Chapter 58: Emergency Care (pp. 846-864)

(pp. 846-864)

Emergencies can occur anywhere!

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• Sometimes, you can save a life if you know what to do.

  ​

• Most agencies require nursing assistants to be CPR certified.

  ​

• Updates can be found online at the American Heart Association's (AHA) website.

​

(pp. 846-847)

Multiple Choice

The emergency care given to an ill or injured person before medical help arrives is __________.

• emergency medical system

• first aid

• Basic Life Support (BLS)

• cardiopulmonary resuscitation (CPR)

Multiple Choice

Before starting chest compressions during CPR, you must __________.

• check for breathlessness

• check for a pulse

• check for a blood pressure

• make the person comfortable

Multiple Choice

Before giving rescue breaths during CPR, you must __________.

• check for adequate breathing

• check for a blood pressure

• check for a pulse

• make the person comfortable

To activate the EMS system, do 1 of the following:

• Dial 911

• Call the local fire/police dept

• Call the phone operator​

(p. 847)

​Each emergency is different.

• The rules in Box 58-1 (above) apply to any emergency​

Multiple Choice

Chest compressions are given to adults at a rate of _____ - _____ per minute.

• 60 - 80

• 80 - 100

• 100 - 120

• 120 - 140

Multiple Choice

TRUE or FALSE:

For effective chest compressions, the person must be supine and on a soft, comfortable surface.

• TRUE

• FALSE

Multiple Choice

TRUE or FALSE:

Never practice CPR on another person.

• TRUE

• FALSE

(pp. 852-853)

(p. 853)

Multiple Choice

CPR is being given to a child by two people. Two breaths are given after every _____ compressions.

• 5

• 10

• 15

• 30

Multiple Choice

TRUE or FALSE:

Cardiopulmonary resuscitation (CPR) is done for sudden cardiac arrest (SCA).

• TRUE

• FALSE

Airway (a/w) obstruction may be mild or severe:

• Severe a/w obstruction

  • Air does NOT move in and out of the lungs.

  • If obstruction is not removed -> person will die!

  • Use abdominal thrusts to relieve severe a/w obstruction (practiced in class)​

​

​

​

(p. 856)

(p. 856)

​Follow the rules in Box 58-1

• Includes activating EMS system

• Check pulse q2min

• If no pulse -> Begin CPR!

• If pulse is 60 or less in an infant or child: BEGIN CPR!​

Multiple Choice

TRUE or FALSE:

Respiratory arrest occurs when breathing stops and the heart stops.

• TRUE

• FALSE

Multiple Choice

TRUE or FALSE:

The airway (a/w) must be open to restore breathing.

• TRUE

• FALSE

If you suspect a heart attack (MI):

• Have person sit & rest

• Loosen tight clothing

• Activate EMS system at once!

  • Prompt tx will reduce amount of myocardial damage

  • Start CPR for SCA

• Follow rules in Box 58-1 for MI​

​

(p. 857)

(p. 857)

Multiple Choice

TRUE or FALSE:

Internal bleeding is controlled by applying direct pressure to the bleeding site.

• TRUE

• FALSE

• Low or falling blood pressure

• Rapid -and- weak pulse

• Rapid respirations (RR > 20)

• Skin is cold, moist, and/or pale

• Thirst

• N/v

• Restlessness

• Confusion and LOC as shock worsens

​

(p. 857)

Multiple Choice

TRUE or FALSE:

High blood pressure (HTN) and a slow, weak pulse are signs of shock.

• TRUE

• FALSE

Multiple Choice

To prevent and treat shock, do all of the following except __________.

• keep the person lying down

• control hemorrhage

• keep the person cool

• reassure the person

• Itchy rash

• Swelling of face ,eyes, -or- lips

• ​Flushed -or- pale skin

• Feeling warm

• Dyspnea/wheezing from a/w narrowing -or- swollen tongue -or- throat

• Feeling of a "lump" in the throat​

• Fast -and- weak pulse

• N/v -or- diarrhea​

• Feeling of dread -or- doom​

• Dizziness -or- fainting (syncope)

• Signs & symptoms of SHOCK​

​

S/Sxs of Anyphylaxis include:

​

(pp. 857-858)

(p. 858)

Multiple Choice

TRUE or FALSE:

Anaphylactic shock is a medical emergency.

• TRUE

• FALSE

• Have person sit/lie down to prevent fainting

  • Sitting -> person bends forward & places head between knees

    • See Fig. 58-22 (next slide)

  • Lying Down -> raise the person's legs (above level of heart)

• Loosen tight clothing

  • E.g. Belts, ties, scarves, collars... ​

​

If the person has warning s/o fainting:

​

(p. 858)

• Activate the EMS system

• Keep person lying down

  • Raise feet ~12 inches/1 ft

  • Start CPR for cardiac arrest

  • Give rescue breathing for respiratory arrest

• Help person to sitting position after recovery from fainting

  • Do NOT let the person get up quickly

  • Observe for possible fainting again!

​If fainting occurs:

​

(p. 858)

Multiple Choice

Which of the following is a warning sign that a person may faint.

• Dizziness

• Talking

• Fatigue

• A slow, strong pulse

• Occurs when brain is suddenly deprived of blood

  • Usually, only part of brain is affected

• May be caused by:

  • Thrombus

    • Blood clot

  • Embolus

    • "Travelling blood clot" (or fatty deposit; air bubble)

  • Hemorrhage

​

(p. 858)

Stroke (Cerebrovascular Accident [CVA]):

​

​If you suspect stroke -> Activate EMS system at once!

• Find out when sxs began

  • Most effective txs must be given w/in 3 hrs of onset​

  • Tell EMS staff the time

• Follow the rules in Box 58-1

• Keep person comfortable, warm, & quiet

  • Provide emergency care for seizure(s) if necessary

  • Start CPR for cardiac arrest; Rescue breathing for resp. arrest

​

(p. 858)

​(pp. 858-859)

• Brain injury

  • During or after birth

• Issues w/ brain development

  • Before birth

• Mother develops injury or infection during pregnancy​

• Traumatic brain injury

  • E.g. Gunshot wound, sports injury, fall, blunt force to head

• Brain tumor

• Poison

  • E.g. Lead; alcohol

• Infection

  • E.g. Meningitis; encephalitis

​

(p. 859)

(p. 859)

(p. 859)

​Emergency Care for Seizures:

• You cannot stop a seizure

• You can protect the person from injury

  • Follow the rules in Box 58-1

  • See Box 58-3 (2 slides away)

    • For when to activate EMS

  • Do not leave the person alone

  • Lower person to the floor

    • Protects person from falls

*** Rules continued in 2 Slides ***​

​

Multiple Choice

A person is having a seizure. You should __________.

• lower the person to the floor

• remove all clothing

• offer the person fluids

• hold the person's tongue down

(p. 859)

(p. 859)

Multiple Choice

TRUE or FALSE:

A person is having a seizure. To promote safety, you must restrain the person’s body movements.

• TRUE

• FALSE

(p. 860)

(p. 860)

(p. 860)

(p. 860)

(p. 860-861)

​(Heat-Related Illnesses; p. 861)

(pp. 861-862)

(p. 862)

Multiple Choice

TRUE or FALSE:

Full-thickness burns are very painful.

• TRUE

• FALSE

(p. 862)

Multiple Choice

Emergency care for burns includes __________.

• removing the person from the fire or burn source

• leaving the burns open to the air

• removing all clothing

• covering the person in ice packs

(p. 862)