Chapter 17Sudden Illnesses

Unexplained Change in Responsiveness

The level of responsiveness indicates how well the brain is functioning.

Heart Attack• Occurs when blood

flow to the heart is reduced or cut off• Atherosclerosis• Ischemia• Heart attack or

myocardial infarction (MI)

Heart Attack vs. Cardiac Arrest• Heart attack—one or more of the

arteries delivering blood to the heart becomes blocked.

• Cardiac arrest—either the heart stops beating or the heart’s lower chambers suddenly develop a rapid irregular rhythm causing the ventricles to quiver rather than contract.

Recognizing a Heart Attack • Chest discomfort• Discomfort in other areas of the body• Shortness of breath• Other signs:

• Breaking out in a cold sweat• Nausea• Lightheadedness

Care for a Heart Attack

• Call 9-1-1.• Monitor breathing.• Help victim into

comfortable position. • Have victim take

aspirin.• Find out if the victim

is using nitroglycerin.

Angina (1 of 2)

• Chest pain called angina pectoris can result from coronary heart disease.

Angina (2 of 2)

• Occurs when coronary arteries become narrow and cannot carry sufficient blood to meet the demands during:• Physical exertion• Excitement• Emotional upset• Eating of a heavy meal• Extreme hot or cold temperature exposure• Cigarette smoking

Recognizing Angina

• Chest pain described as crushing or squeezing• Spreads to jaw, arms, and midback • Lasts from 3 to 10 minutes • Relieved by nitroglycerin

• Pain associated with shortness of breath, nausea, or sweating

• Anxiety

Care for Angina

• Drugs that affect the blood supply:• Coronary vasodilators• Nitroglycerin

• Have victim sit down.• Let victim use prescribed nitroglycerin. • Call 9-1-1 if discomfort does not improve

within 5 minutes.

Stroke (Brain Attack) (1 of 2)

• Occurs when there is a sudden interruption of blood flow to the brain

• Occurs when arteries in the brain rupture or become blocked

• Effects are permanent.

Stroke (Brain Attack) (2 of 2)

Ischemic strokes• Occur when blood

vessels become narrowed or clogged with plaque

Hemorrhagic strokes• Occur when a blood

vessel ruptures in or near the brain

Recognizing Stroke• Weakness, numbness, or paralysis of face

or one side of the body• Blurred or decreased vision• Problems speaking or understanding• Dizziness or loss of balance• Sudden, severe, and unexplained

headache• Deviation of the eyes from PEARL

When You Suspect a Stroke… (1 of 2)

When You Suspect a Stroke… (2 of 2)

• Facial droop• Arm drift• Speech

Care for Stroke• Call 9-1-1 immediately.• Check the time at which the first signs appeared. • Monitor breathing.

• If unresponsive and breathing, place in the recovery position.

• If responsive, place in comfortable position with the head elevated.

• Do not give the victim anything to eat or drink. • Reassure and keep the victim warm.

Asthma (1 of 2)

• Chronic lung disease that inflames and narrows the airways

• Causes recurring periods of wheezing, chest tightness, shortness of breath, and coughing

Asthma (2 of 2)

• Common asthma triggers

Recognizing an Asthma AttackSymptoms can range from mild to severe. • Excessive coughing• Wheezing• Chest tightness• Shortness of breath• Sitting in the tripod position• Inability to speak in complete sentences• Nostrils flaring

Care for an Asthma Attack (1 of 2)

• Place victim in comfortable position.

• Ask about medication.• Long-term control• Quick-relief

• If signs begin, victim can take two puffs of quick-relief medicine.

Care for an Asthma Attack (2 of 2)

• Medicine is not helping if:• Breathing is hard and fast.• Nose opens wide during breathing.• Victim cannot walk or talk well.

• Call 9-1-1 or take the victim to the emergency department.

Hyperventilation

• Fast, deep breathing• Common during emotional stress• Also caused by:

• Untreated diabetes• Severe shock• Certain poisons• Brain swelling• High altitude

Recognizing Hyperventilation

• Shortness of breath• Fast breathing• Tingling or numbness of the hands,

feet, and around the mouth• Dizziness or lightheadedness

Care for Hyperventilation• Calm and reassure the victim.• Take the victim to a quiet place or ask

bystanders to leave. • Encourage the person to breathe slowly,

using the abdominal muscles. • Inhale through the nose. • Hold the full inhalation for 1 to 2 seconds. • Exhale slowly through pursed lips.

Chronic Obstructive Pulmonary Disease (COPD)

• COPD is a broad term applied to:• Emphysema• Chronic bronchitis• Related lung diseases

• Most common factor: cigarette smoking • Most commonly diagnosed: older than 60

years

Recognizing COPD

• Wheezing• Coughing• Shortness of breath• Artificially supplied oxygen

Care for COPD

• Assist victim to take medications.• Place in comfortable sitting position. • Encourage victim to cough up

secretions.• Encourage victim to drink fluids.• For acute breathing distress, obtain

immediate medical assistance.

Fainting (1 of 3)

• Sudden brief loss of responsiveness not associated with a head injury

• Also called syncope or psychogenic shock

• Most fainting episodes are associated with decreased blood flow causing deficient oxygen or glucose in the brain.

Fainting (2 of 3)

Decreased blood flow can be caused by:• A slow heart rate• Heart rhythm disturbances• Dehydration• Heat exhaustion• Anemia• Bleeding

Fainting (3 of 3)

• Decreased glucose can be caused by:• Diabetes• Medications used to treat diabetes• Infections

Recognizing Fainting

• Dizziness• Weakness• Seeing spots• Visual blurring• Nausea• Pale skin• Sweating

Care for Fainting (1 of 3)

• If about to faint:• Prevent person from falling.• Help person lie down.• Loosen tight clothing at neck and

waist.• Stay with the victim until he or she

recovers.

Care for Fainting (2 of 3)

• If fainting has occurred:• Monitor breathing.• Loosen tight clothing and belts.• Check for injuries.• Have the victim sit.• Give cool, sweetened liquids to drink. • Help the victim regain an upright posture.• Fresh air and cold, wet cloth for the face

usually aid recovery.

Care for Fainting (3 of 3)

• Seek medical care if victim:• Has had repeated episodes of

unresponsiveness• Does not regain responsiveness• Loses responsiveness • Faints for no apparent reason

Seizures (1 of 2)

• A symptom of epilepsy • Epilepsy is the underlying tendency of the

brain to produce sudden bursts of electrical energy that disrupt other brain functions.

Seizures (2 of 2)

Several medical conditions can lead to seizures.

• Lack of oxygen• Heatstroke• Poisoning• Electric shock• Hypoglycemia• High fever in children• Brain injury, tumor, or stroke• Alcohol withdrawal, drug abuse, or overdose

Recognizing Convulsive Seizures• Typically last for 1 to 2 minutes• Sudden falling to the floor or ground• Stiffening of arm and leg muscles followed by

jerky movement with arching of the back• Foaming at the mouth• Grinding of teeth• Bluish-gray color of the face and lips• Eyes rolled upward• Loss of bladder and bowel control

Recognizing Nonconvulsive Seizures

• Last only a few seconds• Staring, confused, inattentive• Frequent eye blinking• Involuntary movements

Prolonged Seizures

• Called status epilepticus• Require immediate medical care• Can lead to:

• Brain damage• Fractures• Severe dehydration• Aspiration

First Aid for a Convulsive Seizure (1 of 2)

• Do not restrain or hold the person down. • Clear the area of anything sharp. • Loosen ties, scarves, or anything around

the neck. • Place something flat and soft under the

head. • Turn him or her onto one side.

First Aid for a Convulsive Seizure (2 of 2)

• Do not try to force the mouth open.• Stay with the person until the seizure

ends naturally. • Ask if there is anyone who should be

called to help him or her get home. • Look for a medical ID.

First Aid for a Nonconvulsive Seizure

• Watch the person carefully.• Explain to others what is happening. • Guide the person away from danger.• Stay with the victim until he or she has

fully recovered.

When to Call 9-1-1• A seizure lasts more than 5 minutes. • A second seizure starts soon after first. • Alertness does not return after shaking. • The seizure happened in water. • The victim is injured, diabetic, or pregnant. • No medical identification tag is found. • The victim has never had a seizure.

Diabetic Emergencies

Insulin is a hormone produced by the pancreas that assists the body in using energy from food.• Diabetes develops when

insulin is either ineffective or lacking.

Types of Diabetes• Type I diabetes

• Commonly diagnosed in childhood• Requires external insulin

• Type II diabetes• Excess body weight and sedentary

lifestyle are risk factors.• Gestational diabetes

• Occurs in some pregnancies• Usually treated with diet

Low Blood Sugar: Hypoglycemia

• Too much insulin• Too little or delayed

food intake• Exercise• Alcohol• Any combination of

these factors

Recognizing Low Blood SugarSigns and Symptoms Requiring First Aid

• Sudden onset• Staggering• Poor coordination• Clumsiness• Anger• Bad temper• Pale face color• Confusion

• Disorientation• Sudden hunger• Excessive sweating• Trembling• Shakiness• Seizure• Eventual

unconsciousness

Care for Low Blood Glucose Hypoglycemia (1 of 2)

The rule of 15s:• The diabetic should check blood glucose.

• Eat 15 grams of sugar.• If condition does not improve in 15 minutes,

give 15 more grams sugar.

Care for Low Blood Glucose Hypoglycemia (2 of 2)

• If still no improvement, seek medical care.

• If the victim becomes unresponsive, call 9-1-1 immediately.

• Seek medical care following a diabetic episode.

Glucagon

Glucagon is an injected medication that quickly raises blood glucose. • Given by physician’s prescription• Works the opposite of insulin• Many people vomit after receiving it.

Recognizing High Blood SugarHyperglycemia

• Gradual onset• Drowsiness• Extreme thirst• Very frequent urination• Flushed skin• Vomiting • Fruity breath odor• Heavy breathing• Eventual unconsciousness

Care for High Blood SugarHyperglycemia

• Give a responsive victim a beverage or food containing sugar.

• If there is no improvement within 15 minutes, seek medical care immediately.

Abdominal Complaints

People with gastrointestinal problems complain about:• Abdominal pain that is aching, sharp, or dull• Nausea and vomiting• Diarrhea or constipation

Abdominal Pain

• The abdomen is the area between the diaphragm and the groin.

• It is neither feasible nor useful for a first aider to distinguish among the many causes of abdominal pain.

• First aid usually will be similar regardless of the cause.

Recognizing Abdominal Pain (1 of 2)

• When did pain start? • Where is it located?• Is the pain constant, or does it come

and go?• Does belching or passing gas relieve

the pain?• Does the victim feel nauseated, or does

he or she have a good appetite?

Recognizing Abdominal Pain (2 of 2)

• Is there diarrhea or vomiting?• Is the victim feverish?• Does anyone near the victim have

similar symptoms?• Is there a chance of pregnancy?• Is the abdomen rigid to the touch?

Care for Abdominal Pain (1 of 3)

• Give the victim clear liquids.• Give the victim an antacid.• Place a hot-water bottle against the

victim’s abdomen or soak in a warm bath.

• Be prepared for vomiting. • Keep the victim in a comfortable

position.

Care for Abdominal Pain (2 of 3)

• Seek medical care if:• Pain is constant and severe.• The victim is unable to drink fluids.• The victim is or might be pregnant.• The abdomen is rigid and swollen.• More pain occurs after you press your fingers

on the victim’s abdomen and suddenly release them.

Care for Abdominal Pain (3 of 3)

• Seek medical care if (cont’d):• There is bloody, blood-stained, or black

stool or vomit. • The victim has a fever. • Pain began around the belly button and

later moved to the lower right part of the abdomen.

Nausea and Vomiting

• May occur because of:• Mild altitude sickness• Motion sickness• Brain injury• Intestinal viruses• Eating or drinking too much• Being emotionally upset

Recognizing Nausea and Vomiting

• Is there abdominal pain?• Is there bloody or brown grainy material

in the vomit?• Is there diarrhea?• Are there signs of dehydration?• Does anyone near the victim have

similar symptoms?• Has the victim had a recent head injury?

Care for Nausea and Vomiting (1 of 2)

• Give the victim small amounts of clear fluids.

• If the victim is able to keep fluids down, offer carbohydrates.

• Have the victim rest and avoid exertion. • Prevent inhalation of vomit by positioning

the victim on his or her side.

Care for Nausea and Vomiting (2 of 2)

• Seek medical care if:• Bloody or brown, grainy material in vomit• Constant abdominal pain• The victim faints when standing.• The victim is unable to keep fluids down for

more than 24 hours.• The victim has severe, projectile vomiting.• The vomiting follows a recent head injury.

Recognizing Motion Sickness

• Nausea• Pale skin• Cold sweats• Vomiting• Dizziness• Headache• Fatigue

Care for Motion Sickness

• Sit near the midsection of a plane, boat, bus, train, or car.

• Do not read.• Look ahead. • Avoid overeating.• Try antihistamine 1 hour before

traveling.

Diarrhea

Diarrhea is the passage of loose, watery, or unformed stools. • Dehydration can occur.• Replacing fluids and electrolytes is of primary

importance. • Letting diarrhea run its course is best.

Recognizing Diarrhea• Was the victim recently exposed to untreated,

possibly contaminated water or food?• Is there blood or mucus in the stool?• Are there signs of dehydration?• Does victim have cramping abdominal pain?• Does the victim lose bowel control?• Is the victim feverish?• Does anyone else have similar symptoms?

Care for Diarrhea (1 of 2)

• Have the victim drink lots of clear fluids.• Give mild food, once the victim can

tolerate clear fluids. • BRAT diet

• Bismuth can help.• May turn stool and tongue black • People who are sensitive to aspirin should

not use it.

Care for Diarrhea (2 of 2)

• Seek medical care if:• The victim has bloody stools that might

appear black. • No improvement after 24 hours• The victim has a fever.• The victim has severe, constant abdominal

pain.• The victim is severely dehydrated.

Constipation

Constipation is the passage of hard, dry stools. • Bowel movement changes may result

from change in:• Diet• Fluid intake• Activity• Emotional state

Recognizing Constipation

• Bloating sensation of abdomen• Hard, dry stools

Care for Constipation (1 of 2)

• Have the victim eat more fiber.• Have the victim drink plenty of fluids.• Encourage victim to remain active.• If there is no improvement, try:

• A stool softener• Caffeine

Care for Constipation (2 of 2)

• Seek medical care for:• Severe abdominal pain• Swollen or painful abdomen• Fever• Vomiting