First Aid in Medical Emergencie

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WORK Nª



Facultad De Medicina Humana Escuela Profesional De Medicina Humana

Medical English CURSE : Medical English

TEACHER : Dra. Rosa Gonzáles Llontop

CONTENT : Modern Medical Care

GROUP VI : ALCOSER ARCILA ALONSO

DE LA CRUZ RUIZ LENIN

MENDOZA MEGO BORIS

LUMBRE YUPTON CESAR

QUEVEDO MORI ARTURO

REGALADO ROCHA WILINTON

CYCLE : 2010-I

Lambayeque, Perú

November, 2010



RECOGNIZING MEDICAL EMERGENCIES

According to the American College of Emergency Physicians, the following are

warning signs of a medical emergency:

1. Bleeding that will not stop

2. Breathing problems (difficulty breathing, shortness of breath)

3. Change in mental status (such as unusual behavior, confusion, difficulty

arousing)

4. Chest pain

5. Choking

6. Coughing up or vomiting blood

7. Fainting or loss of consciousness

8. Feeling of committing suicide or murder

9. Head or spine injury

10. Severe or persistent vomiting

11. Sudden injury due to a motor vehicle accident, burns or smoke inhalation,

near drowning, deep or large wound, etc.12. Sudden, severe pain anywhere in the body

13. Sudden dizziness, weakness, or change in vision

14. Swallowing a poisonous substance

15. Upper abdominal pain or pressure



BLEEDING, WHAT TO DO IN CASE OF?

A hemorrhage is bleeding that is caused by a blood vessel damage. The

bleeding may be external, if blood is flowing to the outside or inside if the blood is

kept inside the body.

In the event that damage has occurred in an artery, blood flow will be bright

red in large numbers and depending on the caliber of the artery, with great force.



As the heart continues to drive without regard to blood loss, large amounts of

blood, this is lost in a few moments, so that arterial bleeding is always a medical

emergency and requires urgent transfer to hospital.

If it is a vein that is involved in hemorrhage, blood is a darker red color, and

out of the wounds with less force, although this also requires immediate attention

by a doctor because the bleeding is constant and can lead to significant blood loss

leading to further complications. In the capillary bleeding from blood emanates very

slowly.

Causes: The most common cause of bleeding is the accidental rupture of a

blood vessel caused by a laceration or trauma, but there are other conditions such

as ulcers, cancer, aneurysms, which could lead to bleeding.

First Aid: Ask for help with getting the person to a hospital. Keep the person

flat. Apply a roll of gauze or other material on the site of bleeding. If the wound is

on arm or leg, elevate the affected limb. Press firmly over the affected site at least

five minutes. If an artery is damaged, press the side closest to the heart artery for

15 minutes. Do not remove blood-soaked gauze, apply a clean bandage. If you

have the knowledge for the application of a tourniquet should be noted that this

must be loosened every ten minutes. Remember, bleeding all over each minute is

precious, go to an emergency facility as soon as possible.

BLEEDING

Major bleeding may be a life-threatening condition requiring immediate attention.

Bleeding may be external or internal. Bleeding may be from an ARTERY, a major

blood vessel which carries oxygen-rich blood from the heart throughout the body. It

may be from a VEIN, which carries blood back to the heart to be oxygenated or

bleeding may be from a CAPILLARY, the smallest of our body's blood vessels.



ARTERIAL bleeding is characterized by spurts with each beat of the heart,

is bright red in color (although blood darkens when it meets the air) and is

usually severe and hard to control. ARTERIAL bleeding requires immediate

attention!

VENUS bleeding is characterized by a steady flow and the blood is dark,

almost maroon in shade. Venus bleeding is easier to control than Arterial

bleeding.

CAPILLARY bleeding is usually slow, oozing in nature and this type of

bleeding usually has a higher risk of infection than other types of bleeding.

FIRST AID FOR BLEEDING IS INTENDED TO:

y STOP THE BLEEDING

y PREVENT INFECTION

y PREVENT SHOCK

HOW TO CONTROL BLEEDING?

1. Apply DIRECT PRESSURE on the wound. use a dressing, if available. if a

dressing is not available, use a rag, towel, piece of clothing or your hand

alone.

IMPORTANT:

ONCE PRESSURE IS APPLIED, KEEP IT IN PLACE. IF DRESSINGS BECOME

SOAKED WITH BLOOD, APPLY NEW DRESSINGS OVER THE OLD

DRESSINGS. THE LESS A BLEEDING WOUND IS DISTURBED, THE EASIER IT

WILL BE TO STOP THE BLEEDING!

2. If bleeding continues, and you do not suspect a fracture, ELEVATE the

wound above the level of the heart and continue to apply direct pressure.



3. If the bleeding still cannot be controlled, the next step is to apply

PRESSURE AT A PRESSURE POINT. For wounds of the arms or hands,

pressure points are located on the inside of the wrist ( radial artery-where a

pulse is checked) or on the inside of the upper arm (brachial artery). For

wounds of the legs, the pressure point is at the crease in the groin (femoral

artery). Steps 1 and 2 should be continued with use of the pressure points.

4. The final step to control bleeding is to apply a PRESSURE BANDAGE over

the wound. Note the distinction between a dressing and a bandage. A

dressing may be gauze square applied directly to a wound, while a

bandage, such as roll gauze, is used to hold a dressing in place. Pressure

should be used in applying the bandage. After the bandage is in place, it is

important to check the pulse to make sure circulation is not interrupted.

When faced with the need to control major bleeding, it is not important that

the dressings you will use are sterile! use whatever you have at hand and

work fast!

A SLOW PULSE RATE, OR BLUISH FINGERTIPS OR TOES, SIGNAL A

BANDAGE MAY BE IMPEDING CIRCULATION.

SIGNS AND SYMPTOMS OF INTERNAL BLEEDING ARE:

bruised,swollen, tender or rigid abdomen

bruises on chest or signs of fractured ribs

blood in vomit

wounds that have penetrated the chest or abdomen

bleeding from the rectum or vagina

abnormal pulse and difficulty breathing

cool, moist skin

First aid in the field for internal bleeding is limited. If the injury appears to be a

simple bruise, apply cold packs to slow bleeding, relieve pain and reduce swelling.

If you suspect more severe internal bleeding, carefully monitor the patient and be



prepared to administer CPR if required (and you are trained to do so). You should

also reassure the victim, control external bleeding, care for shock (covered in next

section), loosen tight-fitting clothing and place victim on side so fluids can drain

from the mouth.

MEDICAL IDENTIFICATION TAGS

A person with a serious medical condition ² such as diabetes, a drug

allergy, or a heart condition ² should carry information about the condition on a

necklace or bracelet, or on a card that can be carried in a pocket or wallet, so that

proper care can be given in an emergency.

Be sure to check for a medallion or card if you find yourself in the role of

rescuer. If you or a member of your family has a life-threatening medical condition,

obtain a medical identification tag or medallion from your local pharmacy and wear

it at all times.



A WELL-STOCKED FIRST-AID KI T

A fishing tackle box or a rectangular sealed plastic container makes an ideal first-

aid kit. It is wise to keep one in your home, car, boat, and camper. Stock your first-

aid kit with the following items.

One roll of absorbent cotton

Antihistamine for allergic reactions

Povidone-iodine antiseptic solution

Aspirin (for adult use only) and

acetaminophen and ibuprofen (in

child and adult dosages)

1-inch wide adhesive tape

Bacitracin ointment to treat cuts,

scrapes, or puncture wounds

Bandages in various sizes

Bar of soap

Butterfly bandages and thin

adhesive strips to hold skin edges

together

Calamine lotion

Cold pack

Mouthpiece for protection when

performing mouth-to-mouth

resuscitation

Cotton-tipped swabs

Syrup of ipecac to induce vomit

Elastic bandage or wrap

Eyedropper for irrigating

Flashlight

4-inch x 4-inch gauze pads

Disposable surgical gloves

Matches

Saline eyedrops

Scissors

Safety pins

Sewing needle to help remove a

splinter

Four packets of sugar in a sealed

plastic bag to use in case of low blood

sugar (see Diabetic Emergencies, p.

1206)

Thermometer

Two triangular pieces of cloth to

use as slings or to cut up as

bandages or straps

Tweezers



CARDIOPULMONARY RESUSCITATION (CPR)

What is CPR?

Cardiopulmonary resuscitation (CPR) is a combination of rescue breathing

and chest compressions delivered to victims thought to be in cardiac arrest. When

cardiac arrest occurs, the heart stops pumping blood. CPR can support a small

amount of blood flow to the heart and brain to ³buy time´ until normal heart function

is restored.

Cardiac arrest is often caused by an abnormal heart rhythm called

ventricular fibrillation (VF). When VF develops, the heart quivers and doesn't pump

blood. The victim in VF cardiac arrest needs CPR and delivery of a shock to the

heart, called defibrillation. Defibrillation eliminates the abnormal VF heart rhythm

and allows the normal rhythm to resume. Defibrillation is not effective for all forms

of cardiac arrest but it is effective to treat VF, the most common cause of sudden

cardiac arrest.

BEFORE YOU BEGIN

Before starting CPR, check:

Is the person conscious or unconscious?

If the person appears unconscious, tap or shake his or her shoulder and ask

loudly, "Are you OK?"

If the person doesn't respond and two people are available, one should call

911 or the local emergency number and one should begin CPR. If you are

alone and have immediate access to a telephone, call 911 before beginning

CPR ² unless you think the person has become unresponsive because of

suffocation (such as from drowning). In this special case, begin CPR for one

minute and then call 911.



If an AED is immediately available, deliver one shock if instructed by the

device, then begin CPR.

REMEMBER THE ABCS

Think ABC ² airway, breathing and circulation ² to remember the steps explained

below. Move quickly through airway and breathing to begin chest compressions.

Airway: Clear the airway

1. Put the person on his or her back on a firm surface.

2. Kneel next to the person's neck and shoulders.

3. Open the person's airway using the head-tilt, chin-lift maneuver. Put your

palm on the person's forehead and gently tilt the head back. Then with the

other hand, gently lift the chin forward to open the airway.

4. Check for normal breathing, taking no more than five or 10 seconds. Look

for chest motion, listen for normal breath sounds, and feel for the person's

breath on your cheek and ear. Gasping is not considered to be normal

breathing. If the person isn't breathing normally and you are trained in CPR,

begin mouth-to-mouth breathing. If you believe the person is unconscious

from a heart attack and you haven't been trained in emergency procedures,

skip mouth-to-mouth rescue breathing and proceed directly to chest

compressions.

Breathing: Breathe for the person

Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if

the mouth is seriously injured or can't be opened.

1. With the airway open (using the head-tilt, chin-lift maneuver), pinch the

nostrils shut for mouth-to-mouth breathing and cover the person's mouth

with yours, making a seal.

2. Prepare to give two rescue breaths. Give the first rescue breath ² lasting

one second ² and watch to see if the chest rises. If it does rise, give the

second breath. If the chest doesn't rise, repeat the head-tilt, chin-lift

maneuver and then give the second breath.



3. Begin chest compressions to restore circulation.

Circulation: Restore blood circulation with chest compressions

1. Place the heel of one hand over the center of the person's chest, between

the nipples. Place your other hand on top of the first hand. Keep your

elbows straight and position your shoulders directly above your hands.

2. Use your upper body weight (not just your arms) as you push straight down

on (compress) the chest 2 inches (approximately 5 centimeters). Push hard

at a rate of 100 compressions a minute.

3. After 30 compressions, tilt the head back and lift the chin up to open the

airway. Prepare to give two rescue breaths. Pinch the nose shut and

breathe into the mouth for one second. If the chest rises, give a second

rescue breath. If the chest doesn't rise, repeat the head-tilt, chin-lift

maneuver and then give the second rescue breath. That's one cycle. If

someone else is available, ask that person to give two breaths after you do

30 compressions. If you're not trained in CPR and feel comfortable

performing only chest compressions, skip rescue breathing and continue

chest compressions at a rate of 100 compressions a minute until medical

personnel arrive.

4. If the person has not begun moving after five cycles (about two minutes)

and an automatic external defibrillator (AED) is available, apply it and follow

the prompts. Administer one shock, then resume CPR ² starting with chest

compressions ² for two more minutes before administering a second

shock. If you're not trained to use an AED, a 911 operator may be able to

guide you in its use. Use pediatric pads, if available, for children ages 1 to 8.

Do not use an AED for babies younger than age 1. If an AED isn't available,

go to step 5 below.

5. Continue CPR until there are signs of movement or until emergency medical

personnel take over.

TO PERFORM CPR ON A CHILD



The procedure for giving CPR to a child age 1 through 8 is essentially the same as

that for an adult. The differences are as follows:

If you're alone, perform five cycles of compressions and breaths on the child

² this should take about two minutes ² before calling 911 or your local

emergency number or using an AED.

Use only one hand to perform heart compressions.

Breathe more gently.

Use the same compression-breath rate as is used for adults: 30

compressions followed by two breaths. This is one cycle. Following the two

breaths, immediately begin the next cycle of compressions and breaths.

After five cycles (about two minutes) of CPR, if there is no response and an

AED is available, apply it and follow the prompts. Use pediatric pads if

available. If pediatric pads aren't available, use adult pads.

Continue until the child moves or help arrives.

TO PERFORM CPR ON A BABY

Most cardiac arrests in babies occur from lack of oxygen, such as from drowning or

choking. If you know the baby has an airway obstruction, perform first aid for

choking. If you don't know why the baby isn't breathing, perform CPR.

To begin, examine the situation. Stroke the baby and watch for a response, such

as movement, but don't shake the baby.

If there's no response, follow the ABC procedures below and time the call for help

as follows:

If you're the only rescuer and CPR is needed, do CPR for two minutes ²

about five cycles ² before calling 911 or your local emergency number.

If another person is available, have that person call for help immediately

while you attend to the baby.

Airway: Clear the airway

1. Place the baby on his or her back on a firm, flat surface, such as a table.

The floor or ground also will do.



2. Gently tip the head back by lifting the chin with one hand and pushing down

on the forehead with the other hand.

3. In no more than 10 seconds, put your ear near the baby's mouth and check

for breathing: Look for chest motion, listen for breath sounds, and feel for

breath on your cheek and ear.

If the infant isn't breathing, begin mouth-to-mouth rescue breathing immediately.

Compressions-only CPR doesn't work for infants.

Breathing: Breathe for the infant

1. Cover the baby's mouth and nose with your mouth.

2. Prepare to give two rescue breaths. Use the strength of your cheeks to

deliver gentle puffs of air (instead of deep breaths from your lungs) to slowly

breathe into the baby's mouth one time, taking one second for the breath.

Watch to see if the baby's chest rises. If it does, give a second rescue

breath. If the chest does not rise, repeat the head-tilt, chin-lift maneuver and

then give the second breath.

3. If the baby's chest still doesn't rise, examine the mouth to make sure no

foreign material is inside. If the object is seen, sweep it out with your finger.

If the airway seems blocked, perform first aid for a choking baby.

4. Begin chest compressions to restore blood circulation.

Circulation: Restore blood circulation

1. Imagine a horizontal line drawn between the baby's nipples. Place two

fingers of one hand just below this line, in the center of the chest.

2. Gently compress the chest to about one-third to one-half the depth of the

chest.

3. Count aloud as you pump in a fairly rapid rhythm. You should pump at a rate

of 100 compressions a minute.

4. Give two breaths after every 30 chest compressions.

5. Perform CPR for about two minutes before calling for help unless someone

else can make the call while you attend to the baby.



6. Continue CPR until you see signs of life or until medical personnel arrive.

MOUTH-TO-MOUTH RESUSCITATION

A technique used to resuscitate a person who has stopped breathing, in

which the rescuer presses his or her mouth against the mouth of the victim and,

allowing for passive exhalation, forces air into the lungs at intervals of several

seconds.

Smoke inhalation, heart attack, drowning, choking²all of these can stop a

person's breathing. Mouth-to-mouth resuscitation may well be a gift of life to one of

your own family members. You never know when an emergency will arise thatrequires you to use it. All family members should know how to perform this life-

saving technique.

Stage for the mouth to mouth resuscitation

1. If a victim appears to be unconscious:

Tap victim on the shoulder and shout, "Are you okay?"

2. If there is no response:

Tilt the victim's head, chin pointing up. Place one hand under the victim's neck and

gently lift. At the same time, push with the other hand on the victim's forehead. This

will move the tongue away from the back of the throat to open the airway.

3. Immediately look, listen, and feel for air. While maintaining the backward

head tilt position, place your cheek and ear close to the victim's mouth and

nose. Look for the chest to rise and fall while you listen and feel for the

return of air. Check for about five seconds.

4. If the victim is not breathing:



Check for and clear any foreign matter from the victim's mouth. Give four quick

breaths. Maintain the backward head tilt, pinch the victim's nose with the hand that

is on the victim's forehead to prevent leakage of air; open your mouth wide; take a

deep breath; seal your mouth around the victim's mouth, and blow into the victim's

mouth with four quick but full breaths just as fast as you can. When blowing, take

only enough time between breaths to lift your head slightly for better inhalation. For

an infant, give gentle puffs and blow into both the mouth and nose, and do not tilt

the head back as far as for an adult.

5. If the chest does not rise when you blow, it may help to reposition the head

and try again.

Again, look, listen, and feel for air exchange.

6. If there is still no breathing:

Change rate to one breath every five seconds for an adult.

For an infant, blow into mouth and nose at the same time. Give one gentle puff

every three seconds.

First Aid in Medical Emergencie

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