Sudden Illnesses

1
Sudden Illnesses

• Anthrax
• Smallpox
• Heart Problems
• Stroke
• Asthma
• COPD
• Hyperventilation
• Fainting

2
Sudden Illnesses 2

• Seizures
• Diabetes
• Abdominal distress
• Various other problems
• Food poisoning

3
Anthrax

• Most commonly occurs in hoofed animals
• Bacteria spores can live in the soil years
• Can infect humans

4
Three Serious Forms of Anthrax / Transmission

• Inhalation (breathing spores)
• Cutaneous (skin)
• Intestinal (spread by eating undercooked meat
  from infected animals)
• Historically, rare in the U.S.

5
Anthrax Symptoms

• Inhaled
• Severe cold / flu/ progress to breathing
  problems and shock
• Usually fatal

6
Cutaneous Anthrax

• Resembles insect bite
• Raised itchy bumps
• Develops black (necrotic) area in center
• 20 untreated cases result in death

7
Intestinal Anthrax

• Nausea, vomiting
• Loss of appetite
• Fever
• Abdominal pain, vomiting blood, severe diahrrhea
• 25-60 die

8
Vaccine For Anthrax

• Vaccine has been licensed for humans
• 93 effective
• Recommended for people who work in fields where
  contact is highly likely
• Military personnel
• Mild reactions in 30

9
Suspicious Mail

• Do not open
• Place in a bag
• Prevent spills of powder substance
• Call authorities
• Wash hands
• Cautions with aerosol sprays

10
Smallpox

• Incubation 12 days
• High fever, fatigue, head and back aches
• Rash predominately on face, arms, legs in 2-3
  days
• Flat red lesions
• Become pus filled, crusts and scabs
• Falls off in 3-4 weeks.
• 30 death rate

11
Spread of Smallpox

• Infected saliva droplets
• Vaccination some risks
• George Washington

12
Ricin

• Poison made from waste left over in processing
  castor beans
• Forms powder, mist, pellet or dissolved in water
  or weak acid
• Accidental exposure highly unlikely
• As little as 500 micrograms injected (pin head
  size) could kill
• Larger amounts required if inhaled or swallowed

13
Ricin

• Poisoned victims are not contagious
• Was possibly used in the Iran-Iraq war in the
  80s
• Ricin found in Al Qaeda caves in Afghanistan
• Blocks cells from making proteins

14
Ricin Signs and Symptoms

• Inhalation
• Coughing, tightness in chest, difficulty
  breathing, nausea, aching muscles
• Quickly, lungs become inflamed, lung fluids
  build, skin may turn blue

15
Ricin Signs and Symptoms

• Injestion
• Internal bleeding of stomach and intestines
• Leads to bloody vomit and diarrhea
• Liver, spleen, kidneys may stop functioning
• May lead to death

16
Ricin Signs and Symptoms

• Injection
• All previously cited signs and symptoms may occur

17
Ricin Death

• May occur in 36-48 hours no matter the type of
  exposure
• If one lives longer than 5 days w/o
  complications, they will probably survive

18
Ricin Treatment

• NONE
• No widely available, reliable test to confirm
  exposure

19
Information Regarding Terrorist Related
Emergencies

• DHS.gov

20
The Cardiovascular System and Disease Prevention
42 of all deaths in the U.S. are related to
heart disease
21
Cardiovascular Disease

• 1 million deaths each year
• 275 billion dollars
• Cardiovascular disease (CVD) is the number one
  cause of death in the United States.

22
Coronary Artery Disease

• Primary form of heart disease
• A disease involving waxy plaque build-up in the
  arteries

23
Coronary Artery Disease
24
Coronary Risk Factors

• Primary Risk Factors Factors that have been
  definitively associated with or directly cause
  coronary artery disease.
• Secondary Risk Factors Factors believed to
  contribute to or advance the severity of
  atheroschlerosis and CAD.

25
Primary Risk Factors (Alterable)

• Smoking
• Hypertension (high blood pressure)
• High serum cholesterol
• Physical inactivity
• Diabetes mellitus
• Obesity
• Family History

26
Secondary Risk Factors

• Stress
• Age
• Gender (male vs. female)

27
Arkansas Stats from the Center for Disease
Control/Mortality Rates

• Males 2 CAD
• Males 2 lung cancer
• Males and Females 1 in stroke

28
Angina and Heart Attack
29
Angina

• Chest pain usually brought on by
• Physical exertion, exposure to cold
• Emotional stress
• Ingestion of food
• Due to ischemia
• (reduced oxygen to part of the heart muscle)
• Duration of pain less than 10 minutes
• Usually relieved by nitroglycerin

30
About Nitroglycerine

• Give one dose approximately every 3 to 5 minutes
  (3 dosages in 10 minutes)
• Transport if 3 dosages are necessary
• Dosage amounts vary
• Available in tablets, spray, ointment, patch
• Victim should be sitting or lying down
• Reduces blood pressure
• Reduces work for the heart (dilates arteries
  which increases blood flow)

31
About Nitroglycerine 2

• Shelf life
• 6 months after opening
• Up to 2 years unopened
• May cause severe headache

32
Heart Attack (AMI - acute myocardial infarction)

• Blood supply to a portion of heart muscle is
  severely reduced or stopped
• P.258 atherosclerotic plaque

33
Heart Attack Signs and Symptoms

• Pressure, fullness, squeezing or pain in center
  of chest
• Pain lasts longer than 10 minutes
• Radiating pain
• Light-headedness, fainting, sweating, nausea,
  shortness of breath
• Indigestion?? (neighbor)

34
Heart Attack Signs and Symptoms 2

• May occur during rest or activity
• Pain not relieved by nitroglycerin
• Not all signs are always present
• Victim will be in denial
• Get help immediately

35
Other Causes of Chest Pain

• Rib injury
• Pneumonia, bronchitis, pleurisy
• Lung injury
• Indigestion
• Nerve impingement

36
Chest Pain Heart Attack / What To Do

• Monitor ABCs / give CPR if necessary
• Call EMS or transport
• Place victim in least painful position
• (Usually in half sitting position, knees bent)
• Loosen tight clothing around neck and mid-section
• Maintain composure / reassure
• Determine if there is a history of heart disease
• Check for medications
• Nitroglycerine / other

37
Stroke Cerebrovascular Accident (CVA) Brain
Attack

• Occurs as a result of
• Clot (80)
• Ruptured vessel (20)
• aneurysm
• 50 die
• Lack of oxygen to brain, cells die
• Third largest cause of death in U.S.
• Major cause of disability

38
Transient Ischemic Attacks (TIAs)

• Mini-strokes
• Precursor to major stroke
• May last a few minutes to several hours
• Function normally returns

39
Stroke Risk Factors

• gt50 years of age
• Birth control pills and gt 30 years old
• Overweight
• Hypertension
• High cholesterol
• Diabetes
• Heart disease
• Sickle cell disease
• Substance abuse (esp. crack)
• Family history

40
Stroke Signs and Symptoms

• Sudden weakness or numbness of face, arm, leg, on
  one side of the body (Strokes are usually
  unilateral)
• Loss of speech, difficulty speaking, difficulty
  understanding speech
• Blurred or decreased vision (one side)
• Deviation of PEARL
• Unexplained dizziness, unsteadiness, loss of
  balance
• Sudden severe headache

41
Stroke Test

• Close eyes, arms extended straight out.
• Does one are drop? P. 263
• Notice facial smile
• Hand grip

42
Stroke What To Do

• Check ABCs
• Call EMS
• Victim conscious?
• Have victim lay down with upper body and head
  slightly elevated
• Unresponsive but breathing?
• Recovery position
• Chin extended to keep airway open
• Do not give liquids or food (throat may be
  paralyzed)

43
Asthma

• Chronic, inflammatory lung disease
• Recurrent breathing problems
• Air passages narrow
• Difficulty exhaling
• Tends to resolve with age

44
What Triggers Asthma Attacks?

• Respiratory tract infection
• Extreme temperatures, especially cold
• Strong odors, perfumes, dust, fumes, smoke,
  allergens, air pollution
• Certain drugs (aspirin, beta blockers)
• Exercise
• Emotional stress

45
Signs of Asthma Attack

• Coughing
• Wheezing or whistling sound
• Flared nostrils
• Cyanosis (blue)
• Difficulty speaking
• Blue lips / fingertips
• These symptoms may also indicate other health
  problems such as pneumonia, cystic fibrosis

46
Asthma What To Do

• Sit in upright position, leaning slightly forward
• Pursed lip breathing
• Inhaler or other medications
• (Child at YMCA)
• Monitor ABCs if necessary

47
Asthma What To Do

• Determine cause of attack - remove victim from
  causative environment
• Abrupt change in outdoor temperature, dust,
  feathers, animals, tobacco smoke, paint, etc.
• Keep conversations brief
• Offer coffee (student info)
• Seek medical attention if necessary

48
Chronic Obstructive Pulmonary Disease COPD

• Primary cause SMOKING
• Primarily includes chronic bronchitis and
  emphysema
• Chronic bronchitis
• Affects bronchioles (become thickened)
• Caused by chronic infections and irritations such
  as cigarette smoke
• Symptoms Cigarette cough, breathing
  difficulty, increased sputum and severe coughing

49
COPD Emphysema

• Destruction of alveoli
• Loss of lung elasticity
• Coughing, wheezing, shortness of breath
• May become dependent on oxygen

50
COPD What To Do

• Sitting position
• Usually have their own medications
• Encourage fluid intake
• In acute distress? Get medical assistance

51
Hyperventilation

• Usually brought on by emotional stress
• Shortness of breath
• Characterized by extremely fast breathing
• Dizziness
• Numbness
• Tingling of hands and feet

52
Hyperventilation What To Do

• Encourage slow deep breathing
• Inhale through nose and hold for several seconds
• Exhale slowly through pursed lips
• Calm and reassure the victim
• Do not place a paper bag over the head

53
Fainting

• A sudden, brief loss of consciousness
  unassociated with a head injury
• Occurs when the brains blood flow in interrupted
• Often occurs when standing for prolonged periods
  of time (results in blood pooling) which may
  result in a drop in blood pressure
• Can be brought on by hypoglycemia, dehydration,
  anemia, heat exhaustion, slow heart rate, anxiety
  and emotional stress

54
Fainting

• Look for
• Dizziness
• Weakness
• Seeing spots
• Visual blurring
• Nausea
• Pale skin
• Sweating

55
Fainting What To Do

• Prevent from falling
• Have victim lie down on back
• Elevate feet 8-12 inches
• Loosen tight clothing
• After recovery,
• Give fluid with sugar
• Fresh air / cool cloth

56
Fainting When To Seek Medical Attention

• Over 40 years of age
• Repeated attacks
• Loses consciousness while sitting or lying down
• Does not quickly regain consciousness (is out gt 4
  to 5 minutes)
• Faints for no apparent reason

57
Seizures

• Results from abnormal stimulation of brain cells
• Exact cause is usually not known
• Medications are available yet are not easily
  controlled

58
Conditions That May Lead To Seizures

• Epilepsy
• Heatstroke
• Poisoning
• Electric shock
• Hypoglycemia
• High fever in children
• Brain injury, tumor, stroke
• Alcohol withdrawal, drug abuse / overdose

59
Major Classifications of Seizures

• Grand mal
• (generalized motor seizures)
• Focal motor
• Psychomotor
• (temporal-lobe, or complex partial))
• Petit mal
• (absence seizure)

60
Grand Mal

• Often associated with epilepsy
• May experience a sensation prior to seizure
• Loss of consciousness
• Duration 2 to 5 minutes
• Muscle contraction, perhaps tongue biting
• Is usually followed by a period of coma or
  drowsiness, headache, muscle soreness

61
Focal Motor

• Twitch affecting one side of the body
• (one side of face or arm)

62
Psychomotor

• Altered personality
• Often proceeded by dizziness or a metallic taste
  in the mouth
• May cause attacks of rage

63
Petit Mal

• Usually occur in children
• Rarely an emergency
• Brief loss of consciousness
• Stare off into space for a few seconds

64
First Aid Procedures For Seizures and Convulsions

• If possible
• Cushion head
• Remove items that victim may bump into
• Loosen tight neckwear
• Place on left side
• Medical-alert tag
• As seizure ends, offer help

65
First Aid For Seizures 2

• Call 911???
• Definitely call if
• If seizure lasts longer than 5 minutes
• If not known to have epilepsy or seizure ID
• Slow recovery
• A second seizure
• Difficulty breathing
• Pregnancy or other medical conditions (ID)
• Signs of injury or illness

66
DO NOTS For Seizure Victims

• Do not give food or drink
• Do not restrain victim
• Do not put anything between victims teeth
• Do not throw liquid on face
• Do not move to another place (unless to protect
  from injury)

67
Status Epilepticus

• Two or more seizures with no period of
  consciousness
• Call 911 This is an emergency

68
Diabetes Mellitus

• A condition in which glucose is unable to enter
  the cells
• A disease associated with problems in controlling
  blood glucose or blood sugar
• The disease results when the pancreas has
  problems producing insulin or the body can no
  longer use insulin properly
• Insulin is the taxi that carries sugar from the
  blood to the cells

69
Types of Diabetes

• Type I
• Insulin dependent or juvenile onset
• Congenital
• Type II maturity or adult onset (90 of all
  cases are this type)
• Usually non-insulin dependent
• Results from obesity and inactivity
• Gestational onset

70
Diabetes Mellitus Adult Onset

• The pancreas does not produce enough insulin or
  has just forgotten how
• Directly related to obesity
• Prevention
• Control cholesterol
• Control weight
• Control blood pressure
• Exercise regularly (aerobic)

71
Normal Blood Sugar Levels

• Normal blood sugar levels 65-110

72
Hypoglycemia

• Low levels of blood sugar
• Some may experience hypoglycemia but are not
  diabetic
• protein is often recommended, sometimes along
  with sugar

73
Hypoglycemia Leads To

• Insulin shock
• Sudden onset
• Occurs when eating has been delayed or when too
  much insulin was administered (blood sugar drops)
• May be fatal if left unattended

74
Hypoglycemia Signs and Symptoms

• Sudden onset
• Sudden hunger
• Trembling
• Anger, bad temper
• Staggering, poor coordination
• Pale
• Confusion, disorientation, altered mental status
• Sweating
• Eventual stupor or unconsciousness

75
Hypoglycemia What To Do

• If victim is known diabetic, has altered mental
  status, and is awake enough to swallow
• GIVE 10-15 grams of sugar
• ½ can regular soda
• 6 jelly beans
• P.275
• If no improvement after 15 minutes, give 15 more
  sugar
• If no improvement, take to the hospital
• (trim gym, student at ballgame)
• Glucagon injectable medication

76
Hyperglycemia

• The body has too much sugar in the blood
• Pancreas fails to produce insulin to lower sugar
  levels
• When sugar levels remain high, over time, it
  damages the walls of the vessels, leading to
  impairment of the circulatory system
• Affects functioning of most organs
• Problems healing (small cuts, amputations)
• Blindness

77
Hyperglycemia Leads To

• Diabetic coma (ketoacidosis)
• Levels may rise to 1200
• Body begins to burn fat as primary fuel
• Fat as fuel results in production of acids and
  ketones fruity breath

78
Hyperglycemia Signs and Symptoms

• Gradual onset
• Drowsiness
• Extreme thirst
• Frequent urination
• Flushed skin
• Vomiting
• Fruity breath
• Heavy breathing
• Eventual stupor or unconsciousness

79
Hyperglycemia What To Do

• If you are uncertain if sugar level is high or
  low, GIVE SUGAR
• If no response in 15 minutes, get to the hospital

80
Abdominal Distress

• Gastrointestinal problems
• Cramping, aching, nausea, vomiting, diarrhea
• May be viral or bacterial
• Difficult to determine the cause
• Constipation

81
Abdominal Distress? Ask These Questions

• Cramping pain?
• Constant pain?
• (indicates organ inflammation)
• Nausea? Poor appetite? Fever?
• Diarrhea or vomiting?
• Is a virus going around?
• Chance of pregnancy?
• Abdomen rigid to touch?
• Emergency (son)

82
Nausea, Vomiting, Diarrhea What To Do

• Watch for dehydration
• Pinch test
• Wait for nausea to pass before giving liquids and
  foods
• Give clear fluids
• Sprite, 7-up, water
• Jell-o, pop sickles
• Pepto Bismal or Pepcid might be appropriate
• Pepto Bismal may cause black stools

83
What To Do 2

• Hot water bottle, warm bath
• Lay on left side, knees bent
• Suppository (by prescription)
• Solid food?
• Crackers, toast
• Avoid milk and meats for 48 hours
• Let diarrhea run its course
• Imodium A-D)

84
What To Do For Infants

• Vomiting or projectile vomiting?
• Diahrrea?
• Pedialite

85
Other Problems

• Giardia
• Gallbladder
• Chrones Disease
• Appendicitis
• Diverticulitis / Diverticulosis
• Motion sickness
• Scopolamine Disk
• Avoid empty stomach, back seats, reading
• Focus on distant objects

86
Abdominal Distress When To Seek Medical
Attention

• Constant pain
• Unable to drink for more than 24 hours
• Blood or brown grainy matter in vomit
• Vomiting following a head injury
• Additionally
• Black or bloody stools
• Rigid, swollen, distended stomach
• Pain when abdomen is pressed then released

87
Food Poisoning

• Information from the U.S. Department of Human
  Services (Center for Disease Control), the U.S.
  Dept. of Agriculture, and The Prevention of Food
  Poisoning by Jill Trickett

88
Food-borne Illness

• 6.5 to 81 million cases annually (33 million
  ave.)
• Most are unreported
• Over 85 are preventable
• 2-3 lead to serious problems
• 9,100 deaths annually

89
Food-borne Illnesses Signs and Symptoms

• Signs may arise 30 minutes to 2 weeks after
  ingesting spoiled food
• (Usually 4 to 48 hours)
• Diarrhea, vomiting, abdominal pain, other gastric
  distress
• Serious cases may cause paralysis, double
  vision, difficulty swallowing, breathing
  difficulties

90
Primary Pathogens

• E-Coli
• Salmonella
• Listeria
• Campylobacter

91
E-Coli

• Primary source
• Undercooked ground beef
• Cook to170 degrees (160?)
• Slaughter houses vs. restaurants
• Especially affects kidney functioning in young
  children and infants
• Burger problems in 1997
• Water supply near cattle farms

92
Salmonella

• Primary source
• Foods of animal origin
• Beef, poultry, eggs (uncracked, under cooked,
  Easter eggs, milk, dairy products, pork
• Reactive arthritis
• Serious infections

93
Listeria

• Primary source
• All foods but especially poultry and dairy
  products
• Associated with meningitis and stillbirths
• 20-40 of cases are fatal
• Perhaps the most serious
• Occurrences seem to be limited

94
Campylobacter

• Primary source
• Poultry
• May lead to diseases associated with paralysis
• Greatest incidence in children under 1 year

95
Four Requirements for Bacterial Growth

• Warmth (98.6 is best for developing food
  poisoning)
• Food
• Moisture
• Time

96
Additional Information

• Cold does not kill most bacteria
• Will no longer multiply
• Bacteria can remain dormant in dry foods

97
To Prevent Food Borne Illnesses

• Do not eat from a utensil and place it back in
  the container of food
• Do not dip fingers in food
• Keep pets out of the kitchen (bacteria is on
  their feet and in fur)
• Never use the same dish for humans and pets
• Dry pet food is heavily contaminated with
  bacteria
• Discard chipped plates and damaged utensils
• Clean surfaces and dishcloths with bleach water

98
Prevention 2

• Never leave food in a hot car, take it home
  immediately
• Dont buy anything you wont use before the
  use-by date
• Dont buy food in poor condition
• Dented cans, not cold to touch, not frozen solid

99
Prevention Storing Food

• Refrigerator at 40 degrees
• Freezer at 0 degrees
• Place packages of raw meat on a plate before
  refrigerating

100
Prevention Preparing Food

• Wash hands (60 seconds)
• Wash sponges, kitchen towels, scouring pads etc.
  in hot water with bleach
• Or wash sponges etc. (daily) in the dishwasher
• Consider using paper towels to clean up meat
  juices
• After handling raw meat, wash hands with hot
  soapy water
• Wash all preparation surfaces that came in
  contact with meat or meat juices with hot soapy
  water or better yet, bleach water

101
Prevention Preparing Food 2

• Use non-porous cutting boards
• Run through dishwasher after each use
• Water temperature between 122-140
• Bleach water rinse

102
Prevention Preparing Food 3

• Thaw food in the refrigerator, microwave, or cold
  water NOT on the kitchen counter
• Wash fruits and vegetables

103
Prevention When Cooking

• Cook thoroughly
• Raw or partially cooked meat, poultry, fish or
  eggs increases the chances of poisoning

104
Cooking Guidelines

• Red meat 160 degrees
• Ground beef 170 degrees
• Poultry (ex. chicken) 180 degrees
• Use a meat thermometer

105
Visual Check for Doneness

• Red meat is done when its brown or gray inside
• Poultry juices run clear
• Fish flakes with a fork
• Large cuts of roast etc. may be lightly pink in
  center if temperature has reached 145 degrees
• Shushi

106
When You Serve Food

• Do not use dishes or utensils used in preparation
• Safest when eaten immediately after cooking

107
When You Serve Food

• Never leave perishable food unrefrigerated more
  than 2 hours
• Packed lunches?

108
Leftovers

• Divide into small amounts to allow for rapid
  cooling
• Re-heat only the amount you will eat
• Meat products or rice should never be re-heated
  more than once.
• Safe for 3-5 days

109
Oldy, Moldy Food?

• Looks or smells strange? Do not eat
• Remove mold and a large area around the mold
  before eating

110
Thawed Food

• Food still containing ice crystals can be
  refrozen
• Discard thawed food that has risen to room
  temperature and remained there 2 hours or more

111
Low Risk Foods

• Those with a high concentration of
• Sugar
• Salt
• Fat
• Acid (pickles, citrus fruit)
• Dry foods

112
Staphylococci

• Spread from small cuts on hands while preparing
  food
• Wear gloves or dress and bandage the cut
• Wear hair nets
• Staph grows well on the scalp
• (Sonic)

113
Botulism

• Avoid storing foods in metal containers or pans
• Avoid storing food in foil