Download Chapter 49 - Bakersfield College

Chapter 49
Basic Emergency Care
LEARNING OUTCOMES:
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Define the key terms and key abbreviations listed in this chapter
Describe the rules of emergency care
Identify the signs of sudden cardiac arrest and the emergency care required
Identify the signs, symptoms, and emergency care for hemorrhage
Identify the signs, symptoms, and emergency care for shock
Describe the causes and types of seizures and how to care for a person during a
seizure
Describe the causes, types, and emergency care for burns
Identify the common causes and emergency care for fainting
Describe the signs, symptoms, and emergency care for stroke
Explain how to promote quality of life during emergencies
EMERGENCY
CARE
aid is emergency care given to an ill or injured person before medical help arrives.
•Its goals are to prevent death and prevent injuries from becoming worse.
For emergencies in out-of-hospital settings, the Emergency Medical Services (EMS)
system is activated.
•To activate the EMS system, do one of the following:
Dial 911
Call the local fire or police department
Call the phone operator
First
BASIC
LIFE SUPPORT (BLS) FOR ADULTS
American Heart Association (AHA) BLS procedures support breathing and
circulation.
The AHA’s basic life support courses teach the adult Chain of Survival.
•These actions are taken for:
Heart attack
Sudden cardiac arrest
Respiratory arrest
Stroke
Choking
Other life-threatening problems
The
•Chain of Survival actions are done as soon as possible.
•Chain of Survival actions for the adult are:
Early access to emergency cardiovascular care
–This means activating the EMS system.
Early CPR
Early defibrillation
Early advanced care
–This
is given by EMS staff, doctors, and nurses.
Sudden
cardiac arrest (SCA) or cardiac arrest is when the heart and breathing stop
suddenly and without warning.
•There are three major signs of SCA:
No response
No breathing (Consider agonal gasps to mean “no breathing.”)
No pulse
•The person’s skin is cool, pale, and gray.
•The person is not coughing or moving.
Respiratory arrest
•Respiratory arrest is when breathing stops but heart action continues for several minutes.
If breathing is not restored, cardiac arrest occurs.
When
the heart and breathing stop, the person is clinically dead.
•Cardiopulmonary resuscitation (CPR) must be started at once.
CPR supports breathing and circulation
•CPR involves four parts (the ABCDs of CPR):
Airway
Breathing
Circulation
Defibrillation
•CPR procedures require speed, skill, and efficiency.
•Airway, breathing, and circulation procedures are done until a defibrillator is available.
•Airway
The airway must be open to restore breathing.
The head tilt-chin lift method opens the airway.
•Breathing
If the person does not get oxygen, permanent heart, brain, and other organ damage
occurs.
A rescuer inflates the person’s lungs.
Mouth-to-mouth breathing is one way to give breaths.
Mouth-to-barrier device breathing is used whenever possible.
Mouth-to-nose breathing is used for drowning victims and when the mouth cannot be
used.
Mouth-to-stoma breathing is used for people who breathe through stomas in their necks.
Before giving mouth-to-mouth or mouth-to-nose breathing, always check to see if the
person has a stoma.
•Circulation
Chest compressions force blood through the circulatory system.
Before starting chest compressions, use the carotid artery on the side near you to check
for a pulse.
For effective chest compressions, the person must be supine on a hard, flat surface.
For effective chest compressions, hand position is important.
•Defibrillation
Ventricular fibrillation (VF) causes sudden cardiac arrest.
A defibrillator is used to deliver a shock to the heart.
The shock stops the VF and allows the return of a regular heart rhythm.
Defibrillation as soon as possible after the onset of VF increases the person’s chance of
survival.
CPR
is done only for cardiac arrest.
•It is done if the person does not respond, is not breathing, and has no pulse.
•CPR is done alone or with another person.
The recovery position is used when the person is breathing and has a pulse but is not
responding.
•It helps keep the airway open and prevents aspiration.
•Logroll the person into the recovery position.
•Keep the head, neck, and spine straight.
•Do not use this position if the person might have neck injuries or other trauma.
BASIC
LIFE SUPPORT FOR CHILDREN AND INFANTS
infant death syndrome (SIDS) is the sudden, unexplained death of an infant
younger than 1 year old.
•It is the leading cause of death in children between 1 month and 1 year of age.
•It occurs during sleep.
Sudden
Cardiac
arrest caused by heart disease is rare in children.
•More common causes involve:
Respiratory diseases
Injuries that lead to respiratory arrest or circulatory failure
The AHA’s pediatric Chain of Survival involves these steps:
•Preventing cardiac arrest
•Early and effective CPR
•Rapid activation of the EMS system or the agency’s rapid response team (RRT).
•Early and effective advanced life support
The BLS sequence for infants does not involve defibrillation.
HEMORRHAGE
Hemorrhage
is the excessive loss of blood in a short time.
•If bleeding is not stopped, the person will die.
•You cannot see internal hemorrhage.
The bleeding is inside body tissues and body cavities.
Vomiting blood, coughing up blood, and loss of consciousness signal internal
hemorrhage.
•External bleeding:
If not hidden by clothing, external bleeding is usually seen.
Bleeding from an artery occurs in spurts.
There is a steady flow of blood from a vein.
SHOCK
Shock results when
Causes include:
organs and tissues do not get enough blood.
•Blood loss
•Heart attack (myocardial infarction)
•Burns
•Severe infection
Shock is possible in any person who is acutely ill or severely injured.
Anaphylactic
shock
•Anaphylaxis is a life-threatening sensitivity to an antigen.
An antigen is a substance that the body reacts to.
•Anaphylaxis can occur within seconds.
•Anaphylactic shock is an emergency.
The EMS system must be activated.
The person needs special drugs to reverse the allergic reaction.
Keep the person lying down and the airway open.
Start CPR if cardiac arrest occurs.
SEIZURES
Seizures
(convulsions) are violent and sudden contractions or tremors of muscle groups.
•Movements are uncontrolled.
•The person may lose consciousness.
Seizures are caused by an abnormality in the brain.
Epilepsy
•Epilepsy is a brain disorder in which clusters of nerve cells sometimes signal
abnormally.
•In epilepsy, seizures recur.
•The person has a permanent brain injury or defect.
•Children and young adults are commonly affected.
Epilepsy can develop at any time in a person’s life.
•There is no cure at this time.
Doctors order drugs to prevent seizures.
Drug therapy does not work for some people.
•When controlled, epilepsy usually does not affect learning and activities of daily living.
The
major types of seizures are:
•Partial seizure
•Generalized tonic-clonic seizure (grand mal seizure), which has two phases
In the tonic phase, the person loses consciousness.
The clonic phase follows.
–Muscle groups contract and relax.
•Generalized absence (petit mal) seizure, which usually lasts a few seconds
There is loss of consciousness, twitching of the eyelids, and staring.
You cannot stop a seizure.
•You can protect the person from injury.
BURNS
Burns can severely disable a person.
Burns can cause death.
Most burns occur in the home.
Infants, children, and older persons are
at risk.
Partial
thickness burns involve the epidermis and part of the dermis.
•They are very painful.
•Nerve endings are exposed.
Full thickness burns involve the entire epidermis and dermis.
•Fat, muscle, and bone may be injured or destroyed.
•Nerve endings are destroyed.
Severity depends on:
•Burn size and depth
•The body part involved
•The person’s age
FAINTING
Fainting
is the sudden loss of consciousness from an inadequate blood supply to the
brain.
Dizziness, perspiration, and blackness before the eyes are warning signals.
The person:
•Looks pale
•Has a weak pulse
•Has shallow respirations if consciousness is lost
STROKE
(CEREBROVASCULAR ACCIDENT)
occurs when the brain is suddenly deprived of its blood supply.
•Usually only part of the brain is affected.
A stroke may be caused by:
•A thrombus
•An embolus
•Hemorrhage if a blood vessel in the brain ruptures
Signs of stroke vary, depending on the size and location of brain injury.
Stroke
QUALITY
OF LIFE
quality of life during emergencies.
•Treat the person with dignity and respect.
Protect the right to privacy and confidentiality.
Protect the person from onlookers.
•Information about the person’s care, treatment, and condition is confidential.
Protect the right to personal choice.
Protect personal items from loss and damage.
Protect the person from further injury.
Protect
Reassurance,
explanations about care, and a calm approach are helpful.