Chapter 9

 Sometimes, medical emergencies may be hidden because of an injury. Ex: Pt. with low blood sugar who passes out  Important to be alert of s/s of medical emergencies Ex: altered mental status, unusual breath odors, dizziness, chest or abdominal pain, etc.

 Myocardial Infarction (MI) aka “heart attack” Death of heart tissue due to loss of adequate blood supply Heart attack and cardiac arrest are NOT the same thing  Signs/Symptoms Chest pain (angina)- described as pressure, tightness, heaviness; pain may extend to hand, neck, jaw, upper back Shortness of breath (dyspnea), nausea, sweating (diaphoresis), weakness

 Activate EMS  Keep patient at rest  Ensure open airway and adequate breathing  Assist patient in taking THEIR OWN Nitroglycerin (may take up to 3 nitroglycerin pills 5 minutes apart)  Monitor vital signs, especially blood pressure  Administer oxygen if available

 Heart unable to pump effectively causing backup of fluid in,the body  Signs/symptoms: chest pain, pedal edema, shortness of breath, trouble breathing when laying flat, rapid pulse, JVD, pale skin, altered mental status  Care for CHF: Activate EMS, position patient to upright position if able, administer oxygen, cover pt. to conserve body heat, monitor vital signs

 A group of respiratory conditions such as emphysema and chronic bronchitis  S/S: history of heavy cigarette smoking, allergies, persistent cough, SOB, tightness in chest, wheezing, need to sit in tripod position, barrel chest appearance  Care: EMS, position of comfort, administer oxygen, monitor vital signs, assist with medications, cover patient to conserve body heat

 Blood to the brain is obstructed when a vessel ruptures; brain does not receive adequate oxygen  s/s: headache, syncope (collapse or fainting)  Numbness or paralysis to one side of the body  Slurred speech  Visual disturbances

 Cincinatti Prehospital Stroke Scale (CPSS)- assesses the following: Facial droop- Have patient smile and show teeth. Facial muscles should move symmetrically. Arm drift- have pt hold both arms straight out in from of him and close eyes. Observe for arm drift. Abnormal speech- observe for slurred speech, inappropriate words or inability to respond verbally

 EMS  Airway  Oxygen  Keep patient at rest; protect paralyzed parts  Position for drainage from the mouth  NPO  Monitor pt: shock, respiratory arrest and cardiac arrest are possible

 Irregular electrical activity in the brain which can lead to change in behavior or movement  Can cause convulsions (uncontrolled muscular movements)  When the entire body convulses, called a generalized seizure  Temporary loss of concentration known as partial complex seizure

 Epilepsy  Drugs, alcohol  Brain tumors  High fever  Trauma  Stroke  Head injury

 Sudden loss of responsiveness  Convulsions  Loss of bladder/bowel control  Patient reports bright light, bright colors, or sensation of a strong odor prior to losing responsiveness

 BSI  Protect pt. from injury  IF NECESSARY, GENTLY restrain pt. and pad him. Never force anything into mouth  Loosen restrictive clothing  After convulsion stops, keep pt at rest; position head for drainage  Administer oxygen

 A disease that prevents individuals from producing enough insulin or from using insulin effectively.  Hyperglycemia: high blood sugar  Hypoglycemia: low blood sugar

 Difficult breathing  Extreme thirst  Abdominal pain  Dry, warm skin  Rapid, weak pulse  Sweet, fruity odor on the patient’s breath  Dry mouth  Restlessness  Unresponsiveness

 Perform scene size-up, Activate EMS system  Administer oxygen  Keep patient at rest  If patient is alert, give sugar, candy, orange juice, or soft drink

 Altered mental status  Pale, cool, & often moist skin  Rapid, strong pulse  Dizziness  Headache  Normal or shallow breathing  Very hungry  Some develop seizures

 Perform a scene size-up  Perform initial assessment & ensure adequate ABCs  If patient is alert, provide oral glucose  Someone activate EMS system  Keep patient comfortable & administer oxygen