Lesson 30: Sudden Illness I. 292 AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH...

Lesson 30: Sudden Illness I

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITIONCopyright © 2006 by The American National Red Cross

All rights reserved.2

Introduction

Some illnesses develop over time, whereas others can strike without a moment’s notice.

By knowing the signals of sudden illness and paying careful attention to details at the emergency scene, you can determine how best to help a victim of sudden illness.

You do not need to know the exact cause of the illness to give appropriate care.

Always follow the emergency action steps: CHECK—CALL—CARE.



Responding to a Medical Emergency

Sudden illnesses often show the following signals:

Change in a person’s level of consciousness

Feeling lightheaded, dizzy or weak

Nausea or vomiting

Changes in breathing, circulation, skin temperature, color or moisture



Specific Sudden Illness

Sudden illnesses become evident in a variety of ways. Common sudden illnesses include—

Fainting. Diabetic emergencies. Seizures. Stroke. Poisoning. Heart attack. Shock.



Specific Sudden Illness (continued)

Sudden illness can be—

Acute.

Chronic.

General guidelines of care for sudden illnesses include—

Do no further harm.

Monitor breathing and consciousness.

Help the victim rest in the most comfortable position.

Keep the victim from getting chilled or overheated.

Reassure the victim.

Give any specific care needed.



Fainting

Fainting is a common sudden illness characterized by a partial or complete loss of consciousness.

Fainting is caused by a temporary reduction of blood flow to the brain.

The victim will commonly display shock-like signals, such as—

Cool, pale or moist skin.

Nausea.

Numbness or tingling in the fingers and toes.



Fainting(continued)

Additional signals that precede fainting include—

Sweating.

Vomiting.

Distortion or dimming of vision.

Head or abdominal pain.



Care for Fainting

Position the victim on his or her back on a flat surface. Elevate the legs about 12 inches.

Loosen any restrictive clothing.

Check for any other life-threatening and non-life-threatening conditions.

Do not give the victim anything to eat or drink.

Do not splash the victim with water or slap his or her face.

As long as the fainting victim recovers quickly and has no lasting signals, you may or may not need to call 9-1-1 or the local emergency number.



Diabetic Emergencies

The condition in which the body does not produce enough insulin or does not use insulin effectively is called diabetes mellitus.

In the digestive process, the body breaks down food into simple sugars such as glucose.

Insulin is a hormone that helps sugar (glucose) pass from the bloodstream into the cells.

Without a proper balance of sugar and insulin, cells will starve and the body will not function properly.



There are two major types of diabetes: Type I and Type II.

In Type I diabetes the body produces little or no insulin.

Most people who have Type I diabetes have to inject insulin into their bodies daily.

In Type II diabetes the body produces insulin, but either the cells do not use the insulin effectively or not enough insulin is produced.

Diabetic Emergencies(continued)




A situation in which a victim becomes ill because of an imbalance of insulin and sugar in the bloodstream is called a diabetic emergency.

There are two types of diabetic emergencies:

Hyperglycemia: a condition where the insulin level in the body is too low

Hypoglycemia: a condition where the insulin level in the body is too high.




Hyperglycemia and hypoglycemia are different conditions, but their primary signals are similar. These include—

Changes in the level of consciousness, including dizziness, drowsiness and confusion.

Irregular breathing.

Abnormal pulse (rapid or weak).

Feeling or looking ill.



Care for a Diabetic Emergency

Check and care for any life-threatening conditions.

If the victim is conscious, check for non-life-threatening conditions.

Look for a medical alert tag or ask the victim if he or she has diabetes.



Care for a Diabetic Emergency(continued)

If the victim is conscious and able to swallow, give him or her sugar in the form of fruit juice, candy or a non-diet soft drink.

If the victim is unconscious—

Call 9-1-1 or the local emergency number immediately.

Do not give the victim anything by mouth.

Monitor signs of life.

Keep him or her from getting overheated or chilled.



Seizures

Seizures may be caused by an acute or chronic condition.

The chronic form of seizure is known as epilepsy.

Before a seizure occurs, the victim may experience an aura.

Seizures can range from mild blackouts to sudden, uncontrolled muscular contractions that can last several minutes.



Seizures(continued)

Febrile seizures are most common in children under the age of 5 and can be triggered by infections of the ear, throat or digestive system or when an infant or child runs a fever of over 102°F (38.9°C).



Seizures(continued)

A febrile seizure may have some or all of the following signals:

A sudden rise in body temperature

A change in the level of consciousness

Rhythmic jerking of the head and limbs

Urinating or defecating

Confusion

Drowsiness

Crying out

Becoming rigid

Holding the breath

Upward rolling of the eyes



Care for a Seizure

Do not try to hold or restrain the victim.

Protect the victim from injury and maintain an open airway.

Remove nearby objects that could cause injury.

After the seizure, position him or her on one side so that fluid can drain from the mouth.

Check for life-threatening conditions.

Stay with the victim until he or she is fully conscious and aware of his or her surroundings.

Call 9-1-1 or the local emergency number, if necessary.



Stroke

A stroke, also called a cerebrovascular accident (CVA) or brain attack, is a disruption of blood flow to a part of the brain, causing permanent damage to brain tissue.



Stroke(continued) Stroke is commonly caused by a blood clot, called a thrombus or

embolus, an aneurysm or atherosclerosis.

A transient ischemic attack (TIA) is a temporary episode that is similar to a stroke and is sometimes called a “mini-stroke.” Like a stroke, TIA results from reduced blood flow to the brain.

Ways to reduce the risk of a stroke or TIA include the following:

Controlling blood pressure

Not smoking

Eating a healthy diet

Exercising regularly

Controlling diabetes



Stroke(continued)

For a stroke, think F.A.S.T. —

Face — Weakness on one side of the face. (Ask the person to smile and note any weakness or drooping of the mouth.)

Arm — Weakness or numbness in one arm. (Ask the person to raise both arms and note any non-symmetry of the arms.)

Speech — Slurred speech or trouble speaking. (Ask the person to repeat a simple sentence such as, “I have the lunch orders ready” and note any slurring or difficulty speaking.)

Time — Time to call 9-1-1 if you see any of these signals. (Note the time that the signals began.)



Stroke(continued)

A victim of stroke may exhibit or experience some or all of the following signals:

Appearing or feeling ill, or displaying abnormal behavior

Sudden weakness or numbness of the face, arm or leg, often on only one side of the body

Difficulty speaking or being understood

Blurred or dimmed vision

Pupils of unequal size



Stroke(continued)

Sudden severe headache

Dizziness

Confusion

Change in mood

Ringing in the ears

Loss of consciousness

Loss of bowel or bladder control



Care for a Stroke

Care for life-threatening conditions.


Position him or her on one side (affected or paralyzed side down) to allow fluids to drain.

Stay with the victim and check his or her breathing and signs of life until EMS personnel arrive and take over.

If the victim is conscious—

Check for non-life-threatening conditions.

Offer comfort and reassurance.

Have the victim rest in a comfortable position.



Closing

Sudden illness can strike anyone, at any time. Even if you do not know the cause of the illness, you can still give proper care.

Knowing the signals of sudden illness, such as changes in consciousness, profuse sweating, confusion and weakness, will help you determine the necessary care to give the victim until EMS personnel arrive.

Questions?

Lesson 31: Sudden Illness II/ Poisoning



Introduction

A poison is any substance that can cause injury, illness or death when introduced into the body.

Poisoning is considered a sudden illness.

Between 1 and 2 million poisonings occur each year in the United States.

More than 90 percent of all poisonings take place in the home.



Poisoning

How poisons enter the body:

Inhalation

Ingestion

Absorption

Injection



Checking the Scene

Often, the scene itself is the best clue that a poisoning may have occurred. Factors to notice include—

Unusual odors.

Flames or smoke.

An open medicine cabinet.

Open or spilled containers.

Overturned or damaged plants.

Drug paraphernalia or empty containers.



Signals of Poisoning

The signals of poisoning include—

Nausea or vomiting.

Diarrhea.

Chest or abdominal pain.

Trouble breathing.

Sweating.

Changes in consciousness.

Seizures.

Headache.



Signals of Poisoning(continued)

Dizziness.

Weakness.

Irregular pupil size.

Burning or tearing eyes.

Abnormal skin color.

Burn injuries around the lips or tongue.



Care for Poisoning

The severity of a poisoning depends on—

The type and amount of poison.

How and where the poison entered the body.

The time elapsed since the poisoning.

The victim’s size, weight, medical condition and age.



Care for Poisoning(continued)

General guidelines of care for any poisoning emergency:

Check the scene.

Check for life-threatening conditions. Call 9-1-1 or the local emergency number if the victim is unconscious or is having trouble breathing.

If the victim is conscious, ask questions.

What type of poison did the victim ingest, inhale, inject or come into contact with?

How much poison did the victim ingest, inhale, inject or come into contact with?

When did the poisoning take place (approximate time)?



Care for Poisoning(continued)

Call the National Poison Control Center at (800) 222-1222, 9-1-1 or the local emergency number.

Give care as directed by Poison Control Center personnel or the EMS call taker.



Inhaled Poisons

Poisoning by inhalation occurs when a person breathes in toxic fumes.

The danger associated with inhaled poisons makes checking the safety of the scene important.

Notice clues at the scene:

Unusual odors

Strong smell of fuel

Hissing sound

Call 9-1-1 or the local emergency number from a different location.



Inhaled Poisons(continued)

A commonly inhaled poison is carbon monoxide. It is a colorless, odorless gas.

Carbon monoxide exposure can cause death.

Pale or bluish skin color indicates lack of oxygen, which may indicate exposure.



Care for Inhaled Poisons

All victims of inhaled poison need oxygen as soon as possible.

Help a conscious victim by getting him or her to fresh air.

Call 9-1-1 or the local emergency number.

If you find an unconscious victim—

Remove him or her from the scene if it is safe to do so.


Give care for any other life-threatening conditions.

Call 9-1-1 or the local emergency number if you suspect that toxic fumes are present.



Ingested Poisons

The U.S. Centers for Disease Control and Prevention (CDC) estimates that 76 million people suffer food-borne illnesses each year in the United States.

Two of the most common categories of food poisoning are bacterial food poisoning and chemical food poisoning.

Salmonella is the most common type of food poisoning.

Botulism is the most deadly type of food poisoning.



Ingested Poisons(continued)

Signals of food poisoning include:

Nausea.

Vomiting.

Abdominal pain.

Diarrhea.

Fever.

Dehydration .



Care for Ingested Poisons

In some cases of ingested poisoning, the National Poison Control Center may instruct you to induce vomiting.

Only induce vomiting if instructed to do so by a medical professional.

Vomiting should not be induced if the victim—

Is unconscious.

Is having a seizure.

Is pregnant (in the last trimester).

Has ingested a corrosive substance (such as drain cleaner or oven cleaner) or a petroleum product (such as kerosene or gasoline).

Is known to have heart disease.



Absorbed Poisons

An absorbed poison enters the body after it comes in contact with the skin.

Absorbed poisons come from plants such as poison ivy, poison oak and poison sumac, as well as from fertilizers and pesticides used in lawn and plant care.



Care for Absorbed Poisons

To care for a victim who has come into contact with a poisonous plant:

Immediately rinse the affected area.

If a rash or weeping lesion (oozing sore) develops, seek advice from a pharmacist or physician.

If a victim’s condition worsens, seek a physician.

To care for a victim who has come into contact with wet or dry chemicals—

Flush the area continuously with water.


If running water is not available, carefully brush off any dry chemicals with a gloved hand.



Injected Poisons

Injected poisons enter the body through the bites or stings of certain insects, spiders and scorpions, ticks, marine life, animals and snakes or as drugs or misused medications injected with a hypodermic needle.

Insect and animal bites and stings are the most common sources of injected poisons.

Care for injected poisons will be discussed later.



Anaphylaxis

Severe allergic reactions to poisons are rare. But when one occurs, it is a life-threatening medical emergency. This reaction is called anaphylaxis.

Anaphylaxis is a form of shock.

Onset of anaphylaxis can be rapid and the signals include—

Swelling and redness.

Hives.

Rash.

Itching.

Burning skin and eyes.

Weakness.



Anaphylaxis(continued)

Nausea.

Vomiting.

Restlessness.

Dizziness.

Dilated pupils.

Slurred speech.

Chest discomfort or pain.

Weak or rapid pulse.

Rapid or trouble breathing.

Coughing or wheezing.



Care for Anaphylaxis


Place the victim in a position of comfort for breathing.

Comfort and reassure the victim.

People who know they are extremely allergic to certain substances may carry an anaphylaxis kit.

The kit contains a dose of epinephrine that can be injected into the body to counteract the anaphylactic reaction.

In some cases, you may need to assist the victim in using his or her kit.



Preventing Poisoning

By following these guidelines you will be able to prevent most poisoning emergencies:

Keep the household products and medications out of the reach of children.

Use childproof safety caps on containers of medications and other potentially dangerous substances.

Use special latches and clamps to keep children from opening cabinets.

Keep products in their original containers.

Use poison symbols to identify dangerous substances.



Preventing Poisoning(continued)

Dispose of outdated medications and household products.

Use chemicals only in well-ventilated areas.

Wear proper clothing.

Immediately wash those areas of the body that may have come in contact with a poison.



Closing Poisoning can occur in any one of four ways: inhalation,

ingestion, absorption and injection.

The severity of a poisoning depends on factors such as—

The type and amount of poison.

How and where the poison entered the body.



For suspected poisoning call the National Poison Control Center, 9-1-1 or the local emergency number.

Follow the directions of Poison Control Center personnel or the EMS call taker.

Questions?

Lesson 32: Sudden Illness III/ Bites and Stings



Introduction

Bites and stings are among the most common forms of injected poisonings.

Some of the most common types of bites and stings are from—

Insects.

Ticks.

Spiders and scorpions.

Marine life.

Snakes.

Domestic and wild animals.

Humans.



Signals of Common Bites and Stings

Specific signals of common bites and stings depend on—

The type and location of the bite or sting.

The amount of poison injected.





Signals of Common Bites and Stings(continued)

Less severe reactions to bites and stings may trigger signals including:

A bite or sting mark.

A stinger, tentacle or venom sac.

Redness.

Swelling.

Pain or tenderness.

Severe allergic reactions to bites and stings may bring on a life-threatening condition, a form of shock known as anaphylaxis.



Insects

Between 0.5 to 5 percent of Americans are severely allergic to substances in the venom of bees, wasps, hornets and yellow jackets.

When a highly allergic person is stung, call 9-1-1 or the local emergency number immediately for medical care.

For most people, insect stings may be painful or uncomfortable but are not life threatening.



Care for Insect Stings

To give care for an insect sting—

Examine the sting site.

If the stinger is still present, remove it to prevent any further poisoning.

Wash the area with soap and water and cover the site, then apply ice or a cold pack.

Observe the victim for signals of allergic reaction.



Ticks

Ticks can contract, carry and transmit disease to humans.

Rocky Mountain spotted fever is caused by the transmission of microscopic bacteria from the wood tick or dog tick host to other warm-blooded animals.

The main signal of Rocky Mountain spotted fever is a spotted rash.

Other signals of Rocky Mountain spotted fever include—

Fever.

Chills.

Severe headache.

Joint and muscle aches.



Ticks(continued)

Lyme disease, or Lyme borreliosis, is another illness that people can get from the bite of an infected tick.

The first signal of Lyme disease is a rash.

Other signals of Lyme disease include—

Fever and chills.

Headache.

Weakness or fatigue.

Flu-like joint and muscle aches.



Ticks(continued)

In advanced stages, Lyme disease may cause—

Arthritis.

Numbness.

Memory loss.

Vision or hearing problems.

High fever.

Stiffness in the neck.



Protection from Tick Bites

To protect yourself from tick bites—

Wear repellent and proper clothing.

Check and clean your clothes thoroughly after having been in wooded areas.

Use precautions when removing a tick.



Care for Tick Bites

Remove the embedded tick.

Do not try to burn the tick off.

Do not apply petroleum jelly or nail polish to the tick.

Place the tick in a sealable container for analysis.

If you cannot remove the tick or parts remain, get medical care.

Wash the bite area with soap and water.

Apply antiseptic or antibiotic ointment.

Wash your hands.



Spider Bites

Few spiders in the United States have venom that can cause death.

Two spiders that can cause illness and occasionally death are the—

Black widow spider.

Brown recluse spider.

Bites usually occur on the hands or arms.



Spider Bites(continued)

A black widow spider bite usually causes a sharp pinprick pain followed by a dull pain in the area of the bite.

Other signals of this spider bite include—

Muscular rigidity.

Restlessness.

Anxiety.

Profuse sweating.

Weakness.

Drooping eyelids.



Scorpion Stings

Scorpions live in dry regions of the southwestern United States and Mexico and are most active at night, which is when most stings occur.

Since it is hard to distinguish poisonous scorpions from the non-poisonous scorpions, all scorpion stings should be treated as medical emergencies.



Signals of Spider Bites and Scorpion Stings

Signals of spider bites and scorpion stings may include—

A mark indicating a possible bite or sting.

Severe pain in the area of the bite or sting.

A blister, lesion or swelling at the entry or bite site.

Nausea and vomiting.

Trouble breathing or swallowing.

Sweating or salivating profusely.

Irregular heart rhythm.

Muscle cramping or abdominal pain.



Care for Spider Bites and Scorpion Stings

If a person is bitten by a spider (i.e., brown recluse or black widow) or stung by a scorpion—


Wash the wound.

Apply ice or a cold pack.



Snakes

Medical personnel are not in general agreement about care for snakebites.

Most deaths from snakebites occur because—

The victim has an allergic reaction.

The victim is in poor health.

Too much time passes before the victim receives medical care.

Signals that indicate a poisonous snakebite include—

One or two distinct puncture wounds.

Severe pain and burning at the wound site.

Swelling and discoloration at the wound site.



Care for Snakebites Follow these guidelines to care for someone bitten by a snake:


Wash the wound.

Immobilize the affected part.

Keep the affected area lower than the heart, if possible.

Minimize the victim’s movement.

If the bite is from an elapid snake such as a coral snake:

• Apply an elastic roller bandage.

• Use overlapping turns, gently stretching the bandage as you wrap.

• Begin at the point furthest from the heart.

• Check for circulation of the limb beyond the point where bandaging begins. (Note changes in skin color and temperature.)



Care for Snakebites(continued)

Regardless of what you may have otherwise heard or read—

Do not apply ice.

Do not cut the wound.

Do not apply suction.

Do not apply a tourniquet.

Do not use electric shock.



Marine Life

Some marine life, such as jellyfish, can inflict painful injuries that can make you sick.

The side effects of marine life stings include allergic reactions that can cause—

Trouble breathing.

Heart problems.

Paralysis.



Care for Marine Life Stings

Remove the victim from the water.

Call 9-1-1 or the local emergency number if the victim—

Does not know what stung him or her.

Has a history of allergic reactions to marine life stings.

Is stung on the face or neck.

Develops trouble breathing.



Care for Marine Life Stings

For jellyfish, sea anemone or Portuguese man-of-war stings—

Soak the injured part in vinegar.

Do not apply fresh water or ammonia.

Do not rub the area.

For stingray, sea urchin or spiny fish stings—

Flush the wound with tap water or ocean water.

Immobilize the injured part.

Soak the body part in hot water.

Clean the wound.

Bandage the wound.



Domestic and Wild Animals

The bite of a domestic or wild animal, like a human bite, carries the risk of infection as well as soft tissue injury.

One of the most serious diseases that can result from a wild or domestic animal bite is rabies.

Rabies is fatal if not treated. Professional medical attention is needed as soon as possible.

Tetanus is a potentially fatal infection that affects the central nervous system.

It is caused by the transmission of bacteria that produce a toxin when someone is bitten by an animal or human.



Domestic and Wild Animals(continued)

Signals of tetanus include—

Irritability.

Headache.

Fever.

Painful muscular spasms.

One of the most common signals of tetanus is muscular stiffness in the jaw, which is why tetanus is sometimes known as “lockjaw.”



Care for Domestic and Wild Animal Bites

If someone is bitten by an animal, try to get the person safely away from the animal.

For a minor wound—

Wash the wound with soap and water.

Control bleeding.

Apply a dressing.

Seek medical care.



Care for Domestic and Wild Animal Bites(continued)

If the wound is bleeding heavily—

Control the bleeding.

Seek medical care immediately.

Contact animal control authorities.



Human Bites

Human bites differ from other bites because they may be more contaminated, tend to occur in higher-risk areas of the body and often receive delayed care.

Human saliva has been found to contain at least 42 different kinds of species of bacteria.

According to the CDC, human bites are not considered to carry a risk of transmitting hepatitis B or HIV.



Care for Human Bites

If the wound is not severe:

Wash the wound thoroughly with soap and water.


Apply a dressing.

Take the victim to a physician or medical facility.

If the bite is severe:





Preventing Bites and Stings

Preventing bites and stings from insects, spiders, ticks, snakes, scorpions and marine life is the best protection against the transmission of injected poisons.



Preventing Bites and Stings (continued)

Follow these general guidelines to prevent bites and stings:

Apply repellent.

Wear sturdy boots.

Wear long-sleeved shirts and long pants.

Tuck pant legs into socks or boots and tuck shirt into pants.

Wear light-colored clothing.

Use a rubber band or tape where pants and socks meet to prevent ticks or insects from getting under clothing.

Inspect yourself carefully after being outdoors.



Shower immediately after coming indoors.

Keep an eye out for and avoid nests.

Spray pets that go outdoors with repellent.

Stay in the middle of trails when hiking.

Avoid walking in areas known to be populated with snakes.

Make noise as you walk.

If you encounter a snake, walk away on the same path you were on.

(continued)

Preventing Bites and Stings



Preventing Bites and Stings(continued)

To prevent stings from marine animals, you might consider wearing a wetsuit or drysuit or protective footwear in the water.

To prevent dog bites—

Do not run past a dog.

Avoid eye contact, try to remain motionless.

Do not approach a strange dog.

Always let a dog see and sniff you before you pet the animal.



Closing

Learning how to recognize, care for and prevent some of the most common types of bites and stings can help you give care to a victim.

For suspected injected poisonings, call the National Poison Control Center, 9-1-1 or the local emergency number.

The best way to avoid any kind of poisoning is to take steps to prevent it.

You will learn how the misuse and abuse of substances, such as drugs and medications, can poison the body in the next lesson.

Questions?

Lesson 33: Sudden Illness IV/ Substance Misuse and Abuse



Introduction

Substance abuse and misuse cost the United States billions of dollars annually in medical care, insurance and lost productivity.

Even more important, however, are the lives lost or permanently impaired each year from injuries or medical emergencies related to substance abuse or misuse.



Introduction(continued)

Legal substances are among those most often misused or abused.

Such legal substances include—

Nicotine (found in tobacco products).

Alcohol (found in beer, wine and liquor).

Over-the-counter medications, such as aspirin, sleeping pills and diet pills.



According to the National Vital Statistics Reports, over 40,000 Americans died as a result of drug- or alcohol-induced deaths in 2001.




Define and discuss the following terms:

Substance misuse

Substance abuse

Drug

Medication

Dependency

Addiction

Tolerance

Activity



Define and discuss the following terms:

Overdose

Withdrawal

Synergistic effect

Activity(continued)



Misused and Abused Substances

Substances are categorized according to their effects on the body.

The six major categories of commonly misused and abused substances are—

Stimulants.

Depressants.

Hallucinogens.

Narcotics.

Inhalants.

Cannabis products.



Stimulants

Stimulants are drugs that affect the central nervous system by increasing physical and mental activity.

The effects of stimulants include—

Temporary feelings of alertness and prevention of fatigue.

Appetite suppression.



Stimulants(continued)

Amphetamines, dextroamphetamines and methamphetamines are stimulants.

Cocaine is one of the most publicized and powerful stimulants.

A purer form of cocaine is known as crack.

The most common stimulants in the United States are legal:

Caffeine

Nicotine

Other stimulants are used for medical purposes.



Hallucinogens

Hallucinogens, also known as psychedelics, are substances that affect mood, sensation, thought, emotion and self-awareness.

Hallucinogens sometimes cause what is called a bad trip.

A bad trip can involve intense fear, panic, paranoid delusions, vivid hallucinations, profound depression, tension and anxiety.

The victim may be irrational and feel threatened by any attempt others make to help.



Hallucinogens(continued)

Among the most widely abused hallucinogens are—

Lysergic acid diethylamide (LSD), also known as acid.

Psilocybin (mushrooms).

Phencyclidine (PCP), called angel dust.

Mescaline (peyote, buttons or mesc).



Depressants

Depressants are substances that affect the central nervous system by decreasing physical and mental activity.

Depressants are commonly used for medical purposes.

Common depressants include—

Barbiturates.

Benzodiazepines.

Narcotics.

Alcohol.



Narcotics

Narcotics, derived from opium, are drugs that work on the central nervous system to relieve pain.

The most common natural narcotics are morphine and codeine.

Most other narcotics, including heroin, are synthetic or semisynthetic.



Inhalants

Inhalants are substances inhaled to produce a mood-altering effect.

Inhalants also depress the central nervous system.

Inhalants include medical anesthetics, such as amyl nitrite and nitrous oxide (also known as laughing gas), as well as hydrocarbons, known as solvents.



Cannabis Products

Cannabis products, including marijuana, tetrahydrocannabinol (THC), and hashish, are all derived from the plant Cannabis sativa.

Marijuana is the most widely used illicit drug in the United States.

Marijuana, although illicit, has been used for some medicinal purposes to treat—

Nausea from chemotherapy.

Glaucoma.

Muscular weakness caused by multiple sclerosis.

Weight loss from cancer and AIDS.



Cannabis Products(continued)

The effects of marijuana include—

Feelings of elation.

Distorted perceptions of time and space.

Throat irritation.

Red eyes.

Rapid pulse.

Dizziness.

Increased appetite.



Designer Drugs

These drugs are variations of other substances, such as narcotics and amphetamines.

The molecular structures of designer drugs include substances used for medical purposes that are modified by chemists.



Designer Drugs(continued)

One of the more common designer drugs is methylenedioxy- methamphetamine (MDMA), also known as “ecstasy.”

Ecstasy is popular because it evokes a euphoric high.



Designer Drugs(continued)

Other signals of ecstasy use include—

Increased blood pressure.

Rapid heartbeat.

Profuse sweating.

Paranoia.

Sensory distortion.

Erratic mood swings.



Anabolic Steroids

Anabolic steroids are sometimes used by athletes to enhance performance and increase muscle mass.

Their medical uses include stimulating weight gain.

Chronic use of anabolic steroids can lead to sterility, liver cancer and personality changes.

Steroid abuse by young people may also disrupt normal growth.



Over-the-Counter Substances

The most commonly misused and abused over-the-counter substances are aspirin, laxatives and nasal sprays.



Over-the-Counter Substances(continued)

Aspirin is used to relieve minor pain, reduce fever and treat heart disease.

Aspirin misuse can—

Cause inflammation of the stomach and small intestine.

Impair normal blood clotting.




Laxatives are used to relieve constipation.

Laxative misuse can cause uncontrolled diarrhea that may result in dehydration.

Laxative abuse is associated with attempted weight loss and eating disorders, such as anorexia nervosa and bulimia.




Antihistamines, such as decongestant nasal sprays, can help relieve the congestion of colds or hay fever.

If misused, they can cause physical dependency.



Signals of Substance Misuse and Abuse

Signals of substance misuse and abuse are similar to those of other medical emergencies.

Signals of abuse or misuse include—

Moist or flushed skin.

Sweating, chills, nausea, vomiting.

Fever.

Headache.

Dizziness.

Rapid pulse, rapid breathing.

High blood pressure.

Chest pain.



Signals of Substance Misuse and Abuse(continued)

Respiratory distress, disruption of normal heart rhythm and even death can result from using a stimulant.

A victim of stimulant overdose may appear to be—

Very excited.

Restless.

Talkative.

Irritable.

Unconscious.




Specific signals of hallucinogen abuse may include—

Sudden mood changes.

Flushed face.

Seeing or hearing something that is not present.

Anxiousness or being frightened.

Specific signals of depressant abuse include—

Drowsiness.

Confusion.




Slurred speech.

Slow heart and breathing rates.

Poor coordination.



Care for Substance Misuse and Abuse

Follow these general principles as you would for any poisoning:

Check the scene to make sure it is safe to help the person.

Do not approach if the victim is behaving in a threatening manner.

Call 9–1–1, the local emergency number or the National Poison Control Center.

Care for any life-threatening conditions.

Care for any other conditions you find.

Withdraw from the area if the victim becomes violent or threatening.



Care for Substance Misuse and Abuse(continued)

Look for clues.

Look for product or medicine containers, drug paraphernalia and signals of other medical conditions.

If you suspect that someone has taken a designer drug, tell EMS personnel.

After a substance abuse emergency, the victim may need additional support to overcome addiction.



Preventing Substance Misuse and Abuse

Approaches vary, including educating people about substances and their effects on health and attempting to instill fear of penalties, which have not by themselves proved to be particularly effective.

To be effective, prevention efforts must address the various underlying factors of and approaches to substance abuse.



Preventing Substance Misuse and Abuse(continued)

The following factors may contribute to substance abuse:

A lack of parental supervision

The breakdown of traditional family structures

A wish to escape unpleasant surroundings and stressful situations

The widespread availability of substances

Peer pressure and the basic need to belong

Low self-esteem, including feelings of guilt and shame

Media glamorization

History of substance abuse




Some poisonings from medicines occur when victims knowingly increase the dosage beyond what is directed.

The best way to prevent such misuse is to take medications only as prescribed.

On the other hand, many poisonings from medicines are not intentional.




The following guidelines may help prevent unintentional misuse or overdose:

Read the product information and use only as directed.

Ask your physician or pharmacist about the intended use and side effects of prescriptions and over-the-counter medications. If you are taking more than one medication, check for possible interaction effects.

Never use another person’s prescribed medications.

Always keep medications in their appropriate, marked containers.

Destroy all out-of-date medications.

Always keep medications out of the reach of children.



Closing

There are six major categories of substances that, when abused or misused, can produce a variety of signals.

You do not have to diagnose the condition to give care.

If you suspect that the victim’s condition is caused by substance misuse or abuse—

Give care for a poisoning emergency.

Call 9-1-1, the local emergency number or National Poison Control Center personnel and follow their directions.

Call the police, if necessary.

Questions?

Lesson 34: Heat- and Cold-Related Emergencies



Introduction

When the body is overwhelmed in its attempt to regulate body temperature, a heat- or cold-related emergency can occur.

A heat- or cold-related emergency can happen anywhere (indoors or outdoors) and under a variety of conditions.

The signals of a heat-or cold-related emergency are progressive and can quickly become life threatening.

A person can develop a heat- or cold-related emergency, even when temperatures are not extreme.




The following effects determine an individual’s susceptibility:

Humidity

Wind

Clothing

Living and working environments

Physical activity

Age

Health



How Body Temperature Is Controlled

When the body gets too hot… When the body gets too cold…



How Body Temperature Is Controlled(continued)

The body maintains its temperature by constantly balancing heat loss with heat production.

The body generates heat primarily through converting food to energy and through muscle contractions, such as during exercise or when shivering.




When the body gets too hot, blood vessels near the skin dilate, or widen, to bring more blood to the surface, which allows heat to escape.

The body can also be cooled by the evaporation of sweat or by air moving over the skin.




When the body is cold, the opposite occurs.

Blood vessels near the skin constrict (narrow) and move warm blood to the center of the body. Thus, less heat escapes through the skin and the body stays warm.

When constriction of blood vessels fails to keep the body warm, the body shivers to produce heat through muscle action.



Factors Affecting Body Temperature Regulation

The three main factors affecting how well the body maintains normal body temperature are—

Air temperature.

Humidity.

Wind.

Other factors affect how well your body manages temperature extremes. These factors include—

Clothing.

Breaks from exposure to extreme temperature.

Water intake.

Intensity of activity.



Factors Affecting Body Temperature Regulation(continued)

People more susceptible to a heat- or cold-related emergency include—

Those involved in strenuous activity in a warm or cold environment.

Elderly people.

Young children.

Those who have predisposing health problems.

Those who have had a previous heat- or cold-related emergency in the past.

Those who have cardiovascular disease.

Those who take medications to eliminate water from the body (diuretics).



Heat-Related Emergencies

Conditions associated with overexposure to heat are—

Heat cramps.

Heat exhaustion.

Heat stroke.



Heat Cramps

Heat cramps are painful spasms of skeletal muscles.

Heat cramps usually affect the legs and the abdomen.

To recover from heat cramps—

Rest.

Lightly stretch the affected muscles.

Replenish fluids.



Heat Exhaustion

Heat exhaustion is the earliest stage and the most common form of heat-related illness.

Heat exhaustion is an early indicator that the body’s temperature-regulating mechanism is becoming overtaxed.



Heat Exhaustion(continued)

The signals of heat exhaustion include—

Cool, moist, pale, ashen or flushed skin.

Headache, nausea, dizziness.

Weakness, exhaustion.

Heavy sweating.

Heat exhaustion in its early stage can usually be reversed with prompt care.



Heat Stroke

Heat stroke is the least common and most severe heat-related illness.

Heat stroke most often occurs when people ignore the signals of heat exhaustion.

Heat stroke develops when the body systems are so overtaxed by heat and begin to stop functioning.

Sweating often stops because body fluid levels are low.



Heat Stroke(continued)

Heat stroke is a serious medical emergency.

The signals of heat stroke include—

Red, hot, dry skin.

Changes in level of consciousness.

Vomiting.



Care for Heat-Related Illness

If you recognize heat-related illness in its early stages, you can usually reverse it. Follow these general steps:

Cool the body.

Give fluids if the victim is conscious.

Take steps to minimize shock.



Care for Heat-Related Illness(continued)

Care for someone in the late stages of heat-related illness involves—

Calling 9-1-1 or the local emergency number immediately.

Cooling the body.

Monitoring breathing and consciousness.

Being prepared to give rescue breathing or CPR, if needed.



Cold-Related Emergencies

Frostbite and hypothermia are two types of cold-related emergencies.

Frostbite occurs in body parts exposed to cold.

Hypothermia develops when the body can no longer generate sufficient heat to maintain normal body temperature.



Frostbite

Frostbite is the freezing of body tissues.

Frostbite usually occurs in exposed areas of the body, depending on—

Air temperature.

Length of exposure.

Wind speed.

Frostbite can be either superficial or deep.

Superficial frostbite—the skin is frozen but the tissues below are not.

Deep frostbite—both the skin and the underlying tissues are frozen.



Frostbite(continued)

Signals of frostbite include—

Lack of feeling in the affected area.

Skin that appears waxy.

Skin that is cold to the touch.

Skin that is discolored (flushed, white, yellow or blue).



Care for Frostbite

When caring for a victim of frostbite—


Attempt to remove jewelry or restrictive clothing.

Handle the affected area gently; never rub the affected area.

If there is no chance that the frostbitten part will refreeze, you may begin rewarming the affected area.

Loosely bandage the area with a dry, sterile dressing.

If fingers or toes are frostbitten, place dry, sterile gauze between them to keep them separated.

Avoid breaking blisters.



Hypothermia

Hypothermia is the general cooling of the entire body. Body temperature drops below 95°F (35°C).

Signals of hypothermia include—

Shivering (may be absent in the later stages of hypothermia).

Numbness.

Glassy stare.

Apathy.

Weakness.

Impaired judgment.



Hypothermia(continued)

In the case of severe hypothermia—

The victim may be unconscious.

Breathing may have slowed or stopped.

The body may feel stiff as the muscles become rigid.



Care for Hypothermia

To care for hypothermia—

Check and care for life-threatening conditions.


Carefully remove wet clothing and dry the victim.

Warm the body.

Move the victim to a warm environment.

If available, apply hot water bottles, chemical heat packs or other heat sources to the body.



Care for Hypothermia(continued)

If the victim is alert, give him or her warm nonalcoholic and decaffeinated liquids to drink.

Rewarm the victim gradually and handle him or her gently.

Monitor breathing and signs of life and continue to warm the victim until EMS personnel arrive.

Be prepared to give CPR if necessary.



Preventing Heat- and Cold-Related Emergencies

Emergencies resulting from overexposure to extreme temperatures are usually preventable.

You can prevent overexposure to extreme temperatures by following these guidelines:

Avoid being outdoors

Dress appropriately

Change your activity level

Take frequent breaks

Drink large amounts of nonalcoholic or decaffeinated fluids



Scenario

Twenty-year-old Todd Wilson is doing construction work for his uncle this summer. Todd is putting fiberglass insulation in an attic. He is wearing long pants, a long-sleeved shirt, goggles, a face mask and a hat to protect him from contact with fiberglass.



Scenario(continued)

Outdoor temperatures have been running about 95º F and this day is exceptionally humid as well. Todd had hoped to have finished this job the evening before but has to return to the job around noon the next day. He expects that it will take about 5½ hours to complete the work. Because Todd is in a hurry, he is working quickly to finish the job. He figures he can save some time if he does not take any breaks. About 2 hours later, drenched with sweat, Todd starts to feel dizzy, weak and nauseated. He barely has the energy to get down from the attic.



Closing

Overexposure to extreme heat and cold may cause a person to become ill.

The likelihood of illness also depends on factors such as— Physical activity. Clothing. Wind. Humidity. Working and living conditions. A person’s age and physical condition.

Follow the general steps of care for heat- and cold-related emergencies.

Questions?

Lesson 35: Putting It All Together II/ Injuries and Sudden Illness



You Are the Responder

Activity:

The plan of action

Did the group’s plan follow the emergency action steps: CHECK—CALL—CARE?

Did the plan involve bystanders appropriately?

Did the plan demonstrate proper care?



Scenario 1Conscious Person with Serious Head, Neck or Back Injury

At work, you are called to give care for a co-worker who has fallen from an 8-foot ladder. As you arrive, you see the victim lying on the ground. She is crying and moaning in pain. A bystander says that she landed on her back. The victim has not moved from this position. She says that she has tingling and numbness in her legs and feet and pain in her back. She also has a 2-inch laceration on the side of her head.

You want to help. How do you proceed?



Scenario 2Conscious Victim with Extremity Injury

You are coaching a little league baseball team. The pitcher is struck with a line drive to the ankle and falls to the ground. He is crying and in pain, unable to move the limb. Slight swelling and discoloration are already present. You are about 3 minutes away from the nearest hospital. The player’s parents are not at the game. You have a signed consent form from the parents to give care to all of the kids.




Scenario 3Sudden Illness

For several hours, your 60-year-old aunt has been complaining of indigestion while at your home for a seafood cookout. She now says that she has severe stomach pain and feels nauseous. She thinks pain and nausea relate to the food she ate. You notice that her skin is rather pale, she is breathing rapidly and she looks ill.




Scenario 4Heat-Related Emergency

It is late in the afternoon, and your team is finishing its third match of the volleyball tournament on the beach. The day has been hot with temperatures in the 90s. Suddenly, a teammate collapses. She does not appear to be fully conscious, but is breathing rapidly. You notice that her skin is very warm, sunburned and moist. Her pulse is very fast. She is unable to get up from the ground.




Scenario 5Substance Abuse

A dangerous ritual is about to begin—21 drinks for the 21st birthday. A group of close friends has gathered for a special party for the “birthday boy.” Everyone knows it is a dangerous game, but, because each of these friends went through it, they believe it is a rite of passage into adulthood. The activities begin and the guest of honor is soon chugging beers and downing shots of liquor at a rapid pace. Two hours after the drinking began, you arrive at the party. The guest of honor is vomiting violently in the bathroom. He slumps to the floor and begins violent convulsions, then stops moving. He seems to stop breathing and then takes a deep breath.

You are called to help. How do you proceed?



Closing

Questions?

Lesson 30: Sudden Illness I. 292 AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH...

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