1. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 9 First Emergency Procedures and Aid

2. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Recognizing an Emergency Definition –Any instance in which an individual becomes suddenly ill and requires immediate attention Signs of emergencies –Unusual sounds, strange behavior First aid –Designed to render immediate care to persons injured prior to arrival of physician

3. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Responding to an Emergency Act quickly Screen the situation Assess the patient Check for universal emergency medical identification >>

4. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Primary Survey (A) Airway—tilt the head or thrust the jaw to open airway Click here to see an animationClick here to see an animation (B) Breathing—rescue breathing (C) Circulation—cardiopulmonary resuscitation

5. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Using the 911 or EMS System Situations calling for these services –The provider may give preliminary care but patient may still need to go to the hospital –The provider may not be equipped to give type of care needed One person should always stay with the patient until help arrives –Continually monitor the patient

6. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Good Samaritan Laws Good Samaritan laws –Provide some degree of legal protection to the health care professional who offers first aid –Generally protect off-duty health care professionals

7. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Infection Control Blood, body fluids, and disease transmission –Always protect yourself and the patient –Follow standard precautions

8. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Preparing for an Emergency Develop an in-office handbook of policies and procedures Keep telephone numbers for the local EMS and poison control center posted All personnel should be trained in the basics of first aid and CPR –Medical assistants must be provider-level certified

9. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Preparing for an Emergency Keep proper documentation of all emergencies Keep office environment safe –Keep floors and corridors clean –Wipe up spills immediately to prevent falls

10. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. The Medical Crash Tray or Cart Supplies on tray should be carefully inventoried Common supplies found on most trays and carts

11. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Shock Definition –A condition in which the circulatory system is not providing enough blood to all parts of the body, causing the body’s organs to fail to function properly Always life-threatening Activate EMS

12. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Shock Signs and symptoms of shock Types of shock Treatment for shock –Call EMS, then give immediate attention –Shock is progressive

13. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Wounds Closed wounds –Have no break in skin –Do not usually present an emergency situation –Some may cause internal bleeding –RICE and MICE procedures: Rest or Movement, Ice, Compression, Elevation

14. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Wounds Open wounds –Minor tears in skin or more serious breaks –All represent opportunity for infection –Tetanus injection may be needed –Types of open wounds Abrasions Avulsion Incision Laceration Puncture

15. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Dressings and Bandages Necessary to dress and bandage open wound to curtail infection –Dressings Sterile pads –Bandages Nonsterile wraps placed over dressings

16. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Dressings and Bandages Bandage application –Depends on injury and injury site –Avoid too tight or too loose a wrap

17. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Dressings and Bandages Types of bandages –Open or closed spiral bandages –Figure-of-eight bandage –Tubular gauze bandage >> –Commercial arm slings >>

18. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Burns Caused by heat, chemicals, explosions, and electricity Critical burns can be life-threatening Describe symptoms of critical burns

19. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Burns Degrees of burns –First-degree Superficial; top layer of skin –Second-degree Skin is red and blisters appear –Third-degree Affect all layers of skin plus fat, muscles, bones, and nerves under skin

20. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Burns Caring for burns –Treatment for burns –What to avoid Special kinds of burns –Chemical –Electrical –Solar radiation

21. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Musculoskeletal Injuries Painful and can be disabling Types of injuries –Sprains involve tearing of the ligaments Signs and symptoms of sprains –Strains are injuries to soft tissue between joints that involve tearing of muscles or tendons Signs and symptoms of strains –Dislocations involve separation of bone from normal position Signs and symptoms of dislocations

22. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Musculoskeletal Injuries Types of injuries –Fractures involve a break in a bone Incomplete or greenstick Simple Compound Impacted Comminuted Spiral Depressed Colles

23. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Musculoskeletal Injuries Assessing injuries to muscles, bones, and joints –Note extent of bruising and swelling –Pain is signal of injury –Noticeable deformity to bone or joint –Use of injured area is limited –Talk to patient Caring for muscle, bone, and joint injuries

24. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Heat- and Cold-Related Illnesses Heat-related illnesses –Heat cramps (least serious) –Heat exhaustion (more serious) –Heat stroke (least common, most serious) Cold-related illnesses –Frostbite –Hypothermia

25. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Poisoning Can enter body in four ways: –Ingestion –Inhalation –Absorption –Injection

26. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Poisoning Call poison control center or local emergency number Treatment depends on source of poisoning Activated charcoal may be prescribed

27. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Poisoning Insect stings –May cause swelling Remove stinger by scraping with something rigid (e.g., credit card) –May cause allergic reaction or hypersensitivity –Epinephrine may be prescribed to patients with known allergic reactions (EPIPEN) Snake bite

28. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Sudden Illness Fainting (syncope) –Involves loss of consciousness caused by insufficient supply of blood to brain –If patient feels faint, have her lie down or sit with head level with knees –If patient faints, lower patient to flat surface, loosen tight clothing, and check breathing –May indicate a complex medical condition

29. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Sudden Illness Seizures or convulsions –Occur when normal brain functioning is disrupted –Caused by fever, diabetes, infection, brain injury, epilepsy, and other conditions and diseases –Treat patient with empathy –Protect patient from injury –Determine when an EMS should be called

30. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Sudden Illness Diabetes –Inability of body to properly convert sugar from food into energy –Two types of diabetes –Diabetic coma and insulin shock or reaction may occur

31. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Sudden Illness Hemorrhage –External bleeding includes capillary, venous, and arterial bleeding –Epistaxis (nosebleeds) –Internal bleeding Stay with patient and have someone call EMS

32. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Control of Bleeding

33. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Cerebrovascular Accident (CVA) Common term is stroke Result of ruptured blood vessel in brain Can be caused by occlusion of blood vessel or by a clot

34. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Cerebrovascular Accident (CVA) Varied symptoms of CVA Treatment of CVA –Activate EMS; keep patient comfortable –Keep airway open

35. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Heart Attack Also known as myocardial infarction Usually caused by blockage of coronary arteries Several symptoms of heart attack –Women may have different symptoms than men Treatment of heart attack –Activate EMS; keep patient comfortable

36. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Breathing Emergencies and Cardiac Arrest When a patient stops breathing, give artificial or rescue breathing immediately Give chest compressions with rescue breathing (CPR) if patient has breathing emergency and cardiac arrest

37. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Rescue Breathing Also called mouth-to-mouth resuscitation Provides oxygen to patient until emergency personnel arrive Resuscitation mouthpieces recommended Methods differ for adults, children, and infants

38. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. CPR Preliminary care until advanced medical help is available CPR and defibrillation (AED) increases survival Methods differ for adults, children, and infants

39. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. CPR Click to play the video

40. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety and Emergency Practices Responding to mass disasters –Volunteering at shelters, clinics, hospitals –Using first aid and CPR skills –Giving immunization injections –Medical Reserve Corps Responding to home and facility disasters

41. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety and Emergency Practices Click to play the video