Unconsciousness & Fainting
A person may become unconscious or faint due to
a variety of factors:
- Stress / shock
- Over-exertion
- Stroke
- Alcohol poisoning / drug use
- Medical conditions (hypoglycemia, epilepsy)
- Head trauma
***AIRWAY IS TOP PRIORITY***

How to Manage Fainting and
Unconscious Patient
 If patient is about to faint, use the standing
takedown manoeuvre, loosen clothing and
ensure a fresh supply of air
 Put patient on high concentration, humidified
O2
 Position the patient in the recovery position if
unconscious
 Perform Secondary – history, vitals, head-to-toe

How Can You Tell if a Patient Has a
Medical Condition?

How to Determine What Condition(s)
a Patient Has
 1) Ask the Patient What Happened and if they
have any Pre-Existing Medical Conditions
 2) Family, Friends or Co-Workers (By-standers)
 3) Medic Alert Jewellery/Tattoos/Wallet Cards
 4) Devices/Medications on Patient
 5) Signs, Symptoms and Behaviour

1) What Happened? Ask the Patient if
they have any Pre-Existing Medical
Conditions
 Always ask the conscious patient what happened
and if they have any pre-existing medical
conditions
 Be prepared to get 80% of your information from
the Secondary Survey

2) Family, Friends or Co-Workers (By-
standers)
 If the patient is unconscious, family members, friends
and by-standers can provide key details to first
responders regarding the nature of the condition.
However, there are situations where bystanders are
completely useless.

3) Medic Alert Jewellery/Tattoos/Wallet Cards
 If the patient owns a medic alert device, it is
normally discovered during the rapid body or
head to toe examination.
 Medic alert devices (tattoos, piercings, bracelets,
necklaces, wallet cards) are the best indicators of
pre-existing medical conditions. Unfortunately, not
everyone has a medic alert device.

4) Devices/Medications on Patient
- If unconscious (during the Rapid Body) check for
objects in pockets, on torso or on belt

5) Signs, Symptoms and Behaviour
 Assess LOC, Airway, Breathing and Circulation
- If conscious, perform SAMPLE
- Assess the patient’s Level of Consciousness
and Behaviour - if they are acting aggressively,
approach with caution. This could be indicative of
hypoglycemia or a cardiovascular emergency.
- Complexion/Skin Temperature

The Skeletal System
 The adult Human Skeletal System has 206
bones
 Neonates and Infants have approx. 300 - 350
bones
 By age 9, most children have approx. 206 bones
 Teeth are part of the skeletal system, but not
considered bones
 The skeletal system plays vital roles in processes
such as hematopoiesis, movement, protection,
calcium storage and endocrine regulation
 It takes a minimum of 10 – 16 PSI to break a
bone; the skull and the femur are much tougher
to break

Conditions of the Skeletal
System
 Osteoporosis – Characterized by a decrease in
skeletal Ca levels and weak bones, osteoporosis
is found mostly in older people and even more in
older females
 Arthritis – Joint disorder that includes over 100
types of inflammatory conditions. First aid is ice
pack
 Fractures – Broken bones use Rest Ice/immobilization
Compression Elevation (R I C E)

Gastrointestinal Conditions
 Diverticulitis – Inflammation of the small pockets of the colon:
Increased temperature. Opposite area to that of appendicitis.
 Cystitis – Inflammation of the bladder: pain in lower mid-
abdomen. Pain during urination.
 Perforated Gastric Ulcer – Pain radiates in mid-abdomen or
upper back. Characterized by guarding, bloating. Sharp or
burning sensation after meals.
 Kidney Stones – A calculus (mass of mineral salts around tissue)
in the kidney: Pain in right or left flanks radiating to the
genitalia. Pain during urination.
 Pancreatitis – Pain in both upper quadrants and back.
Characterized by guarding, assuming the fetal position.

Appendicitis
 Inflammation of the appendix, creates pain
Known as Appendicitis
 Rupturing causes faecal matter and other waste
products to seep into the peripheral tissues
Identification of Acute Appendicitis
 Localized pain around navel with direct pain in
lower right abdomen
 Pt may draw up their right knee or clutch their
abdomen
 If RUPTURED, abscess in LR quad forms

Abdominal Assessment
McBurney’s Point

How to Manage Acute Abdominal
Injuries
 Put patient on high concentration, humidified O2
 Position the breathing patient in a comfortable
position, loosen clothing
 Auscultate the lungs, record all observations
 Be prepared to deal with shock
 Update EMS , continuously monitor vitals and
reassure pt

The Human Nervous System
Central Nervous System Peripheral
m
Autonomic Nervous System: Controls automatic actions, such as heart beat,
breathing, pain response, etc.,

Epilepsy & Idiopathic
Seizures
 Epilepsy is characterized by
a chemical imbalance in the
brain which induces seizure
activity. All epileptics have
seizures, but not all people
who have seizures are
epileptic.
 It is unknown what triggers
seizures, but common signs
of oncoming seizure
include: sudden cry,
stiffening of the body and
unconsciousness,
convulsions, frothy saliva,
loss of bladder or bowel
control, irregular breathing

Epilepsy in a Nutshell
 Partial Seizures: Affect only part of the brain. Patient
may experience tingling or twitching on one side of the
body.
 Generalized Seizures: The entire brain is affected –
patient loses consciousness and convulses.
Phases of Generalized Seizures
 Aura – A sense of impending seizure that some
epileptics have just before seizing.
 Tonic Phase – A sudden loss of consciousness. The
face and neck may turn cyanotic.
 Clonic Phase – Convulsions occur, breathing is
irregular and rigid, frothy saliva may appear at mouth.
 Postictal State – A period of confusion. For a few
minutes, the patient will appear incapacitated.

How to Manage Seizures
 Begin ESM – What happened? Perform a scene survey: call
EMS if episode is severe
 Perform primary assessment – LOC, ABCs and Rapid Body
 If the patient is convulsing, clear the area of furniture and
other debris
 If there are any life threatening injuries, treat those first.
Airway management is top priority.
 Find out how long the seizure lasted – if more than 5
minutes or if seizures are recurring, this may be STATUS
EPILEPTICUS and patient must be hospitalized.
***NEVER CHECK PUPIL DILATION IN***
EPILEPTIC PATIENTS
 Perform Secondary – LOC, history, vitals, head-to-toe
 Update EMS

Asthma
 Normally, individuals with
asthma have no trouble
breathing. But during an
asthmatic attack the
bronchioles constrict, inducing
shortness of breath, with
considerable wheezing and
coughing.
 Asthma can be triggered by
intense physical activity,
stress, humidity, smoke, mold,
allergens and pollutants.

Signs and Symptoms of a Severe
Asthmatic Attack
 Shortness of breath with trouble breathing
 Coughing or wheezing
 Fast and shallow breathing
 Cyanosis
 Anxiety and tightness in chest
 Fast pulse, signs of shock
 Initially restlessness, followed by fatigue – patient
becomes tired due to stress and attempting to
breathe

How to Manage an Asthma
Attack
 Begin ESM – perform a scene survey: call EMS if attack is
severe or does not stop
 Perform primary assessment – LOC, ABCs and Rapid
Body
 Position the patient in a semi-sitting position
 Assist with medication administration
Follow the 5 rights of medication:
- Right medication
- Right person
- Right amount
- Right time
- Right method/dose
 Update EMS

***ONLY ASSIST WITH MEDICATION***
IF PATIENT IS CONSCIOUS OR WITH
CONSENT OF FAMILY MEMBER
DOCUMENT TIMES/DOSAGES
ADMINISTERED

Types of Aerosol Inhalers
 Bronchodilator: Usually blue,
Green or white. Can be used
Multiple times to relieve
symptoms. Can not be used if
HR is above 150 bpm in adults or 180 bpm in
children.
 Inhaled Corticosteroid: Usually
Burgundy or brown in colour –
will not help the patient during an
attack. Used to reduce inflammation and
strengthen the airway.

Types of Dry Powder Inhalers
 Turbo Inhalers: Handheld
inhalers that either come
pre-loaded or have
reloadable capsules for
each dose.
 DISKUS®: Holds 60 doses,
With built in counters (so the
patient knows how much
they have left.

Chronic Obstructive Pulmonary
Disease
 Prevalent among older
populations, COPD is a term
that encompasses conditions
such as chronic bronchitis and
emphysema. Characterized by
a patient’s difficulty with or
inability to breathe.
Some signs and symptoms of
COPD are:
 Gasping for air
 Distended neck veins
 Audible wheezing and coughing
 Cyanosis

Devices Used by COPD Patients
 O2 Canister, NRB/NPA
 Salbutamol, Symbicort and Ventolin puffers
(identical to asthma inhalers)
***COPD PATIENTS ARE TYPICALLY OLDER,***
FRAIL AND CARRY O2 CANISTERS WITH THEM

COPD
The ESM and First Aid is the same for all respiratory
emergencies:
 Begin ESM – perform a scene survey: call EMS
 Position the patient semi-sitting, loosen clothing
***ENCOURAGE COUGHING IF PATIENT IS DISCHARGING***
SALIVA OR SPUTUM
- Right medication
- Right person
- Right amount
- Right time
- Right method/dose
 Perform Secondary – history, LOC, vitals, head-to-toe
 Update EMS

Type 1 Diabetes
 Type 1 Diabetes is
characterized by the
patient’s inability to
produce insulin (a
hormone necessary for
maintenance of proper
blood-glucose levels).
 There are two diabetic
emergencies an MFR
may be faced with:
 Hypoglycemia – low
blood glucose
 Hyperglycemia – high
blood-glucose

What Devices do Diabetics Use?
 Glucometer: Used to test
blood-glucose levels
 Insulin Pump: Used to
administer a basal rate (long
term, slow) or bolus (large,
single dose) of fast-acting
insulin
 Insulin Pen: A portable
insulin syringe

Types of Insulin
 Humulin R – Fast acting
 Humlog – Fast acting
 Nova Rapid – Fast acting
 Humulin N – Long acting

How to use a Blood Glucose Meter
(Glucometer)
 Have patient insert strip into
glucometer – the brand name of
the strip should appear facing the
patient
 Have patient prick their finger
with lancet
 Have patient squeeze pricked
finger
 Have patient administer blood to
glucometer
 Within 10 seconds, a BG level
should appear on the meter
1 – 3 mmol/dL LOW
4 – 10 mmol/dL Normal

Hypoglycemia
 The most threatening condition
 Low blood sugar – caused by physical exertion, not
eating, taking too much insulin, stress etc.,
Hypoglycemia is characterized by:
 Extreme hunger
 Change in mental status and behaviour – aggression,
lethargy, slurred speech and intoxication are all signs of
low blood glucose
 Dilated pupils
 Pale, clammy skin
 Confusion
 Unresponsiveness
 Fatigue

How to Manage Hypoglycemia
 Begin ESM – What happened? Perform a scene
survey: call EMS
 Perform primary assessment – LOC, ABCs and
Rapid Body
 Place the conscious patient in semi-sitting position
 Have the patient check their blood glucose (if they
have a meter)
 Assist with GLUCOSE administration
***NEVER GIVE ANYTHING ORALLY TO***
UNRESPONSIVE PATIENTS

Hyperglycemia
 High blood sugar – caused by eating too many
carbohydrates/too much sugar, not getting
enough insulin, stress etc.,
Hyperglycemia is characterized by:
 Unquenchable thirst
 Frequent urination
 Vomiting
 Short breaths
 Rapid heart rate
 Fruity odour
 Flushed appearance
 Fatigue

How to Manage Hyperglycemia
 Begin ESM – What happened? Perform a scene
survey: call EMS
 Perform primary assessment – LOC, ABCs and
Rapid Body
 Place the conscious patient in semi-sitting position
 Have the patient check their blood glucose (if they
have a meter)
 Give patient WATER
***NEVER GIVE ANYTHING ORALLY TO***
UNRESPONSIVE PATIENTS

Anaphylaxis
Severe allergic reactions
(anaphylaxis) occur when an
irritant affects two or more
body systems. Typically
characterized by:
 Red, itchy or flushed skin
(hives)
 Watery eyes, sneezing
 Swelling of the mouth,
tongue and airway
 Coughing
 Nausea and vomiting.

As the condition progresses, MFRs may note:
 Pale skin or cyanosis
 Headache
 Wheezing, chest tightness
 Rapid heart rate
 Shortness of breath, severe respiratory distress
 Decreased LOC / respiratory rate / circulation

How to Manage Anaphylaxis
 Begin ESM – What happened? Perform a scene survey:
call EMS
 Perform primary assessment – LOC, ABCs and vitals
 Place the patient in semi-sitting position
- Right medication
- Right person
- Right amount
- Right time
- Right method/dose
 Update EMS

***EPIPENS MUST ONLY BE***
USED IN RESPIRATORY
EMERGENCIES

Types of Epi Pens
 Auto Injector – Must be administered
intramuscularly (typically, the outer thigh)

How to use the Auto Injector
 Grasp the device in the middle with your
dominant hand – do not place your thumb over
the other end
 Pull the blue safety cap off of the aspirator (end of
the injector)
 Press the tip gently against the mid-outer thigh
and press firmly for 10 seconds (or until the auto
injector activates)

Twinject Auto Injector
 Contains two doses of epinephrine. Similar
administration to the standard auto injector.
***ALWAYS SEND MEDICATIONS TO HOSPITAL***
WITH PATIENT

How to use Twinject Auto
Injectors
 Grasp the device in the middle with your
dominant hand – do not place your thumb over
the other end
 Pull both of the green safety caps off
 Press the red tip gently against the mid-outer
thigh and press firmly for 10 seconds (or until the
auto injector activates)

Cardio-Vascular
Conditions
 CV conditions are
characterized by disorders of
the blood vessels and heart
tissues.
Signs and symptoms include:
 Indigestion, aching jaw or arm
 Clutching of the chest
 Heaviness in chest, shortness
of breath
 Fear, fatigue, denial
 Nausea, vomiting
 Pale, cool, sweaty skin
 Unconsciousness and cardiac

American Heart Association
Interactive Videos:
http://watchlearnlive.heart.org/CVML_Player.php?m
oduleSelect=angina

Devices Used by CV
Patients
 Nitroglycerin Tablets – Taken orally
 Nitroglycerin Patches – Provide long-
acting nitroglycerin
 Nitroglycerin Spray – Sprayed sub-
lingually (under the tongue)

ANGINA
- Arteries harden due to plaque build up. Not
enough O2 gets to the heart.
- Causes pain and discomfort
- Mimics a heart attack but won’t last longer than
10 minutes
- Usually have nitroglycerin patches or sprays and
will be relieved once administered

How to Assist with Nitroglycerin
 Nitroglycerin is a vasodilator that opens the blood
vessels, allowing blood to mobilize freely
 Available in tablet, patch and spray form, Nitro
starts working within 1 to 2 minutes for
approximately 6 minutes
 Ask the patient if they use Nitroglycerin
 Assess vitals
 Ask the patient to administer their Nitro – nitro
may be used every 5 – 10 minutes for a
maximum of 3 doses. BP must be monitored
regularly!
***TELL PATIENT NOT TO TAKE NITRO IF***

How to Assist with Aspirin
 Aspirin (ASA - acetylsalicylic acid) is a blood
thinner that helps blood pass through clogged
arteries into the heart
 MFRs should only recommend patients take ASA
and explain why
 Ask patient if they have already taken ASA before
your arrival – if so, don’t recommend it
 If patient is allergic to ASA do not recommend it
 After the first dose of Nitro, reccomend 2 baby
aspirins (81 mg) or one adult (325 mg). Have
patient chew the tablet(s)
 Document all medication doses/times

How to Manage Angina
 Begin ESM – perform a scene survey: call EMS if episode is severe or
does not stop
 Position the patient in a semi-sitting position, loosen clothing
***If patient’s BP is 100 or below, the patient should NOT***
take nitro
If patient takes nitroglycerin, and their BP is at 150, assist them with their
medication
- Right medication
- Right person
- Right amount
- Right time
- Right method/dose
 Monitor BP
 Update EMS

Cerebro-Vascular Emergencies
 Cerebrovascular emergencies
(strokes/TIAs) are usually
indicative of pre-existing
conditions.
 Hardening of the arteries stops the
flow of blood (and oxygen) to the
brain.
The signs and symptoms for both
TIAs and strokes are similar and
EMS should be called immediately.
Some signs include:
 Paralysis of face muscles
 Difficulty speaking/swallowing
 Dizziness/confusion
 Numbness/weakness in one side of
body, loss of bladder
 Decreased LOC

TIAs and Strokes
 Transient ischemic attacks (TIAs) mimic the
signs/symptoms of a stroke, but typically do not leave
permanent brain damage. TIAs are a warning sign that
a stroke is coming.
 Strokes are very serious and can leave permanent brain
damage
 Use FAST as a method to determine whether a patient
is having a stroke/TIA
 Facial Droop – One side of the face is paralyzed
 Arm Drift – Have the patient hold both arms out – if one
arm doesn’t move as well as the other, they may be
having a stroke/TIA
 Speech – Slurred speech, incorrect words, inarticulate

How to Manage a Stroke/TIA
 Begin ESM – perform a scene survey: call EMS if
episode is severe or does not stop
 Perform primary assessment – ABCs and vitals
 Position the patient in a semi-sitting position,
loosen clothing
 Monitor BP
 Reassure the patient – keep them comfortable
 Update EMS

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Editor's Notes