heart rates can occur.

  • Major organs fail.


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3rd Stage of Hypothermia

  • Clinical death occurs.


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Treatment for Hypothermia

  • Monitor airway, breathing and circulation.

  • Remove wet clothing and dry the casualty.

  • Warm the casualty gently - use ResQ Air/ Heat Treat where trained - if casualty alert, give warm liquids.

  • Handle gently.

  • With severe hypothermia, pulse may be slow. Administer rescue breathing, and start CPR if necessary.


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