Emergency Preparedness

Cast Care: Patient Teaching:

-Keep the casted extremity elevated the 1st day -Avoid indenting the cast until it is completely dry -Check the movement and sensation of the visible extremities frequently -Restrict strenuous activities for the 1st few days -Avoid allowing the affected limb hang down for any length of time -Do not put anything inside the cast -Keep the cast dry -Follow physician's orders regarding activity restrictions *Check pulse, temp, smell, finger/toe movement*

What actions are medical personnel required to take when treating a victim of rape?

-Provide privacy -Limit number of people who ask questions -You are legally required to contact police so they can file a report -Obtain specimen

Signs of GB Attack

-Pt may wake up in the night with acute abdominal pain (gallbladded colic) in the right upper quadrant -Pain may radiate to the back, between the shoulder blades, or be localized in the epigastric region -Nausea and vomiting

How should you position a person who is having a seizure?

-Remove objects that may cause injury -Place patient on floor or ground -Position on side with head turned to the side -Loosen restrictive clothing -Never place anything in the patient's mouth

Symptoms of Shock

-Restlessness -Irritability -Fear -Rapid Pulse -Pale -Cool Skin -Increased Respiratory Rate

Care for a puncture wound:

-Rinse wound under running water for 15 minutes -Clean wound with soap and water, apply a dry, sterile bandage *Breeding ground for tetanus bacteria (live and thrive in absence of oxygen)* -If patient has not had tetanus shot in 7-10 years, inform physician

Four ways in which first aid can benefit victims of accidents or sudden illness?

-Save a life -Reduce pain -Prevent further injury -Reduce risk of permanent disability -Increase the chance of early recovery

Procedure for someone who has been stung by a bee and the stinger is still in the skin:

-Scrape the skin with a credit card or other hard sharp object -Be careful not to release more venom -Avoid using your fingers or tweezers because squeezing the stinger may force more venom into the wound -Wash the skin with soap and water -After stinger is removed, apply ice to the site, 10 minutes on, 10 minutes off to reduce the pain and swelling

Treatment for Heat Stroke

1. Check CABs and call EMS 2. Move pt to cool place and remove outer clothing unless it is made of light cotton or other light fabric 3. Cool pt with any means available 4. Move pt to air conditioning if available, fan vigorously, apply a wet sheet 5. If humidity is above 75%, place ice packs on the patient's groin and armpits 6. Stop cooling when pt mental state improves 7. Keep pt's head and shoulders slightly elevated

Treatment for anaphylaxis:

1. Check the patient's CABs and then notify practitioner 2. As directed, administer epi, oral antihistamines and oxygen and help patient into semi-fowler's position 3. After pt receives epi, monitor his vital signs every 2-3 minutes 4. Note skin color and monitor airway 5. If pt does not recover quickly, arrange for immediate transport to hospital

Proper order of treatment for patients with chest pain, second degree burn, and spider bite.

1. Chest pain 2. Spider Bite 3. Second Degree Burn

Treatment for Inhaled Poison

1. Get patient to fresh air 2. Have someone call EMS or regional poison control center 3. Loosen tight fitting clothing and wrap the pt in a blanket to prevent shock 4. Check the pt's CABs and begin CPR if needed

Symptoms of Snake Bite

-1 or 2 puncture marks -Pain and swelling at the site -Rapid pulse -Nausea -Vomiting -Sometimes unconsciousness and seizures

What do you do in case of amputated ear?

-Call 911 -Apply pressure -Carefully wrap severed ear in a sterile dressing secured with a self-adherent gauze bandage -Wrap ear in plastic, label it, and place it in an ice chest or over an ice pack -Send patient to hospital

How to control bleeding of minor incisions and lacerations

-Covering wound with a clean or sterile dressing -Apply direct pressure -After bleeding stops, clean and dress the wound -Have the patient keep the wound clean and check for signs of infection

Five symptoms of dehydration

-Extreme thirst -Tiredness -Light-headedness -Abdominal or muscle cramping -Confusion (especially in the elderly)

An infant is brought in to the office with a high fever, while her mother is talking to you, the infant begins to have a seizure. What should you do?

-Get the doctor -Place the infant on the floor, clear the area around, turn head to side, and loosen restrictive clothing.

Symptoms of Heat Stroke

-Hot, dry skin -Lack of sweating -Altered mental state -Rapid pulse -Rapid breathing -Dizziness -Headache -Nausea and vomiting -Weakness

Causes of severe abdominal pain

-Internal hemorrhage -Intestinal perforation -Intestinal obstruction -Peptic ulcer -Hernia -Abdominal aortic aneurysm -Ectopic pregnancy -Kidney stones -Trauma to area

Anaphylaxis Signs:

-Itchy, red, hot skin -Swelling occurs in the face, mouth and throat -Patient may have trouble breathing and swallowing (feels as if they have a lump in the throat) -Pallor, perspiration, abdominal pain or nausea and a weak, rapid, irregular pulse

Severe Head Injury

-Keep patient calm -Keep airway open -Get EMS ASAP -May cause leakage of clear or bloody fluid from the ears or nose, seizures, respiratory arrest *Monitor patient's CABs and begin CPR if needed*

Care for Fracture/Dislocation:

-Keep person calm and limit his movement -Assess him for any other injuries -Notify Dr or EMS (Do not try to move person until Dr or EMS arrives) -If skin is broken, cover with a sterile bandage -Immobilize the extremity with a splint or string (use rolled newspaper, wood, etc.; immobilize joint above and below injury, immobilize in position found) *Do not try to put bone back in place* -Ice pack on affected area -Monitor for signs of shock -Assess for signs of lack of circulation in the injured limb, including pale or blue skin, loss of feeling, and tingling in the area

Comminuted Fracture

Bone is broken in 3 or more pieces

Greenstick Fracture

Bone is cracked on one side and bent on the other. -Common fracture in children

Incomplete Fracture

Bone is cracked, but not broken into 2 pieces

Inhaled Poison

Breathing air contaminated with chemicals in the workplace or by a malfunctioning stove or furnace in the home

Hypothermia

Caused by exposure to cold -Occurs when a person loses more body heat than he can produce, resulting in a body temp below 95 degrees -Very young or very old, chronically ill or malnourished

Stroke

Cerebrovascular Accident -Occurs when blood supply to the brain is impaired

CAB

Circulation, Airway, Breathing

Incision

Clean and smooth cut, like that from a kitchen knife

Insulin Shock

Severe hypoglycemia

Hematoma

Swelling caused by blood under the skin

Symptoms of MI

-Chest pain (crushing, burning, heavy, aching) -Pain may radiate down the left arm or into the jaw, throat or both shoulders -SOB -Sweating -Nausea -Vomiting -Pallor -Feeling of doom

You see someone fall, and notice that her right wrist looks swollen and she is complaining of extreme pain, what should you do?

-Do not move the patient -Call for help -Apply ice -Monitor for shock

Chain of Survival for MI

-Immediate recognition and activation of EMS -Early CPR -Rapid Defibrillation -Advanced Life Support -Post Cardiac Arrest Care Do not let patient walk, loosen tight clothing, and have patient sit up -Stay with patient and observe CABs and begin CPR if needed

Symptoms of Concussion:

-May loose consciousness -Temporary loss of vision -Pallor -Listlessness -Memory loss -Vomiting Symptoms may disappear rapidly or last up to 24 hours -May produce slow intracranial bleeding

Symptoms of Insulin Shock:

-Rapid pulse -Shallow respiration -Hunger -Profuse sweating -Pale -Cool, clammy skin -Double vision -Tremors -Restlessness -Confusion -Numbness and Tingling in hands and feet -Possibly fainting

Symptoms of Diabetic Coma

-Rapid, deep, gulping breaths -Flushed, warm, dry skin -Thirst -Acetone breath (sweet, fruity) -Drowsiness, disorientation, confusion -Gradual loss of consciousness *Notify Dr. immediately and expect to arrange transport to hospital

Four steps to follow when treating a patient who has swallowed poison but who is alert and not having convulsions.

1. Call the regional poison control center 2. Seek immediate medical attention 3. Monitor the patient's vital signs 4. Watch for increasing nausea and vomiting

Treatment for internal hemorrhage:

1. Cover pt with a blanket for warmth 2. Keep pt quite and calm 3. Get medical help immediately

Treatment for Concussion:

1st 24 hours are critical -Refrain from strenuous activity, rest, return to regular activity gradually, avoid using pain meds other than acetaminophen -Advise pt to eat lightly -Have family member check pt every few hours

Epistaxis

A nosebleed

A symptom specific to toxic shock syndrome is:

A red rash on the hands and feet

Hematoma

A swelling caused by blood under the skin

An electrical device that shocks the heart to restore normal beating:

AED

Treatment for Insulin Shock:

Administration of some form of sugar (ex. candy, juice, soda - if conscious) *If cause is unknown, give sugar if conscious - Pt will improve quickly if shock (will not harm in case of coma)

As a last resort for external hemorrhage: (If help is more than 1 hour away)

Apply a tourniquet over the main pressure point above the wound and tightening the tourniquet until the bleeding stops -Write application time on pt forehead

A type of head injury?

Contusion

A _______ is a rolling cart of emergency supplies and equipment.

Crash Cart

A severe condition that is the end result of severe hyperglycemia is known as _______.

Diabetic Coma

If a wound is deep and involves muscles, tendons, face, genitals, or tongue, control bleeding with:

Direct pressure to the wound with a sterile dressing or clean cloth held against the surface -Elevation -Use of pressure points -Contact Dr if necessary, the EMS

Dislocation

Displacement of a bone end from a joint

Hypoglycemia Symptoms:

Dizziness, headache, confusion, hunger, weakness, shaking, trembling, full rapid pulse, pallor

Common carriers of rabies

Dogs, cats, skunks, squirrels, raccoons, bats, and foxes

Hyperglycemia Symptoms:

Dry mouth, intense thirst, frequent urination, muscles weakness, blurred vision

Diabetic Coma

End result of severe hyperglycemia -Insulin levels are insufficient to move blood sugar into body cells

F.A.S.T.

Facial Drooping Arm Weakness Speech Difficulty Time to call 911

Minor Stroke Symptoms:

Headache, confusion, dizziness, tinnitus, minor speech difficulties, personality changes, weakness of limbs and memory loss

Epinephrine causes:

Heart rate to increase

A scalp hematoma can be reduced by applying _______ immediately after the injury.

Ice

Main symptom of choking

Inability to speak -Universal sign= hand up to the throat and a fearful look (Children are considered 1-8 yrs) (Infants are considered under 1 yr)

Your neighbor has been spray painting indoors, you check on her, and she is sitting down holding her chest. She says she feels dizzy and nauseated and has a headache. What could be wrong with her? What should you do?

Inhalation poisoning -Get her to fresh air -Call EMS -Loosen tight fitting clothing -Wrap patient in blanket to prevent shock -Check patient CABs and begin CPR if needed -Monitor pulse and respirations

Sprain

Injury characterized by partial tearing of a ligament that supports a joint, such as an ankle -May also involve injuries to tendons, muscles, and local blood vessels and contusions of the surrounding soft tissue -Swelling, tenderness, pain during movement, local discoloration

A patient arrives feeling restless and confused. She has rapid pulse, shallow respirations, hunger, profuse sweating, pale, cool, clammy skin, double vision, and tremors. She states that she took her regular dose of insulin this morning but was not able to eat breakfast. What could be wrong with this patient?

Insulin shock -Give pt sugar (orange juice or candy)

A patient seems disoriented and short of breath, her skin appears flushed. Her breath has a sweet odor. What could be happening? What should you do?

It could be a diabetic coma -Notify the doctor immediately -Arrange transport to hospital -Have the patient sit down

Laceration

Jagged edges, as when a child steps on broken glass

Concussion

Jarring injury to the brain, most common type of head injury

If a patient has a stroke in the office:

Let Dr. know ASAP and call EMS -Maintain pt's airway by turning the head toward the affected side to allow secretions to drain out -Loosen tight clothing -If directed by physician, monitor vital signs and administer oxygen

Symptoms of hypothermia:

Lethargy, loss of coordination, confusion, uncontrollable shivering -Untreated can result in cardiac arrest and coma

An electrical burn is caused by exposure to electric currents or _______.

Lightning

Major Stroke Symptoms:

Loss of consciousness, paralysis on one side of the body, difficulty swallowing, loss of bladder and bowel control, slurred or garbled speech, unequal pupil size

Hypoglycemia

Low blood sugar

Before performing CPR:

Make sure scene is safe -Make sure pt is on a firm, flat, surface

Treatment for hypothermia:

Move person inside if possible and cover with blankets -If patient is wet, remove wet clothing -If confused or unconscious, monitor breathing and call EMS -If awake and alert, give warm, nonalcoholic liquids

Strain

Muscle injury that results from overextension (Ex. back strain when a person carries a heavy load) -Causes pain on motion

Insect Bite

Nuisance

GB Attack

Occurs after a person eat a high-fat meal rich in cholesterol

Choking

Occurs when food or a foreign object blocks the trachea, or windpipe

MI

Occurs when the blood flow to the heart is reduced as a result of blockage in the coronary arteries or their branches

Heat Stroke

Over heating of the body, which results from prolonged exposure to high temps and humidity

Cast Care: Report to the physician:

Pain, swelling, discoloration of exposed skin, lack of pulsation and warmth, or the inability to move exposed parts

Treatment for external hemorrhage:

Prevent rapid blood loss and shock 1. Direct pressure, apply additional dressings as needed 2. Elevate bleeding body part 3. Put pressure over a pressure point 4. Transport to an emergency care facility

Abrasion

Scraping of the skin (ex. sliding across dirt) -Minor don't need a bandage, large do -Wash area with soap and water, Remove all dirt and debris

A series of violet and involuntary contractions of the muscles is known as:

Seizure

Insulin Shock

Severe hypoglycemia in which patient has too little sugar in the blood -Occurs when insulin levels are so high that they move too much sugar from the blood into the cells

Anaphylaxis

Severe, often life-threatening allergic reaction (Can be immediate or delayed 2 hrs)

Symptoms of Insect Bite:

Site is red, swollen, itchy, and painful

Closed Fracture

Skin in the area of the fracture is not broken

Puncture

Small hole created by a piercing object (ex. bullet, knife, nail)

Hematoma Treatment:

Swelling can be reduced by applying ice immediately after the injury

Stroke may cause:

Temporary or permanent damage depending on how long brain cells are deprived of oxygen

Palpitations

Unusually rapid, strong, or irregular pulsations of the heart

The most common abnormal rhythm that occurs during cardiac arrest:

Ventricular fibrillation

Asthma is a common disorder caused by:

Hypovolemic Shock

Toxic Shock Syndrome

An acute infection most often caused by the bacterium staphylococcus aureus -The toxin produced by bacterial overgrowth can act as poison, causing severe, life-threatening symptoms

Stroke

A brain attack caused by impaired blood supply to the brain

Contusion

A closed wound or bruise

Septic Shock

A condition resulting from massive, widespread infection that affects the ability of the blood vessels to circulate blood

Hypovolemic Shock

A condition that results from insufficient blood volume in the circulatory system

Concussion

A jarring injury to the brain

Strain

A muscle injury that results from overextension

A life-threatening allergic reaction is known as:

Anaphylaxis

An important ally in providing emergency care is your local _______ system.

Emergency Medical Services (EMS)

How often do you need a tetanus booster?

Every 10 years -If injury, 5-10 years

Heat Stroke may lead to

Excessive loss of fluids (dehydration) and insufficient blood in the circulatory system (hypovolemic shock) -If untreated, pt will die

Complete Fracture

Fracture extends across the bone, snapping it into 2 pieces

Acute abdominal pain in the right upper quadrant may signal _______.

Gallbladder attack

Signs of infection

Heat, redness, pain, swelling

Hemorrhage - Excessive bleeding

Heavy or uncontrolled bleeding -Generally the result of injury (may be caused by illness) -Can be internal or external

Signs of Hemorrhage:

Heavy or uncontrolled bleeding, internal or external

Hyperglycemia

High blood sugar

Symptoms of TSS

High fever, intense muscle aches, vomiting, diarrhea, headache, bouts of violent shivering, vaginal discharge, red eyes, and a decreased level of consciousness *Deep red rash on the palms of the hands and soles of the feet* - This skin then sloughs off

Dry mouth, intense thirst, muscle weakness, and blurred vision are symptoms of:

Hyperglycemia

Treatment of Snake Bite

If possible get description of snake 1. Call Dr. or EMS 2. If pt must walk, have him walk slowly to prevent dispersion of the poison through circulation 3. Keep pt calm and remove rings, watches, or tight clothing in the area 4. If possible, immobilize the injured part and position it below heart level 5. DO NOT apply ice or a tourniquet and DO NOT cut or suction the wound

Causes of gallbladder attack pain:

Inflammation of gallbladder, usually related to gallstones obstructing the cystic duct

If you suspect bioterrorism, your facility should first contact _______.

Local Public Health Department

Signs of Inhaled Poison

Mimic influenza -Headache, *tinnitus (ringing in the ears)*, angina, shortness of breath, muscle weakness, nausea, vomiting, confusion, and dizziness, followed by blurred or double vision, difficulty breathing, unconsciousness and cardiac arrest

Treatment for GB Attack:

Patient usually seeks medical attention -Diagnosis made with help of ultrasonography -Patient may require surgery to remove the gallbladder

Snakebite

Rattlesnake, water moccasins (cottonmouths), copperheads, and coral snakes (In US)

Infection

Redness, swelling, heat

Main symptom of a choking emergency?

The inability to speak

Open (Compound) Fracture

The skin is broken by the bone fragments or the skin is broken during the course of the fracture

Hematemesis

The vomiting of blood

Check a patient for a medical identification card, necklace, or bracelet because?

To see if they are a DNR or have any allergies or conditions

Treatment for TSS

Treated with IV antibiotics and fluids -Patient will require hospitalization