Altered Mental Status
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- Daniel Arnold
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1 Sudden Illness Suspect when, without warning, a person suddenly appears weak, ill, or in severe pain The most common warning signs of serious illness: Altered mental status Breathing difficulty or shortness of breath Pain, severe pressure, or discomfort in the chest Severe abdominal pain
2 Altered Mental Status Is a warning sign of a serious problem & considered a medical emergency Activate EMS Comfort position Calm & reassure Ongoing assessment
3 Fainting Unexpected drop of blood pressure and blood flow to the brain Causes: anxiety, fear, pain, stress, standing in place too long, or rapid movements Treatment Lay the person flat Raise feet 6-12 inches Or keep person seated forward and place head between knees
4 Stroke Brain attack Occurs when the blood supply to a portion of the brain is suddenly interrupted A blocked or ruptured artery in the brain which stops the adequate flow of blood to a portion of the brain Stroke? blockage of blood and O2 to the brain Aneurysm? ruptured blood vessel
5 Stroke Signs / Symptoms Numbness or weakness of face, arm, or leg; especially one sides Confusion Change in the ability to speak or be understood Changes in sight and balance A severe, sudden headache
6 Stroke Quick test: FAST Face droop: ask the person to smile Arm drift: ask the person to hold up both arms Speech difficulty: ask the person to speak a simple sentence Time to activate EMS: if a person has trouble with any of these tasks, call EMS
7 STROKE What to do: Calm, Comfort, and Reassure Insure that family & bystanders do not make inappropriate comments. Hearing is the last sense to fail Call If patient is unconscious, place on affected side to allow fluids to drain from mouth Minimize movement and continue ongoing assessment until help arrives
8
9 What Is Diabetes? Disease in which the body cannot effectively use sugar for energy. A disorder of the pancreas The pancreas stops making insulin, an essential hormone in the body. Insulin is the key that allows glucose to enter the cells. Glucose is used by every cell in the body for energy
10 INSULIN Without insulin, glucose cannot enter the cell. Glucose stays in the bloodstream, creating high levels of blood sugar.
11 Diabetes Type I body no longer produces insulin most commonly effects children & young adults Type II body no longer utilizes insulin commonly occurs as we age & become inactive (genetic involvement) Gestational women who are pregnant & have high blood pressure
12 LOW SYMPTOMS OF LOW BLOOD SUGAR Weakness or tiredness Shaking Headache Anxious, Pale Pale, cool, and sweaty skin
13 LOW Treatment of Hypoglycemia Treatment : responsive person Provide Glucose tablets--start with 2 Juice Regular soda pop (not diet) If longer than 1 hour until next meal or snack, give small snack containing protein (cheese crackers or milk) Calm, Comfort, and Reassure Ongoing assessment If no response to sugar in minutes, call EMS & provide additional glucose or sugar
14 Hypoglycemia Treatment for Unresponsive Quickly activate EMS Do not give anything to eat or drink Provide any required supportive care
15
16 SEIZURES Brief episodes of disorderly electrical activity in the brain which affects its normal functions and produces changes in a person s movements, behavior, or consciousness.
17 DID YOU KNOW? 2,000,000 people in the U.S. have some form of Epilepsy. 300,000 of those are under age ,000 new cases are reported each year. In 70% of cases, the cause is unknown.
18 ABSENCE SEIZURES Very brief, last only a few seconds, and look like a blank stare, or daydreaming. The person is completely unaware of his surroundings. They begin and end suddenly.
19 TONIC-CLONIC SEIZURES Person blanks out, falls, stiffens, then jerks uncontrollably for a minute or two.
20 Seizure Typically occur without warning May have an aura/smell/noise before seizure Signs/Symptoms Jerking movements Breathing may seem absent Can lose control of bowel or bladder May vomit
21 FIRST AID FOR SEIZURES Protect person from injury Move objects away Do not restrain If possible, roll the person onto his/her side to allow saliva to drain Do not put any thing in her/his mouth Calm, comfort, reassure Ongoing assessment
22 SEIZURES Activate EMS if the person: Is injured or vomits Has no history of seizure Continues to seize for more than 5 minutes Has more than one seizure (one right after the next)
23 Breathing Difficulty, Shortness of Breath A medical emergency Caused by an underlying medical illness such as asthma, allergic reaction, heart failure, or lung disease S/S: coughing, wheezing, or other unusual breathing sounds; bluish lips or fingers Treatment: Call EMS Comfortable position Calm & Reassure Ongoing assessment
24
25 1st 3rd Eas We No WHAT IS ASTHMA? A reversible, obstructive lung disease caused by an excessive reaction of the airways to certain stimuli or triggers cold/change in temp Exercise allergies
26 ASTHMA IS NOT Contagious- Usually genetic Infectious- It is a chronic disease A Good Excuse
27 3 Components of an Asthma Attack 1. Bronchospasm The smooth muscles that wrap around the windpipe (bronchi) tighten, reducing the size of the airway. normal Asthma attack
28 Components of an Asthma Attack 2. Inflammation The mucosal lining of the windpipe becomes inflamed and swells, thereby reducing the size of the airway even further. 3. Mucus Increased mucus production takes up more space; now the airway is very constricted.
29 Possible Early Warning Signs The person may cough, especially after activity. The person may complain of not being able to take a deep breath The person may have a high pitched wheeze The person may feel fatigued He or she may complain of a heavy feeling in the chest, may press on their in chest compensating for the pressure.
30 ASTHMA Signs/symptoms 1. Labored breathing 2. Wheezing sound when exhaling 3. High pitched cough 4. Weakness 5. Chest tightness Treatment 1. Assist with medication 2. Activate EMS if not getting better or no history of asthma 3. Calm them down 4. Monitor vitals*
31 WHEN DO YOU CALL 911 Wheezing or coughing increases after taking medications Medication doesn t help within 5 minutes Difficulty breathing -retractions seen -hunched over position Child has trouble walking or talking, or stops playing and cannot start again Lips or fingernails appear blue
32 ALLERGIC REACTIONS What is an allergy? over reaction by the body to a substance that is normally harmless Causes ingestion inhalation injection insects interaction S/S- Itching or swelling of the lips, tongue, mouth or throat Hoarseness, hacking cough, shortness of breath, wheezing Hives, itchy rash and/or swelling about the face or extremities Nausea, abdominal cramps, vomiting, and/or diarrhea
33 ANAPHYLAXIS Life-Threatening Allergies
34 Insects, Bees Allergic Reactions Types of life-threatening allergies usually seen in persons: Peanuts and Tree Nuts Latex or Rubber Foods
35 Anaphylaxis Symptoms Throat closing off Rapid onset Sweating Weakness Feelings of apprehension Tingling in mouth, face, or throat Itching Wheezing Shallow respirations Loss of consciousness
36
37 ALLERGIC REACTION What to do: Call if onset is rapid (within 1 hour) Epi-pen or other medication Calm, comfort, reassure Continue with ongoing assessement until help arrives
38 What is an Epi-pen? Many people with Anaphylaxis carry an epipen with them at all times. An Epi-pen contains a single dose of epinephrine (adrenalin) that when given, will open the airways for approximately 15 minutes and allow them to breathe. This is only temporary relief. You must also call 911 when a person has an Anaphylaxis reaction.
39 Pain, Severe Pressure, or Discomfort in the Chest Acute coronary syndrome (ACS) occurs when there is reduced blood flow to the tissues of the heart Heart Attack Signs/Symptoms Pain, pressure, or discomfort in the chest Women: indigestion, weakness, or fatigue Shortness of breath, nausea, lightheadedness Pain in the arms or back Pale, cool, and sweaty skin
40 Pain, Severe Pressure, or Discomfort in the Chest Treatment: Activate EMS Get AED Comfortable position Calm, comfort, and reassure Ongoing assessment
41 Poisoning Any substance that can enter the body and create a harmful reaction in the body Ingested: prescribed medications, personal care products, household cleaning products Inhaled: Carbon monoxide, natural gas, solvent fumes, and chemical vapors
42 Poisoning Signs / Symptoms Abdominal pain or cramping Nausea Vomiting Altered mental status Headache Dizziness Difficulty breathing Burns on hands or around mouth, odor of breath Information with witnesses Suspicious circumstances, such as empty containers
43 Poisoning What to Do: Ingested Activate EMS if showing any life-threatening signs Call Poison Control Center: (NATIONWIDE) Never induce vomiting unless Poison Control Center tells you save vomit for EMS Save bottles/containers for EMS
44 Poisoning What to Do: Inhaled Perform SETUP Move patient to fresh air when safe Contact Poison Control Center Absorbed Call Poison Control Center Dry Powder - brush off dry powder and flush with gallons of water for at least 20 mins. Liquid - flush with gallons of water for at least 20 mins
45 Severe Abdominal Pain May be a warning sign of a serious illness Signs and Symptoms Appears suddenly or is a new experience for the person Intense pain Abdomen may be rigid or tender to the touch Nauseated and vomit Treatment Activate EMS Find a comfortable position Calm, comfort, and reassure
46 Heat Emergencies Occur when a body s normal temperature-reducing mechanisms get overwhelmed and become inefficient or stop working Heat Exhaustion Signs/Symptoms Heavy sweating Pale, cool, sweaty skin Nausea and vomiting Headache Dizziness Feeling weak
47 Heat Emergencies Heat Exhaustion Treatment: Move to a cool place Loosen or remove excess clothing Cool person off Drink fluids
48 Heat Emergencies Heat Stroke Body temp rises because the body s cooling system is overwhelmed or shut down Signs/Symptoms Warm, even hot to the touch Heavy sweating may be present may have red and completely dry skin Confused and trouble communicating May become unresponsive and could have a seizure Treatment: EMS medical emergency Cool ASAP
49 Cold Emergencies Hypothermia Generalized cooling of the body Occurs when body temp is below 95 F Signs/Symptoms Pale, cold skin Uncontrollable shivering Loss of coordination Treatment Remove wet clothing and cover with something warm & dry Activate EMS Move to a warm place Cover head and neck to retain body heat Rewarm near a heat source
50 Cold Emergencies Frostbite Skin and underlying body tissue freezes Most common: fingers, toes, earlobes, cheeks, and nose Prevent freezing by simple skin-toskin rewarming technique Signs of freezing Loss of feeling in affected part Firm, pale, cold, numb skin Treatment Warm place Activate EMS Remove wet clothes Do not rub or massage affected area Remove jewelry Place clean pads between fingers & toes Wrap with clean towel or pad
51 Stinging Insects If a stinger is present in the skin, remove it as quickly as possible S/S: local pain, redness, swelling, itching Treatment General: wash site with soap & water Cover with band-aid Use local cooling to help reduce swelling & pain Watch for allergic reaction
52 Snake Bites Venomous snakebite is a medical emergency Person sit and stay calm Activate EMS Remove any constricting items from the affected limb Control any bleeding with clean pad & direct pressure Do not apply a tourniquet, cold compresses, or try to suck out the venom Keep person warm, reassure, and quiet
53 Marine Animal Stings Sea Anemones or Jellyfish Wash wound with vinegar for at least 30 sec to deactivate the venom Take hot shower or bath for 20 mins to pain Monitor ABCs
54 Animal and Human Bites Control bleeding with direct pressure Wash area with lots of water Seek professional medical attention Can cause bacterial infection
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