Health 4 Notes: Sir Daj

Health 4 Notes Sir Daj

Patient Assessment • Scene size-up • Initial assessment • Focused history and physical exam – Vital signs – History

• Detailed physical exam • Ongoing assessment

Body Substance Isolation • Assumes all body fluids present a possible risk for infection • Protective equipment – Latex or vinyl gloves should always be worn – Eye protection – Mask – Gown – Turnout gear

Scene Safety: Potential Hazards Oncoming traffic Unstable surfaces Leaking gasoline Downed electrical lines • Potential for violence • Fire or smoke • • • •

• Hazardous materials • Other dangers at crash or rescue scenes • Crime scenes

Mechanism of Injury • Helps determine the possible extent of injuries on trauma patients • Evaluate: – Amount of force applied to body – Length of time force was applied – Area of the body involved

Nature of Illness • Search for clues to determine the nature of illness. • Often described by the patient’s chief complaint • Gather information from the patient and people on scene. • Observe the scene.

Develop a General Impression • Occurs as you approach the scene and the patient – Assessment of the environment – Patient’s chief complaint – Presenting signs and symptoms of patient

Obtaining Consent • Introduce self. • Ask patient’s name. • Obtain consent.

Chief Complaint • Most serious problem voiced by the patient • May not be the most significant problem present

Assessing Mental Status • Responsiveness – How the patient responds to external stimuli

• Orientation – Mental status and thinking ability

Testing Responsiveness • A Alert • V Responsive to Verbal stimulus • P Responsive to Pain • U Unresponsive

Opening The Airway Head Tilt Chin Lift

Jaw Thrust

FBAO Foreign Body Airway Obstruction

Types of Obstruction

Anatomical

Partial

Complete

Mechanical

Partial

Complete

Partial

Complete

• weak cough

• inability to speak

• wheezing

• absence of breath sounds

• strained breathing

• flared nostrils

• slight cyanosis

• restlessness • unresponsive

First Aid • Back blows • Heimlich Maneuver • Chest Thrusts

Cardiovascular Emergencies A rapid decline in heart function due to poor blood flow or electrical activity. LIFE THREATENING!! Examples are cardiac arrest, heart attack, and arrhythmia

THREE CONDITIONS OF CARDIAC ARREST 1. Cardio Vascular Collapse The heart is still beating but its action is so weak that is not being circulated through the vascular system to the brain body tissues. 2. Ventricular Fibrillation Occurs when the individual fascicles of the heart beat independently rather than the coordinated, synchronized manner that produce rhythmic heart beat. 3. Cardiac standstill It means that the heart has stopped beating.

Cardiovascular Emergencies Heart attack is the death of the heart muscle due to deficient blood supply. Usually mistaken for angina pectoris. What causes heart attack?

What are the symptoms? First Aid? 1. Check ABCs 2. Call EMS 3. If possible, give nitroglycerine 4. If needed, use AED

Cardiovascular Emergencies Arrhythmia is a broad classification of heart disorders that pertain to irregularity in the sinus rhythm 1. Bradycardia – too slow 2. Tachycardia – too fast

Chain of Survival

Basic Life Support A term used to describe the first aid procedures necessary to sustain life when the cardiovascular system is compromised. determine responsiveness

Basic Life Support A term used to describe the first aid procedures necessary to sustain life when the cardiovascular system is compromised. activate EMS

Basic Life Support A term used to describe the first aid procedures necessary to sustain life when the cardiovascular system is compromised. open the airway

Basic Life Support A term used to describe the first aid procedures necessary to sustain life when the cardiovascular system is compromised. determine breathlessness

Basic Life Support A term used to describe the first aid procedures necessary to sustain life when the cardiovascular system is compromised. give chest compressions

Basic Life Support A term used to describe the first aid procedures necessary to sustain life when the cardiovascular system is compromised. give rescue breathing 5 cycles in 2 minutes

Basic Life Support A term used to describe the first aid procedures necessary to sustain life when the cardiovascular system is compromised. defibrillate if available

Basic Life Support A term used to describe the first aid procedures necessary to sustain life recovery position when the cardiovascular system is compromised.

When not to give CPR  Patient has a valid “Do Not Attempt Resuscitation” (DNAR) order.  Signs of irreversible death: Rigor Mortis, Decapitation.  No physiological benefit can be expected because the vital functions have deteriorated despite maximal therapy.

When to S.T.O.P. CPR SPONTANEOUS signs of circulation are restored. TURNED over to medical services or properly trained and authorized personnel. OPERATOR is already exhausted and cannot continue CPR. PHYSICIAN assumes responsibility (declares death, take over, etc.).

Adult

Child

Infant

Compression area

Lower half of the sternum 2 fingers from the substernal notch

Lower half of the sternum 1 finger from substernal notch

Lower half of the sternum 1 finger width below the imaginary nipple line

Depth

Approximately 1½ Approximately 1 Approximately ½ - 2 inches – 1½ inches 1 inch

How to Compress

Heels of 1 hand, Heel of one hand 2 fingers (middle other hand on top. & ring fingertips)

Rate of Compression

Approximately 100/min

Approximately 100/min

At least 100/min

Automated External Defibrillators are medical devices that deliver a controlled shock through pads or electrodes placed in specific locations on the victim’s chest. What is a fibrillation?

Special Situations • if victim is a child . . . • if victim is near water . . . • if victim has pacemaker . . . • if victim has patch over electrode site . . . • if victim has hairy chest

Using an AED 1.Turn the power ON 2.Attach the electrodes to the victim’s bare chest

Using an AED 3. Be sure no one is touching the victim and press ANALYZE 4. Deliver a SHOCK if indicated

Neurological Emergencies Stroke or Cerebrovascular Accident • Lack of blood flow to the brain due to a clot or a blood vessel rupture • Risk factors include gender, age, smoking, hypertension, obesity, and diabetes • Symptoms include dizziness, confusion, slurred speech, sudden numbness, severe headache, and trouble seeing

Neurological Emergencies Cerebral Aneurysm • Rupture of one of the arteries supplying the brain • Leads to stroke or internal bleeding

Neurological Emergencies Subdural Hematoma Epidural Hematoma

Neurological Emergencies Intercranial Hematoma • Symptoms include headache, dizziness, and vomiting • Signs include HR decrease, BP increase, raccoon eyes, battle’s sign, and CSF leak

Neurological Emergencies Concussion • Temporary disturbance in brain function brought about by a blow or jolt to the head • Symptoms include headache, balance problem, confusion, and dizzy • Signs include unconsciousness, amnesia, and clumsy

Neurological Emergencies Skull Fracture • Trauma to the bony structure that protects the brain • Could be linear, comminuted, depressed, or basilar • Watch out for complications!! • Signs and symptoms include cushing’s triad, nausea, and CSF leak

Neurological Emergencies Cervical Sprain Ligaments that stabilizes the vertebrae to one another

Neurological Emergencies Spinal Cord Injury • Trauma to the spinal cord leading to temporary or permanent paralysis • C1-C4 paralysis from neck • C5-C7 paralysis from chest • T1-T9 paralysis of lower extremities

Neurological Emergencies Herniated Disc Protrusion of the jelly like substance that comprises the cartilage in between vertebrae

Management Steps to Spinal Injury Management 1.Check consciousness (AVPU) 2.Manage airway 3.Perform neurological tests 4.Apply cervical collar 5.Log roll into spine board

Secure Airway

Assessment Neurological Tests for SC • Motor (Can you move . . .?) • Sensory (Can you feel . . .?) • Reflexes (Tap tendons)

Cervical Collar • Use the correct size • Do not release cervical spine during application • Secure airway