Levels of Emergency | Emergency Situations Lesson 5

Chronic

Long and drawn out, not acute

Some diseases have slow chronic phase that can change into an acute episode

ex.) COPD, leukemia

Insidious

Hidden / not apparent. Disease has a slow hidden beginning —> quickly dev symptoms

ex.) kidney failure, liver disease

Urgent

Situation requiring intervention asap

ex.) gallstone, ulcer

Sudden

Occurs quickly, without warning

ex.) headache

Severe

Very extensive and adv, req immediate medical attention

ex.) head injury, burn, broken bone

Life Threatening

Could cause death

ex.) shock, heart attack, stroke, internal bleeding, head injury

Incident Report

detailed account of the emergency and how it was managed —> patient record

• full name of injured/ill party

• date and time of accident/emergency

• address + phone # of injured

• notation to whether the individual is a patient, visitor, or office staff member

• location of where incident occured

• name, address and signature of any witnesses to the accident

• detailed description of incident/conditions surrounding it

• description of action taken, medications given, physician who examined the injured person and statement of the patient

• signature of person preparing the report + date/time (military format)

printed form should be available

Seizures

occur when sudden abnormal burst of electrical activity in the brain: result from high body temp (fever), head injuries, infections, brain tumors, and epilepsy

1. onset/beginning of seizure - type of seizure; condition/symptoms?

2. person’s level of awareness?

3. Movements happen during seizure?

Seizure Motor Classification

• clonic - rhythmical jerking mvmts

• atonic - muscles becoming weak/limp

• tonic - muscles becoming tense or rigid

• myoclonus - brief muscle twitching

• epileptic spams - body may flex & extend repeatedly

Diabetes mellitus

Chronic syndrome of insufficient insulin production —> body’s inability to metabolize carbohydrates, protein, and fat

can cause complications: heart disease, blindness, kidney failure, and lower extremity necrosis —> amputations

Type I diabetes - chronic disease that occurs when the pancreas does not produce enough insulin to properly control blood sugar levels

• Type I Pt. need to take insulin every day (mostly affected children, adolescents, young adults)

Type II diabetes - (most common form) issues with how the body produces or uses insulin

Secondary diabetes mellitus - condition that does NOT result from genetics / env conditions

Symptoms:

• frequent urination

• excessive thirst

• unexplained weight loss

• extreme hunger

• sudden vision changes

• frequent fatigue

• very dry skin

• slow healing sores

• more infections than usual

Diabetic pt. emergency : hypoglycemic / hyperglycemic

Fainting

blood supply to the brain decreases and causes the pt. to lose consciousness

results from: hunger, pain, emotion, fatigue, excessive heat/standing for long period of time; may indicate serious medical condition

symptoms:

• skin is pale, perspiring, cold / clammy

• nausea

• lack of balance

Myocardial Infarction (MI) / Heart attack

occurs suddenly, without warning - blood supply to the myocardium (muscular wall of the heart) is. blocked and a part of the heart muscle dies

Chest pain/discomfort, weakness, sweating, nausea, vomiting and irregular heartbeat —> loss of consciousness

*All heart attacks are deemed life-threatening medical emergency —> immediate attnention

MI symptoms

Male

• nausea/vomiting

• jaw, neck, or back pain

• squeezing chest pressure or pain

• shortness of breath

Female

• nausea/vomiting

• jaw, neck, or back pain

• chest pain (not always)

• shortness of breath

• fainting

• indigestion

• pain/pressure in the lower chest or upper abdomen

• extreme fatigue

*Time is critical, treatment within the first hr can save a pt.’s life and reduce permanent damage

cerebrovascular accident CVA / apopplexy / stroke

acute neurological injury that interrupts the blood supply to a part of the brain and causes tissue to die

Stroke - interrupts blood supply —> brain

Heart attack- Blockage —> heart

FAST

F - face drooping

A - arm weakness

S - speech difficulty

T - time; call EMS

other symptoms: suddent numbness/weakness of the leg, trouble seeing in one/both eyes, touble walking, dizziness, loss of balance/coordination, sudden severe headache

*a pt. unconscious or unable to speak can still hear what is being said

Heat exhaustion / Heat stroke

Heat exhaustion - during heavy physical exertion:

occurs: dehydration, electrolyte depletion, lowered blood sugar levels, and lactic acid build up 3

symptoms: —> disappear after pt. drinks adequate water/electrolytes

• headache / dizziness

• fatigue

• increased respiratory rate, rapid pulse

• low blood pressure

• moist, pale skin

Heat Stroke - life-threatening condition (can result in permanent brain damage & coma) body can no longer compensate for the rise in body temp ~past 105 degrees Fahrenheit

symptoms:

• seizures

• possible hot, flushed/dry skin

• rising / falling vital signs

Frostbite

skin is exposed to extreme cold and the tissue is damaged

affects high surface area or tissue mass (fingers, toes, ears, nose)

Gangrene - nerves and blood vessels are severely damaged (death and decay of body tissue) — amputation

symptoms:

• skin discoloration

• burning/tingling sensation

• partial or complete numbness

• possibly intense pain

skin destroyed by frostbite —> black, looks loose & stripped (burnt)

Hemorrhage / Bleeding

excessive, uncontrolled bleeding

• bleeding - loss of blood from the body (*more dangerous for children, less blood to lose)

*average adult is in medical dnager after a loss of 1 liter —> shock (avg 150-180 lb adult = 4.7 - 5.5 gal of blood)

• arterial bleeding - major blood vessel (oxygen rich blood thru the body); spurts with each beat of the heart, severe — immediate attention, death ~ 3 mins or less

• venous bleeding - veins (return blood to body); steady flow, dark blood, easy to control

• capillary bleeding - cappilaries (smallest blood vessel); slow, oozing, higher risk of infection, clots without first-aid

• internal bleeding - occurs inside the body (hard to detect); surgery is ONLY treatment

  • call 911, pt. lying position & little to no mvmt until surgery is performed

• vaginal bleeding - bleeding in females (menstruation, hormonal, reproductive)

  • investigate if in children or postmenopausal women; during pregnancy - may indicate complications

• Epistaxis - nosebleeds blow to the nose externally/internally; caused by chronic conditions nasal/sinus infection, inhalation/irritating substances, high bp, anticoagulation drugs, chronic aspirin, blood diseases (anemia, hemophilia, leukemia)

Poisoning

substance that causes injury, illness or death. Can be eaten, drunk, inhaled, injected or absorbed through the skin

Food poisoning: spoiled food, seafood, prepared dishes —> vomiting, diarrhea

Carbon monoxide: cigarette smoke, gas heaters, exhaust pipes from car —> headaches, dizziness, vomiting, chest pain, blurred vision, loss of consciousness

Bee sting: wasp, bee, yellow jacket sting —> difficulty breathing, swelling, high bp

Choking

blocked airway caused by food caught in an air pocket while eating, partially chewed food is sucked into the windpipe when talking, laughing or coughing while eating

abdominal thrusts; if pregnant or obese —> chest thrusts

Shock

lack of oxygen to the individual cells of the body which is an immediate response by the body tissues when they don’t receive enough oxygen-rich blood

(body adjusts for shock by inc the strength of contractions of the heart and constricting the blood vessels, as it progresses the body can not adjust and tissues and body organs will sustain severe irreversible damage

*leading cause of death in critically ill pt.

Types of Shock

• Hypovolemic shock - caused by loss of blood or other body fluids; dehydration caused by diarrhea, vomniting or heavy sweating can also lead to hypovolemic shock

  • shock caused by blood loss - hemorrhagic shock

• Cardiogenic shock - *most extreme form of heart failure; occurs when the function of the lift ventricle is so compromised that the heart can no longer adequately pump blood to body tissues

• Neurogenic shock - caused by a dysfunction of the nervous system; diamter of the blood vessels in the body can no longer controlled —> dilation of blood vessels (not enough blood in circulation to supply the body with oxygen)

• Anaphylactic shock - acute generalized reaction that occurs within mins - hrs after the body has been exposed to a foreign substance to which it is severely allergic to

• Septic shock - caused by a generalized infection of the bloodstream, may be associated w/ an infection (pneumonia / meningitis); can occur w/o apparent source of infection *common in infants & children

Insects

Anaphylactic shock

Used straight edge (credit card) to remove stinger