Index
This topic covers the identification and management of a range of medical emergencies.
Medical Emergencies – Allergic Reactions
An allergic reaction may be potentially fatal and therefore needs urgent attention. Signs and symptoms include:
· Swelling and redness of the skin
· Itchy, raised rash (hives)
· Swelling of the throat
· Wheezing and/or coughing
· Rapid, irregular pulse
· Nauseas and vomiting
· Dizziness or unconsciousness
Management of a severe allergic reaction
· Follow DRABCD
· Call 000 for an ambulance
· Observe and record pulse and breathing
· If casualty is carrying medicine for the allergy, assist casualty to use at once
· Help casualty to sit in position that most relieves breathing difficulty
Medical Emergencies – Asthma
A person suffers an asthma attack when the lining of their lungs and airway become inflamed and swollen. This prevents the person breathing properly, creating great distress. Usually it is breathing out that is most difficult and noisy.
If the attack continues, the lungs can become over inflated, muscles will become fatigued and the level of oxygen in the blood will fall.
Asthma is a common condition, particularly in children.
Signs and Symptoms of Asthma
The casualty may be:
· Unable to get enough air
· Progressively more anxious, short of breath, subdued or panicky
· Coughing, wheezing
· Pale, sweating
· Blue around lips, ear lobes and fingertips
Unconsciousness
Management of Asthma
Most people who suffer from asthma know how to manage it.
They will probably have medication with them in the form of a blue reliever inhaler (‘puffer’) containing a bronchodilator.
Your role as a First Aider is to help them if they are having difficulty administering their medication and to reassure and calm them.
If no medication is available or the attack appears severe, seek medical aid urgently.
Management of Asthma
1. Follow DRABCD
2. Assist the casualty, if conscious, into a comfortable position – usually sitting upright.
3. Be reassuring and ensure adequate fresh air
4. Assist with prompt administration of medication – give 4 puffs of a reliever inhaler or puffer.
5. If there is no improvement after 4 minutes, give another 4 puffs
6. If still no improvement, call 000 for an ambulance.
7. Keep giving 4 puffs every 4 minutes until the ambulance arrives. For adults with a severe asthma attach, you may give up to 6-8 puffs every 5 minutes.
If the casualty becomes unconscious, follow DRABCD.
Medical Emergencies – Asthma
If the casualty is unable to coordinate breathing and pressing the puffer at the right moment, you can help!
· Locate a spacer (or similar)
· Insert the spacer into the casualty’s mouth ensuring the puffer is attached to the other end
· Press puffer to allow casualty to self administer their medication.
Where permitted under local State or Territory legislation, use another person’s reliever or use one from a first aid Management of Asthma kit.
Medical Emergencies – Diabetes
Diabetes is caused by the failure of the pancreas to produce an essential chemical known as insulin. Insulin is used to control the level of sugar in the blood. Diabetes can lead to either high blood sugar or low blood sugar.
High blood sugar can occur in a person with diabetes either from eating too much, missing an insulin injection or some form of infection.
Low blood sugar is the more common of the two problems. Low blood sugar can occur in a person with diabetes either from missing a meal, not eating enough food containing sugar, injecting too much insulin or unaccustomed exercise.
Diabetes - Signs and Symptoms
High Blood Sugar:
· Excessive thirst
· Frequent need to urinate
· Acetone smell on breath
· Drowsiness
· Hot, dry skin
There will normally be slow onset of symptoms.
Low Blood Sugar:
· Feel dizzy, weak and hungry
· Profuse sweating
· Look pale and have a rapid pulse
· Be numb around lips and fingers
· Aggressive behaviour
There will normally be quick onset of symptoms.
A person who suffers from diabetes will generally recognise the symptoms themselves, and know whether their blood sugar level is high or low. They will know what action to take, but they may ask you to help them.
For a person with low blood sugar, give sugar, glucose or a sweet drink (e.g. soft drink, but NOT ‘diet’ soft drinks). Continue giving sweet drink or sugar every 15 minutes until the casualty recovers or medical aid arrives.
For a person with high blood sugar, allow casualty to self-administer insulin. DO NOT administer it yourself, but help if needed.
If unsure whether the casualty is suffering from high or low blood sugar, give them something with sugar in it. Should the person already have high blood sugar, it will not harm them but yet for a person with low blood sugar – it will be vital!
If no immediate recovery, seek medical aid.
Medical Emergencies – Epileptic Seizures
Epileptic seizures are caused by a disturbance of the brain. They can be a result of chemical imbalance, a previous injury or an unknown cause.
This section is concerned with convulsive type seizures caused by epilepsy, which can affect people of any age.
These seizures can last from 1 to 3 minutes.
Signs and Symptoms
· A ‘cry’ as air is forced out through the vocal cords
· Casualty falls to ground and lies rigid for some seconds
· Congested, blue face and neck
· Jerking, spasmodic muscle movement
· Froth from mouth
· Possible loss of bladder and bowel movement
Epileptic Seizures - Management
During Seizure
· DO NOT try to restrain the person
· DO NOT put anything in the mouth
· Protect person from obvious injury
· Place something under head and shoulders.
After Seizure
· Follow DRABCD
· Place in the recovery position
· Manage all injuries
· DO NOT disturb if casualty falls asleep but continue to check ABC
Seek medical aid if seizure continues for more than 5 minutes, if another seizure quickly follows or the person has been injured.
16 Medical Emergencies – Fainting
Fainting is the result of a temporary reduction in blood flow (and therefore oxygen) to the brain.
A person experiencing this effect will feel dizzy and may lose consciousness for a brief period of time.
People usually faint from a standing position and injuries may result.
Signs and Symptoms may include:
· Feeling light-headed, dizzy or nauseated
· Pale, cool, moist skin
· Numbness in the fingers and toes
Management
· Lay the casualty down with legs raised, and head and body flat.
· Ensure plenty of fresh air
· Loosen tight clothing such as belts or ties.
· Check for injury or illness.
· After recovery, let the casualty rest for some minutes before moving.
DO NOT sit the casualty on a chair with head between knees.
Medical Emergencies – Heart Disorders
The heart is a muscle, which pumps blood throughout the body. Aside from this, the heart itself requires a steady blood supply, in order to keep working. The coronary arteries feed blood, containing nutrients and oxygen, directly to the heart muscle.
If this blood flow is interrupted, the heart has difficulty performing its job of pumping blood to the rest of the body.
The 3 most common heart disorders are:
· Angina
· Heart Attack
· Heart Failure
If the coronary arteries become 'silted up', there may still be enough oxygen and nutrients for the heart to function when the body is at rest.
When the heart begins to work harder due to exercise, it needs extra oxygen and the narrowed coronary arteries are unable to supply enough.
The lack of blood supply causes chest pain.
This condition is called angina.
Blood does not normally clot within the blood vessels, but when it is pumped through arteries made narrow and rough by disease, the turbulence and damage to the blood cells may result in the formation of clots, which further restricts the blood flow.
If the blockage is complete, blood ceases to flow to the heart muscle beyond the blockage. The affected heart muscle is deprived of food and oxygen, and stops working.
This condition causes a heart attack.
Sometimes following a heart attack or disease, or with advanced age, the heart muscle may become weak and inefficient.
The blood flow from the heart may then decrease. Blood may back up and cause congestion in the body and lungs.
This condition results in heart failure.
Heart Disorders - Signs and Symptoms
Angina: Feeling of pressure or tightness in the centre of the chest. Pain or discomfort may spread to the neck, jaw, shoulders and arms
Heart Attack: Pain or discomforts is persistent. Crushing sense of pressure or burning in the centre of the chest. Sweating, shortness of breath and a sick feeling. Pain may spread to back, neck and arms.
Heart Failure: General feeling of tiredness. Breathlessness when exercising. Swollen feet, ankles, legs, abdomen and veins. Coughing and wheezing. Blue lips and extremities
Heart Disorders– Management
For Angina, the management strategy is:
· Support Casualty in sitting position
· Loosen tight clothing
· Assist casualty to take their prescribed medication, if appropriate
· If pain persist for longer than 10 minutes, call 000 for an ambulance
For a heart attack the management strategy is:
· Follow DRABCD
· Call 000 for an ambulance
· If casualty conscious, place in sitting position
· If casualty unconscious, turn to recovery position
· Loosen tight clothing
· If conscious, give one tablet (300mg) of aspirin unless casualty allergic to aspirin, an asthmatic or already taking anti-coagulant medication (e.g. warfarin)
· Manage for Shock.
If Cardiac Arrest occurs:
· Follow DRABCD
· Call 000 for an ambulance
For Heark attack the management strategy is:
· Follow DRABCD
· Call 000 for an ambulance
· If casualty conscious, place in sitting position
· Reassure casualty and loosen tight clothing.
· Manage for shock
Medical Emergencies – Hyperventilation
Hyperventilation is a result of involuntary overbreathing. It is often brought on by hysteria, excitement or some other common emotion.
The casualty feels as if they cannot get enough air, and so they breathe more and more deeply.
This lowers the carbon dioxide and increases the oxygen level in the body, causing an unpleasant sensation.
Signs and Symptoms
There are a number of signs and symptoms which help you to distinguish hyperventilation from other breathing disorders, such as asthma.
· Shallow, rapid breathing
· Rapid pulse
· feeling of choking or suffocation
· dizziness
· pins and needles in hands, feet and face
Management
· Follow DRABCD
· Calm casualty; remove to a quiet, private place
· Encourage slow, regular breathing – slowly count breaths aloud
· Seek medical aid
Medical Emergencies – Infantile Convulsions
Convulsions may occur in infants and young children between the ages of 10 months and five years.
They may be due to fever, infection, epilepsy or other conditions.
Although it is frightening when they happen, infantile convulsions are not normally serious, and can almost always be managed efficiently and effectively.
Signs and Symptoms
· Fever
· Twitching of face and limbs
· Stiffness of body with arched back
· Eyes rolling up
· Congestion of the face and neck
· Blue face and lips
Management
During Convulsion
· Place child on the floor for safety
· DO NOT restrain the child
· DO NOT cool the child by sponging or bathing but do remove excess clothing or wrapping.
After Convulsion
· Follow DRABCD
· Seek medical aid
Medical Emergencies – Stroke
A stroke may be caused by bleeding from a burst blood vessel in the brain, this resulting in an accumulation of blood compressing it against the skull. Another cause is if a blood clot forms in a blood vessel supplying the brain. Should this occur, brain tissue beyond the clot may die.
A stroke affects body functions controlled by the affected part of the brain.
Stroke often occurs in elderly people suffering from high blood pressure but may also occur in the young.
Signs and Symptoms
· Sudden decrease in level of consciousness
· Weakness or paralysis, usually on one side of the body
· Feeling of numbness in face, arm or leg
· Difficulty speaking or understanding
· Unexplained dizziness
· Disturbed vision
· Loss of balance
· Confusion
Management
· Follow DRABCD
· Call 000 for an ambulance
If casualty is conscious:
· Support head and shoulders on pillows
· Loose tight clothing
· Maintain body temperature
· Wipe away secretions from mouth
· Ensure airway is clear and open
If casualty is unconscious:
· Place in recovery position
Index