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CPR RECOGNIZING EMERGENCIES • Emergencies can often be recognized because of unusual sights, appearances or behaviors, odors, and noises. • It may be challenging to recognize an emergency because signals are not always obvious or easy to identify. *a victim may deny anything is wrong *if you think something is wrong, check the victim. CPR EMERGENCIES CONT. • Once an emergency has been recognized, be calm and follow the emergency action steps: CHECK-CALL-CARE. • CHECK- The scene for safety, see how many victims, see what happened. Check victim for consciousness. • CALL-Call 911 or workplace emergency # • CARE-For life threatening conditions. WHEN TO CALL 911 • • • • • • • • • • Unconsciousness Trouble breathing Not breathing No signs of circulation Persistent chest pain Severe bleeding that does not stop Pain in abdomen that does not go away Vomiting blood Seizures Injury to head ADULT VICTIM PRIORITIZING CARE FOR CONSCIOUS VICTIM • Ask the victim questions*What happened? *Do you feel pain? *Do you have any allergies? *Do you have any medical conditions or are you taking any medications? *When did you last eat or drink? PRIORITIZING CARE CONT • CHECK VICTIM FROM HEAD TO TOE *Begin checking top of head, face, ears, nose, and mouth. Look for cuts, bruises, bump, depressions, bleeding, or fluid. *Look at the color of victim’s face and lips *Notice how the skin looks and feels. *Look over the body to see if any bleeding or bones sticking out. PRIORITIZING CARE CONT • Watch victim for signs of pain and listen for sounds of pain. • Watch for changes in consciousness and breathing. • When the check is complete, if the victim can move without any pain and there are no other signs of injury, have the victim rest comfortably. PRIORITIZING CARE CONT • CARING FOR SHOCK PRIORITIZING CARE FOR SHOCK CONT • The signs of shock are*Restlessness *Nausea and vomiting *Altered level of consciousness *Pale or ashen, cool, moist skin. *Blue tinge to lips and nailbeds. *Rapid breathing and rapid pulse Caring for shock • STEPS TO MINIMIZE SHOCK Minimizing Shock • Make sure 911 or workplace emergency # has been called. • Continue to monitor the victim’s airway, breathing, and circulation (ABCs) • Control any external bleeding. • Keep th12e victim from getting chilled or overheated. • Elevate the legs about 12 inches if a head, neck, or back injury or broken bones in the hips or legs are not suspected. • Comfort and reassure victim until advanced help CARING FOR HEART ATTACK • HEART ATTACK OCCURS WHEN HEART MUSCLE IS DEPRIVED OF OXYGEN RICH BLOOD AND NUTRIENTS. • DURING A HEART ATTACK, A CORONARY ARTERY BECOMES BLOCKED, THUS NO OXYGEN IS NOURISHING THE CARDIAC MUSCLE AND THE HEART MUSCLE BEGINS TO DIE. SIGNS OF HEART ATTACK • CHEST DISCOMFORT-Lasts more than 3-5 min. Pain may spread to jaw, shoulder, neck or back, and down left arm. • DIZZINESS • SWEATING • FAINTING • NAUSEA,VOMITING • SHORTNESS OF BREATH • PALE OR GRAY SKIN COLOR • GENERAL WEAKNESS CARING FOR HEART ATTACK • • • • • • CALL 911 CHECK ABC’S PROVIDE CPR IF NECESSARY HELP PATIENT TO LEAST PAINFUL POSITION LOOSEN RESTRICTIVE CLOTHING-NECKTIE STAY CALM ASK PATIENT IF HAS HEART DISEASE? ANY MEDICATIONS? • IF TAKE NITROGLYCERIN, ALLOW HIM TO TAKE IT.(MAKE SURE LIE DOWN AFTER B/C IT LOWERS B/P CARING FOR STROKE • STROKE INVOLVES THE BRAIN. • ARTERY SUPPLYING BLOOD TO BRAIN IS BLOCKED AND CUTS OF OXYGEN SUPPLY OR A BLOOD VESSEL IN BRAIN RUPTURES AND BLEEDS INTO THE BRAIN. SIGNS OF STROKE • SUDDEN NUMBNESS OR WEAKNESS OF FACE, ARM, OR LEG ESP ON ONE SIDE OF BODY • FACIAL DROOP • SUDDEN CONFUSION • DIFFICULTY SPEAKING OR UNDERSTANDING • VISION PROBLEMS • DIZZINESS, LOSS OF BALANCE • A SUDDEN SEVERE HEADACHE CARING FOR STROKE • CALL 911 • CHECK ABC’S PROVIDE CPR IF NECESSARY • IF PATIENT HAS NOT FALLEN, HELP HIM LIE DOWN. ELEVATE HEAD AND SHOULDERS • LOOSEN CONSTRICTIVE CLOTHING • COMFORT PT • IF UNRESPONSIVE BUT BREATHING-RECOVERY POSITION • KEEP ARIWAY OPEN. MINOR WOUND CARE • WASH MINOR WOUNDS WITH SOAP AND WATER • IF BLEEDING RESTARTSAPPLY DIRECT PRESSURE USING CLEAN CLOTH DO NOT USE IODINE, PEROXIDE OR ALCOHOL UNLESS DIRECTED BY PHYSICIAN. APPLY DRY DRESSING HAVE PT WATCH FOR S/S OF INFECTION (REDNESS, DRAINAGE, SWELLING, TENDERNESS CONTROLLING BLEEDING • TYPES OF BLEEDING: • ARTERIAL BLEEDING-Most SERIOUS. Recognized by blood spurting. If uncontrolled can lead to shock and death. Least likely to clot. • VENOUS BLEEDING-Does not spurt-flows steadily. • CAPILLARY BLEEDING-Most common. Blood oozes. Usually bright right where venous is dark red. CONTROLLING EXTERNAL BLEEDING • • • • • • • • • • • • ASSESS SCENE FOR HAZARDS GATHER EQUIPMENT CALL 911 IF NECESSARY PUT ON GLOVES-USE PLASTIC WRAP, T-SHIRT, GROCERY BAGS, ETC. CAN ASK PT TO HOLD PRESSURE TO SITE. PLACE STERILE GAUZE OR CLEAN CLOTH OVER BLEEDING SITE APPLY DIRECT PRESSURE TO THE SITE USING YOUR FINGERS AND PALM OF HAND.DO NOT APPLY DIRECT PRESSURE TO EYE INJURY OR IF OBJECT IS STICKING OUT. HOLD PRESSURE 5-10 MIN ELEVATE INJURED ARM OR LEG ABOVE LEVEL OF HEART IF NO SUSPECTED NECK OR BACK INJURIES OR BROKEN BONES. CONTINUE HOLDING PRESSURE. IF BLEEDING COMES THROUGH BANDAGE, APPLY MORE DRESSINGS ON TOP OF OLD BANDAGE. DO NOT REMOVE APPLY PRESSURE BANDAGE CHECK PULSE AFTER PRESSURE BANDAGE APPLIED. LOOK AT SKIN COLOR ASSESS FOR SHOCK CONTROLLING INTERNAL BLEEDING • • • • TRAUMA TO AN INTERNAL ORGAN DIFFICULTY TO RECOGNIZE PAINFUL, RIGID, BRUISED ABDOMEN VOMITING, COUGHING, BLOOD EITHER BR RED OR COFFEE GROUNDS • TARRY BLACK STOOLS CARING INTERNAL BLEEDING • CHECK SCENE FOR SAFETY • CALL 911 • CHECK ABC’S –CPR IF NECESSARY. CONTROL ALL MAJOR EXTERNAL BLEEDING • IF NO HEAD, NECK OR BACK INJURY, PLACE PT ON LEFT SIDE AND ELEVATE LEGS 8-12 INCHES • COVER PATIENT WITH BLANKETS OR COATS TO MAINTAIN BODY HEAT • KEEP PATIENT CALM • MONITOR ABC’S UNTIL HELP ARRIVES CARING FOR ANAPHYLAXIS • ANAPHYLAXIS IS A TYPE OF SHOCK THAT OCCURS IN MINUTES. PATIENT IS EXPOSED TO ALLERGEN. BEE STINGS, STRAWBERRIES, SHRIMP, PEANUTS, ASPIRIN, PCN. • OCCURS WITHIN MINUTES UP TO HOURS AFTER EXPOSURE SIGNS/SYMPTOMS ANAPHYLAXIS • • • • • • • • • • • • • DIFFICULTY BREATHING-TIGHTNESS IN CHEST SNEEZING, COUGHING, WHEEZING HOARSENESS, LOSS OF VOICE RAPID BREATHING HIVES FLUSHING OF SKIN SWELLING OF FACE, EYES, LIPS, NECK, HANDS, FEET, AND TOUNGE INCREASED HEART RATE HEADACHE RUNNY NOSE NAUSEA/VOMITING FEELING OF IMPENDING DOOM ALTERED LEVEL OF CONSCIOUSNESS CARING FOR ANAPHYLAXIS • CHECK SCENE FOR SAFETY • CALL 911 • CHECK ABC’S-PROVIDE CPR IF NECESSARY • IF PT HAS EPI-KIT- ADM IMMEDIATELY • STAY WITH PATIENT UNTIL HELP ARRIVES CARING FOR BURNS • TYPES OF BURNS • THERMAL-Overexposure to sun, hot water or liquids, steam curling irons • CHEMICAL-Skin comes in contact with household, commercial, or industrial products such as tile cleaners, battery acid, toilet bowl cleaners.-flush with water 20 minutes. Damage depends on length of chemical on skin. • ELECTRICAL-Lightning, exposed to electrical current. BURNS • FIRST DEGREE- Superficial. Involve outer layer of skin (Epidermis) Red, mildly swollen, tender, and painful • SECOND DEGREE-Effects epidermis and dermis. Red with blisters, swell, drain fluid, very painful • THIRD DEGREE-Extend into fat and muscle. Skin looks waxy, leathery, and sometimes charred. CARING FOR BURNS • CHECK SCENE • CALL 911 • IF PT IS ON FIRE-STOP, DROP, ROLL. COVER THEM WITH BLANKET. IF ELECTRICAL-TURN POWER OFF. • CHECK ABC’S-PROVIDE CPR IF NECESSARY CARING FOR BURNS • FIRST DEGREE THERMAL BURN • IMMERSE BURN IN COOL WATER TO RELIEVE PAIN • KEEP SITE ELEVATED • DO NOT APPLY BUTTER, GREASE, ETC. SEAL IN HEAT AND CAUSE FURTHER DAMAGE SECOND DEGREE THERMAL BURN • IMMERSE BURN IN COOL TAP WATER • COVER BURN WITH DRY NONADHESIVE STERIL DRESSING • KEEP BURN DRY • ASSESS FOR SIGNS OF INFECTION THIRD DEGREE THERMAL BURN • COVER BURN WITH DRY NONADHESIVE STERILE DRESSING OR CLEAN CLOTH • TREAT PATIENT FOR SHOCK • COMFORT PATIENT CHEMICAL BURN • FLUS SITE WITH WATER FOR 20 MINUTES. REMOVE CONTAMINATED JEWELRY OR CLOTHING • COVER WITH STERILE DRESSING OR DRY CLEAN CLOTH ELECTRICAL BURN • UNPLUG OR DISCONNECT ELECTRICAL DEVICE • CALL 911 • KEEP AIRWAY OPEN • TREAT PATIENT FOR SHOCK • DETERMINE SEVERITY OF BURNMOST HAVE TO BE TREATED IN HOSPITAL. INJURIES TO BONES JOINTS MUSCLE • WE’LL DISCUSS LATER WHEN WE HAVE OUR LAB PRACTICE. DIABETIC EMERGENCIES • HYPOGLYCEMIA-When blood sugar drops because of too much insulin, exercise, too little food, or too much alcohol. Can become unconscious and even die. • SYMPTOMS• SUDDEN IRRITABILITY • CONFUSION • SHAKING • DIZZINESS • SWEATING • PALE • WEAKNESS • POOR COORDINATION • UNCONSCIOUSNESS DIABETIC EMERGENCIES • • • • • • • • • • • • HYPERGLYCEMIA-When a diabetic’s blood sugar level is too high because of too little insulin, too much food, illness, or stress. Can lead to dehydration, kidney problems, unconsciousness SYMPTOMSEXTREME THIRST DRY SKIN FREQUENT URINATION EXCESSIVE HUNGER N/V BLURRED VISION FRUITY ODOR ON BREATH HEAVY BREATHING DROWSINESS UNCONSCIOUSNESS CARING FOR DIABETIC EMERGENCIES • CHECK ABC’S-PROVIDE CPR IF NECESSARY • LOW BLOOD SUGAR-GIVE OJ, SODA, HARD CANDY-IF KNOW DIABETIC • IF NOT SURE IF DIABETIC-GIVE SUGAR CARING FOR SEIZURES • GRAND MAL SEIZURE: • LOSS OF CONSCIOUSSNESS • STIFFENING OF BODY FOLLOWED BY SHAKING OF ARMS AND LEGS • LOSS OF BODY TONE • CLENCHING OF TEETH • LOSS OF BLADDER CONTROL • PERIOD OF DROWSINESS AND CONFUSION AFTER SEIZURE. CARING FOR SEIZURES • • • • • • • • PETIT MAL SEIZURES: LAST ONLY A FEW SECONDS MAY STARE INTO SPACE CALL 911 IF LASTS MORE THAN 5 MINUTES A SECOND SEIZURE OCCURS THE PATIENT IS PREGNANT THERE ARE SIGNS OF INJURY CARING FOR SEIZURES • • • • • • • • • LOWER PATIENT TO FLOOR CUSHION HEAD LOOSEN TIGHT CLOTHING MOVE FURNITURE LOOK FOR APPROPRIATE MEDICAL ID TURN PT ON LT SIDE TIME SEIZURE DO NOT RESTRIC MOVEMENT STAY WITH PT UNTIL SEIZURE ENDS HEAT EMERGENCIES • HEAT STROKE-When inner temperature rises so fast the body cannot cool itself. 105 or higher • Usually occurs during summer and usually effects elderly, obese, alcoholic, and chronically ill. Can also effect athletes and construction workers. Heat stroke • • • • • • • • S/S CONFUSION LOSS OF CONSCIOUSNESS STRONG RAPID PULSE EXTREME FATIGUE BODY TEMP 105 OR HIGHER NO SWEATING DRY RED SKIN HEAT CRAMPS • PAINFUL SPASMS OF BACK LEG MUSCLES OR ABDOMINAL MUSCLES • ASSOCIATED WITH LACK OF FLUIDS, HIGH TEMPERATURES, LACK OF PHYSICAL CONDITIONING. • NOT LIFE THREATENING • GIVE SPORTS DRINK • REST FOR A FEW HOURS • STRETCH CRAMPING MUSCLE HEAT EXHAUSTION • PROLONGED EXPOSURE TO EXCESSIVE HEAT CAUSES THE BODY TO PERSPIRE AND LOSE FLUIDS AND ELECTROLYTES. • EFFECTS ATHLETES, CONSTRUCTION WORKERS, ROOFERS, AND OTHERS WHO WORK IN EXTREME HEAT CONDITIONS. SYMPTOMS HEAT EXHAUSTION • • • • • • • • • • • • ANXIETY COOL MOIST SKIN DIZZINESS FATIGUE H/A HEAVY SWEATING IMPAIRED JUDGEMENT THIRSTY LOSS OF APPETITE LOSS OF COORDINATION NAUSE RAPID WEAK PULSE TREATMENT OF HEAT EXHAUSTION AND HEAT STROKE • HEAT EXHAUSTION • LOSSEN CLOTHING • LAY ON BACK WITH LEGS ELEVATED 8-12 INCHES • SPONGE PT WITH COOL WATER • IF CONSCIOUS GIVE WATER TO DRINK • IF NO IMPROVEMENT 15 MIN SEEK MEDICAL ATTENTION TREATMENT OF HEAT STROKE • • • • • • CALL 911 REMOVE ALL NONCOTTON CLOTHING SOAK PT WITH WATER ESPECIALLY HEAD AND NECK FAN PT TO INCREASE RATE OF EVAPORATION USE ICE PACKS ON NECK, UNDER ARMS AND ON GROIN-DON’T LET PT SHIVER KEEP PT LYING DOWN WITH FEET ELEVATED MASSAGE EXTREMETIES TO ENCOURAGE RETURN OF COOLER BLOOD TO HEART COLD RELATED EMERGENCIES • HYPOTHERMIA-The body loses more heat than it produces and the temp drops below 95. If drops below 80-usually death occurs. • Usually cause of being immersed into cold water • Infants, elderly, alcoholics most vulnerable • Symptoms • Alteration in mental status • Shivering • Cool abdomen CARING FOR HYPOTHERMIA • HANDLE WITH EXTREME CARE • ADD INSULATION ABOVE AND BELOW PAT USING BLANKETS, TOWELS, ETC • KEEP PT FLAT AND STILL • CALL 911 FROST NIP • AFFECTS AREAS EXPOSED TO COLD SUCH AS CHEEKS, NOSE, EARS, FINGERS, AND TOES LEAVING THEM NUMB AND WHITE. • EASILY TREATED • BRING INSIDE OR COVER FINGERS WITH ARMPITS AND COVER FACE WITH GLOVED HAND • REMOVE WET CLOTHING • IMMERSE CHILLED BODY PARTS INTO WARM(NOT HOT) WATER FROST BITE • FREEZING OF SKIN AND TISSUES UNDER SKIN. • CAUSES DAMAGE TO BLOOD VESSELS AND RESULTS IN BLOOD CLOTTING AND LACK OF OXYGEN TO AFFECTED AREA. • WHITE, WAXY SKIN THAT FEELS NUMB AND HARD CARING FOR FROST BITE • REMOVE WET CLOTHING AND REPLACE WITH DRY COVERING • CALL 911 OR TAKE PT TO ER • IMMERSE FROZEN PART IN WARM WATER • DO NOT USE DIRECT HEAT SUCH AS HEATING PAD. DO NOT RUB FROSTBITTEN SKIN OR RUB SNOW ON AREA. • DO NOT BREAK ANY BLISTERS • REWARMING TAKES UP TO 40 MIN AND PT WILL COMPLAIN OF BURNING SENSATION. SKIN MAY TURN RED, BLUE, OR PURPLE AND MAY HAVE BLISTERS. THAWED SKIN IS PINK AND NO LONGER NUMB • APPLY STERILE DRESSING TO THAWED AREA AND DO NOT MOVE AFFECTED BODY PART CARING FOR POISONING • INHALED POISONS- CARBON MONOXIDE AMMONIA, CHLORINE GAS • GET PT OUT OF POISONOUS ENV AND INTO OPEN FRESH AIR • CALL 911 • PLACE ON LT SIDE IF NAUSEATED OR UNRESPONSIVE POISONS • • • • • • • • • • • • CARBON MONOXIDE CAR EXHAUST, GAS LOG BURNERS, WOOD BURNING FIREPLACES, KEROSENE HEATERS, BBQ GRILLS, GAS WATER HEATERS OR DRYERS, GAS STOVES. S/S ALTERED MENTAL STATUS BREATHING PROBLEMS CHEST PAIN DIZZINESS H/A MUSCLE WEAKNESS N/V RAPID HEART BEAT TREAT SAME AS INHALED POISONING ABSORBED POISON • POISONS THAT ARE TAKEN INTO BODY THROUGH SKIN • PLANTS • INSECTICIDES OR PESTICIDES • TREATMENT • WASH SKIN WITH SOAP AND WATER • IF WITH CHEMICAL-WASH WITH WATER 20 MIN • IF NOT BREATHING-RESCUE BREATHING • CALL 911 INGESTED POISON • • • • • • • • • • • • • HOUSELHOLD CHEMICALS, MEDICAITONS, BURNS OR ODORS AROUND MOUTH BOTTLES OR CONTAINERS NEAR PT NAUSEA/VOMITING ABD PAIN DROWSINESS CALL POISON CONTROL IMMEDIATELY IF UNRESPONSIVE CALL 911 THEN POISON CONTROL GIVE POISON CONTROL AGE AND WEIGHT IF CHILD NAME OF POISON AMOUNT OF POISON FOLLOW POISON CONTROL DIRECTIONS SAVE ALL CONTAINERS