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Chapter 17

Chapter 17. Sudden Illnesses. Heart Attack. Clot in coronary artery blocks blood supply. Blood supply to part of the heart muscle is reduced or stopped. Heart muscle tissue dies. Cardiac arrest Heart stops if electrical system of heart is affected. Recognizing Heart Attack (1 of 2).

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Chapter 17

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  1. Chapter 17 Sudden Illnesses

  2. Heart Attack • Clot in coronary artery blocks blood supply. • Blood supply to part of the heart muscle is reduced or stopped. • Heart muscle tissue dies. • Cardiac arrest • Heart stops if electrical system of heart is affected.

  3. Recognizing Heart Attack (1 of 2) • Chest pressure, squeezing, or pain that lasts longer than a few minutes or goes away and comes back • Pain spreading to shoulders, neck, or arms • Dizziness, sweating, nausea • Shortness of breath

  4. Recognizing Heart Attack (2 of 2) • Not all warning signs occur with every heart attack. • Some victims — as many as one third — have no chest pain. • Prompt action is important. • Hospital can administer clot-dissolving drugs (thrombolytics). • The sooner this is done, the better.

  5. Call 9-1-1. Monitor breathing. Give CPR if necessary. Help victim into comfortable position. If victim has nitroglycerin, assist them in taking it. Care for a Heart Attack (1 of 2)

  6. Care for a Heart Attack (2 of 2) • Nitroglycerin • Can relieve chest pain from angina but not heart attack. • Dilates coronary arteries, increasing blood flow to heart muscle. • Lowers blood pressure • Caution: Victim should lie down once nitro is taken.

  7. Angina • Chest pain from coronary heart disease • Heart muscle does not get enough blood • Brought on by physical activity, cold exposure, emotional stress • Seldom lasts longer than 10 minutes • Relieved by nitroglycerin

  8. Recognizing Angina • Signs are similar to heart attack • Crushing, squeezing pain • Pain like someone is standing on victim’s chest • Lasts 3 to 10 minutes • Shortness of breath, nausea, sweating • Victim feels anxious

  9. Care for Angina • If victim has nitroglycerin, help the victim use it. • If pain lasts longer than 10 minutes, suspect a heart attack, and call 9-1-1. • Other causes of chest pain: • Exercise or injury • Respiratory infections • Indigestion

  10. Cannot be changed Heredity Sex Age Can be changed Smoking High blood pressure High cholesterol Diabetes Obesity Inactivity Stress Risk Factors of Heart Disease

  11. Stroke (Brain Attack) (1 of 4) • Part of blood flow to brain is cut off • Blocked or ruptured blood vessel • Nerve cells die within minutes • One quarter of victims die; third leading cause of death

  12. Risk factors Age older than 50 Use of birth control pill, age older than 30 Overweight Hypertension High cholesterol Diabetes Heart disease Sickle cell disease Substance abuse Family history of strokes or TIAs Stroke (Brain Attack) (2 of 4)

  13. Stroke (Brain Attack) (3 of 4) • Most common type is ischemic: • Clot forms in artery in brain • Travels from heart to brain • Blood vessel may rupture • Other causes: tumors, vessel spasms, aneurysms

  14. Stroke (Brain Attack) (4 of 4) • TIA has similar signs as stroke • Symptoms last several minutes to several hours • Neurologic function returns • Warning sign of potential stroke • Signs and symptoms should be reported to physician

  15. Recognizing Stroke • Weakness, numbness, or paralysis of face or one side of body • Blurred or decreased vision • Problems speaking or understanding • Dizziness or loss of balance • Sudden, severe headache • Pupils not equal or not reactive to light

  16. Care for Stroke (1 of 2) • Call 9-1-1. Seek medical care. • If responsive, lay patient on back with head and shoulders slightly elevated. • If unresponsive, open airway, check breathing. Give CPR if needed. • If unresponsive patient is breathing, place in recovery position. • Do not give anything to eat or drink.

  17. Care for Stroke (2 of 2) • Los Angeles Stroke Screen quickly identifies stroke victims with three tests: • Arm strength • Facial smile • Hand grip

  18. Asthma (1 of 2) • Chronic inflammatory lung disease • Oversensitivity of air passages • Attacks: Air passages get narrower, breathing becomes difficult • Common in children, young adults

  19. Asthma triggers: Respiratory tract infection Temperature extremes Strong odors Occupational exposures Certain drugs Exercise Emotional stress Allergens Air pollution Asthma (2 of 2)

  20. Recognizing Asthma • Coughing • Cyanosis (bluish skin) • Pause when speaking to catch breath • Nostrils flaring with breath • Difficulty breathing, wheezing

  21. Position of comfort Monitor breathing. Assist with asthma inhaler. If victim does not respond or attack is extreme, seek medical care. Care for Asthma

  22. Hyperventilation • Fast, deep breathing • Common during emotional stress • Also caused by: • Untreated diabetes • Severe shock • Certain poisons • Brain swelling

  23. Recognizing Hyperventilation • Dizziness, lightheadedness • Numbness • Tingling of hands and feet • Shortness of breath • Breathing faster than 40 breaths/min

  24. Care for Hyperventilation • Calm and reassure • Have person breathe slowly. • Inhale through nose. • Hold several seconds. • Exhale slowly. • Do not breathe into paper bag.

  25. COPD (1 of 2) • Chronic obstructive pulmonary disease • Includes emphysema, chronic bronchitis, lung diseases • Hard to breathe; air flow obstructed • Affects older adults

  26. COPD (2 of 2) • Chronic bronchitis • Caused by chronic infection • Symptoms: Cough, difficulty breathing, sputum • Emphysema • Often occurs with chronic bronchitis • Alveoli partially destroyed • Symptoms: Cough, wheezing, shortness of breath

  27. Recognizing COPD • Wheezing • Coughing • Shortness of breath • Artificially supplied oxygen

  28. Care for COPD • Assist with prescribed medications. • Place in position of comfort. • Encourage to cough up secretions. • Encourage to drink fluids. • If acute, seek medical care. • Administer oxygen.

  29. Sudden brief loss of responsiveness Also called syncope or psychogenic shock Decreased blood flow to the brain Can result from physical or emotional causes Fainting

  30. Recognizing Fainting • Dizziness • Weakness • Seeing spots • Visual blurring • Nausea • Pale skin • Sweating

  31. Care for Fainting (1 of 3) • If about to faint: • Prevent person from falling. • Help person lie down with legs raised 6 to 12 inches. • Loosen tight clothing at neck and waist. • Stay with victim.

  32. Care for Fainting (2 of 3) • If fainting occurred: • Monitor breathing. • Loosen tight clothing and belts. • Raise legs 6 to 12 inches. • Have victim sit, drink cool, sweetened liquids. • Fresh air, cold wet cloth

  33. Care for Fainting (3 of 3) • Seek medical care if victim: • Has repeated fainting episodes • Does not quickly regain consciousness • Loses consciousness while sitting or lying down • Faints for no apparent reason

  34. Seizures (1 of 2) • Caused by medical conditions • Epilepsy, heatstroke, poisoning, electric shock, hypoglycemia, high fever, brain injury, tumor, stroke, alcohol withdrawal, or drug overdose • Four types • Generalized tonic-clonic • Focal motor • Complex partial • Absence

  35. Seizures (2 of 2) • Typical sequence for tonic-clonic: aura, loss of consciousness, muscle contractions for 2 to 5 minutes. • Obtain the following information: • Is there a history of seizures? • What did the seizure look like? How long did it last? • Alcohol/drug involvement? • Recent fever, headache, stiff neck? • History of diabetes, heart disease, stroke?

  36. Recognizing Seizures • Generalized tonic-clonic: Loss of consciousness, muscle contraction, coma/drowsiness • Focal motor: One part of body twitches • Complex partial: Altered personality state, dizziness, metallic taste in mouth • Absence: Brief loss of consciousness, usually in children

  37. Care for a Seizure (1 of 2) • Protect from injury. • Loosen restrictive clothing. • Place in recovery position. • Look for medical tag. • Call 9-1-1 if: • Unknown reason or longer than 5 minutes • Slow to recover, second seizure, or difficulty breathing • Pregnant or medical condition • Signs of illness or injury

  38. Care for a Seizure (2 of 2) • Status epilepticus • Two or more seizures without an intervening period of consciousness • Emergency situation • Can lead to aspiration, brain damage, fractures, severe dehydration

  39. Diabetic Emergencies • Diabetes: Insulin is lacking or ineffective • Excess sugar remains in blood • Type I juvenile-onset (insulin-dependent) • Type II adult-onset (non-insulin dependent) • Too much insulin, not enough blood sugar = low blood sugar, possible insulin shock • Too much sugar, not enough insulin = high blood sugar, possible diabetic coma

  40. Low Blood Sugar • Hypoglycemia or insulin reaction: Very low blood sugar • Causes: too much insulin, too little or delayed food intake, exercise, alcohol

  41. Recognizing Low Blood Sugar • Sudden onset • Poor coordination • Anger • Pale skin • Confusion • Sudden hunger • Excessive sweating • Trembling, unresponsiveness

  42. Care for Low Blood Sugar • Give 15 grams sugar. • If condition does not improve in 15 minutes, give 15 more grams sugar. • If still no improvement, seek medical care.

  43. High Blood Sugar • Hyperglycemia or diabetic coma: Very high blood sugar • Causes: Insufficient insulin, overeating, inactivity, illness, stress

  44. Recognizing High Blood Sugar • Gradual onset • Drowsiness • Extreme thirst, frequent urination • Flushed skin • Vomiting • Fruity breath odor • Heavy breathing • Unresponsiveness

  45. Care for High Blood Sugar • If you are unsure whether it is high or low blood sugar, provide same care as you would for low blood sugar. • If condition does not improve in 15 minutes, seek medical care.

  46. Abdominal Complaints • Aching, cramping, sharp, or dull pain • Constant or can come and go • Nausea and vomiting • Diarrhea or constipation

  47. Abdominal Pain • Peritoneum: Thin membrane lining entire abdominal cavity • Peritonitis: Inflammation of the peritoneum • Many possible causes for abdominal pain

  48. Recognizing Abdominal Pain • Ask: • When did pain start? Where located? • Constant, or does it come and go? • Nausea, diarrhea, or vomiting? • Warm (feverish)? • Other victims? • Pregnancy? • Rigid abdomen?

  49. Care for Abdominal Pain (1 of 2) • Give only clear fluids. • Have victim sip slowly. • Give victim an antacid. • Place hot-water bottle against victim’s abdomen or soak in warm bath. • Be prepared for vomiting. • Keep victim on left side.

  50. Care for Abdominal Pain (2 of 2) • Seek medical care if: • Constant pain or more than 6 hours • Victim unable to drink fluids • Possible pregnancy • Rigid, painful abdomen, swollen abdomen • More pain when abdomen is pressed • Bloody or black stool • Fever • Pain began around belly button, moved to lower right side

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