Download Chapter 8 Power Point - Garnet Valley School District

Chapter 8
Emergency Conditions
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Obstructed Airway
• Blockage can be due to a variety of conditions
– Solid foreign object
– Fluids
– Swelling in throat
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Obstructed Airway (cont’d)
• Partial obstruction
– Some air exchange in the lungs
– S&S
• Individual able to cough
• Typically grasps the throat (universal distress
signal for choking)
– Management: encourage coughing
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Obstructed Airway (cont’d)
• Total airway obstruction
– No air is passing through the vocal cords
– S&S
• Individual is unable to speak, breathe, or cough
• Universal distress signal is usually apparent
– Perform rescue breathing and if breathing begins
again, then monitor the ABC’s
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Obstructed Airway (cont’d)
• Total airway obstruction (cont’d)
– Management
• Heimlich maneuver
• Unconscious individual
• Clear the airway and stimulate the breathing
process.
• Activate emergency plan
• Waiting for EMS, continue to perform rescue
breathing and if breathing begins again, then
monitor the ABC’s
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Cardiopulmonary Emergencies
• Sudden cardiac death (SCD)
– Unexpected death owing to sudden cardiac
arrest within 6 hours of an otherwise normal
clinical healthy state
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Cardiopulmonary Emergencies
• Sudden cardiac death (SCD)
– Possible causes
• Hypertrophic cardiomyopathy
• Abnormal thickening of the left ventricular wall
• Symptoms of cardiac dysfunction do not appear
until early adulthood and result in impaired
ventricle filling
• Periods of arrhythmia
• Blood flow obstruction may produce syncope
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Cardiopulmonary Emergencies (cont’d)
• Sudden cardiac death (cont’d)
– Possible causes (cont’d)
• Atherosclerosis
• Excessive buildup of cholesterol within the
coronary arteries, narrows arteries &
impedes blood flow
• Angina due to diminished O2
• Risk for myocardial infarction
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Cardiopulmonary Emergencies (cont’d)
• Heart attack and cardiac arrest
– S&S
• Chest discomfort (e.g., uncomfortable pressure;
squeezing; pain)
• Pain originating behind the sternum and
radiating into either or both arms (usually the
left)
• Pain radiating into the neck, jaw, teeth, or
upper back
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Cardiopulmonary Emergencies (cont’d)
• Heart attack and cardiac arrest (cont’d)
– S&S (cont’d)
• Shortness of breath
• Nausea
• Lightheadedness
• Management
• Activate emergency plan, including summoning
EMS
• Monitor; perform CPR & rescue breathing, if
necessary
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Unconscious Individual
• Causes: variety; most often- head trauma
• S&S
– Lacks conscious awareness and is unable to
respond to superficial sensory stimuli
– Coma – individual cannot be aroused even by
stimuli as powerful as pin pricks
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Unconscious Individual (cont’d)
• Management
– Assume a life-threatening condition
– Activate emergency plan, including summoning
EMS
– Refer to Application Strategy 8.1
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Shock
• If the heart is unable to exert adequate pressure to
circulate enough oxygenated blood, shock occurs
• Heart pumps faster but due to decreased volume, pulse
is weak and BP drops, breathing will become rapid and
shallow, sweating profuse, leading to unconsciousness
and death
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Shock (cont’d)
• Could be due to damaged heart, low blood volume, blood
vessel dilation
• Occurs in injuries involving severe pain, bleeding,
fracture or intraabdominal or intrathoracic injuries
• Severity varies with age , physical condition, pain
tolerance, fatigue, dehydration, extreme exposure to
heat or cold, presence of any disease, improper handling
or movement of an injured area
• Types of shock vary, but S&S same
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Shock (cont’d)
• S&S
– Feeling of uneasiness or restlessness
– Respiration: increased
– Pulse: increased weakened heart rate
– Skin: pale and clammy; profuse sweating;
lips, nail beds, and membranes of mouth appear
cyanotic
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Shock (cont’d)
• S&S (cont’d)
– Thirst, weakness, nausea, and vomiting may
develop
– Later stages: rapid, weak pulse & labored,
weakened respirations may lead to decreased BP
& unconsciousness
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Shock (cont’d)
• Management
– Activate emergency plan, including summoning
EMS
– Monitor and maintain
• Airway
• Normal body temperature
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Shock (cont’d)
• Management (cont’d)
– Control any bleeding
– Body position – depends on other possible
conditions
– Refer to Application Strategy 8.2
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Anaphylaxis
• Shock-like, frequently fatal; hypersensitive reaction
to an allergen
• Common substances
– Medications
– Foods
– Insect stings
– Inhaled substances
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Anaphylaxis (cont’d)
• S&S
– General feeling of warmth; intense itching,
especially soles of feet and palms of hands
– Skin reactions (e.g., localized rash or swelling)
– Choking, wheezing, and shortness of breath
– Rapid and weak pulse
– Dizziness, lightheadedness, or fainting
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Anaphylaxis (cont’d)
• S&S (cont’d)
– Tightness and swelling – throat and chest;
swelling of mucous membranes
– Blueness – lips and mouth
– Nausea, vomiting, or diarrhea
– Anxiety; confusion
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Anaphylaxis (cont’d)
• Management
– Activate emergency plan, including summoning
EMS
– Monitor; perform CPR & rescue breathing if
necessary
– If the individual has medication (e.g., selfadministered epinephrine device EpiPen®),
administered immediately.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Hemorrhage
• Abnormal discharge of blood results in decrease in blood
volume and BP
– Causes heart action to increase, but pumping action
is weakened
– Result rapid, weak pulse
• S&S
– Arterial: spurting, bright red color
– Venous: steady flow, dark bluish-red color
– Capillary: oozing, dull red color
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Hemorrhage (cont’d)
• Management
– External hemorrhage
• Follow universal precautions
• Apply direct pressure and elevate
• Elevation – injured area above the heart
• Continue pressure until blood coagulates
• If direct pressure is not effective, apply indirect
pressure
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Hemorrhage (cont’d)
• Management
– Internal hemorrhage
• Can result from blunt trauma or certain
fractures (such as those of the pelvis, rib, or
skull)
• Not visible, so often overlooked
• S&S: history of trauma; S&S of shock
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Hemorrhage (cont’d)
• Management (cont’d)
– Internal hemorrhage (cont’d)
• Emergency plan should be activated, including
either immediate referral to a physician or
emergent care facility or summoning of EMS
• Treat for shock even if there is no outward
indication
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins