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MEDICAL CONDITIONS MedicAlert ® MedicAlert ® Medical ID Alert identification engraved with primary medical condition(s), ID number, and the 24-Hour Emergency Response Center number 2 MedicAlert ® 3 MedicAlert ® New product this spring/summer Being marketed for children in particular Can be worn over or instead of bracelet 4 Medical Conditions Angina Anaphylaxis Asphyxia Asthma Diabetes Epilepsy Heart Attack Hyperventilation Stroke (CVA) Syncope (Fainting) Unresponsiveness 5 Angina Angina is pain resulting from a deficiency of blood supply, and therefore oxygen to the heart muscle Pain may vary from discomfort, tightness, to very severe Pain usually eases or disappears with rest Normally doesn’t last longer than 15 min Usually aware of their condition, and may be on medication 6 Signs Symptoms Vary from one person to another Will normally be the same for that person If a change in symptoms – suspect heart attack Sub-sternal pain – “pressure or squeezing” May radiate across chest, upper extremities, neck, jaw, back Feeling of indigestion Will be relieved almost immediately with medication Will NOT be influenced by changing the rate of respirations, coughing, or movement 7 Treatment If the patient has medication, assist the patient in taking it Keep the patient at rest Give oxygen Take a medical history Check for MedicAlert ® identification Evaluate vital signs Monitor vital signs during transportation If the patient does not improve with mediation, has no medication or shows signs of getting worse, activate EMS and treat as Load and Go If the patient does improve with medication, recommend they seek further care at a medical facility and offer transportation Be prepared to treat the patient if they lose consciousness 8 Anaphylaxis Caused by a serious and rapid allergic reaction This is life threatening Allergies to nuts, bee stings, latex,etc. can trigger this reaction People with known anaphylaxis usually carry epinephrine 9 Signs and Symptoms Respiratory distress (wheezing) Rapid breathing and pulse Throat tightness and difficulty swallowing Dizziness, faintness Cool and clammy skin Swelling Vomiting Red, watery eyes Abdominal cramps, diarrhea Tingling in the lips and mouth Itchy rash Sense of doom May be wearing MedicAlert ® 10 Treatment Activate EMS Assist the patient to administer the injection in the thigh muscle (no other area) Hold the injector at a 90 degree angle to the skin and press against the thigh muscle Monitor vital signs closely Administer oxygen Be prepared for AR Treat for shock Transport to medical aid 11 EpiPen Administration Remove from tube Remove blue safety release Help patient swing and push the orange tip against their mid-outer thigh until you hear a “click” 12 EpiPen Administration Hold on thigh for several seconds When EpiPen® is removed, the orange needle cover automatically extends to cover the injection needle 13 Asphyxia Suffocation caused by decreased oxygen and increased carbon dioxide in the blood Causes: Trauma Drowning Suffocation Lack of oxygen in the air 14 Symptoms and Treatment Symptoms Bluish tint or a pale appearance to the skin and lips (cyanosis) Deteriorating level of consciousness Treatment Move patient to clean air Establish an airway and administer oxygen Perform AR if required Monitor vital signs Activate EMS and treat as Load & Go 15 Asthma Caused by an acute reactive constriction of the bronchi Asthma attack may be brought on by: Allergic reactions Respiratory infections Emotional stress Cold weather Exercise 16 Signs and Symptoms Whistling or high pitched wheezing during respiration Anxiety Over-inflated chest Shallow rapid respiration Increased pulse Breathing through pursed lips, as if sucking in air through a straw Appear to be “air hungry” Use of accessory neck muscles to assist breathing Prefer sitting forward 17 Treatment Reassure the patient Maintain an open airway Be prepared to assist breathing Administer high flow oxygen Put the patient in the most comfortable position Transport to a medical aid facility Assist the patient to take medication if they have any Many asthmatics will recover with use of inhaler 18 Inhalers Assist the patient to: Remove the cover Place the opening in their mouth Start inhaling Press down on the inhaler to administer medication 19 Diabetes A disorder which affects the body’s ability to regulate the level of blood sugar Approximately 1 in 20 Canadians have diabetes When the body cannot produce enough insulin, cells are unable to take up and utilise the glucose Or, if there is too much insulin in the blood stream or not enough glucose, the energy within the cells become depleted, and they begin to malfunction 20 Hypoglycemia (Insulin Shock) Severe low blood sugar Most common complication of insulin use Extremely dangerous Signs and symptoms appear quite similar to those of shock Treatment must be rapid 21 Causes Delayed or missed meals Vomiting Prolonged exercise without extra food or insulin adjustment Overdose of insulin Excessive alcohol ingestion Emotional distress Illness 22 Signs and Symptoms Cold, clammy skin Combativeness Confusion or disorientation Irritability Hostility Slurred speech Trembling, shakiness of hands Seizures Reduced LOC Unresponsiveness Tingling or numbness of lips and mouth Thickening of the tongue Sensation of forceful heartbeats, or ‘skipping a beat’ Poor co-ordination Headache Hunger 23 Treatment Check for a MedicAlert® Activate EMS Provide sugar immediately fruit juice or non-diet soda pop (1 cup) Lifesavers (5 or 6 lozenges) honey (2 tablespoons) sugar (3 packets or teaspoons) glucose (3 tablets), or dextrose (3 tablets) If the patient is alert, urge the patient to eat or drink as quickly as possible and if symptoms do not subside within ten minutes, repeat the treatment Recommend the patient seek further medical aid 24 Treatment - Unresponsive Ensure there is an adequate airway Place in the semi-prone position Check for a MedicAlert® Place liquid sugar source into downside cheek Wait 3-4 minutes and repeat Monitor vital signs continuously; activate EMS If patient regains consciousness: Continue sugar by mouth Give a more complex carbohydrate, such as bread, crackers, cheese, meat or peanut butter Avoid excessive activity Transport to medical aid 25 Hyperglycemia (Diabetic Coma) Develops slowly, over a period of days Appropriate medical attention is the key to treatment Causes of high blood sugar may include: missed or insufficient doses of insulin increasing resistance to insulin, possibly as the result of infection inability to take medications and follow diet properly undiagnosed diabetes 26 Signs and Symptoms Fatigue Dry, warm, flushed skin Extreme thirst Dehydration Frequent urination Rapid, weak pulse Rapid, deep breathing Fruity odour on breath (“acetone odour” or “apple cider odour”) Nausea Abdominal pain Irritation and agitation Confusion, eventually leading to unconsciousness and coma 27 Treatment Monitor vital signs Check for MedicAlert ® Transport to medical aid When in doubt, give sugar. 28 Insulin Shock (Needs Sugar) Diabetic Coma (Needs Insulin) Pulse: strong and rapid weak and rapid Breathing shallow deep and sighing Skin pale and sweating flushed, dry, warm Breath Odor odorless like musty apple or nail polish LOC faintness to unconsciousness gradual onset of unconsciousness Other Signs headache trembling hunger unsteady walk nausea Do not assist the diabetic to take their insulin shot 29 Epilepsy Usually well-controlled by drug therapy Affects approximately 1in 200 people An epileptic seizure is the physical result of uncoordinated electrical activity in the brain May be brought on by: Emotional strain Fatigue Flashing lights or loud noises Alcohol intake Failure to take medications 30 Signs and Symptoms Petit Mal No overt physical signs Person may simply suddenly stop talking Trance-like gaze for a short period of time May not remember the event Grand Mal Involuntary muscle contractions (seizures) Loss of consciousness May have loss of bladder or bowel control Possible temporary cessation of breathing Fatigue and wanting to sleep Pupil response may not be normal 31 Treatment – Grand Mal Lay the patient down –even during a seizure– to prevent further injury Remove any sources of potential injury Be prepared to support breathing with AR Never place any fingers or any other object in a patient’s mouth during a seizure Check for a MedicAlert ® and get additional information After the end of the convulsion, check breathing and pulse, and maintain an open airway Transport the patient to medical aid Reassure the patient 32 Heart Attack Myocardial Infarction (M.I.) Occurs when the circulation to a part of the cardiac muscle becomes impaired, resulting in an inadequate oxygen supply The cardiac muscle may lose its ability to function effectively 33 Signs and Symptoms Pain in the chest radiating down one or both arms, to the jaw, neck or back squeezing, crushing, stabbing, or vice-like Apprehension Denial Laboured breathing Sweaty or nauseous Face may be pale and ashen Skin may have a bluish tint (cyanosis) Severity of signs and symptoms varies. 34 Treatment - Conscious Activate EMS and treat as Load & Go Transport the patient in a position of comfort (usually semi-sitting) to medical aid Do not allow the patient to exert themselves in any way Give oxygen Keep the patient calm and still Loosen restrictive clothing Take a medical history Check for a MedicAlert ® 35 …continued Evaluate vital signs Assist the patient to take their own medication Keep the patient warm, but do not overheat Monitor vital signs during transportation Be prepared to treat the patient if they lose consciousness 36 Treatment - Unresponsive Establish and maintain an airway Loosen restrictive clothing Administer oxygen Provide AR or CPR if needed Activate EMS and treat as Load & Go 37 Aspirin® Administration Taking an Aspirin ® within the first four hours of a heart attack can reduce a person's risk of fatality by 25 % Do NOT administer Aspirin ® or an ASA product if: The patient is already taking blood thinning medication such as warfarin / Coumadin ® Sign and symptoms indicate a possible stroke 38 Aspirin™ Administration Five (5) following conditions must be met: The patient is conscious and alert The patient is able to provide an accurate medical history The patient is able to chew and/or swallow the medication The patient is not allergic to Aspirin ® or ASA products The patient is NOT asthmatic 39 If all conditions are met: Check for MedicAlert ® identification Ask questions about allergies or chronic respiratory conditions Administer ASA by one of the two following methods: Preferentially, two children’s Aspirin ® (81 mg each) by chewing OR One adult Aspirin ®(325 mg) by swallowing Monitor and communicate the patient’s response to the medication and any possible complication Continue to be available to assist the patient with the use of their own medication 40 Rescuers may not recommend the use of Aspirin® or ASA products in any other circumstance, for example headache, or sprains and strains. 41 Hyperventilation Involves breathing too quickly (carbon dioxide and oxygen levels in the blood are altered) Not a medical emergency Usually as a result of stress, strain or overexertion Patient does not wheeze or make other abnormal sounds with respiration Do not treat with a paper bag, or cupped hands 42 Hyperventilation Signs and Symptoms Tingling and numbness in the hands and around the mouth Deep, rapid respiration with rapid pulse Marked anxiety, escalating to panic Dizziness, syncope Fingers and hands drawn into a claw like spasm Treatment Try to calm and reassure Explain to the casualty what is happening Slow the breathing by mimicking breathing Administer oxygen 43 Stroke Also known as a Cerebral Vascular Accident (CVA) Is the result of a reduction in the supply of blood to a section of the brain Signs and symptoms will depend on where the damage occurred 44 Stroke Sign and Symptoms inability to talk confused, unable to express themselves pulse is strong, though slow one side of the face may be droopy one pupil may be dilated compared to the other may have muscle paralysis on one side, or reduced muscle power on one side of the body 45 History Patient may have a history of: high blood pressure (hypertension) short duration fainting spells “mini-strokes”, known as transient ischemic attacks (TIAs) headaches periods of dizziness visual disturbances 46 Treatment - Conscious Maintain an open airway Administer oxygen Reassure the patient Keep the patient calm Monitor vital signs Activate EMS and treat as Load &Go Give nothing by mouth 47 Treatment - Unresponsive Maintain an open airway Administer oxygen Monitor vital signs Activate EMS and treat as Load & Go 48 Syncope - fainting Caused by dilation of blood vessels in the extremities of the body Blood pools in these vessels leaving the brain without sufficient circulation May be caused by fear or emotional stress 49 Symptoms and Treatment Signs and Symptoms Pale skin Profuse sweating Dizziness Weakness Treatment Lie them down (head lower than heart) Cool cloth to forehead or neck Loosen clothing 50 Altered Level of Consciousness Lowered level of consciousness is the abnormal state of inappropriate response or complete lack of response to sensory stimuli AVPU Scale A -Alert ( fully conscious response) V - Verbal ( responds to loudly spoken verbal stimulus) P - Pain (responds to pain stimulus, such as rubbing knuckles over patient sternum) U - Unresponsive (no response) 51 Causes of Unresponsiveness “U” on the AVPU Scale Altitude Sickness Angina Asphyxia Asthma Diabetes Epilepsy Heart Attack Hyperventilation Lightening Strikes Poisoning Stroke Syncope 52 Treatment Establish presence of ABCs Administer oxygen ASAP Monitor vital signs Move patient to semi-prone position Continue to monitor and record vitals Establish reasons for unconsciousness Check for MedicAlert ® Activate EMS 53
