Chapter 17
Sudden Illnesses
Heart Attack
• Clot in coronary artery blocks blood
supply.
• Blood supply to part of the heart
muscle is reduced or stopped.
• Heart muscle tissue dies.
• Cardiac arrest
• Heart stops if electrical system of
heart is affected.
Recognizing Heart Attack
(1 of 2)
• Chest pressure, squeezing, or pain
that lasts longer than a few
minutes or goes away and comes
back
• Pain spreading to shoulders, neck,
or arms
• Dizziness, sweating, nausea
• Shortness of breath
Recognizing Heart Attack
(2 of 2)
• Not all warning signs occur with every heart
attack.
• Some victims — as many as one third —
have no chest pain.
• Prompt action is important.
• Hospital can administer clot-dissolving
drugs (thrombolytics).
• The sooner this is done, the better.
Care for a Heart Attack (1 of 2)
• Call 9-1-1.
• Monitor breathing.
Give CPR if
necessary.
• Help victim into
comfortable
position.
• If victim has
nitroglycerin, assist
them in taking it.
Care for a Heart Attack (2 of 2)
• Nitroglycerin
• Can relieve chest pain from angina but
not heart attack.
• Dilates coronary arteries, increasing
blood flow to heart muscle.
• Lowers blood pressure
• Caution: Victim should lie down once
nitro is taken.
Angina
• Chest pain from coronary heart
disease
• Heart muscle does not get enough
blood
• Brought on by physical activity, cold
exposure, emotional stress
• Seldom lasts longer than 10 minutes
• Relieved by nitroglycerin
Recognizing Angina
• Signs are similar to heart attack
• Crushing, squeezing pain
• Pain like someone is standing on
victim’s chest
• Lasts 3 to 10 minutes
• Shortness of breath, nausea,
sweating
• Victim feels anxious
Care for Angina
• If victim has nitroglycerin, help
the victim use it.
• If pain lasts longer than 10
minutes, suspect a heart
attack, and call 9-1-1.
• Other causes of chest pain:
• Exercise or injury
• Respiratory infections
• Indigestion
Risk Factors of
Heart Disease
• Cannot be changed
• Heredity
• Sex
• Age
• Can be changed
• Smoking
• High blood
pressure
• High cholesterol
• Diabetes
• Obesity
• Inactivity
• Stress
Stroke (Brain Attack) (1 of 4)
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Part of blood flow to brain is cut off
Blocked or ruptured blood vessel
Nerve cells die within minutes
One quarter of victims die; third
leading cause of death
Stroke (Brain Attack) (2 of 4)
• Risk factors
• Age older than 50
• Use of birth
control pill, age
older than 30
• Overweight
• Hypertension
• High cholesterol
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Diabetes
Heart disease
Sickle cell disease
Substance abuse
Family history of
strokes or TIAs
Stroke (Brain Attack) (3 of 4)
• Most common type is ischemic:
• Clot forms in artery in brain
• Travels from heart to brain
• Blood vessel may rupture
• Other causes: tumors, vessel
spasms, aneurysms
Stroke (Brain Attack) (4 of 4)
• TIA has similar signs as stroke
• Symptoms last several minutes to
several hours
• Neurologic function returns
• Warning sign of potential stroke
• Signs and symptoms should be
reported to physician
Recognizing Stroke
• Weakness, numbness, or paralysis
of face or one side of body
• Blurred or decreased vision
• Problems speaking or
understanding
• Dizziness or loss of balance
• Sudden, severe headache
• Pupils not equal or not reactive to
light
Care for Stroke (1 of 2)
• Call 9-1-1. Seek medical care.
• If responsive, lay patient on back with
head and shoulders slightly elevated.
• If unresponsive, open airway, check
breathing. Give CPR if needed.
• If unresponsive patient is breathing,
place in recovery position.
• Do not give anything to eat or drink.
Care for Stroke (2 of 2)
• Los Angeles Stroke Screen
quickly identifies stroke victims
with three tests:
• Arm strength
• Facial smile
• Hand grip
Asthma (1 of 2)
• Chronic inflammatory lung disease
• Oversensitivity of air passages
• Attacks: Air passages get narrower, breathing
becomes difficult
• Common in children, young adults
Asthma (2 of 2)
• Asthma triggers:
• Respiratory tract
infection
• Temperature
extremes
• Strong odors
• Occupational
exposures
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Certain drugs
Exercise
Emotional stress
Allergens
Air pollution
Recognizing Asthma
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Coughing
Cyanosis (bluish skin)
Pause when speaking to catch breath
Nostrils flaring with breath
Difficulty breathing, wheezing
Care for Asthma
• Position of comfort
• Monitor breathing.
• Assist with asthma
inhaler.
• If victim does not
respond or attack is
extreme, seek
medical care.
Hyperventilation
• Fast, deep breathing
• Common during emotional stress
• Also caused by:
• Untreated diabetes
• Severe shock
• Certain poisons
• Brain swelling
Recognizing Hyperventilation
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Dizziness, lightheadedness
Numbness
Tingling of hands and feet
Shortness of breath
Breathing faster than 40 breaths/min
Care for Hyperventilation
• Calm and reassure
• Have person breathe slowly.
• Inhale through nose.
• Hold several seconds.
• Exhale slowly.
• Do not breathe into paper bag.
COPD (1 of 2)
• Chronic obstructive pulmonary
disease
• Includes emphysema, chronic
bronchitis, lung diseases
• Hard to breathe; air flow obstructed
• Affects older adults
COPD (2 of 2)
• Chronic bronchitis
• Caused by chronic infection
• Symptoms: Cough, difficulty
breathing, sputum
• Emphysema
• Often occurs with chronic bronchitis
• Alveoli partially destroyed
• Symptoms: Cough, wheezing,
shortness of breath
Recognizing COPD
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Wheezing
Coughing
Shortness of breath
Artificially supplied oxygen
Care for COPD
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Assist with prescribed medications.
Place in position of comfort.
Encourage to cough up secretions.
Encourage to drink fluids.
If acute, seek medical care.
Administer oxygen.
Fainting
• Sudden brief loss of
responsiveness
• Also called syncope
or psychogenic
shock
• Decreased blood
flow to the brain
• Can result from
physical or emotional
causes
Recognizing Fainting
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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 with legs
raised 6 to 12 inches.
• Loosen tight clothing at neck and
waist.
• Stay with victim.
Care for Fainting (2 of 3)
• If fainting occurred:
• Monitor breathing.
• Loosen tight clothing and belts.
• Raise legs 6 to 12 inches.
• Have victim sit, drink cool, sweetened
liquids.
• Fresh air, cold wet cloth
Care for Fainting (3 of 3)
• Seek medical care if victim:
• Has repeated fainting episodes
• Does not quickly regain
consciousness
• Loses consciousness while sitting or
lying down
• Faints for no apparent reason
Seizures (1 of 2)
• Caused by medical conditions
• Epilepsy, heatstroke, poisoning, electric
shock, hypoglycemia, high fever, brain injury,
tumor, stroke, alcohol withdrawal, or drug
overdose
• Four types
• Generalized tonic-clonic
• Focal motor
• Complex partial
• Absence
Seizures (2 of 2)
• Typical sequence for tonic-clonic: aura, loss of
consciousness, muscle contractions for 2 to 5
minutes.
• Obtain the following information:
• Is there a history of seizures?
• What did the seizure look like? How long did it
last?
• Alcohol/drug involvement?
• Recent fever, headache, stiff neck?
• History of diabetes, heart disease, stroke?
Recognizing Seizures
• Generalized tonic-clonic: Loss of
consciousness, muscle contraction,
coma/drowsiness
• Focal motor: One part of body twitches
• Complex partial: Altered personality state,
dizziness, metallic taste in mouth
• Absence: Brief loss of consciousness, usually
in children
Care for a Seizure (1 of 2)
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Protect from injury.
Loosen restrictive clothing.
Place in recovery position.
Look for medical tag.
Call 9-1-1 if:
• Unknown reason or longer than 5 minutes
• Slow to recover, second seizure, or difficulty
breathing
• Pregnant or medical condition
• Signs of illness or injury
Care for a Seizure (2 of 2)
• Status epilepticus
• Two or more seizures without an
intervening period of consciousness
• Emergency situation
• Can lead to aspiration, brain damage,
fractures, severe dehydration
Diabetic Emergencies
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Diabetes: Insulin is lacking or ineffective
Excess sugar remains in blood
Type I juvenile-onset (insulin-dependent)
Type II adult-onset (non-insulin dependent)
Too much insulin, not enough blood sugar =
low blood sugar, possible insulin shock
• Too much sugar, not enough insulin = high
blood sugar, possible diabetic coma
Low Blood Sugar
• Hypoglycemia or
insulin reaction: Very
low blood sugar
• Causes: too much
insulin, too little or
delayed food intake,
exercise, alcohol
Recognizing Low Blood Sugar
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Sudden onset
Poor coordination
Anger
Pale skin
Confusion
Sudden hunger
Excessive sweating
Trembling,
unresponsiveness
Care for Low Blood Sugar
• Give 15 grams sugar.
• If condition does not improve in 15
minutes, give 15 more grams sugar.
• If still no improvement, seek medical
care.
High Blood Sugar
• Hyperglycemia or
diabetic coma: Very
high blood sugar
• Causes: Insufficient
insulin, overeating,
inactivity, illness, stress
Recognizing High Blood Sugar
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Gradual onset
Drowsiness
Extreme thirst, frequent urination
Flushed skin
Vomiting
Fruity breath odor
Heavy breathing
Unresponsiveness
Care for High Blood Sugar
• If you are unsure whether it is
high or low blood sugar, provide
same care as you would for low
blood sugar.
• If condition does not improve in
15 minutes, seek medical care.
Abdominal Complaints
• Aching, cramping, sharp, or dull pain
• Constant or can come and go
• Nausea and vomiting
• Diarrhea or constipation
Abdominal Pain
• Peritoneum: Thin membrane lining entire
abdominal cavity
• Peritonitis: Inflammation of the peritoneum
• Many possible causes for abdominal pain
Recognizing Abdominal Pain
• Ask:
• When did pain start? Where located?
• Constant, or does it come and go?
• Nausea, diarrhea, or vomiting?
• Warm (feverish)?
• Other victims?
• Pregnancy?
• Rigid abdomen?
Care for Abdominal Pain
(1 of 2)
• Give only clear fluids.
• Have victim sip slowly.
• Give victim an antacid.
• Place hot-water bottle against victim’s
abdomen or soak in warm bath.
• Be prepared for vomiting.
• Keep victim on left side.
Care for Abdominal Pain
(2 of 2)
• Seek medical care if:
• Constant pain or more than 6 hours
• Victim unable to drink fluids
• Possible pregnancy
• Rigid, painful abdomen, swollen abdomen
• More pain when abdomen is pressed
• Bloody or black stool
• Fever
• Pain began around belly button, moved to lower
right side
Nausea and Vomiting
• Many potential causes
• Persistence can signal serious illness
• If lasts more than 1 or 2 days,
dehydration can occur.
• Young children and elderly more
seriously affected
Recognizing Nausea and
Vomiting
• Ask:
• Abdominal pain?
• Bloody or brown grainy vomit?
• Diarrhea?
• Dehydration?
• Other victims?
• Recent head injury?
Care for Nausea and Vomiting
(1 of 2)
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Give small amounts of clear fluids.
If able to keep down, offer carbohydrates
Have victim rest, avoid exertion.
Recovery position
Care for Nausea and Vomiting
(2 of 2)
• Seek medical care if:
• Bloody or brown, grainy vomit
• Constant abdominal pain
• Unable to keep fluids down more than
24 hours
• Severe, projectile vomiting
• Recent head injury
Recognizing Motion Sickness
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Nausea
Pale skin
Cold sweats
Vomiting
Diarrhea
Headache
Fatigue
Care for Motion Sickness
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Sit near midsection of vehicle.
Do not read.
Look onto horizon.
Avoid overeating.
Try antihistamine 1 hour before traveling.
Diarrhea
• Passage of loose, watery, or
unformed stools
• Causes: Intestinal infection, food
poisoning, allergy
• Dehydration can occur.
• Must replace fluids
Recognizing Diarrhea
• Ask:
• Contaminated water or food?
• Blood or mucus in stool?
• Signs of dehydration?
• Cramping?
• Loss of bowel control?
• Feverish?
• Other victims?
Care for Diarrhea
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Have victim drink lots of clear fluids.
Give mild foods.
Bismuth can help.
Seek medical care if:
• Blood stools
• No improvement after 24 hours
• Fever
• Severe, constant abdominal pain
• Severely dehydrated
Constipation
• Passage of hard,
dry stools
• Solutions: Diet,
fluids, activity,
emotional state
Recognizing Constipation
• Bloating
• Hard, dry stools
Care for Constipation
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Have victim eat more fiber.
Have victim drink fluids.
Encourage victim to remain active.
If no improvement: Milk of magnesia or caffeine
Seek medical care if:
• Severe abdominal pain
• Swollen or painful abdomen
• Fever
• Vomiting
Recognizing Pregnancy
Emergencies
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Vaginal bleeding
Cramps in lower abdomen
Swelling of the face or fingers
Severe continuous headache
Dizziness or fainting
Blurring of vision or seeing spots
Uncontrollable vomiting
Care for Pregnancy
Emergencies
• Vaginal bleeding or abdominal pain or
injury:
• Keep victim warm.
• For vaginal bleeding, place sterile
pad over opening of vagina.
• Send blood-soaked pads to hospital
with victim.
• Seek medical care.