Bài giảng Medical Assisting - Chapter 44: Medical Emergencies and First Aid

ChapterPowerPoint® to accompany Second EditionRamutkowski  Booth  Pugh  Thompson  WhickerCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.Medical AssistingChapter 441Objectives44-1 Discuss the importance of first aid during a medical emergency.44-2 Describe the purpose of the emergency medical services (EMS) system and explain how to contact it.44-3 List items found on a crash cart or first-aid tray.44-4 List general guidelines to follow in emergencies.Medical Emergencies and First Aid 2Objectives (cont.)44-5 Compare various degrees of burns and their treatments.44-6 Demonstrate how to help a choking victim.44-7 Demonstrate cardiopulmonary resuscitation (CPR).44-8 Demonstrate four ways to control bleeding. Medical Emergencies and First Aid3Objectives (cont.)44-9 List the symptoms of heart attack, shock, and stroke.44-10 Explain how to calm a patient who is under extreme stress.44-11 Describe your role in responding to natural disasters and those caused by humans. Medical Emergencies and First Aid4Introduction Emergencies of all types occur when you are working as a medical assistant.You may have to handle a phone call from a patient who has an urgent physical or psychological problem. You must be prepared to determine the urgency and handle any emergency that arises.5Understanding Medical Emergencies You may see life-threatening medical emergencies in the health care setting.First aid can:Save a lifeReduce painPrevent further injuryReduce risk of permanent disability6Preparing for EmergenciesPost emergency telephone numbers near crash cart and near all phones.Crash cart is a rolling cart of emergency supplies and equipment.Provide information to EMSYour name and locationNature of the emergencyCondition of the injured patientSummary of the first aid you have given Do not hang up until the dispatcher gives you permission to do so.7Common Emergency and First Aid Supplies Crash cartBasic drugsSuppliesEquipment Restock the crash cart regularly. Make sure all supplies are up-to-date.8Guidelines for Handling Emergencies Medical emergency requires you to take certain steps.Note the presence of serious condition that threaten the patient’s life, assess the situation and and if appropriate put on PPEDo six steps of initial assessmentGeneral impression Level of responsivenessAssess ABCsDetermine priority of patient’s conditionFocus exam and history9Telephone Emergencies Triaging – classification of injuries according to severity, urgency of treatment and place for treatmentFollow physician's protocolsStay calmReassure the patientAct confidently in an organized manner10Personal Protection Take precautions to reduce chance of exposure during an emergencyKeep personal protective equipment in first-aid kit at home and workGlovesGogglesMask or face shield GownPocket mask or mouth shield11Accidental InjuriesAccidental injuries may require emergency medical careBites and stingsBurnsChokingEar & eye traumasFalls & fracturesHead injuries12Types of BurnsThermal – caused by contract with hot liquids, steam, flames, radiation or excessive heat from firesChemical – exposure to chemical or industrial facilities chemicalsElectrical – exposure to electrical current or lightening 13ChokingForeign objects or food blocks the trachea or windpipePatient cannot speak Patient is holding hand to throat and looks afraidMedical assistants should know first aid for choking adult, child, or infant!14Apply Your Knowledge What is the universal sign of choking?15Apply Your Knowledge -AnswerPatient is holding hand to throatand looks afraid.What is the universal sign of choking?16Ear and Eye Trauma Ear traumaApply bandage with even pressurePreserve the ear by placing in sterile dressing, plastic, labeling and keeping chilledEye traumaForeign objects most commonTiny specks should be removed with a tissue17Falls Do not move unless situation is life-threatening.Stabilize neck if injury suspectedFor minor falls, notify the physician and document.18Fractures, Dislocations, Sprains, and Strains Fracture - breaks in the bone which vary in severityDislocation - displacement of a bone end from the jointSprain - partial tearing of ligamentsStrain - muscle injury that occurs from overexertion19Head Injuries Concussion – jarring injury of the brainPatient may lose consciousness, have temporary loss of vision, pallor, listlessness, memory loss, or vomitingSevere head injuries – contusions, fractures, and intracranial bleeding.May requires immediate hospitalization and/or CPRScalp hematoma and laceration – blood under the skin or break in the skinControl swelling with iceControl bleeding with direct pressure20HemorrhagingHemorrhaging – heavy or uncontrollable bleedingCan be internal or externalUse direct pressure, apply additional dressing as neededElevate body part, put pressure on pressure point21PoisoningSubstance that produces harmful effects if it enters the body.Majority of accidental poisonings happen in children under age 5.Call poison control center22Weather Related Injuries FrostbiteWarm with clothing or other body partDo not massageHeat stroke Recognize symptoms and treat as emergencyPlace ice packs in groin and armpitsSunburnApply cool water or compressesElevate legs and arms to reduce swellingDrink liquids and take pain relieverUse sunscreen23WoundsOpen wounds – skin or mucous membrane is damagedAbrasions – scraping of the skinPunctures – small hole created by a piercing object.Closed wounds – injury inside the body without breaking the skin.24Apply Your Knowledge A patient arrives at the clinic with severe hemorrhaging from the left thigh. What steps should you take to control the bleeding?25Apply Your Knowledge -AnswerApply direct pressure with sterile gauze Add additional dressing as necessaryElevate the legApply pressure to the left femoral artery A patient arrives at the clinic with severe hemorrhaging from the left thigh. What steps should you take to control the bleeding?26Common IllnessesAbdominal painAsthmaDehydrationDiarrheaFaintingFeverHyperventilationNosebleed TachycardiaVomiting27Less Common IllnessesAnaphylaxisBacterial meningitisDiabetic EmergenciesGallbladder attackHeart attackHematemesisObstetric emergenciesRespiratory arrestSeizuresShockStrokeToxic shock syndromeViral encephalitis28Heart Attack Myocardial Infarction (MI) Symptoms:Blocked blood flow to the heartCrushing, burning, heavy aching pain or feeling like indigestionPain may radiate down the left arm, into the jaw, throat, or both shouldersShortness of breath, sweating, nausea, and vomitingPale and have a feeling of doom.29CPRObjective- provide ventilation and blood circulation for a patient who shows none.Correctly performed cardiopulmonary resuscitation (CPR) can save a lifeAn automated external defibrillator (AED) may be used Respiratory arrest – lack of breathing Start CPR and call EMS (911)30ShockShock is life-threatening associated with failure of the cardiovascular system.Symptoms:Restlessness Irritability Increased respirationFear Rapid pulse rate31Shock (cont.)TreatmentElevate the feet 8 to 12 inches if no head injury is suspectedMonitor ABCsControl bleedingCall EMS (911)32StrokeStroke or cerebrovascular accident (CVA)occurs when the blood supply to the brain is impaired.Symptoms:HeadacheConfusionDizzinessLoss of consciousnessParalysis of one side of the bodySlurred or garbled speech33Stroke (cont.)Impairment may cause temporary or permanentdamage, notify the physician at once.Call EMS (911)Maintain patient’s airway by turning the head toward the affected side to allow secretions to drain outLoosen tight clothingMonitor vital signs Administer oxygen34Common Psychosocial Emergencies Alcohol, spousal, child, and elder abuseOverdose on drugsViolent behaviorSuicideRape – follow protocol for chain of custody of specimenUse community resources35The Patient Under StressYou must realize that people react differently to emergency situationsKeep victims and family calmPromote calmness by listening carefully36Educating the Patient Encourage patients and families to learn first aid and CPRProvide first-aid kit check listKnow how to access EMS and list emergency numbers by the phoneChildproof homesProvide appropriate easy-to-read handouts37DisastersYou must be familiar with standard protocols for responding to disasters.You may have to participate in fire or other disaster drills to familiarize yourself with emergency procedures.Triage – each victim gets a tag to classify the person as emergent (needing immediate care), urgent (needing care within several hours) and nonurgent (needing care when time is not critical) or dead.38BioterrorismIntentional release of a biologic agent with the intent to harm individuals.Physician’s offices are the front lines should a biological agent be released.The local public health department should be notified if bioterrorism is suspected as cause of illness.Follow state and national guidelines.39Apply Your KnowledgeA patient arrives at the office with a headache, some confusion, and garbled speech. What should you do and why?40Apply Your Knowledge -AnswerThe patient may be having a stroke, you should call EMS (911), maintain patient’s airway by turning the head toward the affected side to allow secretions to drain out, loosen tight clothing, monitor vital signs and administer oxygenA patient arrives at the office with a headache, some confusion, and garbled speech. What should you do and why?41Summary Medical Assistant You can make a positive difference in the health and lives of people who face medical emergencies to which you respond. You will need to stay calm and communicate clearly during emergencies42End of ChapterEnd of Chapter43