Download Care After Injury Or Illness

Care After Injury or Illness
Information From Your Ambulance Service
Topics Covered
Medical Conditions
Blood Sugar Problems
1
Seizures
2
Seizures in Children
3
Choking
4
Fainting
5
Injuries
Burns
6
Wound Care
7
Sprains, Strains and Contusions
8
Head Injuries
9
Injuries from Lap Belts, Shoulder Straps
and Airbags
10
Blood Sugar Problems – Diabetes
Abnormal blood sugar (glucose) levels can be the result of diabetes, taking too
much insulin, inadequate food intake, excessive physical activity or a variety of
other medical conditions. The crew may have administered medication or
sugars to improve your condition. This improvement after treatment is often
only temporary and you may be at risk for the problem to reoccur. We are
concerned for your health and safety and offer the following recommendations.
What To Watch For
If you have decided not to be treated or transported by the ambulance crew,
contact your doctor or seek other medical help if any of the following develop:
• A decline in the level of consciousness, confusion, unexplained behavior
or personality changes
• Unexplained weakness, drowsiness, sleepiness, or inability to perform
usual activities
• Profuse sweating, unresponsiveness, or even seizures can be a result
of low blood sugar
• Profound thirst, lack of urine output, or fruity odor (keytones) to
the breath can be a sign of high blood sugar
Consider These Actions Following Episode of Low Blood Sugar
• Eat a balanced meal right away. Take your medication as prescribed. If you
were given sugar or medicine by the ambulance crew, the benefit is short-term.
• If you are trained to do so, recheck your blood sugar again over the next few
hours. Then continue to check and record your urine or blood as advised by
your doctor
• Make certain that you are not alone and that you are observed by a competent
friend or family member for at least the next few hours or longer
• Avoid driving a vehicle or strenuous activity until your blood sugar is within
normal limits
• Contact your doctor and inform them that an ambulance was called for you.
If the ambulance crew tested your blood sugar, share with your doctor the
measurement number written below
• If needed, contact the ambulance again by calling 911
The sugar (glucose) level in your blood measured by the ambulance
crew on their arrival was:
HIGH
LOW
NORMAL (80-140)
The ambulance crew measured it to be ____________________
at __________ AM/PM
on _____/_____/_____
1
Seizures
A seizure is usually evidenced by a series of muscle contractions that can last
from a few seconds to several minutes. A seizure can cause loss of
consciousness or involuntary movements of parts of the body such as the face,
arms, and legs. Seizures generally are due to a burst of abnormal electrical
activity in nerve cells in the brain. When a seizure causes stiffening or
rhythmic jerking movements of the body, this is sometimes called a
“convulsion.” Seizures can be caused by a wide variety of conditions such as
fevers (febrile seizures), head injury, brain tumors, changes in body chemistry,
or epilepsy.
It is important that any individual who has a first time, unexplained seizure be
evaluated by a physician as soon as possible. Seizures can be a warning sign of
a serious underlying medical condition.
What To Watch For
If you have decided not to be transported by ambulance to a medical facility
following a probable seizure, seek medical help if any of the following develop:
• The seizure activity reoccurs within the next 24 hours
• If you suspect you have been injured as a result of the seizure
• If you experience periods of confusion, weakness, or loss of sensation
Consider These Actions
• Take your medications as prescribed – if you have a history of seizures,
inform your physician about the frequency and types of your seizure activity
• Do not drive a motor vehicle, operate machinery, or swim until your seizures
are controlled
• If you feel a seizure coming on, lie down in a safe place to avoid getting injured
• If needed, contact the ambulance again by calling 911
2
Seizures in Children Due to Fevers (Febrile)
Febrile seizures in children are fairly common, occurring most often in children
younger than three years of age. They are usually associated with a high fever
caused by a bacterial or viral infection of the ears, nose and throat, or the
stomach and intestines (the flu). For children who have febrile seizures, about
60% have only one seizure in their lifetime. Most febrile seizures are isolated
events, do not cause permanent harm, and do not require long term treatment.
The muscle contractions that accompany these seizures may last 3-5 minutes
and can be distressing for a parent or caretaker to witness.
Preventing Febrile Seizures in Children
To help reduce a fever that could lead to a febrile seizure:
• Avoid excessive clothing or blankets that will trap body heat from escaping
• Do not sponge them with alcohol and do not give them aspirin
• Give the child a medication to reduce their fever, such as children’s
acetaminophen or ibuprofen (Tylenol™ ,Feverall™ ,Motrin™ ,Advil™ ) – use
the dose recommended by your physician or the instructions on the container
• If they continue to feel very warm, consider sponging them with luke-warm
(not cold) water to assist in cooling them down
What To Do If Your Child Has A Seizure
While there is nothing you can do to make the seizure stop, you can help your
child remain safe:
• Gently turn the child on their side to help keep the air passage
clear and open
• Do not put anything into the child’s mouth and do not try to
control any muscle contractions
• Immediately request an ambulance by calling 911
• Once the muscle rigidity or contractions stop, breathing should return
to normal and the child may appear to be sleeping heavily for the
next 10 to 20 minutes
• It is recommended that all first time seizures not attributed to fever, seizures
in children under 6 years of age, or multiple seizures that occur over a short
period of time, be evaluated by a physician as soon as possible
3
Choking and Foreign Object Ingestion
Obstruction of the airway into the lungs by food, fluids, or other foreign objects
can be life threatening. Children are especially prone to choking during
mealtime or when placing small objects in their mouth. Some items that initially
cause choking are cleared by coughing and are then swallowed or spit-out.
On rare occcasions, a solid object may lodge in the breathing passages or the
lung. This always requires medical care.
If a large object passes and gets stuck in the esophagus (food tube), it must be
removed as soon as possible. If a non-food object passes into the stomach, it
probably will pass through the body without causing problems. Sharp or
pointed objects are more dangerous than round or smooth ones. It is sometimes
difficult to tell for certain if the foreign object that caused the choking has
entered the food tube or the breathing tube.
What To Watch For
If you have decided not to be transported by ambulance to a medical facility,
contact your doctor or seek other medical help if any of the following develop:
• Additional choking, gagging, drooling, or vomiting
• Continued coughing, wheezing, or abnormally noisy or difficult breathing
• If a fever develops over 100.4˚ F (32˚C) – this may be a sign of lung infection
• Developing chest, neck or throat pain, or an inability to swallow or talk
• Abdominal pain or a bloody bowel movement
• If a non-food object does not pass in the stool within a few days
Consider These Actions
• If a non-food object entered the stomach, check the stool until the object has
passed – putting the stool in a strainer and running water over it will make
the job easier
• There is no need to change your diet while waiting for the object to pass –
do not take any medications such as laxatives to make the object pass sooner
• Keep small objects, such as coins, balloons and hard candy, out of the
reach of infants and toddlers
• If needed, seek additional help by contacting your doctor or medical facility,
going to the hospital emergency room, or contact the ambulance again by
calling 911
4
Fainting (syncope)
Fainting or “passing out” may frequently be explained or dismissed by a set of
circumstances prior to the event. However, it can also be a sign of a serious and
undiagnosed medical condition.
What To Watch For
If you have decided not to be transported by ambulance to a medical facility, we
encourage you to seek immediate medical help if any of the following develop:
• Chest pain, back pain, or difficulty breathing
• Feeling faintness, light headedness, dizziness, or profound weakness
• Numbness, loss of feeling or paralysis in your face or an arm or leg
• A severe headache, stiffness to neck, nausea or vomiting
• Any unusual changes in sensation such as loss of sight or hearing
• Another episode of fainting or a decline in the level of consciousness
• Confusion or unexplained sudden changes in personality or behavior
• Unexplained falling or loss of balance
• Any evidence of blood in your urine or stool
Consider These Actions
• Refrain from driving a motor vehicle, operating machinery, or engaging in
strenuous physical activity for the next several hours or longer until you feel
back to normal
• Drink plenty of water or non-alcoholic fluids if the fainting was due to
dehydration or heat exposure
• Immediately stop your activity and sit or lie down if you feel faint again
• Contact your physician if any symptoms persist or there is a question about
taking your medications
• If needed, contact the ambulance again by calling 911
5
Burns
A burn injury can be caused by heat, radiation, excessive cold, or exposure to
strong chemicals. The severity is determined by both the depth and the size of
the wound. Burns destroy layers of skin and weaken the skin’s resistance to
infection. Protect the damaged area and watch for signs of a developing
infection. Infection may increase chances for scarring.
What To Watch For
• Carefully monitor for signs of infection including increased pain, swelling or
redness, yellow pus or foul-smelling drainage, red streaks coming from the
wound, or developing a fever over 100.4˚ F. (38˚ C.)
• Severe burns (3rd degree) and burns associated with swelling to an extremity
that can interfere with normal function and use, must be evaluated and
treated at a medical facility
Consider These Actions
• Keep the burn area clean and apply a sterile dressing. Change your dressing
at least 2 times a day. Always wash your hands before touching or changing
your dressing.
• Do not break blisters. If a blister breaks on its own, thoroughly wash the area
twice a day, pat dry, and apply antibiotic ointment before covering again with
a sterile dressing.
• Serious or extensive burns need to be evaluated and treated at a clinic or
hospital. If your area has a specialty burn center, you can go there directly to
receive care.
• Burns to the face, hands, feet, or genitalia should be evaluated at a clinic or
hospital and closely followed to avoid scarring and maintain function.
• Sunburn, if minor and not blistered, can be treated with cool compresses or
creams and ointments designed to moisturize the skin or decrease the pain.
It will usually heal within a few days and may involving pealing of the
damaged skin. More serious sunburn that involves blistering is best treated
by a physician or at a burn center to prevent infection.
• Scald wounds, such as from hot liquids, are difficult to determine the
severity. If the skin peals off following a scald injury, the damage may be
deep and needs to be evaluated by a physician.
• Contact your physician or seek other medical help if symptoms worsen,
infection develops, or the wound does not show signs of healing within
a few days.
• If needed, contact the ambulance again by calling 911.
6
Wound Care – Lacerations and Abrasions
Lacerations are cuts that leave a smooth or jagged wound in the skin. They
may affect only the top layer of skin or involve deeper tissues below the skin
such as muscles, nerves and blood vessels.
Abrasions usually involve destruction of only the outer layers of skin and appear
wet with traces of blood and other fluids before scabbing over. We encourage you
to engage in good wound care that will improve healing, help prevent an infection,
and may prevent later problems or inability to use an arm or leg normally.
What To Watch For
If you have decided not to be transported by ambulance to a medical facility
for wound care, contact your doctor or seek other medical help if any of the
following develop:
• Increased pain or tenderness over time
• Redness or red streaks around the wound
• Increased swelling, numbness or tingling
• Pus or excessive drainage coming from the wound
• Bleeding that cannot be controlled
• Fever over 100.4˚ F (32˚C), chills, or other signs of infection
Consider These Actions
• If the ambulance crew has recommended, or you feel you should be
evaluated for sutures (stitches to close wound), you should seek this
treatment as soon as possible and within 6 hours of the injury
• Clean the wound with soap and water, pat it dry and keep it clean
• After washing, you may apply to the surface an antibiotic ointment such as
Bacitracin or Neosporin (available without prescription) – do not apply an
ointment if you will soon be seeking medical care of the wound.
• Cover the wound with a sterile gauze dressing – avoid plastic coverings that
seal out air or make the skin wet and may increase the chance for infection
• Contact your doctor if it has been more than 10 years since your last tetanus
shot. If needed, a tetanus shot should be given within 24 hours of the injury.
• Seek additional help by contacting your doctor or medical facility, going to
the hospital emergency room or contact the ambulance again by calling 911
7
Strains, Sprains, and Contusions
In addition to open wounds, other injuries to soft tissues of the body can occur.
Strains usually involve overuse or over-stretching of muscles.
Sprains are injuries to joints that result from partial or complete tearing of
ligaments.
Contusions can result from blunt trauma when damaged blood vessels leak
under the skin.
With any of these injuries, there may be swelling under the skin due to blood or
fluid buildup called a hematoma. The signs and symptoms of strains and
sprains are often similar to those of a broken bone (fracture) or dislocation of a
joint, both of which would need the care of a physician. The seriousness of the
injury may not be recognized until hours or days later.
What To Watch For
If you have decided not to be transported by ambulance to a medical facility,
contact your doctor or seek other medical help if any of the following develop:
• Increasing pain or tenderness, excessive swelling, or extensive bruising of the
injured area
• Coldness, numbness, tingling, or loss of feeling to the area of injury or
beyond
• Continued inability to move or use and arm or leg or an individual joint
Consider These Actions
• Protect the injured area and avoid movement or activity that may aggravate
the injury
• For an injured joint, keep it immobilized and elevated on pillows
• Apply cold compresses every 2 hours for 20-30 minutes – continue the cold
treatments on and off for 24 hours – do not freeze the area and do not apply
heat if there is any swelling evident
• Ibuprofen or acetaminophen may be taken for pain or discomfort – avoid
taking aspirin
• Contact your physician or seek other medical help if symptoms persist or
worsen
• If needed, contact the ambulance again by calling 911
8
Head Injuries
Striking your head against an object or receiving a blow to your head may
result in a minor head injury. Your face or head may be bruised or cut and you
may have been unconscious for a short time as a result of the injury. Head
injuries can also occur without bruising, cuts, or unconsciousness. Head
injuries can be potentially dangerous if bleeding or swelling occur inside the
head. Furthermore, because a head injury may not be noticed at first, it is
important to follow these instructions, even if you do not have symptoms now.
What To Watch For
If you have decided not to be transported by ambulance to a medical facility,
contact your doctor or seek other medical help if any of the following develop:
• Unexplained drowsiness, stupor, or unresponsiveness (loss of consciousness)
• Severe or persistent headache
• Persistent neck or back pain
• Weakness or loss of feeling in arms or legs, difficulty walking
or loss of balance
• Dizziness or vision problems
• Ongoing nausea or vomiting
• Speech or hearing difficulty
• Bleeding or unusual discharge from the nose or ears
• Confusion, loss of memory, unexplained irritability or personality changes
• Twitching, convulsions or seizures
Consider These Actions
• The head-injured person should not be alone for the next 24 hours. If you are
caring for them, awaken them every 2 hours to make sure they can be easily
wakened and can answer simple questions. The patient should rest and
avoid strenuous activities.
• Do not take any alcohol, sedatives or pain medication without checking with
a doctor. Check with your doctor if you are taking aspirin on a regular basis.
• A cold compress or ice pack can be applied to any tender/painful area of the
head. Avoid excessive cold applications.
• If needed, seek additional help by contacting your doctor or medical facility,
going to the hospital emergency room or contact the ambulance again by
calling 911.
9
Injuries from Lap Belts, Shoulder Straps
and Airbags
Your use of seat belts and shoulder straps or deployment of your vehicle’s airbag
may have prevented a serious injury. However, serious injuries are not always
immediately obvious. Even if serious injury was prevented, there are patterns of
lesser injuries associated with these devices we want you to be aware of and to
watch for over the next few days.
What To Watch For
Seat Belt Injuries
Compression of the organs and bony structures under the belt can cause
internal injuries not noticed at the time of the accident. For rear seat passengers
or larger children where a lap belt was the only restraint employed, watch for
injuries resulting from the head or torso being thrust forward or sideways.
Signs and symptoms of concern include:
• Evidence of blood in your urine or stool or any changes in your ability to
urinate or move your bowels
• Bleeding from some internal injuries may be evidenced by symptoms of
shock such as dizziness, weakness, or skin that appears pale or wet
• Coughing up or vomiting traces of blood
• Watch the belly area or lower back for developing pain, tenderness, or swelling
• Weakness in one or both legs may be due to injuries in the abdomen, to the
lower back, or nerves in the spine. Injuries to the head and neck are possible
if a lap belt was the only device used.
Shoulder Strap Injuries
Muscle strains, contusions, and bruising can occur to the areas of the body
under the strap. You may develop discoloration or swelling to the skin
following the path of the strap across your chest and neck. This discoloration
should clear over time. Signs and symptoms of concern include:
• Difficult or painful breathing, chest pain or back pain can be an indication of
injury to the lungs, heart, or the large vessels in the chest
• The neck may also have been subjected to a whiplash type motion due to the
strap holding the chest in place but not the head – watch for increases in pain
or stiffness to the neck
10
Airbag Injuries
These devices deploy forcefully and quickly at a rate of around 200 miles per
hour. Your face, neck and arms may show evidence of abrasions, fabric rub
burns, or bruises where the airbag impacted. The powder from the airbag is
cornstarch based and can easily be brushed or washed off. Signs and symptoms
of concern include:
• Changes in vision or pain to the surface of the eye itself
• Any indication that a head injury or concussion has occurred – see the section
on Head Injury
• Increasingly difficult or painful breathing or chest and back pain
• Persistent or increasing pain, stiffness, or immobility in the neck or arms.
Recommended Actions
• If you develop any potentially concerning injuries as described – immediately
seek the services of a physician or a medical facility
• If needed, contact the ambulance again by calling 911
11
About Your Ambulance Call
We are providing this pamphlet because we are concerned about your
health and safety. Please review this guide for information and advice
specific to your medical condition or injury.
The evaluation and treatment provided you by our ambulance crew may
not provide all the medical care required for your condition. Additional
treatment at a hospital or by a physician may be necessary to ensure
your health and recovery. Obtain needed care as soon as possible.
The advice and instructions contained in this pamphlet are not a
substitute for definitive and comprehensive treatment of your condition.
When needed, we encourage you to seek additional help by contacting
your doctor or medical facility, going to the hospital emergency room, or
contacting the ambulance again by calling 911.
If appropriate, inform your physician that an ambulance was called for
you. Your physician will want to know about the incident and any notes
or information the ambulance crew recorded in this pamphlet. Your
physician can contact us if additional information is needed to improve
your care.
Date of Ambulance Call : _____/_____/_____
Time : _______________
Notes by Crew:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
1216 Second Street SW
Rochester, Minnesota 55905
www.mayomedicaltransport.com
MC2559-03rev1003
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