Responding to Medical Emergencies

1. Responding to Medical Emergencies PO 006.02

2. Learning Objectives • The Physical Therapy Technician will respond to medical emergencies in the physical therapy clinic by: • Summoning medical personnel to the physical therapy clinic • Providing basic life support and first aid within the physical therapy clinic • Documenting lessons learned

3. Medical Emergencies • A medical emergency is an injury or illness that is acute and poses an immediate risk to a person's life or long term health • These emergencies may require assistance from another suitably qualified person • Any response to an emergency medical situation will depend on the situation, the patient involved and availability of medical resources

4. PT Medical Emergencies • In the PT department, there is the potential for medical emergencies to take place such as; • Myocardial infarction (heart attack) • Cardiac arrest • Pneumothorax • Pulmonary embolism • Respiratory failure • Cerebro-vascular attack (stroke)

5. Signs and Symptoms of Emergencies • If you notice any of the following signs or symptoms, medical help needs to be sought: • Uncomfortable pressure, fullness, squeezing sensation or pain in the center of the chest that lingers • Lightheadedness/dizziness • Fainting/loss of consciousness • Shortness of breath/difficulty breathing • Change in mental status • Severe or persistent vomiting • Paralysis of the arms or legs, tingling, numbness, confusion, dizziness, double vision, slurred speech, trouble finding words, or weakness, especially on one side of the face or body

6. Responding to Medical Emergencies • In the case that there is a medical emergency in the PT department, the skills taught on the combat medic course apply • If you come across a medical emergency, it is your responsibility to provide life saving first aid until a more qualified health care professional arrives to take over • The gathering of information required to help determine what is wrong with the patient is essential

7. Patient Assessment Review • When presented with a medical emergency, it’s important to first: • Perform a scene survey • Gather information from the scene to help understand what happened to the patient and ensure scene is safe for caregivers • Perform a primary survey • ABCDE’s

8. Patient Assessment Continued . . . • Secondary survey • Look, listen and feel • Vital Signs • BP, respiratory rate, temperature, • AMPLE history • On-going assessment • Vitals every 5 minutes if unstable, 15 minutes if stable

9. Medical Attention • If a medical emergency occurs, it is essential that further medical assistance is requested • If in a hospital setting, emergency responders will be paged from another ward • Once the medical team arrives on the scene, they will take over, but may require assistance from first responders • In the polyclinic or a regional setting, there should be a standard operating procedure (SOP) in place indicating who to contact and how to do

10. Documentation • It is important to document the occurrence of a medical emergency in the patients chart • Depending on a facility’s SOPs, it may also be required to file paperwork such as an incident report • These documents may used by Quality Control or Standards to assess policy, procedure, quality of care or risk assessment

11. Lessons Learned • Lessons learned is useful information gained through experience that should be retained for future use as it may be relevant to future situations • Depending on the lesson, it could be a valuable technique or an desirable outcome, or it could be an undesirable result to be avoided in future occurances • Often, identifying your lessons learned is as simple as asking the question, “What worked well or what didn’t work so well?” • A method of improving the productivity and efficiency of a process

12. PT Lessons Learned • Following medical emergencies in the PT department, it is important to self-evaluate in the form of lessons learned • The information gathered can be used to identify: • Areas of strength of the PT department and staff • Area for improvement in preparation for future medical emergencies • Identifying areas or skills which require refresher training • Example: CPR, patient assessment, etc.

13. Summary • A medical emergency is an injury or illness that is acute and poses an immediate risk to a person's life or long term health • If you come across a medical emergency, it is your responsibility to provide life saving first aid until a more qualified health care professional arrives to take over • Provide basic life support and first aid

14. Summary • PT techs must be aware of SOPs for requesting medical aid in the case of emergency • It is important to document the occurrence of a medical emergency in the patients chart • Following medical emergencies in the PT department, it is important to self-evaluate in the form of lessons learned

15. Questions?

16. Comprehension Check • What constitutes a medical emergency? • What signs and symptoms would raise concern that a medical emergency is occurring? • What are the responsibilities of a PT tech during a medical emergency? • What are lessons learned? • Why is it important to gather lessons learned after a medical emergency occurs in the PT department?

17. Answers • An injury or illness that is acute and poses an immediate risk to a person's life or long term health • Concerning signs and symptoms include: • Lightheadedness/dizziness • Fainting/loss of consciousness • Shortness of breath/difficulty breathing • Change in mental status • Severe or persistent vomiting • Paralysis of the arms or legs, tingling, numbness, confusion, dizziness, double vision, slurred speech, trouble finding words, or weakness, especially on one side of the face or body • Uncomfortable pressure, fullness, squeezing sensation or pain in the center of the chest that lingers

18. Answers… • Provide life saving first aid until a more qualified health care professional arrives to take over, and call for further medical assistance • Useful information gained through experience that can be used to improve the productivity and efficiency of a process • They can be used to identify: • Areas of strength of the PT department and staff • Area for improvement in preparation for future medical emergencies • Identifying areas or skills which require refresher training