Download Chp. 51 PPT

EMERGENCY CARE
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FIRST AID IS EMERGENCY CARE GIVEN TO AN ILL OR INJURED PERSON
BEFORE MEDICAL HELP ARRIVES.
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ITS GOALS ARE TO PREVENT:
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DEATH
INJURIES FROM BECOMING WORSE
IN AN EMERGENCY, THE EMERGENCY MEDICAL SERVICES (EMS) SYSTEM IS
ACTIVATED.
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TO ACTIVATE THE EMS SYSTEM, DO ONE OF THE FOLLOWING:
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DIAL 911
CALL THE LOCAL FIRE OR POLICE DEPARTMENT
CALL THE PHONE OPERATOR
BASIC LIFE SUPPORT
(BLS) FOR HEALTH CARE PROVIDERS
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THE AMERICAN HEART ASSOCIATION’S (AHA) BLS (HEARTCODE)
PROCEDURES SUPPORT CIRCULATION, AIRWAY AND BREATHING (CAB).
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THE AHA’S BASIC LIFE SUPPORT COURSES TEACH THE ADULT CHAIN OF
SURVIVAL.
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THESE ACTIONS ARE TAKEN FOR:
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HEART ATTACK
SUDDEN CARDIAC ARREST
RESPIRATORY ARREST
STROKE
CHOKING
OTHER LIFE-THREATENING PROBLEMS
BASIC LIFE SUPPORT
(BLS) FOR HEALTH CARE
PROVIDERS (CONT’D)
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CHAIN OF SURVIVAL ACTIONS ARE DONE AS SOON AS POSSIBLE.
CHAIN OF SURVIVAL ACTIONS FOR THE ADULT ARE:
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2.
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4.
5.
RECOGNIZING CARDIAC ARREST AND ACTIVATING THE EMS SYSTEM AT ONCE
EARLY CARDIOPULMONARY RESUSCITATION (CPR)
EARLY DEFIBRILLATION
EARLY ADVANCED CARE
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THIS IS GIVEN BY EMS STAFF, DOCTORS, AND NURSES.
ORGANIZED POST-CARDIAC ARREST CARE
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THIS IS CARE GIVEN TO IMPROVE SURVIVAL FOLLOWING CARDIAC ARREST.
HYPOTHERMIA PROTOCOL WITH ROSC (RETURN OF SPONTANEOUS CIRCULATION)
BASIC LIFE SUPPORT
(BLS) FOR HEALTH CARE PROVIDERS
(CONT’D)
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SUDDEN CARDIAC ARREST (SCA) OR
CARDIAC ARREST IS WHEN THE HEART STOPS
SUDDENLY AND WITHOUT WARNING.
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THERE ARE 3 MAJOR SIGNS OF SCA.
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NO RESPONSE
NO BREATHING OR NO NORMAL BREATHING
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AGONAL GASPS ARE NOT NORMAL
BREATHING.
NO PULSE
THE PERSON’S SKIN IS COOL, PALE, AND GRAY.
THE PERSON IS NOT COUGHING OR MOVING.
BASIC LIFE SUPPORT (BLS) FOR HEALTH
CARE PROVIDERS (CONT’D)
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RESPIRATORY ARREST IS WHEN BREATHING STOPS BUT HEART ACTION CONTINUES FOR
SEVERAL MINUTES.
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IF BREATHING IS NOT RESTORED, CARDIAC ARREST OCCURS.
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TO GIVE RESCUE BREATHS:
RESCUE BREATHS ARE GIVEN WHEN THERE IS A PULSE BUT NO BREATHING OR ONLY
GASPING.
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OPEN THE AIRWAY.
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GIVE 1 BREATH EVERY 5 TO 6 SECONDS FOR ADULTS
GIVE 1 BREATH EVERY 3 TO 5 SECONDS FOR INFANTS AND CHILDREN.
GIVE EACH BREATH OVER 1 SECOND.
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THE CHEST SHOULD RISE WHEN BREATHS ARE GIVEN.
CHECK THE PULSE EVERY 2 MINUTES.
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IF THERE IS NO PULSE, BEGIN CPR.
IF THE PULSE IS LOWER THAN 60 IN AN INFANT OR CHILD, BEGIN CPR.
BASIC LIFE SUPPORT (BLS) FOR HEALTH
CARE PROVIDERS (CONT’D)
• WHEN THE HEART AND BREATHING STOP,
BLOOD AND OXYGEN ARE NOT SUPPLIED TO
THE BODY.
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CARDIOPULMONARY RESUSCITATION (CPR) MUST BE
STARTED AT ONCE WHEN A PERSON HAS SCA.
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CPR SUPPORTS CIRCULATION AND BREATHING.
CPR INVOLVES FOUR PARTS.
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2.
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4.
CHEST COMPRESSIONS
AIRWAY
BREATHING
DEFIBRILLATION
CPR PROCEDURES REQUIRE SKILL, EFFICIENCY, AND SPEED.
CHEST COMPRESSIONS AND AIRWAY AND BREATHING
PROCEDURES ARE DONE UNTIL A DEFIBRILLATOR ARRIVES.
BASIC LIFE SUPPORT (BLS) FOR HEALTH
CARE PROVIDERS (CONT’D)
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CHEST COMPRESSIONS
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CHEST COMPRESSIONS FORCE BLOOD
THROUGH THE CIRCULATORY SYSTEM.
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BEFORE STARTING CHEST
COMPRESSIONS, USE THE CAROTID
ARTERY ON THE SIDE NEAR YOU TO
CHECK FOR A PULSE.
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FOR EFFECTIVE CHEST COMPRESSIONS,
THE PERSON MUST BE SUPINE ON A
HARD, FLAT SURFACE.
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HAND POSITION IS IMPORTANT FOR
EFFECTIVE CHEST COMPRESSIONS.
AIRWAY
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THE RESPIRATORY PASSAGES (AIRWAY)
MUST BE OPEN TO RESTORE BREATHING.
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THE HEAD TILT-CHIN LIFT METHOD
OPENS THE AIRWAY.
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JAW THRUST OPENS THE AIRWAY IN
PERSONS WITH SUSPECTED HEAD
TRAUMA
BASIC LIFE SUPPORT (BLS) FOR HEALTH
CARE PROVIDERS (CONT’D)
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BREATHING
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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.
BARRIER DEVICE BREATHING IS USED WHENEVER
POSSIBLE.
MOUTH-TO-NOSE BREATHING IS USED WHEN YOU
CANNOT BREATHE THROUGH THE PERSON’S MOUTH.
MOUTH-TO-STOMA BREATHING IS USED FOR
PEOPLE WHO BREATHE THROUGH STOMAS IN THEIR
NECKS.
BEFORE GIVING MOUTH-TO-MOUTH OR MOUTH-TONOSE BREATHING, ALWAYS CHECK TO SEE IF THE
PERSON HAS A STOMA.
BASIC LIFE SUPPORT (BLS) FOR HEALTH
CARE PROVIDERS (CONT’D)
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DEFIBRILLATION
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VENTRICULAR FIBRILLATION (VF, V-FIB) CAUSES SUDDEN CARDIAC ARREST.
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DEFIBRILLATION AS SOON AS POSSIBLE AFTER THE ONSET OF VF (V-FIB)
INCREASES THE PERSON’S CHANCE OF SURVIVAL.
A DEFIBRILLATOR IS USED TO DELIVER A SHOCK TO THE HEART.
THE SHOCK STOPS THE VF (V-FIB) AND ALLOWS THE RETURN OF A REGULAR
HEART RHYTHM.
AUTOMATED EXTERNAL
DEFIBRILLATOR (AED)
BASIC LIFE SUPPORT (BLS) FOR HEALTH
CARE PROVIDERS (CONT’D)
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CPR IS DONE ONLY FOR CARDIAC ARREST.
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IT IS DONE IF THE PERSON DOES NOT RESPOND, IS NOT BREATHING (OR HAS
NO NORMAL BREATHING), AND HAS NO PULSE.
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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.
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IT HELPS KEEP THE AIRWAY OPEN AND PREVENTS ASPIRATION.
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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
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SUDDEN INFANT DEATH SYNDROME
(SIDS) IS THE SUDDEN, UNEXPLAINED
DEATH OF AN INFANT YOUNGER THAN 1
YEAR OLD.
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IT IS THE LEADING CAUSE OF DEATH IN
CHILDREN BETWEEN 1 MONTH AND 1
YEAR OF AGE.
IT USUALLY OCCURS DURING SLEEP.
CARDIAC ARREST CAUSED BY HEART
DISEASE IS RARE IN CHILDREN.
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MORE COMMON CAUSES INVOLVE:
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RESPIRATORY DISEASES
INJURIES THAT LEAD TO RESPIRATORY
ARREST OR CIRCULATORY FAILURE
BASIC LIFE SUPPORT
FOR CHILDREN AND INFANTS (CONT’D)
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THE AHA’S PEDIATRIC CHAIN OF SURVIVAL INVOLVES THE FOLLOWING
STEPS:
1.
2.
3.
4.
5.
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
ORGANIZED POST-CARDIAC ARREST CARE
HYPOTHERMIA PROTOCOL
(WITH ROSC)
To save brain
CHOKING
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FOREIGN BODIES CAN OBSTRUCT THE AIRWAY. THIS IS CALLED CHOKING
OR FOREIGN-BODY AIRWAY OBSTRUCTION (FBAO).
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AIR CANNOT PASS THROUGH THE AIRWAYS INTO THE LUNGS.
THE BODY DOES NOT GET ENOUGH OXYGEN.
IT CAN LEAD TO CARDIAC ARREST.
SEVERE AIRWAY OBSTRUCTION
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AIR DOES NOT MOVE IN AND OUT OF THE LUNGS.
IF NOT REMOVED, THE PERSON WILL DIE.
ABDOMINAL THRUSTS ARE USED TO RELIEVE THE OBSTRUCTION.
HEMORRHAGE
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HEMORRHAGE IS THE EXCESSIVE LOSS OF BLOOD IN A SHORT
TIME.
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IF BLEEDING IS NOT STOPPED, THE PERSON WILL DIE.
YOU CANNOT SEE INTERNAL HEMORRHAGE.
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THE BLEEDING IS INSIDE BODY TISSUES AND
BODY CAVITIES.
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SIGNS AND SYMPTOMS INCLUDE PAIN, SHOCK,
VOMITING BLOOD, COUGHING UP BLOOD, AND
LOSS OF CONSCIOUSNESS.
EXTERNAL BLEEDING
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IF NOT HIDDEN BY CLOTHING, EXTERNAL
BLEEDING IS USUALLY SEEN.
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BLEEDING FROM AN ARTERY OCCURS IN SPURTS.
THERE IS A STEADY FLOW OF BLOOD FROM A VEIN.
FAINTING (SYNCOPE)
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FAINTING IS THE SUDDEN LOSS OF
CONSCIOUSNESS FROM AN INADEQUATE
BLOOD SUPPLY TO THE BRAIN.
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COMMON CAUSES INCLUDE HUNGER,
FATIGUE, FEAR, AND PAIN.
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DIZZINESS, PERSPIRATION (SWEATING),
AND BLACKNESS BEFORE THE EYES ARE
WARNING SIGNALS.
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THE PERSON:
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LOOKS PALE
HAS A WEAK PULSE
HAS SHALLOW RESPIRATIONS IF
CONSCIOUSNESS IS LOST
SHOCK
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SHOCK RESULTS WHEN ORGANS AND TISSUES DO NOT
GET ENOUGH BLOOD.
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CAUSES INCLUDE BLOOD LOSS, HEART ATTACK
(MYOCARDIAL INFARCTION), BURNS, AND SEVERE
INFECTION.
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SIGNS AND SYMPTOMS INCLUDE:
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LOW OR FALLING BLOOD PRESSURE
RAPID AND WEAK PULSE
RAPID RESPIRATIONS
COOL, MOIST, AND PALE SKIN
THIRST
RESTLESSNESS
CONFUSION
LOSS OF CONSCIOUSNESS.
SHOCK IS POSSIBLE IN ANY PERSON WHO IS ACUTELY
ILL OR SEVERELY INJURED.
SHOCK (CONT’D)
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ANAPHYLACTIC SHOCK
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ANAPHYLAXIS IS A LIFE-THREATENING SENSITIVITY TO AN
ANTIGEN.
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AN ANTIGEN IS A SUBSTANCE THAT THE BODY
REACTS TO.
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ANAPHYLAXIS CAN OCCUR WITHIN SECONDS.
ANAPHYLACTIC SHOCK IS AN EMERGENCY.
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THE EMS SYSTEM MUST BE ACTIVATED.
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KEEP THE PERSON LYING DOWN AND THE AIRWAY
OPEN.
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START CPR IF CARDIAC ARREST OCCURS.
THE PERSON NEEDS SPECIAL DRUGS TO REVERSE
THE ALLERGIC REACTION.
STROKE
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STROKE (CEREBROVASCULAR ACCIDENT)
OCCURS WHEN THE BRAIN IS SUDDENLY
DEPRIVED OF ITS BLOOD SUPPLY.
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A STROKE MAY BE CAUSED BY:
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USUALLY ONLY PART OF THE BRAIN IS AFFECTED.
A THROMBUS – COLLECTION OF PLTS, FIBRIN, &
RBCS ATTACHED TO INNER WALL OF ARTERY
AN EMBOLUS – FOREIGN OBJECT, AIR/GAS,
TISSUE/TUMOR, PIECE OF THROMBUS
HEMORRHAGE IF A BLOOD VESSEL IN THE BRAIN
RUPTURES
SIGNS OF STROKE VARY, DEPENDING ON THE
SIZE AND LOCATION OF BRAIN INJURY.
FAST
SEIZURES
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SEIZURES (CONVULSIONS) ARE VIOLENT AND
SUDDEN CONTRACTIONS OR TREMORS OF
MUSCLE GROUPS.
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MOVEMENTS ARE UNCONTROLLED.
THE PERSON MAY LOSE CONSCIOUSNESS.
SEIZURES ARE CAUSED BY AN ABNORMALITY
IN THE BRAIN. COMMON CAUSES INCLUDE
HEAD INJURY, HIGH FEVER, BRAIN TUMOR,
POISONING, NERVOUS SYSTEM DISORDERS OR
INFECTIONS, LACK OF BLOOD FLOW TO THE
BRAIN, SEIZURE DISORDER, AND EPILEPSY.
SEIZURES (CONT’D)
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EPILEPSY IS A BRAIN DISORDER IN WHICH CLUSTERS OF
NERVE CELLS SOMETIMES SIGNAL ABNORMALLY.
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IN EPILEPSY, SEIZURES RECUR.
THE PERSON HAS A PERMANENT BRAIN INJURY OR DEFECT.
CHILDREN AND YOUNG ADULTS ARE COMMONLY AFFECTED.
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EPILEPSY CAN DEVELOP AT ANY TIME IN A PERSON’S LIFE.
THERE IS NO CURE AT THIS TIME.
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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.
SEIZURES (CONT’D)
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THE MAJOR TYPES OF SEIZURES ARE:
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PARTIAL SEIZURE
GENERALIZED TONIC-CLONIC SEIZURE (GRAND MAL SEIZURE), WHICH HAS TWO PHASES
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IN THE TONIC PHASE, THE PERSON LOSES CONSCIOUSNESS.
THE CLONIC PHASE FOLLOWS.
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MUSCLE GROUPS CONTRACT AND RELAX.
GENERALIZED ABSENCE (PETIT MAL) SEIZURE, WHICH USUALLY LASTS A FEW SECONDS
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THERE IS LOSS OF CONSCIOUSNESS, TWITCHING OF THE EYELIDS, AND STARING.
NO FIRST AID IS NECESSARY.
YOU CANNOT STOP A SEIZURE.
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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.
BURNS (CONT’D)
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SUPERFICIAL BURNS (FIRST DEGREE)
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INVOLVE THE EPIDERMIS ONLY.
THEY ARE PAINFUL, BUT THE BURN IS NOT
SEVERE.
PARTIAL-THICKNESS BURNS (SECOND DEGREE)
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INVOLVE THE EPIDERMIS AND PART OF THE
DERMIS.
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THEY ARE VERY PAINFUL.
NERVE ENDINGS ARE EXPOSED.
FULL-THICKNESS BURNS (THIRD DEGREE)
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INVOLVE THE ENTIRE EPIDERMIS AND DERMIS.
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NERVE ENDINGS ARE DESTROYED.
FAT, MUSCLE, AND BONE MAY BE INJURED OR
DESTROYED.
BURNS (CONT’D)
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SEVERITY DEPENDS ON:
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BURN SIZE AND DEPTH
THE BODY PART INVOLVED
THE PERSON’S AGE
BURNS TO THE FACE, EYES, EARS, HANDS, AND FEET ARE MORE SERIOUS THAN BURNS TO AN
ARM OR LEG.
INFANTS, YOUNG CHILDREN, AND OLDER PERSONS ARE AT HIGH RISK FOR DEATH.