Transcript Medical Emergencies

Medical Emergencies
Medical Emergencies
• As a healthcare provider you may encounter a
variety of medical emergencies.
• In these situations you may be required to
take quick action.
• You have already learned about medical
emergencies that may require CPR, rescue
breathing and the Heimlich maneuver.
Asthma
• Most people with asthma have their condition
controlled. Often they use an inhaler and/or take
oral medications.
• Signs and Symptoms of an Acute Asthma Attack:
coughing, wheezing, shortness of breath and
recession (drawing in the flesh between the ribs
and sternum). The symptoms will persist, and
may become more marked or even change in
nature.
What should you do?
Actions the PTA should take
• If the patient has an inhaler have them use it.
• Keep the patient calm.
• Have the patient sit up or lean back in a semi-reclining
position, whichever is the most comfortable. Do not let
the person lie flat; it can make breathing even more
difficult.
• If symptoms do not subside after a reasonable amount
of time additional medical attention is needed…
• outpatient call 911
• inpatient call nurse
Chest Pain(Angina)/Heart Attack
Signs and Symptoms:
• uncomfortable pressure, fullness, squeezing, pain, or discomfort in
the center of the chest that lasts for more than two minutes. This
pain may be persistent, or may go away and return.
• pain or discomfort that spreads to the shoulders, neck, or arms
• pain, sweating, nausea, or shortness of breath.
• any chest discomfort that causes anxiety or concern
• any chest discomfort that is accompanied by lightheadedness,
fainting, or dizziness
• any of the above symptoms that disappear with rest, then return
with exertion
• unexplained weakness or fatigue
• palpitations, cold sweat, or paleness
• Pain that lasts for 10 to 15 minutes while you are resting should
also be evaluated immediately.
What should you do?
Actions the PTA should take
• Immediately stop activity.
• Assess vital signs.
• If symptoms do not subside within 10-15
minutes seek medical assistance.
• OP – call 911
• IP – call RN or MD
Dehydration
• When a person becomes so sick with fever, diarrhea,
or vomiting or if an individual is overexposed to the
sun, dehydration occurs. This is caused when the
body loses water content and essential body salts
such as sodium, potassium, calcium bicarbonate and
phosphate.
• Occasionally, dehydration can be caused by drugs,
such as diuretics, which deplete body fluids and
electrolytes.
Dehydration
Symptoms may include:
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thirst
less-frequent urination
dry skin
fatigue
light-headedness
dizziness
confusion
dry mouth and mucous
membranes
• increased heart rate and
breathing
In children, additional
symptoms may include:
• dry mouth and tongue
• no tears when crying
• no wet diapers for more than 3
hours
• sunken abdomen, eyes or cheeks
• high fever
• listlessness
• irritability
• skin that does not flatten when
pinched and released
What should you do?
Actions a PTA should take
• In cases of mild dehydration, simple rehydration is
recommended by drinking fluids.
• For moderate dehydration, intravenous fluids may be
required, although if caught early enough, simple
rehydration may be effective. Cases of serious
dehydration should be treated as a medical
emergency, and hospitalization, along with
intravenous fluids, is necessary. Immediate action
should be taken.
Heat Stroke
• Heat stroke is the most severe form of heat
illness and is a life-threatening emergency. It is
the result of long, extreme exposure to the
sun, in which a person does not sweat enough
to lower body temperature. The elderly,
infants, persons who work outdoors and those
on certain types of medications are most
susceptible to heat stroke. It is a condition
that develops rapidly and requires immediate
medical treatment.
Heat Stroke
Symptoms may include:
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headache
dizziness
disorientation, agitation or confusion
sluggishness or fatigue
seizure
hot, dry skin that is flushed but not sweaty
a high body temperature
loss of consciousness
rapid heart beat
hallucinations
What should you do?
Actions a PTA should take
• Get the person indoors.
• Remove clothing and gently apply cool water
to the skin followed by fanning to stimulate
sweating.
• Apply ice packs to the groin and armpits.
• Have the person lie down in a cool area with
their feet slightly elevated
• Call for medical assistance - 911
Stroke (CVA)
Warning signs and symptoms may include:
– sudden weakness or numbness of the face, arm,
or leg on one side of the body
– sudden difficulties with speech and understanding
what others are saying
– sudden problems with vision -- dimness or loss of
vision, particularly in one eye
– sudden dizziness
– sudden problems with walking
What should you do?
What action should PTA take?
• Seek immediate medical assistance
– OP : call 911
– IP : call for RN or MD
Anaphylaxis
• A severe allergic reaction (anaphylaxis) can
produce shock and life-threatening respiratory
distress and circulatory collapse.
Anaphylaxis
• Signs and Symptoms:
– Hives
– Eyes or lips may swell severely
– The inside the throat may swell causing difficulty
breathing and shock
– Blood pressure drops
– Dizziness
– Mental confusion
– Abdominal cramping
– Nausea
– Vomiting
– Diarrhea
What will you do ?
Actions of the PTA
• Call 911 or a code in the facility.
• Check for special medications that the person might be carrying to treat
an allergic attack, such as an auto-injector of epinephrine (for example,
EpiPen). Administer the drug as directed — usually by pressing the autoinjector against the person's thigh and holding it in place for several
seconds. Massage the injection site for 10 seconds to enhance absorption.
• Have the person lie still on his or her back with feet higher than the head.
• Loosen tight clothing and cover the person with a blanket. Don't give
anything else to drink.
• If there's vomiting or bleeding from the mouth, turn the person on his or
her side to prevent choking.
• If there are no signs of circulation (breathing, coughing or
movement),begin CPR.
Head Trauma
• If a patient suffers a head trauma while in
your care what will you do?
If injuries are minor you need see that patient receives
appropriate medical care. You then must report the
incident to the appropriate parties and complete a
medical report
A head trauma is considered a medical emergency if
any of the following signs are apparent:
• Severe head or facial
bleeding
• Bleeding from the nose or
ears
• Severe headache
• Change in level of
consciousness for more
than a few seconds
• Black-and-blue
discoloration below the
eyes or behind the ears
• Confusion
• Loss of balance
• Weakness or an inability to
use an arm or leg
• Unequal pupil size
• Repeated vomiting
• Slurred speech
• Seizures
• Cessation of breathing
What do you do?
Actions of the PTA
• First, address any bleeding by putting firm
compression on the wound. Then call for
help.
• If patient stops breathing begin CPR/Rescue
Breathing
• Call for medical assistance and watch for
changes in breathing and alertness.
Severe Bleeding
• You encounter a patient or person
who is bleeding severely. What will
you do?
Severe Bleeding
• If possible, before you try to stop severe
bleeding, wash your hands to avoid infection
and put on synthetic gloves. Don't reposition
displaced organs. If the wound is abdominal
and organs have been displaced, don't try to
push them back into place. Cover the wound
with a dressing.
• Have the injured person lie down. If possible, position the person's head
slightly lower than the trunk or elevate the legs. This position reduces the
risk of fainting by increasing blood flow to the brain. If possible, elevate
the site of bleeding.
• While wearing gloves, remove any obvious dirt or debris from the
wound. Don't remove any large or more deeply embedded objects. Don't
probe the wound or attempt to clean it at this point. Your principal
concern is to stop the bleeding.
• Apply pressure directly on the wound. Use a sterile bandage, clean cloth
or even a piece of clothing. If nothing else is available, use your hand.
• Maintain pressure until the bleeding stops. Hold continuous pressure for
at least 20 minutes without looking to see if the bleeding has stopped. You
can maintain pressure by binding the wound tightly with a bandage (or
even a piece of clean clothing) and adhesive tape.
• Don't remove the gauze or bandage. If the bleeding
continues and seeps through the gauze or other material you
are holding on the wound, don't remove it. Instead, add more
absorbent material on top of it.
• Squeeze a main artery if necessary. If the bleeding doesn't
stop with direct pressure, apply pressure to the artery
delivering blood to the area of the wound. Pressure points of
the arm are on the inside of the arm just above the elbow and
just below the armpit. Pressure points of the leg are just
behind the knee and in the groin. Squeeze the main artery in
these areas against the bone. Keep your fingers flat. With your
other hand, continue to exert pressure on the wound itself.
• Immobilize the injured body part once the bleeding has
stopped. Leave the bandages in place and get the injured
person to the emergency room as soon as possible.
Diabetic Emergency
• Insulin Reaction - This condition occurs when there is TOO
MUCH INSULIN in the body. This condition rapidly reduces the
level of sugar in the blood and brain cells suffer.
• Insulin reaction can be caused by taking too much medication,
by failing to eat, by heavy exercise and by emotional factors.
• SIGNS & SYMPTOMS: Fast breathing, fast pulse, dizziness,
weakness, change in the level of consciousness, vision
difficulties, sweating, headache, numb hands or feet, and
hunger.
What should you do?
• ASK "HAVE YOU EATEN TODAY?“
– Someone who has eaten, but has not taken
prescribed medication may be in a diabetic coma.
• ASK "HAVE YOU TAKEN YOUR MEDICATION
TODAY?“
– Someone who has not eaten, but did take their
medication, may be having an Insulin reaction.
• A PERSON IN INSULIN SHOCK NEEDS SUGAR,
QUICKLY!
• IF THE PERSON IS CONSCIOUS, GIVE SUGAR IN
ANY FORM: CANDY, FRUIT JUICE OR A SOFT
DRINK!
• Call for medical assistance if symptoms do not
improve after this action
• This is a list of just some of the more common
medical emergencies that may be
encountered as you practice in the physical
therapy field.
• As you begin to study specific patient
populations you will learn specific medical
emergencies that can arise in each population.
Resources
• http://www.umm.edu/non_trauma/condhub.
htm
• http://www.mayoclinic.com/
• http://www.survivalcenter.com/firstaid/diabetic.htm