Health 4 Notes

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Health 4 Notes

• Sir Daj

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Patient Assessment

• Scene size-up
• Initial assessment
• Focused history and physical exam
• Vital signs
• History
• Detailed physical exam
• Ongoing assessment

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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

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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

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Develop a General Impression

• Occurs as you approach the scene and the patient
• Assessment of the environment
• Patients chief complaint
• Presenting signs and symptoms of patient

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Obtaining Consent

• Introduce self.
• Ask patients name.
• Obtain consent.

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Chief Complaint

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

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Assessing Mental Status

• Responsiveness
• How the patient responds to external stimuli
• Orientation
• Mental status and thinking ability

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Testing Responsiveness

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

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Check Airway

• Labored breathing
• Accessory muscles
• Noisy breathing
• Cyanosis
• Rate and depth
• Air movement
• Choking

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Unconscious?
Absence of Breathing?
Perform BLS!!
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Unresponsive but BREATHING??
. . . Continue with the Assessment
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Vital Signs
Pulse Rapid/weak shock, diabetic
coma Rapid/strong heat stroke, hypertension
Slow/strong stroke, skull fracture None cardiac
arrest
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Vital Signs
Respiration Shallow shock Irregular obstruction
Wheezing asthma None cardiac arrest
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Vital Signs
Blood Pressure lt 100 mmHg shock gt 135
mmHg hypertension Skin Temperature Hot
dry heat exposure Cool clammy shock
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Vital Signs
Pupils Constricted drugs, poison Unequal concuss
ion, stroke Dilated shock, hemorrhage
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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

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Nature of Illness

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

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Opening The Airway
Head Tilt Chin Lift
Jaw Thrust
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FBAO
Foreign Body Airway Obstruction
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Types of Obstruction
Anatomical
Mechanical
Partial
Complete
Partial
Complete
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Partial
Complete

• inability to speak
• absence of breath sounds
• flared nostrils
• restlessness
• unresponsive

• weak cough
• wheezing
• strained breathing
• slight cyanosis

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First Aid

• Back blows
• Heimlich Maneuver
• Chest Thrusts

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

• Arrhythmia is a broad classification of heart
  disorders that pertain to irregularity in the
  sinus rhythm
• Bradycardia too slow
• Tachycardia too fast

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Chain of Survival
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Basic Life Support
A term used to describe the first aid procedures
necessary to sustain life when the cardiovascular
system is compromised.
determine responsiveness
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Basic Life Support
A term used to describe the first aid procedures
necessary to sustain life when the cardiovascular
system is compromised.
activate EMS
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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
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Basic Life Support
A term used to describe the first aid procedures
necessary to sustain life when the cardiovascular
system is compromised.
determine breathlessness
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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
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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
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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
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Basic Life Support
A term used to describe the first aid procedures
necessary to sustain life when the cardiovascular
system is compromised.
recovery position
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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.

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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.).
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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 - 2 inches Approximately 1 1½ inches Approximately ½ - 1 inch
How to Compress Heels of 1 hand, other hand on top. Heel of one hand 2 fingers (middle ring fingertips)
Rate of Compression Approximately 100/min Approximately 100/min At least 100/min
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Automated External Defibrillators are medical
devices that deliver a controlled shock through
pads or electrodes placed in specific locations
on the victims chest.
What is a fibrillation?
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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

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Using an AED

1. Turn the power ON
2. Attach the electrodes to the victims bare chest

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