1. Common Medical Emergencies
Jeff Sells, Captain
Coeur d Alene Fire Department

2. products/aeds/video/ Reality-Training- Citizens-as-first-care-providers-at-fire-and-EMS- incidents/

3. What’s on the menu!! What happens when you call 911
How paramedics approach medical emergencies
The most common calls
Chest Pain
Difficulty Breathing
Fainting
Stroke
Falls
Seizures
Not acting right

4. 911 What’s Your Emergency?
Don’t worry about trying to give the dispatcher a diagnosis. Don’t wait until you feel you have all the information before you call
Relay what you see or what the patient tells you.
The dispatcher will walk you through additional questions to ask and/or ask you to do something specific. i.e. administered aspirin
Stay on the phone with the dispatcher, there may be lots of questions and it may get frustrating. The fire department is still on the way!

5. How Paramedics Approach Medical Emergencies
Medical emergencies can be dynamic incidents where the patients’ condition changes from when you called 911 to when the fire department arrives.
Your description of the events is important but be patient. The paramedic most often is going to talk with the patient first and the caller second. Please stick around, if you are not sure, ask.
The paramedic can not force anyone to go to the hospital or seek further medical assistance. As long as the patient is alert and oriented, they have a choice.
Patients who are refusing care that have an altered mental status or are a danger to themselves or others must be placed in protective custody by the police before any medical treatment can be provided.

6. Rule #1 Your personal safety is paramount
If you feel uncomfortable about your surroundings or the situation you are in, remove yourself
Wear gloves
If you come in to contact with fluids, ask the firefighters’ help with decontaminating yourself.

7. Chest Pain https://www.youtube.com/watch?v=2GkVYgf6E6k
The dispatcher will most likely ask you to assist with administering aspirin. You will be prompted to ask the patient if they are allergic to aspirin.
Make sure the patient is alert and oriented before giving them anything. If they don’t want to take it, that is fine. Don’t feel like you need to force them to take it.
Paramedics will almost always treat any chest pain in someone over 30 years of age as a cardiac problem until proven otherwise
There are many different medical problems that can also result in chest pain that are not cardiac related.

8. Difficulty Breathing https://www.youtube.com/watch?v=ccr4lKZjHks
You may be asked to assist the patient with administering their own rescue inhaler
Don’t use someone else’s inhaler, even if you are sure it’s the same medication.
Try and let the patient pick the position that is easiest for them to breath. You will most often see these folks sitting up or standing. Let them stay that way
Paramedics will almost always try and transport these patients in the position that makes breathing easier for them
Hyperventilation is often a very dramatic scene, just be supportive

9. Fainting/Syncope
A temporary and self correcting episode of an altered mental status.
The altered mental status can range from disorientation to unconscious
There are many causes of fainting, some very serious, some not so much
Try and keep them lying down until the fire department arrives
Most of these patients wake up quickly after landing on the floor and are completely coherent and denying any complaints when the fire department arrives.
We DO believe you when you said they were unconscious

10. Stroke
The most important thing you can do is help keep them from further harm. i.e. falling
Be supportive
If there are family or friends there, please keep them there. They often will have valuable information for paramedics
Nothing by mouth, many times the stroke has affected their ability to swallow and patients can choke
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11. Falls
Did another medical problem precipitate the fall. Customer said she felt dizzy
Was the fall caused by a mechanical issue. The customer tripped over a rug
Was the customer unconscious before the fall. The suddenly stopped talking and fell
Was the customer unconscious after the fall. This can be an indication for a traumatic brain injury
The most important pre-care is trying to relay the sequence of events (if you know), keeping the patient still, warm and calm
Cuts, scrapes, breaks and other trauma

12. Seizures https://www.youtube.com/watch?v=ktgZOR5Gm TM
Can be a little frightening to witness
Assist the customer to the ground if you are able
Remove objects from around the customer that may injure them
Try and stay out of the way. Don’t get hurt
After the seizure, they will often be unconscious
Place them on their side if you are able
Attempt to see if they were there with anyone else and have them assist. They will often be familiar with the patients’ seizure history and will have valuable information

13. Not Acting Right?!? Altered mental status
Causes can range from diabetes to drugs
You will have to make a judgement call as to if/how you approach them. Most of the time though, a calm voice will be very effective.
Don’t try and physically restrain them until the fire department or police arrive. We can go find them.
Avoid gathering crowds, avoid trying to talk to these customers and being the one who calls Your answers to the dispatcher may seem confrontational or judgmental to your customer.
Be observant. What did they say/do/look like etc.

14. Questions????