1. Incidents and Emergencies
Chapter 12
Incidents and Emergencies

2. Explain basic, immediate actions and initial treatment needed for selected types of patient injury or acute illnesses
Differentiate between heat exhaustion and heat stroke through the observation of signs and symptoms and apply appropriate treatment
Differentiate between an insulin reaction and acidosis through the observation of signs and symptoms and apply appropriate treatment
Chapter Objectives

3. Chapter Objectives (cont’d)
Differentiate between autonomic hyperreflexia and postural (orthostatic) hypotension through the observation of signs and symptoms and apply appropriate treatment
Analyze patient care activities and determine the need to modify, reduce, or discontinue treatment
Chapter Objectives (cont’d)

4. Preparing Crash carts Emergency evacuations Bomb threats
Terrorist treats
various codes
Preparing
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5. Emergency Care: Support Devices
Bandage materials
Types
Triangular-
Cravat-
Ankle wrap
Protective splints, sleeves, and slings
Emergency Care: Support Devices

6. How do you respond? Allergic Reactions
Mild/Moderate
Itchy skin
Rash
Itchy eyes
Sneezing
Hives
Severe
Swelling of face/mouth
Difficulty swallowing/speaking
Wheezing
Abdominal pain, vomiting
Dizziness
How do you respond? Allergic Reactions

7. Your patient just arrived for therapy and told you they had a great lunch at Panera. A few minutes later you notice the patient wheezing, and their mouth is starting swell.
What is happening? What do you do?
Patient case
Copyright © 2013, 2008, 2002, 1999, 1994 by Saunders, an imprint of Elsevier Inc.

8. Reduce or remove cause and prevent or reduce extent of physiologic state of shock
Signs/symptoms:
Pale, moist, cool skin
Shallow and irregular breathing
Dilated pupils
Weak and rapid pulse
Diaphoresis
Dizziness or nausea
Syncope
Treatment- remedy cause if able, place in supine head slightly lower than LEs, cool compress, avoid exertion,
Shock

9. Orthostatic (Postural) Hypotension
Most frequently occurs when one attempts to stand quickly
Signs/symptoms:
Dizziness or nausea
Syncope
Place in supine position or reclined until symptoms subside
May need lower extremities ace wrapped or full body compression suit.
Orthostatic (Postural) Hypotension

10. Falls Common occurrences in daily lives Joint Commission safety goal
Causes:
Risk-related activities
Carelessness
Ill health
Process of aging
See Box 12-3 for human factors vs environmental
Common tests used in PT to determine fall risk
Berg balance, timed up and go, tinetti
Falls

11. What factors would be appropriate when educating a patient on fall prevention?
Think-write-share
Patient Education
Copyright © 2013, 2008, 2002, 1999, 1994 by Saunders, an imprint of Elsevier Inc.

12. Protect fracture site and avoid further injury, prevent shock, reduce pain, and guard against wound contamination
See Procedure 12-5 pg 340
Fractures

13. Burns Prevent wound contamination, relieve pain, and prevent shock
See Procedure 12-6 pg 341
Burns

14. Convulsions/Seizures
Protect person from injury
Provide for person’s modesty and privacy
Do not place anything in the mouth
Do not restrain person or limbs
Respiration rate may change or cease for seconds
When convulsions subside position with head to one side in case occurs
See Procedure 12-7 pg 341
Convulsions/Seizures

15. Heat-Related Illnesses
Heat Exhaustion
Heat Stroke
Least threatening to life
Cause: hot, humid environment; vigorous physical activity; dehydration; depleted body electrolytes
See Procedure 12-9
Medical emergency
Cause: hot, humid environment; vigorous physical activity; dehydration; depleted body electrolytes
See Procedure 12-10
Heat-Related Illnesses

16. Problem Solving Refer to pg. 347 problem #1
Copyright © 2013, 2008, 2002, 1999, 1994 by Saunders, an imprint of Elsevier Inc.

17. Insulin-Related Illnesses
Hypoglycemia
Hyperglycemia
Too much systemic insulin, too little food intake, or excessive exercise
Provide some form of sugar
Too little systemic insulin, intake of too much or improper food, or insufficient physical activity
Can lead to diabetic coma or death
Medical emergency
Do NOT give sugar
Insulin-Related Illnesses

18. Patient Case Which is more serious hypoglycemia or acidosis?
What would you do if you entered a patient room for their PT session and noticed a fruity breath odor. They reported feeling too tired for therapy today?
Can you give a patient with diabetes juice if you notice signs of low blood sugar?
Patient Case
Copyright © 2013, 2008, 2002, 1999, 1994 by Saunders, an imprint of Elsevier Inc.

19. Autonomic Hyperreflexia (Dysreflexia) in Spinal Cord Injury
Determine and remove noxious stimulus
Most common in pt with new SCI to T6 level
Signs/symptoms: severe hypertension, bradycardia, profuse diaphoresis, pounding headache, red skin blotches, and piloerection (goose bumps)
Person may convulse, have difficulty with respiration, or lose consciousness
Causes: urine retention/kink in line,fecal impaction, open pressure ulcers, tight straps, localized pressure, or exercise
See Procedure for treatment
Autonomic Hyperreflexia (Dysreflexia) in Spinal Cord Injury

20. http://quizlet. com/17112483/test
e=on&prompt-with=2&limit=16
#2 pg 347
Problem solving
Copyright © 2013, 2008, 2002, 1999, 1994 by Saunders, an imprint of Elsevier Inc.