Medical Emergencies and First Aid

8/14/2019 Medical Emergencies and First Aid

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2009 The McGraw-Hill Companies, Inc. All rights reserved

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Medical Emergencies

and First AidPowerPoint presentation to accompany:

Medical Assisting

Third Edition

Booth, Whicker, Wyman, Pugh, Thompson


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Learning Outcomes

43.1 Discuss the importance of first aid during amedical emergency.

43.2 Describe the purpose of the emergencymedical services (EMS) system and explainhow tocontact it.

43.3 List items found on a crash cart or first-aid

tray.

43.4 List general guidelines to follow inemergencies.


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Learning Outcomes (cont.)

43.5 Compare various degrees of burns

and theirtreatments.

43.6 Demonstrate how to help a choking victim.

43.7 Demonstrate cardiopulmonary resuscitation(CPR).

43.8 Demonstrate four ways to control bleeding.

43.9 List the symptoms of heart attack, shock, andstroke.


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43-4

Learning Outcomes (cont.)

43.10 Explain how to calm a patient who isunder

extreme stress.

43.11 Discuss ways to educate patientsabout ways to

prevent and respond to emergencies.

43.12 Describe your role in responding tonatural

disasters and those caused

by humans.


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Introduction

Emergencies

Acuteillnesses

Acute

injuries

Phone calls

frompatients with

urgent

problems

Disasters

The medical assistant must be prepared to

determine the urgency and handle any

emergencies that arise


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Understanding Medical Emerge

ncies

Any situation in which a person becomes ill or sustains an injury requiring

immediate care

Prompt action may prevent disability or death

Can occur within or outside the health-care setting


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Understanding MedicalEmergencies

Quick response usingfirst aid is vital

First aid can

Save a life

Reduce pain

Prevent furtherinjury

Reduce risk ofpermanent disability

Increase the chanceof early recovery

Patient education

First aid

Proper way to respond in anemergency



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Apply Your Knowledge

Why is it important to perform first aid in a medical

emergency?

ANSWER: First aid can: Save a life Prevent further injury

Reduce pain Reduce risk of permanent disability

Increase the chance of early recovery



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Preparing for Emergencies:Office

Establish roles

Post emergency telephone numbers

EMS if different than 911

Fire

Police

Poison control

Crash cartrolling cart with emergency supplies and equipment

Womens shelter

Rape hotline

Drug and alcoholcenter



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Preparing for Emergencies: Office (cont.)

Provide information to EMS

Your name and location

Nature of the emergency

Number of people needing help Condition of the injured or ill patient(s)

Summary of the first aid already given

Directions to your location

Do not hang up unti l the dispatcher gives

you permission to do so.



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Preparing for Emergencies: Office (cont.)

Emergency and first-aidsupplies

Crash cart / tray

Basic drugs, supplies, andequipment for medicalemergencies

First-aid kit for minor injuriesand ailments

Must be routinely checkedand restocked



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Preparing for Emergencies:Guidelines A medical emergency requires certain steps

Medical assistant provides only first aid

Patient emergencies

Assess the situation PPE

Assess patient

Six steps to initial assessment

1. General impression

2. Level of responsiveness

3. Assess ABCs

4. Urgency of condition

5. Focused exam

6. Document

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Preparing for Emergencies:Guidelines (cont.)

Telephone emergencies

Triaging

Classification of injuries according to severity, urgency of treatment, and place fortreatment

Follow office protocols

General guidelines

Stay calm

Reassure the patient

Act confidently in an organized manner

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Personal protection

Take precautions to reduce chance of exposure during an

emergency

Follow Standard Precautions

Keep personal protective

equipment in first-aid kit

at home and work

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Documentation

Assessment

Treatment given

Patient response If patient transported, location of facility

Date, time

Signature, credentials

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What are the steps of the initial assessment of apatient

in an emergency?

ANSWER: The steps of the initial assessment are:

1. Form a general impression of the patient

2. Determine the patients level of responsiveness

3. Assess ABCs4. Determine the urgency of condition

5. Perform a focused exam (head to toe); vital signs; skin

color

6. Document findings / report to physician or EMT

Correct

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Accidental Injuries

Injuries requiring emergencytreatment

Bites and stings Burns

Choking

Ear and eye traumas Falls and fractures

Head injuries

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Accidental Injuries:

Bites and Stings Animal bites

Bruise, tear, orpuncture

Cleanse wound, applyointment, and dry,sterile dressing

Insect stings

Remove stinger, if

present

Wash area, apply ice

Snake bites

Poisonous bite will need antivenin

Immobilize and position below heart

Spider bites

Refer patient to physician

Wash area, apply ice, and keep

below heart level

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Accidental Injuries: Burns

Thermal

Hot liquids, steam,flame, etc.

Water, wet cloth, orblanket

Chemical

Remove chemical

Wash with cool water

for 15 minutes

Cover with dry, steriledressing

Electrical

Entry and exit sites Tissue damage along

currents pathway

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(cont.) Classifications of burns

Severity determined by

Depth and extent of burnarea

Source of burn

Age of patient

Body area burned

Other illness / injuries

CategoriesMinor

Moderate

Major

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(cont.) Classifications of burns

By depth

Superficial

Partial-thickness

Full-thickness

Estimation ofextent of a burn

Rule of nines

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Accidental Injuries: Choking

Foreign object or food blocks the trachea or

windpipe

Universal sign

Hand up to throat with a fearful look

Medical assistants should know first aid for

choking adult, child, or infant!

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Accidental Injuries (cont.)

Ear trauma

Lacerations, cuts

Severed ear wrap ear and

transport with patient

Eye trauma

Falls, blows to eye, puncture,

foreign objects

Care depends on severity

Falls

Have patient examined

before moving

Stabilize neck if injury

suspected

Minor falls, notify the

physician; document

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Accidental Injuries: Fractures andDislocations Fracture break in the bone

Dislocation displacement of a

bone end from the joint

Sprain partial tearing of ligaments

Strainmuscle injury occurring

from overexertion

Treatment

Immobilize

Ice

Monitor patient

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Accidental Injuries: Head Injuries Concussionjarring injury of the brain

Patient may lose consciousness, have temporary loss ofvision, pallor, listlessness, memory loss, or vomiting

Severe head injuries contusions, fractures, andintracranial bleeding

May requires immediate hospitalization and/or CPR

Scalp hematoma and laceration blood under theskin or break in the skin

Control swelling with ice

Control bleeding with direct pressure

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Accidental Injuries: Hemorrhaging

Heavy or uncontrollable bleeding

InternalKeep patient warm, quiet, and

calm, and get medical help

ExternalUse direct pressure, apply

additional dressing as neededElevate body part, put pressure on nearest

pressure point between wound and heart

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Accidental Injuries: Multiple Injuries

Often the result of automobile accident or fall

Assess ABCs, perform CPR if needed

Only perform first aid after ABCs ensured

Treat most life-threatening injuries first

Notify EMS / physician

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Accidental Injuries: Poisoning

Substance that produces harmful effects if it enters the body

Majority of accidental poisonings happen in children under age 5

Post poison control centernumber

Patient education prevention

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Accidental Injuries: Poisoning

(cont.) Ingested poisons

Only induce vomiting if directed

Position patient on left side

Send poison container with patient

Absorbed poisons

Remove contaminatedclothing

Wash skin, alcohol,rinse

Inhaled poisons

Get to fresh air

Loosen clothing

Check ABCs

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Accidental Injuries: Weather-

Related Injuries Hypothermia

Body temperaturebelow 95

Move patient inside,cover with blankets,give warm liquids

Frostbite

Ice crystals formbetween tissue cells

Warm with clothing orother body part

Heat stroke

Prolonged exposure tohigh temperatures andhumidity

Move to cool place,cool with whatever isavailable

Sunburn

Soak in cool water,

cold compresses


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Accidental Injuries: Closed Wounds

Injury occurring inside thebody without breaking theskin

Caused by blunt trauma

Contusionsbruises

Cold compresses

Color changes are normal

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ANSWER: The patient holds his hand to his throat andlooks afraid.

1. What is the universal sign of choking?

2. A patient arrives at the clinic with severe

hemorrhaging from the left thigh. What steps should

you take to control the bleeding?

ANSWER: The steps are:1. Apply direct pressure with sterile gauze

2. Add additional dressing as necessary

3. Elevate the leg

4. Apply pressure to the left femoral artery

Yeah!

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Common Illnesses

Abdominal pain a

variety of causes

Asthma spasmodicnarrowing of bronchi

Dehydration lack of

adequate water in the

body

Diarrhea can result in

dehydration and electrolyte

imbalance

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Common Illnesses (cont.)

Fainting syncope: partial orcomplete loss of consciousness

Fever usually indicates infection

Hyperventilation breathing toorapidly and too deeply

Nosebleed epistaxis

Tachycardia heart rate greater

than 100 bpm

Vomiting can result in

dehydration and electrolyte

imbalance

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Matching:

___ Syncope A. Nosebleed

___ Pulse > 100 bpm B. Fainting

___ Spasmodic narrowing of bronchi C. Dehydration

___ Dehydration and electrolyte imbalance D. Tachycardia

___ Epistaxis E. Diarrhea / vomiting

___ Rapid and deep breathing F. Asthma

___ Lack of adequate water G. Hyperventilation

ANSWER:

G

F

E

D

C

B

A

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Less Common Illnesses

Anaphylaxis

Severe, life-threatening allergic reaction

Check ABCs, perform CPR if needed

Bacterial meningitis usually a

complication of another bacterial

infection Diabetic emergencies

Insulin shock severe hypoglycemia

Diabetic coma severe hyperglycemia


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Less Common Illnesses (cont.)

Seizures

Convulsions

Patient safety a

priority

Shock

Life-threateningstate related tofailure of the

cardiovascularsystem

Hypovolemic

Septic

Stroke cerebrovascularaccident due to impairedblood supply to brain

Toxic shock syndrome acutebacterial infectionoriginating in the uterus

Viral encephalitis

inflammation of thebrain due to a virus

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CPR Provides ventilation and

circulation for an arrest victim

Assess responsiveness, call EMS (911)

Assess ABCs

If available, connect patient to the automated external defibrillator (AED)

Start CPR

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Matching:

___ Hypo- or hyperglycemia A. Stroke

___ Myocardial infarction B. Diabetic emergencies

___ Vomiting blood C. Seizures

___ Impaired blood supply to brain D. Hematemesis

___ Convulsions E. Shock

___ May be hypovolemic or septic F. Heart attack

F

E

D

C

ANSWER:

B

A

S

U

P

E

R!

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Common PsychosocialEmergencies

Alcohol, spousal, child,

and elder abuse

Report per state law

Provide information on

community resources

Overdose on drugs

Requires emergency

care

Call EMS

Violent behavior

Office protocols

Document

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Common Psychosocial

Emergencies (cont.) Suicide

Allow patient to verbalize

Report suspicions to physician

Always take patient seriously

Rape

Provide privacy

Contact authorities and local

rape hotline

Follow protocol for chain of

custody of specimens

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Mrs. Jamison tells you that she is very tired of being ill and often

thinks of ending it all. She then laughs and says she was just

kidding. What is/are your responsibilities in this matter?

ANSWER: You should allow her to talk about her feelings and

despite the fact that she said she was just kidding you

should take her seriously. The physician should be told of

her comments. You may be asked to provide her with

information on community services available. You shoulddocument her comments and your actions.

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The Patient Under Stress

People react differently

to emergency situations

Detect stress

Behaviordifferent from

normal

Unable to focus

or follow

directions

Keep victims and

family calm

Challenges

Non-English speaking

Visual impairments

Hearing impairments

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Educating the Patient

How to prevent and handle medicalemergencies

Encourage patients and familiesto learn first aid and CPR

Provide first-aid kit checklist

How to access EMS and to keep emergencynumbers by the phone

How to childproof homes

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True or False:

___ All people react the same during an emergency.

___ Patients should be encouraged to learn CPR and first aid.

___ Challenges to dealing with patients during an emergency

include visual and hearing impairments and English-

speaking people.

___ Patients should be instructed how to prevent emergencies.

___ It is not important to keep the victim of an emergency

calm.

ANSWER:

F

F

F

T

T

differently

non-

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Disasters

Be familiar with standard protocols for responding to disasters

Participate in fire or other disaster drills to familiarize yourselfwithemergency procedures

Triagevictims are tagged to classify the victim

Emergentneeding immediate care

Urgentneeding care within several hours

Nonurgentneeding care when time is not critical, or dead


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Bioterrorism

Intentional release of a biologic agent with the intent to harm individuals

Biologic agent = weapon

Easy to disseminate

High potential for mortality

Cause public panic or social disruption

Requires public health preparedness


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1. What are the categories for triaging patients?

ANSWER: They are:emergentneeding immediate care;

urgentneeding care within several hours; nonurgent

needing care when time is not critical, or dead

2. What criteria does a biologic agent have to meet to be

a biological weapon?

ANSWER: It must be easy to disseminate, have a high

potential for mortality, cause public panic, and

require public health preparedness.

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In Summary

Medical emergencies can occur anywhere

Notify physician or EMS

Do not perform procedures out of your scope of practice

Assess and provide first aid

Remain calm and communicate clearly

Educate patients about how to prevent and respond to

emergencies

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End of Chapter

In the sick room, ten cents' worth

of human understanding equals

ten dollars' worth of medical

science.

~ Martin H. Fischer

Documents

Medical Emergencies and First Aid