Emergency Preparedness

1. 57 Emergency Preparedness

2. Learning Outcomes 57.1 Discuss the importance of first aid during a medical emergency. 57.2 Identify items found on a crash cart. 57.3 Recognize various accidental emergencies and how to deal with them. 57.4 List common illnesses that can result in medical emergencies. 57.5 Identify less common illnesses that can result in medical emergencies.

3. Learning Outcomes 57.6Discuss your role in caring for people with psychosocial emergencies. 57.7 Carry out the procedure for calming a patient who is under extreme stress. 57.8 Discuss ways to educate patients about how to prevent and respond to emergencies. 57.9 Illustrate your role in responding to natural disasters and pandemic illness. 57.10Discuss your role in responding to acts of bioterrorism.

4. Emergencies Acute illnesses Injuries Phone calls from patients with urgent problems Disasters Introduction The medical assistant must be prepared to determine the urgency of and handle any emergencies that arise.

5. Understanding Medical Emergencies • Any situation requiring immediate care • First aid • Save a life • Reduce pain • Prevent further injury • Reduce the risk of permanent disability • Increase the chance of early recovery

6. Apply Your Knowledge Why is it important to perform first aid in a medical emergency? • ANSWER: First aid can: • Save a life  Prevent further injury • Reduce pain Reduce risk of permanent disability • Increase the chance of early recovery Good Job!

7. Preparing the Office Know what is expected of you Post emergency telephone numbers At every telephone On the Crash cart or firstaid tray Preparing Medical Emergencies

8. Preparing the Office (cont.) • Provide information to EMS • Your name and location • Nature of the emergency • Number of people needing help • Condition of the injured or ill patient(s) • Summary of the first aid already given • Directions to your location Do not hang up until the dispatcher gives you permission to do so.

9. Preparing for Medical Emergencies (cont.) • Emergency and first-aid supplies • Crash cart / tray • Basic drugs, supplies, and equipment for medical emergencies • First-aid kit for minor injuries and ailments • Must be routinely checked and restocked

10. Guidelines for Handling Emergencies • Medical assistants • Recognize life-threatening condition • Take appropriate actions • Patient emergencies • Assess the situation • PPE • Assess patient • Initial assessment • General impression • Level of responsiveness • Assess CABs • Urgency of condition • Focused exam • Document

11. Guidelines for Handling Emergencies (cont.) • Telephone emergencies • Triaging • Classification of injuries • Follow office protocols • General guidelines • Stay calm • Reassure the patient • Act confidently

12. Guidelines for Handling Emergencies (cont.) • Personal protection • Take precautions to reduce chance of exposure during an emergency • Follow Standard Precautions and use PPE • Minimize splashing • Wash hands • Keep PPE in first-aid kit at home and work

13. Handling Emergencies (cont.) • Documentation • Assessment • Treatment given • Patient response • If patient transported, location of facility

14. Apply Your Knowledge What are the steps of the initial assessment of a patient in an emergency? Correct! ANSWER: The steps of the initial assessment are: Form a general impression of the patient Determine the patient’s level of responsiveness Assess CABs Determine the urgency of condition Perform a focused exam Document findings/report to physician or EMT

15. Accidental Injuries • Provide first aid • Be able to help in emergency situations • Bites and stings • Burns • Choking • Eye and ear injuries • Falls, fractures, dislocations • Head injuries

16. Bites and Stings • Animal bites • Bruise, tear, puncture • Cleanse wound, apply ointment and dry, sterile dressing • Insect stings • Remove stinger • Wash area, apply ice

17. Bites and Stings (cont.) • Snake bites • May need antivenin • Immobilize and position below heart • Spider bites • Refer to physician • Wash area, apply ice, and keep below heart level

18. Thermal Hot liquids, steam, flame, etc. Water, wet cloth, or blanket Chemical Remove chemical Wash with cool water for 15 minutes Cover with dry, sterile dressing Burns

19. Burns (cont.) • Electrical • Entry and exit sites • Tissue damage along current’s pathway • Classifications of burns – severity • Depth and extent • Source of burn • Age of patient • Body area burned • Other illness or injuries

20. Choking • Food or foreign object blocks the trachea or windpipe • Unable to speak • Universal sign – hand up to throat with a fearful look Be prepared to act promptly!

21. Accidental Injuries (cont.) • Ear trauma • Lacerations, cuts • Severed ear ~ transport with patient • Eye trauma • Care depends on severity • Foreign object in the eye

22. Accidental Injuries (cont.) • Falls • Have patient examined before moving • Stabilize neck if injury suspected • Minor falls, notify the physician • Document

23. Fractures and Dislocations • Fracture – break in the bone • Dislocation – displacement of bone end from the joint • Immobilization • Sling or splint • Cast

24. Fractures and Dislocations • Sprain • Partial tearing of a ligament supporting a joint • Splint and apply ice • Strain– muscle injury from overexertion

25. Head Injuries • Concussion – jarring injury of the brain • Severe head injuries – contusions, fractures, and intracranial bleeding • Scalp hematoma– bleeding under skin on head • Scalp lacerations – often bleed profusely

26. Hemorrhaging • Internal • Keep patient warm, quiet, and calm • Get medical help • External • Elevate body part • Put direct pressure on nearestpressure point between wound and heart

27. Multiple Injuries • Assess CABs • Call EMS • Perform CPR if needed • Only perform first aid after CABs ensured • Treat most life-threatening injuries first

28. Poisoning • Substance that produces harmful effects if it enters the body • Ingested • Absorbed • Inhaled • Patient education – symptoms and treatments • Poison control center telephone number

29. Inhaled poisons Get to fresh air Loosen clothing Check CABs Poisoning (cont.) • Ingested poisons • Only induce vomiting if directed • Position patient on left side • Send poison container with patient • Absorbed poisons • Remove contaminated clothing • Wash skin, alcohol, rinse

30. Weather-Related Injuries • Hypothermia • Temperature below 95º • Move patient inside, cover with blankets • Frostbite • Ice crystals form between tissue cells • Warm with clothing or other body part

31. Weather-Related Injuries • Heat stroke • Prolonged exposure to high temperatures and humidity • Move to cool place, cool with whatever is available • Sunburn • Soak in cool water, cold compresses • Patient education

32. Wounds • Incisions and lacerations • Control bleeding • Clean and dress wound • Amputations • Elevate extremity • Transport body part with patient Laceration

33. Wounds • Abrasion • Wash with soap and water • Remove debris • Apply dressing if large area • Punctures • Rinse, clean, dress • Tetanus toxoid immunization Abrasion Puncture

34. Wounds • Closed wounds • Injury occurring inside the body without breaking the skin • Caused by blunt trauma • Contusions– bruises • Cold compresses • Color changes are normal Contusion

35. Apply Your Knowledge Yeah! What is the universal sign of choking? ANSWER:The patient holds his hand to his throat and looks afraid. A patient arrives at the clinic hemorrhaging from the left thigh. What steps should you take to control the bleeding? • ANSWER: The steps are: • Apply direct pressure with sterile gauze • Add additional dressing as necessary • Elevate the leg • Apply pressure to the left femoral artery

36. Abdominal pain – a variety of causes Asthma – spasmodic narrowing of bronchi Dehydration – lack of adequate water in the body Diarrhea – can result in dehydration and electrolyte imbalance Common Illnesses

37. Common Illnesses (cont.) • Fainting – partial or complete loss of consciousness • Fever – usually indicates infection • Hyperventilation – breathing too rapidly and too deeply

38. Common Illnesses (cont.) • Nosebleed – epistaxis • Tachycardia • Rapid heart • Palpitations • Vomiting – can result in dehydration and electrolyte imbalance

39. Apply Your Knowledge ANSWER: Matching: ___ Syncope A. Nosebleed ___ Pulse > 100 bpm B. Fainting ___ Spasmodic narrowing of bronchi C. Dehydration ___ Dehydration and electrolyte imbalance D. Tachycardia ___ Epistaxis E. Diarrhea/vomiting ___ Rapid and deep breathing F. Asthma ___ Lack of adequate water G. Hyperventilation Bravo! B D F E A G C

40. Less Common Illnesses • Anaphylaxis • Severe, life-threatening allergic reaction • Check CABs, perform CPR if needed • Bacterial meningitis – usually a complication of another bacterial infection • Diabetic emergencies • Insulin shock – severe hypoglycemia • Diabetic coma – severe hyperglycemia

41. Less Common Illnesses (cont.) • Gallbladder attack – inflammation of the gallbladder • Heart attack • Myocardial infarction • Chest pain ~ cardinal symptom • Cardiac arrest ~ ventricular fibrillation

42. Less Common Illnesses (cont.) • Hematemesis – vomiting blood • Obstetric emergencies – office protocols • Respiratory arrest • Lack of breathing • May follow respiratory distress • Assess CABs, perform CPR, if needed

43. Less Common Illnesses (cont.) • Seizures • Convulsions • Prevent injury • Shock • Cardiovascular system failure • Hypovolemic shock • Septic shock

44. Less Common Illnesses (cont.) • Cerebrovascular accident (CVA) – due to impaired blood supply to brain • Toxic shock syndrome – acute bacterial infection • Viral encephalitis – inflammation of the brain due to a virus

45. Apply Your Knowledge ANSWER: Matching: ___ Hypo- or hyperglycemia A. Stroke ___ Myocardial infarction B. Diabetic emergencies ___ Vomiting blood C. Seizures ___ Impaired blood supply to brain D. Hematemesis ___ Convulsions E. Shock ___ May be hypovolemic or septic F. Heart attack B SUPER! F D A C E

46. Spousal, child, and elder abuse Drug or alcohol abuse Depression / suicide Violent behavior Office protocols Document Report of rape – chain of custody Common Psychosocial Emergencies Remember legal obligation to report spousal, child, and elder abuse as well as rape.

47. Apply Your Knowledge Mrs. Jamison tells you that she is very tired of being ill and often thinks of “ending it all.” She then laughs and says she was just kidding. What is/are your responsibilities in this matter? ANSWER: You should allow her to talk about her feelings and despite the fact that she said she was “just kidding” you should take her seriously. The physician should be told of her comments. You may be asked to provide her with information on community services available. You should document her comments and your actions. Fantastic!

48. Extreme stress Behavior different from normal Unable to focus or follow directions Keep victims and family calm Challenges Non-English speaking Visual and hearing impairments The Patient Under Stress

49. Educating the Patient • How to prevent and handle medical emergencies • Encourage patients and families to learn first aid and CPR • How to access EMS • Post emergency phone numbers • How to childproof homes

50. Apply Your Knowledge True or False: ___ All people react the same during an emergency. ___ Patients should be encouraged to learn CPR and first aid. ___ Challenges to dealing with patients during an emergency include visual and hearing impairments and English- speaking people. ___ Patients should be instructed on how to prevent emergencies. ___ It is not important to keep the victim of an emergency calm. ANSWER: differently F T F non- T F Very Good!