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PowerPoint® to accompany Medical Assisting Chapter 44 Second Edition Ramutkowski Booth Pugh Thompson Whicker Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1 Medical Emergencies and First Aid Objectives 44-1 Discuss the importance of first aid during a medical emergency. 44-2 Describe the purpose of the emergency medical services (EMS) system and explain how to contact it. 44-3 List items found on a crash cart or first-aid tray. 44-4 List general guidelines to follow in emergencies. 2 Medical Emergencies and First Aid Objectives (cont.) 44-5 Compare various degrees of burns and their treatments. 44-6 Demonstrate how to help a choking victim. 44-7 Demonstrate cardiopulmonary resuscitation (CPR). 44-8 Demonstrate four ways to control bleeding. 3 Medical Emergencies and First Aid Objectives (cont.) 44-9 List the symptoms of heart attack, shock, and stroke. 44-10 Explain how to calm a patient who is under extreme stress. 44-11 Describe your role in responding to natural disasters and those caused by humans. 4 Introduction Emergencies of all types occur when you are working as a medical assistant. You may have to handle a phone call from a patient who has an urgent physical or psychological problem. You must be prepared to determine the urgency and handle any emergency that arises. 5 Understanding Medical Emergencies You may see life-threatening medical emergencies in the health care setting. First aid can: Save a life Reduce pain Prevent further injury Reduce risk of permanent disability 6 Preparing for Emergencies Post emergency telephone numbers near crash cart and near all phones. Crash cart is a rolling cart of emergency supplies and equipment. Provide information to EMS Your name and location Nature of the emergency Condition of the injured patient Summary of the first aid you have given Do not hang up until the dispatcher gives you permission to do so. 7 Common Emergency and First Aid Supplies Crash cart Basic drugs Supplies Equipment Restock the crash cart regularly. Make sure all supplies are up-to-date. 8 Guidelines for Handling Emergencies Medical emergency requires you to take certain steps. Note the presence of serious condition that threaten the patient’s life, assess the situation and and if appropriate put on PPE Do six steps of initial assessment 1. General impression 2. Level of responsiveness 3. Assess ABCs 4. Determine priority of patient’s condition 5. Focus exam and history 9 Telephone Emergencies Triaging – classification of injuries according to severity, urgency of treatment and place for treatment Follow physician's protocols Stay calm Reassure the patient Act confidently in an organized manner 10 Personal Protection Take precautions to reduce chance of exposure during an emergency Keep personal protective equipment in firstaid kit at home and work Gloves Goggles Mask or face shield Gown Pocket mask or mouth shield 11 Accidental Injuries Accidental injuries may require emergency medical care Bites and stings Burns Choking Ear & eye traumas Falls & fractures Head injuries 12 Types of Burns Thermal – caused by contract with hot liquids, steam, flames, radiation or excessive heat from fires Chemical – exposure to chemical or industrial facilities chemicals Electrical – exposure to electrical current or lightening 13 Choking Foreign objects or food blocks the trachea or windpipe Patient cannot speak Patient is holding hand to throat and looks afraid Medical assistants should know first aid for choking adult, child, or infant! 14 Apply Your Knowledge What is the universal sign of choking? 15 Apply Your Knowledge -Answer What is the universal sign of choking? Patient is holding hand to throat and looks afraid. 16 Ear and Eye Trauma Ear trauma Apply bandage with even pressure Preserve the ear by placing in sterile dressing, plastic, labeling and keeping chilled Eye trauma Foreign objects most common Tiny specks should be removed with a tissue 17 Falls Do not move unless situation is lifethreatening. Stabilize neck if injury suspected For minor falls, notify the physician and document. 18 Fractures, Dislocations, Sprains, and Strains Fracture - breaks in the bone which vary in severity Dislocation - displacement of a bone end from the joint Sprain - partial tearing of ligaments Strain - muscle injury that occurs from overexertion 19 Head Injuries Concussion – jarring injury of the brain Severe head injuries – contusions, fractures, and intracranial bleeding. Patient may lose consciousness, have temporary loss of vision, pallor, listlessness, memory loss, or vomiting May requires immediate hospitalization and/or CPR Scalp hematoma and laceration – blood under the skin or break in the skin Control swelling with ice Control bleeding with direct pressure 20 Hemorrhaging Hemorrhaging – heavy or uncontrollable bleeding Can be internal or external Use direct pressure, apply additional dressing as needed Elevate body part, put pressure on pressure point 21 Poisoning Substance that produces harmful effects if it enters the body. Majority of accidental poisonings happen in children under age 5. Call poison control center 22 Weather Related Injuries Frostbite Heat stroke Warm with clothing or other body part Do not massage Recognize symptoms and treat as emergency Place ice packs in groin and armpits Sunburn Apply cool water or compresses Elevate legs and arms to reduce swelling Drink liquids and take pain reliever Use sunscreen 23 Wounds Open wounds – skin or mucous membrane is damaged Abrasions – scraping of the skin Punctures – small hole created by a piercing object. Closed wounds – injury inside the body without breaking the skin. 24 Apply Your Knowledge A patient arrives at the clinic with severe hemorrhaging from the left thigh. What steps should you take to control the bleeding? 25 Apply Your Knowledge -Answer A patient arrives at the clinic with severe hemorrhaging from the left thigh. What steps should you take to control the bleeding? 1. 2. 3. 4. Apply direct pressure with sterile gauze Add additional dressing as necessary Elevate the leg Apply pressure to the left femoral artery 26 Common Illnesses Abdominal pain Asthma Dehydration Diarrhea Fainting Fever Hyperventilation Nosebleed Tachycardia Vomiting 27 Less Common Illnesses Anaphylaxis Bacterial meningitis Diabetic Emergencies Gallbladder attack Heart attack Hematemesis Obstetric emergencies Respiratory arrest Seizures Shock Stroke Toxic shock syndrome Viral encephalitis 28 Heart Attack Myocardial Infarction (MI) Symptoms: Blocked blood flow to the heart Crushing, burning, heavy aching pain or feeling like indigestion Pain may radiate down the left arm, into the jaw, throat, or both shoulders Shortness of breath, sweating, nausea, and vomiting Pale and have a feeling of doom. 29 CPR Objective- provide ventilation and blood circulation for a patient who shows none. Correctly performed cardiopulmonary resuscitation (CPR) can save a life An automated external defibrillator (AED) may be used Respiratory arrest – lack of breathing Start CPR and call EMS (911) 30 Shock Shock is life-threatening associated with failure of the cardiovascular system. Symptoms: Restlessness Irritability Increased respiration Fear Rapid pulse rate 31 Shock (cont.) Treatment Elevate the feet 8 to 12 inches if no head injury is suspected Monitor ABCs Control bleeding Call EMS (911) 32 Stroke Stroke or cerebrovascular accident (CVA) occurs when the blood supply to the brain is impaired. Symptoms: Headache Confusion Dizziness Loss of consciousness Paralysis of one side of the body Slurred or garbled speech 33 Stroke (cont.) Impairment may cause temporary or permanent damage, notify the physician at once. Call EMS (911) Maintain patient’s airway by turning the head toward the affected side to allow secretions to drain out Loosen tight clothing Monitor vital signs Administer oxygen 34 Common Psychosocial Emergencies Alcohol, spousal, child, and elder abuse Overdose on drugs Violent behavior Suicide Rape – follow protocol for chain of custody of specimen Use community resources 35 The Patient Under Stress You must realize that people react differently to emergency situations Keep victims and family calm Promote calmness by listening carefully 36 Educating the Patient Encourage patients and families to learn first aid and CPR Provide first-aid kit check list Know how to access EMS and list emergency numbers by the phone Childproof homes Provide appropriate easy-to-read handouts 37 Disasters You must be familiar with standard protocols for responding to disasters. You may have to participate in fire or other disaster drills to familiarize yourself with emergency procedures. Triage – each victim gets a tag to classify the person as emergent (needing immediate care), urgent (needing care within several hours) and nonurgent (needing care when time is not critical) or dead. 38 Bioterrorism Intentional release of a biologic agent with the intent to harm individuals. Physician’s offices are the front lines should a biological agent be released. The local public health department should be notified if bioterrorism is suspected as cause of illness. Follow state and national guidelines. 39 Apply Your Knowledge A patient arrives at the office with a headache, some confusion, and garbled speech. What should you do and why? 40 Apply Your Knowledge -Answer A patient arrives at the office with a headache, some confusion, and garbled speech. What should you do and why? The patient may be having a stroke, you should call EMS (911), maintain patient’s airway by turning the head toward the affected side to allow secretions to drain out, loosen tight clothing, monitor vital signs and administer oxygen 41 Summary Medical Assistant You can make a positive difference in the health and lives of people who face medical emergencies to which you respond. You will need to stay calm and communicate clearly during emergencies 42 End of Chapter 43