Chapter 54 1/8/2018. Key Terms. Basic Life Support. Cardiac arrest Hemorrhage Respiratory arrest

Transcription

1 Chapter 54 Basic Emergency Care Key Terms Cardiac arrest Hemorrhage Respiratory arrest Basic Life Support This will be discussed and CPR skills demonstrated when you have your CPR class. In nursing centers, a nurse decides when to activate the EMS system. The nurse tells you how to help, if a person has stopped breathing or is in cardiac arrest. 1

2 General Rules of Emergency Care Know your limits. Do what you can under the circumstances. Even if you only call 911. STAY CALM. This helps the victim feel more secure. Know what type of EMS system you have in the area that you live. Post the numbers near the phone. Cont. Post your address, & phone number near the phone. You may panic in an emergency and forget them. Post Poison Control Number Hemorrhage Excessive loss of blood in a short time. May be internal or external Follow Standard Precautions and Bloodborne Pathogen Standard 2

3 Internal Hemorrhage You can not see internal hemorrhage Pain, shock, vomiting blood, coughing up blood and loss of consciousness There is little that you can do. Activate the EMS system Keep the person warm, flat, and quiet until EMS arrives Do Not give fluids External Hemorrhage Is usually seen Bleeding from an artery occurs in spurts Steady flow from a vein Do not remove any objects that have pierced or stabbed the person. Place a sterile dressing over the wound. Use any clean material if there is no sterile dressing. Cont. The victim should be lying down Apply direct pressure with your hand over the bleeding site. Reinforce dressing if it becomes saturated, continue pressure. May need to apply pressure to pressure points above the bleeding site see 3

4 Fainting Is a sudden loss of consciousness from an inadequate blood supply to the brain. Hunger, fatigue, fear, and pain are some common causes. Some people faint at the sight of blood. Standing in one position for a long time and being in a crowded room are some other causes Warning signals Dizziness Perspiration Blackness before the eyes Person looks pale Weak pulse Respirations are shallow if consciousness is lost Fainting Emergency Care Have the person sit or lie down If sitting, the person bends forward and places their head between the knees If the person is lying down, raise the legs Loosen tight clothing 4

5 If they faint, raise their legs Do not let them get up until symptoms have subsided for about 5 minutes Shock Results when organs and tissues do not get enough blood. Causes: Blood loss, heart attack (myocardial Infarction), burns, and severe infection. Signs & Symptoms Low or falling blood pressure Rapid and weak pulse Rapid respirations Cold, moist, and pale skin Thirst Restlessness Confusion & loss of consciousness 5

6 Prevent & Treat Activate EMS Keep the victim lying down. Maintain and open airway. Control hemorrhage. Keep the person warm. Reassure Follow Standard Precautions & Bloodborne Pathogen standards Anaphylactic Shock Some people are allergic or sensitive to foods, insects, chemical, and drugs May react with an area of redness, swelling, or itching. Or the reaction can involve the entire body. Signs & Symptoms Anaphylaxis is life threatening sensitivity to an antigen. It can occur within seconds. Sweating Shortness of Breath Low blood pressure Irregular pulse Respiratory congestion Swelling of the larynx Hoarseness Dyspnea 6

7 cont. The person needs special drugs to reverse the allergic reaction. Keep the person lying down and the airway open. Stroke Cerebrovascular accident (CVA) Occurs when the brain is suddenly deprived of its blood supply Usually part of the brain is affected May be caused by a clot, or hemorrhage Signs of Stroke Depend on the size and location of brain injury. Loss of consciousness or semi-consciousness, rapid pulse, labored respirations (breathing), elevated blood pressure and hemiplegia (left or right side paralysis) Slurred speech, or aphasia (can t speak) 7

8 Stroke cont. This is a medical emergency You must get them to the hospital immediately. There is a medications that they can give that will dissolve the clot, but it must be given within 3 hours of when the symptoms began. The person must meet certain criteria. Stroke (cont) Loss of consciousness, rapid pulse, labored breathing, high B/P Blurred or loss of vision in one eye Unsteadiness, falling, numbness, or weakness on one side Sudden confusion, severe headache, Aphasia inability to have normal speech Stroke (cont) Ask person to smile - checking for facial drooping Ask person to say a simple sentence It is sunny out today. checking for aphasia (receptive or expressive) Ask them to raise their arms checking for hemiplegia 8

9 Seizures (convulsions) are violent and sudden contractions or tremors of muscle groups. You cannot stop a seizure. You can protect the person from injury. This includes activating the EMS system. DO NOT LEAVE THE PERSON ALONE. Cont. Lower the person to the floor Protect the persons head from striking the floor by placing folded blanket, towel, cushion, pillow, or other soft item under their head. Place their head in your lap Move objects such as furniture, equipment, sharp objects Cont. Turn person onto their side. Loosen tight jewelry and clothing around the neck Do not give food or fluids Do not restrain body movements during the seizure Do not put objects or your fingers between the person s teeth 9

10 Burns Can severely disable a person They can also cause death Most occur in home Infants, children and older persons are at risk Common Causes of Burns and Fires Scald from hot liquids Playing with matches and lighters Electrical injuries Cooking accidents (BBQ s, microwaves, stoves, ovens Falling asleep while smoking Fireplaces Cont. Space heaters No smoke detectors or nonfunctioning smoke detectors Sunburn Chemicals 10

11 Cont. (burns) Do not touch the person if they are in contact with an electrical source Remove person from the fire or burn source Stop the burning process, with water, or roll the person in a blanket, coat, sheet, or towel Cont. Do not remove burned clothing that is sticking to the skin. Remove hot clothing that is not sticking to the skin. If you cannot remove, cool with water Remove jewelry and any tight clothing that is not sticking to the skin Provide rescue breathing and CPR as needed Cont. (burns) Cover burns with sterile, cool, moist coverings. Or use towels, sheets, or any other clean cloth. Keep the covering wet. Do not put oil, butter, salve, or ointment on the burns Cover the person with a blanket or coat to prevent heat loss 11

12 Heat stroke Heat stroke is the most serious form of heat injury, and is a medical emergency (a.k.a. sunstroke) You should call 911 immediately and render aid until they arrive. It can kill or cause damage to the brain and other internal organs Usually affects persons over age 50, it also take a toll on healthy young athletes Heat stroke (cont) Often occurs as a progression from milder heat related illnesses such as heat cramps (painful brief muscle cramps, Muscles may spasm or jerk involuntarily), heat syncope (fainting) and heat exhaustion. Heat exhaustion occurs due to high temperatures and dehydration. Signs include nausea, dizziness, headaches, cramps, and more. Heat exhaustion can progress to heat stroke if not treated quickly. Anyone experiencing signs of heat exhaustion should drink plenty of fluids, get into cool water (shower, bath, etc), and apply other cool items such as ice or cold compresses Heat stroke Occurs from prolonged exposure to high temperatures Usually in combination with dehydration Which leads to failure of the body s temperature control system The body s core temperature greater than 105 degrees F. With complications involving the central nervous system. 12

13 Common symptoms Nausea Seizures Confusion Disorientation Sometimes loss of consciousness or coma Other symptoms: Throbbing headache Dizziness & light headedness Lack of sweating Red, hot, dry skin Muscle weakness or cramps Nausea & vomiting Rapid heart rate which may be strong or weak Rapid, shallow breathing Behavioral changes such as confusion, disoriented staggering Seizures unconsciousness Cooling strategies Ice packs or cool wet towels to armpits, groin, neck and back Immerse in a shower or tub of cool water Fan air while wetting the skin with a sponge or garden hose Call 911 Kids in Hot Cars -Never leave kids alone in a hot car, even briefly. -Always check the front and back seats of the car before you lock it and leave. -See a kid alone in a hot car? Call 911 immediately. Get them out ASAP if they are in distress. -Put your purse, briefcase, or something else you need by the car seat so you don t forget to check. -Always lock your car when it s empty so kids can t get in without you knowing. SOURCE: National Highway Traffic Safety Administration When you walk past a vehicle in a parking lot that has a car seat in it, please glance inside to make sure a child has not been left unattended. 13

14 SAFETY RECOMMENDATIONS NEVER LEAVE A CHILD UNATTENDED IN A VEHICLE. NOT EVEN FOR A MINUTE! IF YOU SEE A CHILD UNATTENDED IN A HOT VEHICLE CALL Be sure that all occupants leave the vehicle when unloading. Don't overlook sleeping babies. Always lock your car and ensure children do not have access to keys or remote entry devices. IF A CHILD IS MISSING, ALWAYS CHECK THE POOL FIRST, AND THEN THE CAR, INCLUDING THE TRUNK. Teach your children that vehicles are never to be used as a play area. Keep a stuffed animal in the carseat and when the child is put in the seat place the animal in the front with the driver. Or place your purse or briefcase in the back seat as a reminder that you have your child in the car. Make "look before you leave" a routine whenever you get out of the car. Have a plan that your childcare provider will call you if your child does not show up for school. STUDY CONCLUSIONS Average elapsed time and temperature rise 10 minutes ~ 19 deg F 20 minutes ~ 29 deg F 30 minutes ~ 34 deg F 60 minutes ~ 43 deg F 1 to 2 hours ~ deg F Cracking the windows had little effect Vehicle interior color probably biggest factor "Parents and other caregivers need to be educated that a vehicle is not a babysitter or play area... but it can easily become tragedy" Circumstances An examination of media reports about the 561 child vehicular heatstroke deaths for an thirteen year period (1998 through 2012) shows the following circumstances: 51% - child "forgotten" by caregiver (288 Children) 29% - child playing in unattended vehicle (163) 18% - child intentionally left in vehicle by adult (101) 2% - circumstances unknown (9) 14