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Chapter 10 Medical Emergencies

Chapter 10 Medical Emergencies. EMR 10- 1. Introduction. The medical patient verbalizes or appears to have a disease, an illness, or a reaction Most often an EMR will not be able to determine the specific medical condition and may only have a general idea

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Chapter 10 Medical Emergencies

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  1. Chapter 10Medical Emergencies EMR 10-1

  2. Introduction • The medical patient verbalizes or appears to have a disease, an illness, or a reaction • Most often an EMR will not be able to determine the specific medical condition and may only have a general idea • This chapter will provide an overview of various medical conditions; however, the main role of the EMR is to provide critical interventions, trend vital signs, and reassess for any change in the patient’s status EMR 10-2

  3. Learning Objective 1 Define Focused Assessment FOCUSED ASSESSMENT • Perform all the components of an initial assessment • Provide critical interventions if indicated • Baseline vitals • Secondary or rapid survey • Subjectiveinformation, objective information, critical thinking skills EMR 10-3

  4. General care guidelines: • Monitor ABCs • Position patient • Administer oxygen • Monitor vital signs and mental status • Provide emotional support • Notify EMS of changes

  5. Learning Objective 2 • RESPIRATORY EMERGENCIES • Overview • Assessment tools • SAMPLE, OPQRST, and pulse oximeter if available • Signs and symptoms • Tripod position • Dyspnea (shortness of breath) or tachypnea • Use of accessory muscles while breathing • Diaphoresis(profuse sweating) • Difficulty speaking in complete sentences without stopping to catch a breath EMR 10-5

  6. Progression • As hypoxia worsens • Respiratory system starts to fail • Patient will become cyanotic • If not treated properly • Patient will become very tired • The respiratory rate will begin to fall

  7. Learning Objective 2 • PULMONARY EMBOLISM • Overview • Blood clot travels to lungs • Management • Critical interventions • + O2, fowlers position • Reassess every 5 minutes EMR 10-7

  8. Learning Objective 2 • ASTHMA • Overview • Chronic condition • Narrowing of the airway • Management • Critical interventions • Assist with meds EMR 10-8

  9. Learning Objective 2 • CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) • Overview • Two main types of COPD • Chronic bronchitis • Emphysema • Management • Critical interventions EMR 10-9

  10. Learning Objective 2 Describe Respiratory Emergency Care • RESPIRATORY INFECTIONS • Overview • Can be caused by virus or bacteria • Signs and symptoms • Management • Critical interventions • Allow for position of comfort EMR 10-10

  11. Learning Objective 2 Describe Respiratory Emergency Care • HYPERVENTILATION • Overbreathing • Breathing faster than normal • Management • Critical interventions • Convince normal breathing if possible • Do not have patient breathe into bag EMR 10-11

  12. Learning Objective 3 Cardiovascular Medical Emergencies • CARDIOVASCULAR MEDICAL EMERGENCIES • Involves heart and blood vessels • Causes • Cardiovascular and respiratory complications coexist • Early recognition and transport are critical EMR 10-12

  13. Learning Objective 3 Cardiovascular Medical Emergencies • MYOCARDIAL INFARCTION • Overview • Chest pain, or angina pectoris • With severe or total blockage, lack of oxygenated blood to the heart muscle causes an area or areas of the heart to die • This is called a heart attack or acute myocardial infarction (MI) EMR 10-13

  14. Signs and Symptoms • Chest pain or discomfort described as pressure, squeezing, a vise grip, or a heavy weight on his chest • Unexplained pain in the shoulder, back, jaw, or neck • Pain radiating from the center of the chest to one or both arms • Dyspnea, or a feeling of not having enough air • Lightheadedness

  15. Signs and Symptoms • Indigestion or heartburn • Nausea or vomiting • Diaphoresis, or cold sweats • Fast or irregular pulse, feels like the heart skips a beat or is racing • Pale, grey, cyanotic skin color • Weakness, unusual fatigue • Feelings of impending doom, anxiety, irritability • Altered mental status (AMS)

  16. Learning Objective 3 Cardiovascular Medical Emergencies • CARDIAC ARREST • Overview • Heart stops beating • Critical interventions • Ventilations with BVM at 100 percent oxygen EMR 10-16

  17. Learning Objective 3 Cardiovascular Medical Emergencies • HEART FAILURE • Overview • Inability to pump enough oxygenated amounts of blood • Blood backs up into the lungs and other areas of the body causing congestion • The accumulation of fluid is called edema and is often most evident visibly in the ankles and feet • Accumulation of fluid in the lungs is called pulmonary edema EMR 10-17

  18. Learning Objective 4 Stroke Assessment and Emergency Care • STROKE • A stroke or cerebrovascular accident (CVA) occurs as a result of a disruption of blood flow to part of the brain - • the brain does not receive adequate perfusion • Assessment tools • Cincinnati Prehospital Stroke Scale (FAST) • Face, Arms, Speech, Time • Management • Critical interventions EMR 10-18

  19. Assessment and Management of Allergic Reactions • Moderate to severe reaction signs and symptoms • Hives, itchy red bumps, either local or covering large body areas • Difficulty breathing, talking, or swallowing or tightness in the throat • Tachycardia • Chest tightness or discomfort • Wheezing • Swelling of the face, eyes, lips, tongue, or throat • Treatment • Treat for shock • Assist with Epi-Pen • Calm and reassure • Seek rapid transport EMR 10-19

  20. Learning Objective 6 Diabetes and Two Kinds of Complications • DIABETES • Overview • Pancreas function • Diabetes mellitus • Insulin injections • Controlling diabetes • Assessment tools EMR 10-20

  21. Learning Objective 6 • HYPOGLYCEMIA- Lower than normal blood sugar level • Signs and symptoms • Nervousness to unresponsiveness • Low blood sugar level (patient or family data) • Shaking, tremors • Tachycardia, heart palpitations • Headache • AMS, confusion, disorientation • Personality changes, agitation, restlessness, and possible combativeness • Appears intoxicated by slurring of speech and staggering • Management • Give sugar if agency allows • Do not give diet drinks EMR 10-21

  22. Learning Objective 6 • HYPERGLYCEMIA- Higher than normal glucose level • Similar signs and symptoms + • Fruity breath • Frequent urination • Management • Critical interventions • Sugar, sugar drinks, or oral glucose EMR 10-22

  23. Learning Objective 7 SEIZURES • Partial, Generalized, status epilepticus • Protect from further harm • Never put anything in the mouth • Lateral recumbent is preferred • Padding under head EMR 10-23

  24. Learning Objective 8 Abdominal Emergency Conditions • ABDOMINAL EMERGENCIES • Many conditions and causes • Classifications • Visceral, parietal, and referred pain • Assessment tools – OPQRST, DRGERM • Management is similar EMR 10-24

  25. Learning Objective 8 Abdominal Emergency Conditions • ABDOMINAL AORTIC ANEURYSM • Overview • Weakness in wall of aorta • Signs and symptoms • Abdominal or back pain • Radiates to pelvic area EMR 10-25

  26. Learning Objective 8 Abdominal Emergency Conditions • PEPTIC ULCER DISEASE • Overview • Open sore in lining of stomach, duodenum, or esophagus • Bleeding ulcer • Signs and symptoms • Burning, cramping pain in the upper or mid abdomen • Nausea, heartburn, belching EMR 10-26

  27. Learning Objective 8 Abdominal Emergency Conditions • ESOPHAGEAL VARICES • Overview • Dilated veins in lower esophagus • Common cause, severe liver disease • Vessels become distended and rupture • Signs and symptoms • Nausea, vomiting bright red blood • Black, tarry stool EMR 10-27

  28. Learning Objective 8 Abdominal Emergency Conditions • GASTROENTERITIS • Overview • Inflammation of lining of stomach and intestine • Causes • Illnesses causing dehydration • Signs and symptoms • Nausea, vomiting • Diarrhea • Abdominal cramping • Fever, chills EMR 10-28

  29. Learning Objective 8 Abdominal Emergency Conditions • BOWEL OBSTRUCTION • Overview • Narrowing or completely blocked bowel • Rupture • Causes of bowel obstruction • Signs and symptoms • Vomiting partially digested food • Abdominal distension, rigidity EMR 10-29

  30. Learning Objective 8 Abdominal Emergency Conditions • GALLBLADDER DISEASE • Overview • Causes • Gallstones • Signs and symptoms • Sometimes mistaken • for heart attack EMR 10-30

  31. Learning Objective 8 Abdominal Emergency Conditions • APPENDICITIS • Overview • Appendix is a pouch attached to large intestine • Appendix becomes inflamed, distends, or ruptures • Signs and symptoms • Dull pain that becomes sharp EMR 10-31

  32. Learning Objective 8 Abdominal Emergency Conditions • DIVERTICULITIS • Overview • Inflammation of diverticulum • Pouch in area of large intestine wall • Signs and symptoms • Sudden severe abdominal pain EMR 10-32

  33. Learning Objective 8 Abdominal Emergency Conditions • PACREATITIS • Overview • Gland behind the stomach • Role in insulin production • Signs and symptoms • Persistent, severe upper abdominal pain EMR 10-33

  34. Learning Objective 8 Abdominal Emergency Conditions • KIDNEY STONES • Overview • Minerals crystallize in the urine • Cause blockage to bladder • Signs and symptoms • Severe flank pain radiating to groin EMR 10-34

  35. Learning Objective 9 • POISONING – recognize delivery • Management • Critical interventions • Proper response teams • In an industrial setting, refer to Material Safety Data Sheets • If time allows, contact the Poison Control Center at 1-800-222-1222 for assistance • Be aware that vomiting caustic substances can seriously burn the gastrointestinal tract EMR 10-35

  36. Learning Objective 9 Four Different Types of Poison Exposure • INGESTED POISONS • Overview • Substance absorbed through stomach and intestines • Most common poisoning • Symptoms may not appear for hours • Signs and symptoms EMR 10-36

  37. Learning Objective 9 Four Different Types of Poison Exposure • INHALED POISONS • Overview • Gases, vapors, powders, or aerosols • Rapidly absorb into the body • Damage or destroy respiratory tract • Signs and symptoms EMR 10-37

  38. Learning Objective 9 Four Different Types of Poison Exposure • INJECTED POISONS • Overview • Into bloodstream by puncture of the skin • Reaction can be • local or general • Stings and bites • Signs and symptoms EMR 10-38

  39. Learning Objective 9 Four Different Types of Poison Exposure • ABSORBED POISONS • Overview • Absorption through skin or mucous membrane • Liquids and dry powders • Examples • Signs and symptoms EMR 10-39

  40. Learning Objective 9 • NERVE AGENT ANTIDOTE AUTOINJECTOR KIT • Types • Mark I • DuoDote • Signs and symptoms • Administration EMR 10-40

  41. Summary • An EMR will routinely respond to medical emergencies and must perform critical interventions, obtaining vital information, performing a secondary survey or rapid secondary survey incorporating objective and subjective information, and then focusing on specific interventions • Using critical thinking skills and a basic knowledge of common medical conditions, an EMR can provide necessary care and determine if rapid transport is necessary EMR 10-41

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