Transcript Sudden Illnesses

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.
Why patients delay calling for
help






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.
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, foodsespecially 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)


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 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.
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 1015 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 and cold injuries
Heat Loss from the Body
Five ways that the
body loses heat
 Conduction
 Convection
 Evaporation
 Radiation
 Respiration
Increased Risk of Frostbite



Exposure to below freezing
temperature
Exposure to high winds
Exposure to high altitude



Use of tobacco, alcohol, drugs
Contact with metal or gasoline
Previous frostbite injury
Frostbite




Can cause severe
damage resulting in
gangrene and amputation
Freezes tissue
Obstructs blood supply
Body areas most affected
are feet, hands, ears,
nose
Types of Frostbite
Pre-thaw
Superficial — skin feels cold and
crusty on top, while soft
underneath. Skin does not
blanch
 Deep — skin feels cold and hard

Post-thaw

Similar to burns — superficial,
semi-thickness and fullthickness
First Aid for Frostbite
1. Remove
victim from
cold
2. Remove
tight clothing
3. Seek
medical
attention
Cautions for Frostbite
DO NOT
Break blisters
 Rub or
massage
 Re-expose to
cold
 Thaw if there is
a possibility of
refreezing
 Allow alcohol or
smoking

Remote First Aid for Frostbite
If in a remote location, use wet,
rapid rewarming
1. Place body part in warm
water (102-105 ºF)
2. Place dry, sterile dressings
between toes and fingers
3. Slightly elevate part
4. Give aspirin or ibuprofen
Hypothermia - Types of Exposure
1. Acute (immersion)
exposure
2. Sub-acute
(mountain or
exhaustion) exposure
3. Chronic (urban)
exposure
Types of Hypothermia (1 of 2)
Mild — body temperature
higher than 90ºF
 Signs:


Shivering
Cold abdomen
Types of Hypothermia (2 of 2)
Severe or profound — body
temperature less than 90ºF
 Signs:
Muscles rigid
 Shivering stopped
 Altered mental status


50-80% of victims die
First Aid for Hypothermia (1 of 2)
1. Stop heat loss
• Get victim out of cold
• Cover victim with
insulation
• Replace wet clothing
• Cover the head
• Handle victim gently
2. Call EMS for transport
First Aid for Hypothermia (2 of 2)
3. For mild hypothermia

Allow shivering
4. For severe hypothermia
Check ABC
 Evacuate by helicopter or
ambulance

Cautions for Hypothermia (1 of 2)
DO NOT
Give alcohol
 Give a warm drink
 Start CPR until pulse has been
checked for 30- 45 seconds
 Rewarm outside of hospital

Cautions for Hypothermia (2 of 2)
DO NOT stop shivering by:
Immersing in warm water
 Using chemical heat
packs
 Body-to-body contact

Immersion Hypothermia
“Rule of 50s”
 50-year-old man
 50ºF water
 50 minutes in
water
 50:50 chance of
survival
Signs of Heat Stroke



Extremely hot skin — usually
dry, but may be wet
Altered mental status
• If responsive, maybe
confused and/or agitated
• Unresponsive
Coma
First Aid for Heat
Stroke
1. Check ABC
2. Move to cool place
3. Remove clothing
down to underwear
4. Seek medical
attention
5. Rapidly cool
Cooling Methods for Heat
Stroke
Cooling method based on
humidity
 If humidity less than 75%,
use water and fan
 If humidity more than 75%,
use ice/cold packs on neck,
armpits, and groin
Heat Stroke DO NOTS



Continue cooling after victim’s
mental status improves —
danger of hypothermia.
Use rubbing alcohol sponging
or baths — can be absorbed
into blood and vapors can
ignite.
Give aspirin or acetaminophen
— they do not affect
hypothalmic set-point
Other Heat Illnesses



Heat syncope
Heat edema
Prickly heat
Signs of Heat
Exhaustion




Profuse sweating
Flu-like symptoms
(headache, nausea,
vomiting, fatigue, dizzy)
Rapid pulse
Thirst
First Aid for Heat
Exhaustion
1. Move to a cool place
2. Give cool liquids
3. Raise victim’s legs 8 to 12
inches
4. Remove excess clothing
5. Sponge and fan victim
6. If no improvement in 30
minutes, seek medical attention
First Aid for Heat
Cramps
1. Rest in a cool place
2. Give lightly salted or
electrolyte
drink
3. Stretch cramped muscle

Use acupressure method —
pinch upper lip just below the
nose
Sports Drinks
Should electrolytes be added?
 Victim very unlikely to have
deficiency
• Exception — if physical activity
exceeds 4 hours
Water
How important is water?
 Average adult requires 2 quarts
a day
 Thirst not a good indicator
 “Rule of 3s”
 3 minutes without oxygen
 3 days without water
 3 weeks without food