Sudden Illnesses And other first aid emergencies
Heart Attack • Heart Attack (acute myocardial infarction) occurs when the blood supply to part of the heart muscle is severely reduced or stopped. • Coronary thrombosis • Coronary embolism • Coronary occlusion
Signs and Symptoms • Uncomfortable pressure, fullness, squeezing, or pain in the center of the chest that lasts more than a few minutes or that goes away and comes back. • Pain spreading to the shoulders, neck, or arms • Chest discomfort with lightheadedness, fainting, sweating, nausea, or shortness of breath.
What to do • Don’t delay; take prompt action • Call EMS • Monitor ABC’s and give CPR if necessary • Help victim into the least painful position, usually a half-sitting position. Loosen tight clothing. Be calm and reassuring • Give nitroglycerin tablets if patient is a heart patient.
Thought the symptoms would go away Thought the symptoms were not severe enough Thought it was a different illness Worried about medical costs Afraid of hospitals Feared being embarrassed Wanted to wait for a better time Did not want to find out what was wrong Average time between symptom onset and hospital arrival was 2 hours; 28% waited 1 hour; 33% waited 1 to 3; 15% waited 3 to 6; 23% waited more than 3 hours. Why patients delay calling for help
Stroke • A stroke, or cerebrovascular accident, occurs when oxygen is denied to a portion of the brain as a result of disrupted blood flow: • Thrombosis • Embolism • Ruptured blood vessel (hemorrhagic stroke) • Occlusion • Aneurism
What to look for • Weakness, numbness, or paralysis of the face, an arm, or a leg on one side of the body • Blurred or decreased vision, especially in one eye • Problems speaking or understanding • Dizziness or loss of balance • Sudden, severe, and unexplained headache • Deviation of the eyes from PEARL (Pupils Equal And Reactive to Light), which may mean the brain is being affected by lack of oxygen
If you suspect a stroke, but are not sure apply these three simple tests • Arm strength (both arms): person closes eyes and holds both arms out with palms down. Slowly count to five. If one arm does not move and the other drifts down, suspect a stroke. • Facial smile: person smiles or shows teeth. If one side of face does not move as well as the other side, suspect a stroke. • Hand grip (both hands): person grips two of your fingers at the same time. If grip strength is not equal, suspect a stroke.
What to do • Call EMS • If victim is unresponsive, check ABC’s; give CPR if necessary • If the victim is conscious, lay the victim down with the head and shoulders slightly elevated • Do not give a stroke victim anything to drink or eat. The throat may be paralyzed, which restricts swallowing.
Asthma • Asthma is a chronic, inflammatory lung disease characterized by repeated breathing problems. • The muscles that surround the airways can become tight, producing muscle spasms. • The inner lining of the airways may swell. • There can be an increase in mucous production and/or inflammation (within the trachea, bronchi, and/or the lungs). • Asthma sufferers may have acute episodes brought on by specific triggers. • Asthma affects an estimated 10 million people in the U.S. and accounts for an annual death toll of 6,000+. • Mortality rates have increased over 72% since 1970.
Asthma triggers • Allergens (animal dander, dust, mites, molds, pollens, foods-especially seafood & peanuts, etc.) • Lung irritants (tobacco smoke, leaf burning smoke, perfume, chalk, dust, etc.) • Weather changes, e.g. cold air • Infections (colds, sinus infections, etc.) • Exercise and overexertion • Excitement
Early Warning Signs of an Asthma Attack • Coughing with no cold • Wheezing (however light), especially upon exhaling • Fast/irregular breathing • Upset stomach • Tickly throat • Anxiousness
Severe Symptoms of Asthma • Student stops wheezing, especially with other symptoms. • Increased anxiety • Cyanosis (bluish skin color) • Increased effort to breathe • Nostrils flaring with each breath • Worsening of any early warning signs
What to do • Keep the victim in a comfortable upright position and leaning slightly forward. This is known as the “tripod” position. Generally the victim will dictate what position is most tolerable, usually sitting up since that makes it easier to breathe. • Check and monitor ABC’s. • Try to calm and reassure; help relax the victim • Administer warm fluids if possible. • Ask the victim about any asthma medication he or she may be using. Usually the victim will have an inhaler nearby. • If the victim does not respond to his or her inhaled medication, seek medical attention immediately.
Fainting • A sudden brief loss of consciousness not associated with a head injury. • Can have either physical or emotional causes. • Sight of blood • Strong fear • Low blood sugar • Dehydration • Heat exhaustion • Anemia
What to look for • A person who is about to faint usually will have one or more of the following signs and symptoms: • Dizziness • Weakness • Seeing spots • Visual blurring • Nausea • Pale skin • Sweating
If a person appears about to faint • Prevent the person from falling • Help the person lie down and raise the legs 8 to 12 inches. This position increases venous blood flow back to the heart, which in turn pumps more blood to the brain. • Loosen tight clothing at the neck and waist. • Stay with the victim until he or she recovers.
If fainting has happened or is anticipated • Check ABC’s. • Loosen tight clothing and belts. • If the victim has fallen, check for any sign of injury. • If injuries allow, turn victim into recovery position. • After recovery, have the victim sit for a while and, when he or she is able to swallow, give cool, sweetened liquids to drink, and slowly help the victim regain an upright posture. • Fresh air and a cold, wet cloth for the face usually aid recovery.
Seek medical attention, if: • The victim has had repeated attacks of unconsciousness, • Does not quickly regain consciousness, • Loses consciousness while sitting or lying down, • Or faints for no apparent reason. • Do not: • Splash or pour water on the victim’s face • Use smelling salts or ammonia inhalants • Slap the victim’s face in an attempt to revive him or her • Give the victim anything to drink until he or she has fully recovered and can swallow.
Seizures • A seizure is the result of an abnormal stimulation of the brain’s cells. • A variety of medical conditions can lead to seizures, including the following: • Epilepsy • Heat stroke • Poisoning • Electric shock • Hypoglycemia • High fever in children • Brain injury, tumor, or stroke • Alcohol withdrawal, drug abuse/overdose
Types of Seizures • Generalized motor seizures (grand mal) • Characterized by loss of consciousness, muscle contraction, and sometimes tongue biting, loss of bladder control, and mental confusion. Usually followed by a period of coma or drowsiness. • Focal motor seizures • Usually cause one part of the body such as one side of the face or an arm to twitch. • Psychomotor (temporal-lobe) seizures • Characterized by an altered personality state and are often preceded by dizziness or a peculiar metallic taste in the mouth. • Petit mal seizures • Characterized by a brief loss of consciousness. “Staring off into space” for a brief time.
What to do • For convulsions and grand mal seizures: • Cushion the victim’s head; remove items that could cause injury if the person were to bump into them. • Loosen tight clothing; especially around neck. • Roll the victim onto his or her side. • Look for a medical-alert tag • As the seizure ends, offer your help. Most seizures in people with epilepsy are not medical emergencies. They end after a minute or two without harm and usually do not require medical attention.
Call EMS if: • A seizure happens to someone who is not known to have epilepsy or seizure disorder; it could be a sign of serious illness. • A seizure lasts more than five minutes. • The victim is slow to recover, has a second seizure, or has difficulty breathing afterward. • The victim is pregnant or has another medical condition. • There are any signs of injury or illnesses.
Do not: • Give the victim anything to eat or drink. • Restrain the victim. • Put anything between the victim’s teeth during the seizure. • Splash or pour any liquid on the victim’s face. • Move the victim to another place (unless it is the only way to protect the victim from injury).
Diabetes • A chronic illness in which the pancreas fails to produce enough insulin, and/or when insulin cell receptors are defective, an excess of sugar is carried throughout the blood stream.
Diabetes – Symptoms • Initial symptoms generally include weight loss, visual disorders, increased thirst/hunger, frequent urination, fatigue, irritability, and nausea. • If left untreated over time, this excess in sugar levels can cause permanent visual problems, organ damage (especially to the kidneys), cardiovascular disorders, and possible death.
Type I Diabetes • Also known as juvenile diabetes • Requires daily insulin injections and sometimes oral medication. • Caused by recessive gene that may become activated after an illness, such as strep or mono, especially during a growth spurt (age 5-6, 10-11, etc.).
Type I Diabetes • Considered an autoimmune disorder whereby the white blood cells attack the pancreas (beta cells) that normally produce insulin. The beta cells will become completely destroyed generally within a year, requiring insulin shots/pump/inhaler.
Type II Diabetes • Also known as adult onset diabetes • Generally treated with diet, exercise, and oral medications. • Most experts consider it preventable.
Diabetes • Normal blood sugar levels average from 80-120. • A level of up to 140 is generally considered acceptable for an insulin dependent diabetic.
Diabetic Emergencies • Insulin shock – Too much insulin (giving a shot with too much insulin; lack of activity; not eating for a long period of time; etc.) • Also known as low blood sugar (blood sugar levels less than 80). • Symptoms: sudden onset, irritability (cry, belligerent, etc.), hungry (especially a craving for sweets), perspire excessively, trembling, dizzy/disoriented/pale, pulse is generally full and normal. • This condition is potentially life threatening.
First Aid for Insulin Shock • If victim is known diabetic, his or her mental status is altered, and is awake enough to swallow: • “Rule of 15’s” • Give the person some form of sugar such as a sugar cube, soda, candy, raisins, prescribed candy, honey or corn syrup. • Symptoms should subside within 10-15 minutes.
Diabetic coma • Too little insulin (failure to take insulin shot; not having enough insulin with shot; over-activity; illness; improper diet of sugars, alcohol, etc.) • High blood sugar – blood sugar levels above 240. Levels exceeding 300 can cause kidney and cardiovascular damage.
First Aid for Diabetic Coma • Symptoms: gradual onset; pulse weak and rapid, thirsty, frequent urination, flushed face, vomiting/nausea, fruity breath odor, labored breathing, craving for sweets, irritable • This condition is not immediately life threatening but can result in kidney damage, eye damage, nerve damage, heart damage, etc., over an extended period of time (years).
Make sure that the victim rests; maintaining body temperature; letting the victim (or medical staff) administer an insulin shot; seeking medical attention.
Poisoning emergencies • Types of poisoning: • Ingested • Inhaled • Absorbed • Injected
Signs of Swallowed Poisoning • Abdominal pain and cramping • Nausea or vomiting • Diarrhea • Burns, stains, odor near or in mouth • Drowsiness or unconsciousness • Poison containers
First Aid for Swallowed Poisons (1 of 3) 1. Determine critical information • Age and size of victim • What was the poison? • How much was taken? • When was it swallowed? 2. If poison is corrosive or caustic, dilute by having victim drink water or milk
First Aid for Swallowed Poisons (2 of 3) 3. For responsive victim, call poison control center 4. For unresponsive victim, check ABCs and call 9-1-1 5. Place victim in recovery position
First Aid for Swallowed Poisons (3 of 3) 6. If advised, induce vomiting 7. If advised, give activated charcoal 8. Save poison containers, plants, and victim’s vomit to help medical personnel identify poison
Activated Charcoal • Effective • Acts as a sponge • Does not absorb all poisons • Give only in pre-mixed form
First Aid for Alcohol Emergency (1 of 2) 1. Look for injuries 2. Check ABC and treat 3. Place victim in recovery position 4. Call poison control center
First Aid for Alcohol Emergency (2 of 2) 5. Leave scene if victim is violent 6. Provide emotional support 7. Assume injured or unconscious victim has a spinal injury 8. If victim has been exposed to the cold, suspect hypothermia
Signs of Carbon Monoxide Poisoning • Flu-like complaints, but no fever • Symptoms come and go • Symptoms worsen or improve in certain places or times of day • Nearby people have similar complaints • Pets seem ill
First Aid for CO Poisoning • Remove victim from environment immediately • Call EMS • Monitor ABC • Place unresponsive victim on side • Seek medical attention
Poison Ivy, Oak, Sumac • Resin is slightly yellow light oil • Identification: • “Leaflets 3, let it be” • Locations • More than 60 plants • “Black spot” test
First Aid for Poison Ivy, Oak, Sumac 1. Wash with soapy water or rubbing alcohol 2. For mild cases, use calamine lotion, oatmeal baths, baking soda paste 3. For severe cases, consult doctor for corticosteroid
Heat Loss from the Body Five ways that the body loses heat • Conduction • Convection • Evaporation • Radiation • Respiration