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Emergency Care
Duty: Communicate Client Information to Authorized Persons
Task : E.04 Respond to Emergency Situations
Objectives:
• Demonstrate how to recognize and respond to
medical emergencies.
• Describe basic CPR and demonstrate knowledge of
first aid procedures.
Emergency Care
Immediate steps in responding to an emergency are:
• Assess the situation. Make sure you it is safe for you
to enter the area.
• Assess the victim. Check the victim’s level of
consciousness. If unresponsive, call for help or send
someone to get help.
Be prepared to give the following information when
reporting emergencies:
• Phone number and address, including directions and
landmarks
• Victim’s condition and any relevant medical
background
• Your name and position
• First aid given
Emergency Care
First aid is emergency care given immediately to an injured
person. The aims of first aid are:
• To preserve life - this is the main aim of first aid; to save
lives. This includes the life of the first aider, the victim or
injured/sick person, and bystanders.
• To prevent further harm - the patient must be kept stable
and his/her condition must not worsen before medical
services arrive. This may include moving the patient out of
harm's way, applying first aid techniques, keeping him/her
warm and dry, etc.
•
Promote recovery - this may include anything that may
help in the recovery process.
Emergency Care
Tend to life-threatening emergencies in priority order:
• Breathing
• Cardiac arrest
• Severe bleeding
• Shock
• Severe head injury
• Open wound at the chest or abdomen
Emergency Care
Obstructed airway (choking) - a condition in which the tube
through which air enters the lungs is blocked. Clutching the
throat is the universal sign of choking. Ask the person to speak
or cough. If the person cannot, or if the response is very weak,
proceed with abdominal thrusts.
Abdominal thrusts - a method of attempting to remove an
object from the airway of someone who is choking.
Back blows - first aid for an infant who is choking in which the
rescuer strikes the infant between the shoulder blades in order
to try to remove an obstruction.
Chest thrusts - first aid for an infant who is choking in which
the rescuer places two or three fingers in the center of the
breastbone and pushes in order to try to remove an obstruction
Emergency Care
Abdominal thrusts procedure - for conscious adult (see
task sheet at end of this section)
If the choking person loses consciousness:
• Gently lower person to the ground, taking care to
protect the head all the way down.
• Place person on their back.
• Tilt head back and lift chin to open airway.
• Check for breath
• If no breath, open mouth and try to sweep the mouth
to remove blockage.
• If obstruction remains, place hands, one on top of
other, between the bottom of the breastbone and the
navel.
Emergency Care
Abdominal thrusts for unconscious person (cont.)
• Execute a series of 5 sharp compressions by pushing
inward and upward.
• After the abdominal thrusts, repeat the process of
opening airway and checking for breath, feeling for
and possibly removing the foreign material,
attempting to ventilate
• If the airway is not clear, repeat process as often as
necessary.
Emergency Care
Cardiopulmonary resuscitation (CPR) is medical
procedures used when a person’s heart or lungs have
stopped working. In October, 2010 the American Heart
Association issued new guidelines. The new sequence is:
• Check for unresponsiveness and lack of breathing or
abnormal breathing.
• Activate emergency response (call 911 in the US and
Canada).
• Perform 30 chest compressions - push hard and push
fast in the center of the chest at a rate of 100 per
minute.
• If you are trained give 2 ventilation and then alternate
30 compressions with 2 ventilations.
• If you are not trained in ventilations continue with chest
compressions.
Emergency Care
Severe bleeding must be controlled immediately. Take time
to put on gloves before trying to control bleeding.
First aid for severe bleeding:
• Have the injured person lie down and cover the
person to prevent loss of body heat. If possible,
position the person's head slightly lower than the trunk
or elevate the legs and elevate the site of bleeding.
• Apply pressure directly on the wound until the
bleeding stops. Hold continuous pressure for at least
20 minutes without looking to see if the bleeding has
stopped. Maintain pressure by binding the wound tightly
with a bandage or adhesive tape. Use your hands if
nothing else is available.
Emergency Care
First aid for severe bleeding (cont.)
• 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 - on the inside of the
arm just above the elbow and just below the armpit; just
behind the knee and in the groin.
• 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.
Emergency Care
Shock - a condition that occurs when organs and tissues in
the body do not receive an adequate blood supply.
Signs of shock are :
• Skin is pale, cold, clammy and may be sweaty
• Decreased level of consciousness
• Increased and weak pulse
• Decreased blood pressure
• Increased and shallow respirations
• Extreme thirst, may vomit and “feel sick”
Emergency Care
First aid for shock:
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Call 911 or send someone to call for help.
Stay with the person.
Lay person down and raise legs if possible.
Keep person warm.
Loosen tight clothing to help circulation and breathing.
Moisten lips if thirsty – do not give anything to drink.
Avoid moving unnecessarily.
Begin CPR if breathing or heartbeat stop.
Emergency Care
Heart attack - a sudden, serious, painful, and sometimes
fatal interruption of the heart's normal functioning,
especially due to a blockage in the coronary artery that
causes damage to the heart muscle.
Symptoms of a heart attack are:
• Sudden, severe pain in the chest, usually on the left
side or in the center behind the sternum
• Pain or discomfort in other areas of the body, such
as the arms, the back, neck, jaw, or stomach
• Indigestion or heartburn
• Nausea and vomiting
• Dyspnea – difficulty breathing
• Dizziness
Emergency Care
Symptoms of a heart attack (cont’d.):
• Skin color may be pale, gray, or cyanotic (bluish)
• Perspiration
• Cold and clammy skin
• Weak and irregular pulse rate
• Low blood pressure
• Anxiety and a sense of impending doom
• Women’s most common symptoms are chest pain or
discomfort. They are more likely to have shortness of
breath, nausea/vomiting, and back or jaw pain.
Call 911 immedicately as the client could go into shock
or cardiac arrest.
Emergency Care
First aid for heart attack:
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Call 911 immediately.
Check ABC’s: Airway, Breathing, Circulation.
Calm and reassure the client.
Place client in semi-reclining position or in most
comfortable position for them to breath. Lower if signs
of shock.
• If possible, ask questions about any previous heart
problems and medications they may be taking to
share with EMS personnel.
Emergency Care
Poisoning is caused by swallowing, injecting, breathing in,
or otherwise being exposed to a harmful substance. Most
poisonings occur by accident.
Signs of poisoning are:
• Sudden collapse
• Vomiting
• Heavy breathing
In the United States, call 1-800-222-1222 to speak with a
local poison control center. This hotline number will let you
talk to experts in poisoning. They will give you further
instructions.
Emergency Care
The best treatment for burns is prevention. It is important to
do no harm to severe burns, which could later cause infection
or damage to skin that should be saved.
Treatment for burns includes:
• Treat a first or second degree burn right away by
putting it in cool water. Cool the burn for fifteen minutes.
• Cover burn with a clean, dry cloth. Do not apply creams,
ointments, sprays or other home remedies.
• Remove all clothing, diapers, jewelry and metal from the
burned area. These can hide underlying burns and
retain heat, which can increase skin damage.
• For third degree burn and signs of shock, call 911
Emergency Care
Epilepsy - an illness of the brain that produces seizures
The signs of seizures are:
• Severe shaking
• Thrusting arms and legs uncontrollably
• Jaw clenching
• Drooling
• Inability to swallow
First aid for seizures involves responding in ways that can
keep the person safe until the seizure stops by itself.
Emergency Care
First aid for seizures:
• Keep calm and reassure other people who may be
nearby
• Prevent injury by clearing the area around the person
of anything hard or sharp.
• Ease the person to the floor and put something soft
and flat, like a folded jacket, under his head.
• Remove eyeglasses and loosen ties or anything
around the neck that may make breathing difficult.
• Time the seizure with your watch. If the seizure
continues for longer than five minutes without signs of
slowing down or if a person has trouble breathing
afterwards, appears to be injured, in pain, or recovery
is unusual in some way, call 911.
Emergency Care
First aid for seizures (cont.):
• Do not hold the person down or try to stop his
movements.
• Contrary to popular belief, it is not true that a person
having a seizure can swallow his tongue. Do not put
anything in the person’s mouth. Efforts to hold the
tongue down can injure the teeth or jaw.
• Turn the person gently onto one side. This will help
keep the airway clear.
Emergency Care
Syncope - fainting
Signs and symptoms of fainting are:
• Dizziness
• Perspiration
• Pale skin
• Weak pulse
• Shallow respirations
• Blackness in visual field
Emergency Care
Fracture - a break in the bone With a closed fracture, the
bone is broken but there is no connecting wound from the
break in the bone through the skin. In an open fracture, the
bone is broken with connecting wound through the surface
of the skin. The danger of infection exists.
Symptoms of fracture are:
• Swelling
• Pain
• Tenderness
• Deformity
• Protruding bone
• Grating sound.
Emergency Care
First aid for fracture:
• Stop any bleeding. Apply pressure to the wound with
a sterile bandage, a clean cloth or a clean piece of
clothing.
• Immobilize the injured area. Don't try to realign the
bone or push a bone that's sticking out back in.
• Apply ice packs to limit swelling and help relieve
pain until emergency personnel arrive. Don't apply
ice directly to the skin — wrap the ice in a towel,
piece of cloth or some other material.
• Treat for shock. If the person feels faint or is
breathing in short, rapid breaths, lay the person down
with the head slightly lower than the trunk and, if
possible, elevate the legs.
Demonstrable Skill
Abdominal Thrust on Conscious Choking Client
1. Candidate asks client, "Are you choking?" and calls for help.
2. Brings client to a standing position and stands behind client.
3. Wraps arms around client above the waist and makes a fist with one hand.
4. Place the thumb side of the fist against the client's abdomen.
5. Positions fist slightly above navel and positions fist below bottom of sternum.
6. Grasps fist with other hand.
7. Verbalizes (for testing purposes only) that s(he) would press fist and
hand into the victim's abdomen with an inward, upward thrust.
8. Verbalizes s(he) would thrust until the object was expelled.
9. Asks client, "Are you still choking?" Client will say, "No."
a. Client may breath and speak normally.
10. RN Observer asks candidate, "What would you have done if the client
would have indicated, "Yes."
11. At a minimum, candidate states, "I would repeat this procedure until it
was successful or the client lost consciousness."
Demonstrable Skill
Abdominal Thrust on Conscious Choking Client (cont.)
12. Observer asks, "What would you have done if the client lost
consciousness?
a. Candidate replies that they would have, "Safely lowered the client
to the ground, placed the individual in supine position and
continued the administration of abdominal thrusts until help
arrived."
13. Candidate leaves client in supine position and indicates they would report
the incident to a supervisor or emergency contact.