1. Chapter 10: Medical Emergencies

2. Cognitive Objectives
5-1.1 Identify the patient who presents with a general medical complaint.
5-1.2 Explain the steps in providing emergency medical care to a patient with a general medical complaint.
5-1.3 Identify the patient who presents with a specific medical complaint of altered mental status.
(1 of 3)

3. Cognitive Objectives
5-1.4 Explain the steps in providing emergency medical care to a patient with an altered mental status.
5-1.5 Identify the patient who presents with a specific medical complaint of seizures.
5-1.6 Explain the steps in providing emergency medical care to a patient with seizures.
5-1.7 Identify the patient who presents with a specific medical complaint of exposure to cold.
(2 of 3)

4. Cognitive Objectives
5-1.8 Explain the steps in providing emergency medical care to a patient with an exposure to cold.
5-1.9 Identify the patient who presents with a specific medical complaint of exposure to heat.
Explain the steps in providing emergency medical care to a patient with an exposure to heat.
(3 of 3)

5. Affective Objectives
Attend to the feelings of the patient and/or family when dealing with the patient with a general medical complaint.
Attend to the feelings of the patient and/or family when dealing with the patient with a specific medical complaint.
Demonstrate a caring attitude toward patients with a general medical complaint who request emergency medical services.
(1 of 3)

6. Affective Objectives
Place the interests of the patient with a general medical complaint as the foremost consideration when making any and all patient care decisions.
Communicate with empathy to patients with a general medical complaint, as well as with family members and friends of the patient.
(2 of 3)

7. Affective Objectives
Demonstrate a caring attitude toward patients with a specific medical complaint who request emergency medical services.
Place the interests of the patient with a specific medical complaint as the foremost consideration when making any and all patient care decisions.
Communicate with empathy to patients with a specific medical complaint, as well as with family members and friends of the patient.
(3 of 3)

8. Psychomotor Objectives
Demonstrate the steps in providing emergency medical care to a patient with a general medical complaint.
Demonstrate the steps in providing emergency medical care to a patient with an altered mental status.
Demonstrate the steps in providing emergency medical care to a patient with seizures.
(1 of 2)

9. Psychomotor Objectives
Demonstrate the steps in providing emergency medical care to a patient with an exposure to cold.
Demonstrate the steps in providing emergency medical care to a patient with an exposure to heat.
(2 of 2)

10. Knowledge and Attitude Objectives
Describe the general approach to a medical patient.
Explain the causes, symptoms, and treatment of a patient with altered mental status.
Explain the causes, symptoms, and treatment of a patient with seizures.
Describe the treatment of a patient who shows signs and symptoms of exposure to heat.
(1 of 5)

11. Knowledge and Attitude Objectives
Describe the treatment of a patient who shows signs and symptoms of exposure to cold.
Explain the causes of angina pectoris.
Describe the signs, symptoms, and initial treatment of a patient with angina pectoris.
Explain the major cause of a heart attack.
Describe the signs, symptoms, and initial treatment of a patient with a heart attack.
(2 of 5)

12. Knowledge and Attitude Objectives
Explain the cause of congestive heart failure.
Describe the signs, symptoms, and initial treatment of a patient with congestive heart failure.
Describe the causes of dyspnea.
Explain the signs, symptoms, and initial treatment of a patient with dyspnea.
Describe the causes of asthma.
(3 of 5)

13. Knowledge and Attitude Objectives
Explain the signs, symptoms, and initial treatment of a patient suffering an asthma attack.
Describe the major cause of a stroke.
Explain the signs, symptoms, and initial treatment of a patient with a stroke.
Describe the signs and symptoms of insulin shock.
Describe the initial treatment of a patient in insulin shock.
(4 of 5)

14. Knowledge and Attitude Objectives
Describe the signs and symptoms of a patient in a diabetic coma.
Describe the initial treatment of a patient in a diabetic coma.
Describe the signs and symptoms of an abdominal problem.
Describe the initial treatment of a patient with abdominal pain.
(5 of 5)

15. Skill Objectives Perform a patient assessment on a medical patient.
Place an unconscious patient in the recovery position.
Protect a patient who is seizing from sustaining further harm.
Cool a patient who has suffered exposure to heat.
(1 of 2)

16. Skill Objectives Treat a patient who has suffered exposure to cold.
Position a patient who has congestive heart failure.
Administer fluids or oral glucose to a patient who is in insulin shock.
(2 of 2)

17. Medical Emergencies
Medical complaints result from a wide variety of conditions.
Treating patients with medical conditions can be very challenging.
Know the signs, symptoms, and treatment for common medical conditions.

18. General Approach to a Medical Patient
Perform initial assessment.
Determine responsiveness.
Introduce yourself.
Check ABCs.
Acknowledge chief complaint.
Obtain SAMPLE history.
Perform physical exam as needed.

19. Altered Mental Status
Sudden or gradual decrease in patient’s level of responsiveness.
Change may range from a decrease in level of understanding to unresponsiveness.
Use AVPU scale when assessing altered mental status.

20. Causes of Altered Mental Status
Head injury
Seizures
Shock
High fever
Infection
Poisoning
Drug overdose
Low blood sugar
Insulin reaction
Psychiatric conditions

21. Care for Altered Mental Status
Maintain ABCs and normal body temperature.
Keep patient from additional harm.
If unresponsive and not trauma, place in recovery position.
Be prepared to suction.

22. Seizures
Sudden episodes of uncontrolled electrical impulses in the brain
Shaking movements that may involve whole body
Serious but rarely life threatening
Caused by many factors, including epilepsy, trauma, head injury, and stroke

23. Care for Seizures Do not attempt to restrain patient.
Clear area to protect patient from injury.
Do not place anything in patient’s mouth.
(1 of 2)

24. Care for Seizures
If patient is not breathing after seizure, begin rescue breathing.
Place patient in recovery position if breathing to maintain a clear airway.
(2 of 2)

25. Exposure to Heat and Cold
Heat exhaustion
Heatstroke
Frostbite
Hypothermia

26. Heat Exhaustion Common in temperatures above 80°F with high humidity
Very young, older people, and those with preexisting medical conditions are susceptible.
Signs and symptoms:
Light-headedness
Weak feeling
Dizziness
Nausea
Weak pulse
Profuse sweating

27. Care for Heat Exhaustion
Move patient to a cooler place.
Remove constricting clothing.
Monitor ABCs.
If patient is FULLY conscious, give water to drink.
Arrange transport.

28. Heatstroke
Results when a person has been in a hot environment for long period of time
Patient’s temperature rises, overwhelming the sweating mechanism
Brain damage and death may occur if not treated rapidly.

29. Signs and Symptoms of Heatstroke
Very high body temperature
Flushed, dry skin
Skin feels hot to the touch
Semiconsciousness or unconsciousness

30. Care for Heatstroke Remove patient from hot environment.
Immediately cool the patient.
Remove patient’s clothing.
Wrap patient in wet towels.
Prepare patient for rapid transport.

31. Superficial Frostbite
Part becomes numb and bright red.
Part then becomes pale white.
Loss of sensation/feeling

32. Deep Frostbite Skin will be white and waxy.
Skin may be firm or frozen.
Swelling and blisters may be present.

33. Care for Frostbite Frostbitten part must be rewarmed quickly.
Do not rub frostbitten area.
Remove jewelry and cover part in dry clothing/dry dressings.
Apply heat to rewarm the part.
Do not rewarm if there is a chance of refreezing.

34. Hypothermia Results when body temperature drops below 95°F
People with wet clothing and preexisting illnesses are susceptible to hypothermia.

35. Signs and Symptoms of Hypothermia
Feeling cold
Shivering
Decreasing/altered level of consciousness
Sleepiness
Slowed reactions
Lack of coordination

36. Care for Hypothermia Move patient to warm location.
Remove wet clothing.
Wrap patient in warm clothing and blankets.
In severe hypothermia, you may need to start CPR.

37. Heart Conditions The heart must receive a constant supply of oxygen.
Receives oxygen through a complex system of coronary arteries
Atherosclerosis may cause arteries to narrow.

38. Angina Pectoris Heart does not receive enough oxygen.
Crushing pain occurs—brought on by exertion, emotion, or eating.
Pain may radiate to neck, jaws, and both arms.
Patient may have shortness of breath or sweating.
(1 of 3)

39. Angina Pectoris Ask if patient has prescribed nitroglycerin.
Help patient take one pill.
If no relief after 5 minutes, help patient take another.
If still no relief, assume a heart attack and transport immediately.
Always follow local protocols.
(2 of 3)

40. Angina Pectoris
Nitroglycerin pills and spray used for relief of chest pain.
(3 of 3)

41. Heart Attack Caused by complete blockage of a coronary artery
Patient suffers immediate, severe pain.
Pain persists—unlike angina, which goes away in 5–10 minutes.
If blocked area is critical or large, heart may stop completely.
(1 of 2)

42. Heart Attack
Blocked cardiac artery results in heart attack.
(2 of 2)

43. Care for Heart Attack Summon additional help. Reassure the patient.
Place patient in comfortable position and minimize movement.
Administer oxygen if available and you are trained to use it.

44. Congestive Heart Failure (CHF)
Failure of the heart to pump adequately
Results in congestion (overload) in the blood vessels

45. Signs and Symptoms of CHF
Shortness of breath
Rapid, shallow breathing
Moist/gurgling respirations
Profuse sweating
Enlarged neck veins
Swollen ankles
Anxiety

46. Care for CHF Place patient in sitting position.
Administer oxygen, if available and you are trained to use it.
Summon additional help.
Arrange for prompt transport.

47. Dyspnea Shortness of breath or difficulty breathing
Usually associated with serious heart or lung disease
Angina pectoris or heart attack
COPD, emphysema, bronchitis
Asthma
Pneumonia

48. Care for Dyspnea
Check airway for obstruction and rate and depth of breathing.
Place patient in comfortable position and reassure.
Administer oxygen if available and you are trained to use it.
Be prepared to provide rescue breathing.

49. Stroke A leading cause of brain injury and disability in adults
Blood clot deprives a portion of the brain from an adequate supply of oxygen.
Think of a stroke as a “brain attack.”
High blood pressure increases the risk of stroke.

50. Signs and Symptoms of Stroke
Headache
Dizziness
Confusion
Drooling
Numbness/paralysis on one side of body
Inability to speak
Difficulty seeing
Unequal pupil size
Unconscious
Convulsions
Respiratory arrest
Incontinence

51. Care for Stroke Maintain an open airway.
Administer oxygen, if available.
Provide psychological support.
Place an unconscious person in recovery position.
Be prepared to provide rescue breathing.

52. Stroke Scale The Cincinnati Prehospital Stroke Scale
A tool to determine if a patient is showing signs or symptoms of stroke:
Facial droop
Arm drift
Abnormal speech

53. Diabetes Caused by the body’s inability to process and use sugar
If the body does not produce enough of the hormone insulin, cells “starve.”
Two specific conditions:
Insulin shock
Diabetic coma
(1 of 2)

54. Diabetes Insulin shock: Pale, moist, cool skin Rapid pulse
Dizziness or headache
Confusion
Rapid onset
Diabetic coma:
History of diabetes
Warm, dry skin
Rapid, weak pulse
Deep, rapid breathing
Fruity odor
Slow onset
(2 of 2)

55. Care for Diabetic Emergencies
Ask:
Are you a diabetic?
Did you take your insulin today?
Have you eaten today?
If you suspect insulin shock, give patient sugar by mouth if fully conscious.
If unconscious, monitor airway and breathing.
Arrange for prompt transport.

56. Care for Diabetic Emergencies
Instant glucose provides a high concentration of sugar.

57. Acute Abdomen Caused by irritation of abdominal wall
Pain can be referred to other parts of the body.
If the patient is a woman of child-bearing years, consider ectopic pregnancy.

58. Abdominal Aortic Aneurysm
Layers of the aorta become weakened and separate.
Patients may complain of pain that radiates to shoulder.
Place in comfortable position, treat for shock, and arrange for prompt transport.