Chapter 9

1. Chapter 9 First Emergency Procedures and Aid

2. 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. Responding to an Emergency • Act quickly • Screen the situation • Assess the patient • Check for universal emergency medical identification >>

4. Primary Survey • (A) Airway—tilt the head or thrust the jaw to open airway Click here to see an animation • (B) Breathing—rescue breathing • (C) Circulation—cardiopulmonary resuscitation

5. 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. 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. Infection Control • Blood, body fluids, and disease transmission • Always protect yourself and the patient • Follow standard precautions

8. 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. 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. The Medical Crash Tray or Cart • Supplies on tray should be carefully inventoried • Common supplies found on most trays and carts

11. 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. Shock • Signs and symptoms of shock • Types of shock • Treatment for shock • Call EMS, then give immediate attention • Shock is progressive

13. 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. 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. Dressings and Bandages • Necessary to dress and bandage open wound to curtail infection • Dressings • Sterile pads • Bandages • Nonsterile wraps placed over dressings

16. Dressings and Bandages • Bandage application • Depends on injury and injury site • Avoid too tight or too loose a wrap

17. Dressings and Bandages • Types of bandages • Open or closed spiral bandages • Figure-of-eight bandage • Tubular gauze bandage >> • Commercial arm slings >>

18. Burns • Caused by heat, chemicals, explosions, and electricity • Critical burns can be life-threatening • Describe symptoms of critical burns

19. 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. Burns • Caring for burns • Treatment for burns • What to avoid • Special kinds of burns • Chemical • Electrical • Solar radiation

21. 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. Musculoskeletal Injuries • Types of injuries • Fractures involve a break in a bone • Incomplete or greenstick • Simple • Compound • Impacted • Comminuted • Spiral • Depressed • Colles

23. 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. 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. Poisoning • Can enter body in four ways: • Ingestion • Inhalation • Absorption • Injection

26. Poisoning • Call poison control center or local emergency number • Treatment depends on source of poisoning • Activated charcoal may be prescribed

27. 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. 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. 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. 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. Sudden Illness • Hemorrhage • External bleeding includes capillary, venous, and arterial bleeding • Epistaxis (nosebleeds) • Internal bleeding • Stay with patient and have someone call EMS

32. Control of Bleeding

33. 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. Cerebrovascular Accident (CVA) • Varied symptoms of CVA • Treatment of CVA • Activate EMS; keep patient comfortable • Keep airway open

35. 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. Breathing Emergenciesand 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. 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. CPR • Preliminary care until advanced medical help is available • CPR and defibrillation (AED) increases survival • Methods differ for adults, children, and infants

39. CPR • Click to play the video

40. 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. Safety and Emergency Practices • Click to play the video