Recognizing and Caring for Sudden Illnesses

1. Recognizing and Caring for Sudden Illnesses http://www.instructorscorner.org/media/videos/e1.html

2. Signals of Sudden Illness ■ Common signals of sudden illnesses include: Changes in level of consciousness, such as feeling light-headed, dizzy, drowsy or confused, or becoming unconscious. Breathing problems (i.e., trouble breathing or no breathing). Signals of a possible heart attack Signals of a stroke Signals of shock Loss of vision or blurred vision. Sweating. Persistent abdominal pain or pressure. Nausea or vomiting. Diarrhea. Seizures.

3. Care for Sudden Illnesses ■ Care for sudden illnesses by following the same general guidelines as you would for any emergency. Do no further harm. Monitor the person’s level of consciousness and breathing. Help the person to rest in the most comfortable position. Keep the person from getting chilled or overheated. Comfort and reassure the person but do not give false hope. Give any specific care as needed. ■ If the person is conscious, ask if he or she has any medical conditions or is taking any medications. ■ Do not give the person anything to eat or drink unless he or she is fully conscious, able to swallow and does not show any signals of a stroke. ■ If the person vomits and is unconscious and lying down, position the person on his or her side in the modified H.A.IN.E.S. position so you can clear the mouth. ■ Knowing enough about sudden illnesses to recognize when to call 9-1-1 or the local emergency number is your top priority as a lay responder.

4. Specific Sudden Illnesses Some sudden illnesses may be linked with chronic conditions, such as heart or lung disease. ■ When checking the person, look for a medical identification (ID) tag, bracelet, necklace or anklet indicating that the person has a chronic condition or allergy. ■ You do not need to know the cause to help. Signals for sudden illness are similar to other conditions and the care probably involves skills that you already know.

5. Diabetic Emergencies • A total of 23.6 million people in the United States (7.8% of the population) have diabetes. • Diabetes is defined as the inability of the body to change sugar (glucose) form food into energy. This process is regulated by insulin, a hormone produced in the pancreas. Diabetes mellitus, or diabetes, is a condition in which the body does not produce enough insulin or does not use insulin effectively. • The cells in the body need sugar (glucose) as a source of energy. The cells receive this energy either from digested food or from stored forms of sugar. The sugar is absorbed into the bloodstream with the help of insulin. • For the body to function properly, insulin and sugar must be in balance. • The two major types of diabetes are: • Type 1 diabetes, formerly called juvenile diabetes, affects about 1 million Americans. People with Type I diabetes must inject insulin into their bodies daily because their bodies produces little or no insulin. • Type 2 diabetes is the most common type, affecting about 90 to 95 percent of people with diabetes. • With Type 2 diabetes, the body produces insulin, but not enough to meet the body’s needs, or the body becomes resistant to the insulin produced. • Type 2 diabetes is progressive; people with this type of diabetes eventually may need to use insulin. • Anyone who has diabetes must carefully monitor his or her blood glucose levels, diet and exercise. If not controlled, the person can have a diabetic emergency.

6. Diabetic Emergencies, Cont. Hyperglycemia occurs when the insulin level in the body is too low and the sugar level in the blood begins to rise too high. Sugar is present in the blood, but it cannot be transported from the blood into the cells without insulin. Body cells become starved for sugar. The body attempts to meet its need for energy by using other stored food and energy sources, such as fats. Converting fat to energy is less efficient, produces waste products and increases the acidity level in the blood, causing a condition known as diabetic ketoacidosis. A person with diabetic ketoacidosis becomes ill. He or she may have flushed, hot, dry skin and a sweet, fruity breath odor that can be mistaken for the smell of alcohol. The person also may appear restless or agitated. If the condition is not treated promptly, a life-threatening emergency called a diabetic coma can occur. Hypoglycemia occurs when the insulin level in the body is too high and the person has a low blood sugar level. The blood sugar level can become too low if the person takes too much insulin, fails to eat adequately or, due to sudden illness, cannot keep food or liquids down, over exercises and burns off sugar faster than normal, or experiences great emotional stress. In this situation, sugar is used up rapidly, so not enough sugar is available for the brain to function properly. If left untreated, hypoglycemia may result in a life-threatening condition called insulin shock.

7. Diabetic Emergencies, Cont. • Although hyperglycemia and hypoglycemia are different conditions, their major signals are similar and include: • Changes in the level of consciousness. • Changes in mood. • Irregular breathing. • Feeling or looking ill. • Abnormal skin appearance. • Dizziness and headache. • Confusion. • Care for both of these diabetic emergencies is the same. • If you know someone experiencing the signals, you may know the person is diabetic. A person who is conscious may also tell you he or she is diabetic. • Also look for a medical ID tag, bracelet, necklace or anklet. • Often individuals with diabetes know what is wrong and will ask for something with sugar in it or they may carry some form of sugar with them in case they need it. • If the person is conscious and able to swallow, and advises you that he or she needs sugar, give sugar in the form of several glucose tablets or glucose paste, a 12-ounce serving of fruit juice, milk, or non-diet soft drink, or table sugar dissolved in a glass of water. If the problem is too much sugar, this amount of sugar will not cause further harm. • People with diabetes also may carry glucagon, which they can self-administer to counter hypoglycemia. • People who take insulin to control diabetes may have injectable medication with them to care for hyperglycemia. Do not try to assist a person by administering insulin to them. • Always call 9-1-1 or the local emergency number if: • The person is unconscious or about to lose consciousness. • The person is conscious but unable to swallow. • The person does not feel better approximately 5 minutes after taking sugar. • You cannot find any form of sugar immediately. • If the person is unconscious: • Do not give him or her anything by mouth. • Give care in the same way you would for any unconscious person.

8. Stroke • A stroke, also called a cerebrovascular accident (CVA) or brain attack, is caused when blood flow to the brain is cut off or when there is bleeding into the brain. • It can cause permanent brain damage if not treated appropriately; sometimes, the damage can be stopped or reversed. • Stroke is most commonly caused by a blood clot, called a thrombus or embolus, that forms or lodges in the arteries supplying blood to the brain. • Another common cause of stroke is bleeding from a ruptured artery in the brain caused by a head injury, high blood pressure or an aneurysm (a weak area in the wall of an artery that balloons out and can rupture). • Fat deposits lining an artery (atherosclerosis) may also cause stroke. Less commonly, a tumor or swelling from a head injury may compress an artery and cause a stroke. • A transient ischemic attack (TIA), often called a “mini-stroke,” is a temporary episode that like a stroke is caused by a disruption in blood flow to a part of the brain. • However, unlike a stroke, the signals of TIA disappear within a few minutes or hours of its onset. Although the indicators of TIA disappear quickly, the person is not out of danger. • Because you cannot distinguish a stroke from a TIA, call 9-1-1 or the local emergency number immediately when any signals appear. • The risk factors for stroke are similar to those for heart disease. Some risk factors are beyond your control, such as age, gender, family history of stroke or heart disease. Other risk factors can be controlled through diet, changes in lifestyle or medication. • Uncontrolled high blood pressure is the number one risk factor for stroke. Diabetes is another major risk factor. • Experiencing a TIA is the clearest warning that stroke may occur. Looking or feeling ill or displaying abnormal behavior are common general signals. • Other specific signals have a sudden onset including: • Facial droop or drooling. • Weakness or numbness of the face, arm or leg, usually on only one side of the body. • Trouble with speech, such as trouble talking, getting words out or being understood when speaking and possibly trouble understanding. • Loss of vision or disturbed (blurred or dimmed) vision in one or both eyes. The pupils may be of unequal size. • Sudden severe headache, often described as “the worst headache ever.” • Dizziness, confusion, agitation, loss of consciousness or other severe altered mental status. • Loss of balance or coordination, trouble walking or ringing in the ears. • Incontinence. • Think FAST for stroke: • Face: weakness, numbness, or drooping on one side • Arm: weakness or numbness in one arm. • Speech: slurred speech or difficulty speaking • Time: determination of when signals began. • Call 9-1-1 or the local emergency number immediately if you encounter someone who is having or has had a stroke, or if the person had a mini-stroke (even if the signals have gone away).

9. Stroke, cont. • In addition: • Note the time of onset of signals and report it to the emergency medical dispatcher or EMS personnel when they arrive. • If the person is unconscious, make sure that he or she has an open airway and care for any life-threatening conditions. • If fluid or vomit is in the person’s mouth, position him or her in a modified H.A.IN.E.S position. • You may have to remove some fluids or vomit from the mouth by using one of your fingers. • Stay with the person and monitor his or her breathing and changes in his or her condition. • If the person is conscious, check for non-life-threatening conditions. • Offer comfort and reassurance as a stroke can make the person fearful and anxious. Often, he or she does not understand what has happened. • Have the person rest in a comfortable position. • Do not give him or her anything to eat or drink. • Although a stroke may cause the person to experience difficulty speaking, he or she can usually understand what you say. If the person is unable to speak, use nonverbal forms of communication, such as hand squeezing or eye blinking, and communicate in forms that require a yes-or-no response (squeeze or blink once for “yes,” twice for “no.”)