Presentation is loading. Please wait.

Presentation is loading. Please wait.

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Medical Emergencies Chapter 9.

Similar presentations


Presentation on theme: "Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Medical Emergencies Chapter 9."— Presentation transcript:

1 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Medical Emergencies Chapter 9

2 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Outline General Medical Complaints Specific Medical Complaints –Difficulty Breathing –Chest Pain –Altered Mental Status –Seizures –Stroke General Medical Complaints Specific Medical Complaints –Difficulty Breathing –Chest Pain –Altered Mental Status –Seizures –Stroke –Acute Abdomen –Exposure to Cold –Exposure to Heat –Poisoning –Allergic Reactions –Behavioral Emergencies

3 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. General Medical Complaints

4 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. General Medical Complaints Scene size-up Initial assessment Physical exam (as needed) Vital signs/SAMPLE history Ongoing assessment Scene size-up Initial assessment Physical exam (as needed) Vital signs/SAMPLE history Ongoing assessment

5 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Specific Medical Complaints

6 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Difficulty Breathing

7 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Difficulty Breathing Common complaint Variety of causes Common complaint Variety of causes

8 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Causes include: FBAO Chronic lung disease –COPD Infections –Pneumonia –Influenza FBAO Chronic lung disease –COPD Infections –Pneumonia –Influenza CHF with pulmonary edema Hyperventilation syndrome

9 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Does a First Responder have to determine the cause of difficulty breathing?

10 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. The most important considerations for the First Responder are to recognize signs and symptoms of inadequate breathing and… The most important considerations for the First Responder are to recognize signs and symptoms of inadequate breathing and…

11 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. provide airway management and ventilation as needed provide airway management and ventilation as needed Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

12 OPQRST O = Onset P = Provocation Q = Quality R = Radiation S = Severity T = Time O = Onset P = Provocation Q = Quality R = Radiation S = Severity T = Time

13 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Chest Pain

14 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Chest Pain Common complaint May be life threatening Be prepared to assist with a/w, breathing and circulation Common complaint May be life threatening Be prepared to assist with a/w, breathing and circulation Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

15 Chest Pain Heart related Lung related Musculoskeletal related Always assume it life threatening Heart related Lung related Musculoskeletal related Always assume it life threatening Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

16 Chest Pain - Heart Acute Coronary Syndrome (ACS) –Myocardial infarction –Angina –Abnormal heart rhythms What are some signs and symptoms of ACS? Acute Coronary Syndrome (ACS) –Myocardial infarction –Angina –Abnormal heart rhythms What are some signs and symptoms of ACS?

17 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. ACS - Signs and Symptoms Pale, cool, clammy skin Cyanotic lips and nail beds Altered mental status Indigestion Pale, cool, clammy skin Cyanotic lips and nail beds Altered mental status Indigestion Vomiting/Nausea Chest pain Sense of impending doom Irregular pulse rate

18 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Chest Pain - Lungs Pulmonary embolism Congestive heart failure Pulmonary embolism Congestive heart failure

19 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Does a First Responder have to determine the cause of chest pain?

20 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. A First Responder should recognize that a complaint of chest pain is potentially life threatening, and… A First Responder should recognize that a complaint of chest pain is potentially life threatening, and…

21 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Chest Pain Continually re- evaluate the patient for signs of deterioration Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

22 Altered Mental Status

23 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. What is altered mental status?

24 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Altered Mental Status A gradual or sudden change in the patient’s level of awareness and responsiveness to his or her surroundings. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

25 Altered Mental Status Can range from disorientation to complete unresponsiveness Important to determine the patient’s usual mental status Can range from disorientation to complete unresponsiveness Important to determine the patient’s usual mental status

26 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Causes of AMS Fever Infection Poisoning Drugs/Alcohol Fever Infection Poisoning Drugs/Alcohol Low blood sugar Head injury Decreased O 2 to brain Psychiatric disorders

27 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Altered Mental Status Status may change Look for clues during scene size-up Is it necessary to know the cause of the AMS? Status may change Look for clues during scene size-up Is it necessary to know the cause of the AMS?

28 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Goals of Treatment Maintain scene and personal safety Support airway, breathing, circulation Don’t need to determine the specific cause. Maintain scene and personal safety Support airway, breathing, circulation Don’t need to determine the specific cause.

29 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. AMS - Treatment Scene size-up Initial assessment Vital signs/SAMPLE history Physical examination (as needed) Place in recovery position/position of comfort Reassure patient and family Scene size-up Initial assessment Vital signs/SAMPLE history Physical examination (as needed) Place in recovery position/position of comfort Reassure patient and family

30 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Remember! Maintain the airway Place in recovery position Have suction available Ongoing assessment Maintain the airway Place in recovery position Have suction available Ongoing assessment

31 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Diabetes

32 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Hyperglycemia or Hypoglycemia? Hyperglycemia or Hypoglycemia? Diabetes

33 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. That is the question…

34 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Diabetes Rx same as that for AMS Ask questions: –Do you take insulin? –When did you last eat? –What did you eat? –Have you exercised recently? Rx same as that for AMS Ask questions: –Do you take insulin? –When did you last eat? –What did you eat? –Have you exercised recently?

35 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Seizures

36 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. ? What is a seizure?

37 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Seizures A sudden attack due to a change in the electrical activity of the brain.

38 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Causes of Seizures Epilepsy Chronic medical condition Fever Infections Poisoning Low blood sugar Epilepsy Chronic medical condition Fever Infections Poisoning Low blood sugar Head injury Decreased O 2 to brain Brain tumor Pregnancy complications Unknown cause

39 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Regardless of the cause of the seizure, the First Responder’s role is to maintain the patient’s airway and breathing.

40 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Seizures (with convulsions) Patients Are almost always unresponsive Have excessive salivation May lose control of the bladder Patients Are almost always unresponsive Have excessive salivation May lose control of the bladder

41 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Post-seizure Patients may be: Very sleepy Confused Unable to answer questions Combative Patients may be: Very sleepy Confused Unable to answer questions Combative

42 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Seizures Most are brief (< 5 min) If prolonged, may need advanced care Most are non life threatening Most are brief (< 5 min) If prolonged, may need advanced care Most are non life threatening

43 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Treatment Scene size-up Initial assessment Vital signs/SAMPLE history Physical exam Ongoing assessment Sound familiar? Scene size-up Initial assessment Vital signs/SAMPLE history Physical exam Ongoing assessment Sound familiar?

44 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Special Considerations Protect patient –Move objects –Protect privacy –Place in recovery position after seizure Protect patient –Move objects –Protect privacy –Place in recovery position after seizure

45 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Special Considerations Never restrain patient Never place anything in patient’s mouth Have suction ready Be prepared to manage airway and provide ventilation Never restrain patient Never place anything in patient’s mouth Have suction ready Be prepared to manage airway and provide ventilation

46 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Hand-Off Report Your observations can be helpful Did the seizure start in one extremity and then spread? Was only one side of body involved? How long did the seizure last? Your observations can be helpful Did the seizure start in one extremity and then spread? Was only one side of body involved? How long did the seizure last?

47 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Stroke

48 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Stroke Leading cause of death and disability Commonly encountered What causes a stroke? Leading cause of death and disability Commonly encountered What causes a stroke?

49 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Stroke Occurs when artery in brain is occluded or ruptures, interrupts blood flow to brain Cerebral Vascular Accident (CVA) or “Brain Attack” Signs and symptoms depend on location and area involved Occurs when artery in brain is occluded or ruptures, interrupts blood flow to brain Cerebral Vascular Accident (CVA) or “Brain Attack” Signs and symptoms depend on location and area involved

50 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Signs & Symptoms Facial drooping One-sided paralysis Slurred speech Dilated pupil(s) Facial drooping One-sided paralysis Slurred speech Dilated pupil(s) Weakness Nausea/vomiting Dizziness Blurred vision

51 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Cincinnati Prehospital Stroke Scale Assess Facial droop Arm drift Abnormal speech Assess Facial droop Arm drift Abnormal speech

52 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Cincinnati Prehospital Stroke Scale Assess Facial droop Arm drift Abnormal speech Assess Facial droop Arm drift Abnormal speech

53 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Time is Critical! Stroke patients can be treated with drugs that dissolve blood clots if they reach an appropriate hospital in a short amount of time.

54 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Treatment Support airway, breathing, and circulation Reassure patient Ensure rapid transport by EMS Support airway, breathing, and circulation Reassure patient Ensure rapid transport by EMS

55 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Acute Abdomen

56 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Acute Abdomen Term used to describe sudden onset of abdominal pain.

57 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Signs and Symptoms Abdominal pain Nausea/vomiting Abdominal guarding Distended/rigid abdomen Shock Abdominal pain Nausea/vomiting Abdominal guarding Distended/rigid abdomen Shock

58 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Common Causes Gall bladder disease Gastric ulcers Aortic aneurysm Gastrointestinal illness Appendicitis Gall bladder disease Gastric ulcers Aortic aneurysm Gastrointestinal illness Appendicitis Diverticulitis Bowel obstruction Female reproductive system

59 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Acute Abdomen Observe for signs and symptoms of shock Allow patient to remain in position of comfort Be prepared to clear airway Observe for signs and symptoms of shock Allow patient to remain in position of comfort Be prepared to clear airway

60 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Exposure to Cold

61 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. BRRRRRR… Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

62 Exposure to Cold Localized cold emergency = frostbite Generalized cold emergency = hypothermia Patient can have either one or both Localized cold emergency = frostbite Generalized cold emergency = hypothermia Patient can have either one or both

63 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Contributing Factors Cold environment Age Underlying medical conditions Alcohol, drugs, poisons Wind Wet conditions Cold environment Age Underlying medical conditions Alcohol, drugs, poisons Wind Wet conditions

64 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Frostbite Freezing or near- freezing of body part –Nose –Ears –Fingers –Toes –Face Freezing or near- freezing of body part –Nose –Ears –Fingers –Toes –Face Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

65 Early Signs – Frostbite Blanched skin (white) Loss of sensation to area Skin soft to touch Tingling/burning sensation with rewarming Blanched skin (white) Loss of sensation to area Skin soft to touch Tingling/burning sensation with rewarming

66 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Late Signs - Frostbite Firm, pale, waxy skin Area feels frozen Swelling Blisters Skin may appear mottled with thawing or partial thawing Firm, pale, waxy skin Area feels frozen Swelling Blisters Skin may appear mottled with thawing or partial thawing

67 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. 6 Weeks later Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

68 Treatment Remove patient from cold Protect part from further harm Remove wet or restrictive clothing/jewelry Remove patient from cold Protect part from further harm Remove wet or restrictive clothing/jewelry Stabilize extremity and cover loosely (if early injury) Do not rub or massage area Do not re-expose to cold

69 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Late or Deep Injury Cover area with loose, dry dressing Do not break blisters Do not apply heat Do not allow patient to use affected extremity Cover area with loose, dry dressing Do not break blisters Do not apply heat Do not allow patient to use affected extremity

70 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Hypothermia Occurs when body temp < 95° F Can occur in normal temperature Occurs when body temp < 95° F Can occur in normal temperature

71 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

72 Treatment Assess pulses for 30–45 sec before starting CPR Remove patient from cold Remove wet clothing/prevent further heat loss Handle patient gently Assess pulses for 30–45 sec before starting CPR Remove patient from cold Remove wet clothing/prevent further heat loss Handle patient gently

73 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Treatment Do not allow patient to eat or drink –Avoid caffeine, nicotine, alcohol Do not massage extremities Do not attempt to rewarm patient Do not allow patient to eat or drink –Avoid caffeine, nicotine, alcohol Do not massage extremities Do not attempt to rewarm patient

74 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Exposure to Heat

75 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Contributing Factors Hot, humid climate Exercise/activity Age Pre-existing illness Drugs and medications Hot, humid climate Exercise/activity Age Pre-existing illness Drugs and medications

76 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Heat-Related Illness Heat cramps Heat exhaustion Heat stroke FR needs to recognize heat emergencies but not distinguish between them Heat cramps Heat exhaustion Heat stroke FR needs to recognize heat emergencies but not distinguish between them

77 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

78 Management Remove patient from heat into cool environment Place patient in recovery position if AMS Maintain patient comfort Reassure patient Remove patient from heat into cool environment Place patient in recovery position if AMS Maintain patient comfort Reassure patient

79 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Poisonings

80 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Poison Any substance that can potentially harm the body Can enter body in four ways –Ingestion –Inhalation –Absorption –Injection Any substance that can potentially harm the body Can enter body in four ways –Ingestion –Inhalation –Absorption –Injection

81 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

82 Poisoning May be accidental or intentional Amount required may vary May be accidental or intentional Amount required may vary

83 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Common Poisons Drugs/medicine Plants Snake/spider venom Alcohol Spoiled food Drugs/medicine Plants Snake/spider venom Alcohol Spoiled food Household chemicals Carbon monoxide Insecticides Nerve agents

84 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Be Careful! Do your scene size-up. Make sure that you won’t be exposed to the poison! Do your scene size-up. Make sure that you won’t be exposed to the poison!

85 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Carbon monoxide poisoning is a serious possibility with fire victims. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

86 Decontamination The patient may need to be decontaminated Done by specially trained HAZMAT personnel The patient may need to be decontaminated Done by specially trained HAZMAT personnel

87 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Effects of Poisons Respiratory failure Shock Abdominal pain Nausea/vomiting Diarrhea Altered mental status Respiratory failure Shock Abdominal pain Nausea/vomiting Diarrhea Altered mental status

88 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Management Call Poison Control Center –Specific poisons may have specific treatment Support airway and breathing Provide CPR if necessary Call Poison Control Center –Specific poisons may have specific treatment Support airway and breathing Provide CPR if necessary

89 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Allergic Reactions

90 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Allergic Reactions Occur when a person is sensitized to a foreign substance and comes in contact with it

91 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Signs and Symptoms Localized rash Swelling Watery eyes Sneezing Asthma-like reaction Localized rash Swelling Watery eyes Sneezing Asthma-like reaction

92 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Allergic Reactions Commonly caused by: Shellfish Peanuts Strawberries Sesame seeds Commonly caused by: Shellfish Peanuts Strawberries Sesame seeds

93 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Anaphylaxis Severe, life-threatening allergic reaction Body overwhelmed with substance Patient goes into shock Severe, life-threatening allergic reaction Body overwhelmed with substance Patient goes into shock

94 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Signs and Symptoms Generalized swelling Hives Wheezing Abdominal pain Low blood pressure Generalized swelling Hives Wheezing Abdominal pain Low blood pressure Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

95 Management Anaphylaxis is a life-threatening emergency Swelling → Airway Obstruction → Respiratory Arrest Watch patient for signs of deterioration Support airway, breathing, and circulation Anaphylaxis is a life-threatening emergency Swelling → Airway Obstruction → Respiratory Arrest Watch patient for signs of deterioration Support airway, breathing, and circulation

96 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Behavioral Emergencies

97 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Behavior refers to all of the physical and mental activities of a person A behavioral emergency occurs when a person exhibits abnormal behavior that is unacceptable to the patient, family or community Behavior refers to all of the physical and mental activities of a person A behavioral emergency occurs when a person exhibits abnormal behavior that is unacceptable to the patient, family or community

98 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Behavioral Changes May result from: Extremes of emotions Mental illness psychological stress Physical illness May result from: Extremes of emotions Mental illness psychological stress Physical illness Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

99 Common Causes Situational stress Low blood sugar Decreased oxygen to brain Head injury Heat or cold injury Drugs/alcohol Situational stress Low blood sugar Decreased oxygen to brain Head injury Heat or cold injury Drugs/alcohol Psychiatric illness Psychological crisis

100 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Does anything look wrong here? Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

101 Always keep your escape routes open! Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

102 Do a thorough scene size-up –Potential for violence –Unpredictable behavior Do a thorough scene size-up –Potential for violence –Unpredictable behavior Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

103 Role of the FR Attempt to calm patient Do not leave patient alone –Unless patient threatens your safety Consider need for law enforcement or backup Collect containers if an OD or poisoning Attempt to calm patient Do not leave patient alone –Unless patient threatens your safety Consider need for law enforcement or backup Collect containers if an OD or poisoning

104 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Assessment Identify yourself and that you are there to help Inform patient of your actions Identify yourself and that you are there to help Inform patient of your actions Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

105 Assessment Use calm, reassuring voice Don’t be judgmental Show you are listening Use calm, reassuring voice Don’t be judgmental Show you are listening Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

106 Assessment Acknowledge the patient’s feelings Assess patient’s mental status as you talk Note patient’s rate and content of speech Acknowledge the patient’s feelings Assess patient’s mental status as you talk Note patient’s rate and content of speech Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

107 Assessment Note patient’s general appearance Note patient’s level of physical activity Note patient’s general appearance Note patient’s level of physical activity Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

108 Violent Situations The safety of everyone is critical Watch for signs of impending violence The safety of everyone is critical Watch for signs of impending violence Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

109 Violent Situations Is there a weapon? Anything that can be used as a weapon? Does patient have a history of violence? Is there a weapon? Anything that can be used as a weapon? Does patient have a history of violence? Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

110 Impending Violence Tense, threatening posture Clenched fist Loudness, profanity, threats Quick erratic movements Tense, threatening posture Clenched fist Loudness, profanity, threats Quick erratic movements

111 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Agitated Patients Do not put yourself in harms way Acknowledge that the person is upset State that you are there to help Keep the patient informed Use a calm voice Do not put yourself in harms way Acknowledge that the person is upset State that you are there to help Keep the patient informed Use a calm voice

112 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Agitated Patients Maintain a comfortable distance Encourage patient to talk Don’t make sudden moves Be honest Do not threaten, challenge, or argue Maintain a comfortable distance Encourage patient to talk Don’t make sudden moves Be honest Do not threaten, challenge, or argue

113 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Agitated Patients Do not “play along” with hallucinations/voices Involve trusted friends/family Be prepared to spend lots of time Use eye contact if appropriate Avoid unnecessary physical contact Do not “play along” with hallucinations/voices Involve trusted friends/family Be prepared to spend lots of time Use eye contact if appropriate Avoid unnecessary physical contact

114 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Restraints Responsibility of law enforcement Special considerations –Monitor airway and breathing –Monitor circulation distal to restraint Responsibility of law enforcement Special considerations –Monitor airway and breathing –Monitor circulation distal to restraint

115 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Legal Considerations Document patient’s behaviors accurately Have witnesses Use same-sex attendant Obtain consent Document patient’s behaviors accurately Have witnesses Use same-sex attendant Obtain consent

116 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Summary Medical complaints make up a large number of calls. Although there are a variety of medical problems, the principle of treatment is to maintain the patient’s airway, breathing and circulation until the transporting unit arrives.

117 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Summary Some medical emergencies, such as cold and heat emergencies, require special measures such as protecting the patient from the environment. Behavioral emergencies present special challenges to First Responders because there are only guidelines for dealing with them, rather than specific hands-on skills with which to help the patient. Some medical emergencies, such as cold and heat emergencies, require special measures such as protecting the patient from the environment. Behavioral emergencies present special challenges to First Responders because there are only guidelines for dealing with them, rather than specific hands-on skills with which to help the patient.

118 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Is this man intoxicated? diabetic? fallen? sleeping? Suspect the worst and treat accordingly. Is this man intoxicated? diabetic? fallen? sleeping? Suspect the worst and treat accordingly. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.


Download ppt "Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Medical Emergencies Chapter 9."

Similar presentations


Ads by Google