FIRST AID 5
Sudden Medical Conditions
2009
CANADIAN
CANADIANCOAST
COASTGUARD
GUARDAUXILIARY
AUXILIARY- -PACIFIC
PACIFIC
Introduction
• Some medical conditions can cause a
casualty to become extremely ill and require
immediate first aid and emergency medical
care.
• There may be no warning signals.
• In some cases the person may feel ill or feel
something is wrong.
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Introduction
• These can include:
Diabetes
Convulsions
Heat Emergencies
Hypothermia
Childbirth??
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Diabetes
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Diabetes
• A diabetic emergency can happen only to
someone who has diabetes.
• Diabetic emergencies are caused by an
imbalance in the person’s sugar and insulin
levels.
• Any imbalance can be an emergency.
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Hyperglycemia
• When the insulin level in the body is too low,
the sugar will be come too high causing
“hyperglycemia”.
• This can then lead to a diabetic coma.
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Hypoglycemia
• When the insulin is too high, the person will
develop a low sugar level, causing
hypoglycemia.
• It is caused by the diabetic:
1. Taking too much insulin
2. Failing to eat enough
3. Overexercising and burning of sugar faster
than normal
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Hypoglycemia
• The small amount of sugar is used up rapidly,
and there is not enough for the brain to work.
• This will cause the person to become
unconscious.
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Signs and Symptoms of Diabetes
• There is a difference between the signs and
symptoms of hyperglycemia and
hypoglycemia - however the major ones are
similar.
1. Changes in consciousness including
dizziness, drowsiness and confusion, leading
to coma
2. Rapid breathing and pulse
3. Feeling and looking ill
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First Aid for Diabetes
• The first aid treatment for both hyperglycemia
and hypoglycemia is the same.
• Start with the emergency action principles.
• If they tell you they are diabetic, or they are
wearing a necklace or bracelet saying so, and
they are displaying the signs and symptoms,
suspect a diabetic emergency.
• If the patient can take food or fluids, give
them something with sugar in it.
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First Aid for Diabetes
• If the patient already has too much sugar, the
extra will not cause further harm over a short
period.
• Often the patient will know what is wrong and
will ask for something for sugar in it.
• If the person is unconscious, do not give
anything to eat or drink.
• Watch their ABCs, and maintain body
temperature.
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First Aid for Diabetes
• If the casualty is unconscious or is conscious
but does not feel better within 5 minutes,
transport to EHS.
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Convulsions
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Convulsions
• Sometimes the brain is affected by injury,
disease, fever infection, or unknown reasons,
that causes a loss of control known as a
convulsion.
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Causes of Convulsions
• A common cause is epilepsy, which can be
controlled with medicine, but the patient can
still have convulsions.
• The patients can sometimes be aware of an
onset a convulsion, and take precautions.
• Convulsions range from mild blackouts, which
to others is like day dreaming, to sudden and
uncontrolled shaking with unconsciousness
lasting several minutes.
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First Aid for Convulsions
• You can easily help the person.
• Do not try to restrain to person or stop the
convulsion.
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First Aid for Convulsions
• Start with the emergency action principles.
• The object is to stop the person hurting
themselves.
1. Move away nearby objects that may cause
injury, and from fire and the water.
2. Protect the person’s head by placing rolled
up clothing underneath it.
3. If there is saliva, blood, or vomit, place in the
recovery position.
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First Aid for Convulsions
4. Do not try to place anything between the
teeth.
• After the convulsion the person will be drowsy
and confused.
• Conduct a secondary survey so see if they
injured themselves during the convulsion
• Reassure and comfort.
• Stay with them until they are fully recovered
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First Aid for Convulsions
• EHS should be used if:
1. The convulsion lasts more than a few
minutes
2. The casualty has repeated convulsions
3. The casualty appears to be injured
4. You are uncertain about the cause of the
convulsion
5. The casualty is pregnant
6. The casualty is a known diabetic
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First Aid for Convulsions
7. The casualty is an infant or child
8. The convulsion takes place in the water
9. The casualty fails to regain consciousness
after the convulsion
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First Aid for Infant or Child with
High Fever
• A child or infact with a fever over 39°C
(102°F) is at risk of convulsions.
• A high fever can become a medical
emergency and you need to lower the
temperature by cooling the body.
• Sponge with cool water.
• Transport to EHS as soon as possible.
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Heat Emergencies
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Heat Emergencies
• This is where the body is unable to manage
extreme heat.
• The way a person responds to heat is
affected by humidity, wind, clothing, the work
environment, physical activity, age and
personal health.
• Heat cramps, heat exhaustion and heat
stroke are all caused by exposure to heat.
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Heat Emergencies
• Heat cramps are the least serious but may
lead to heat exhaustion and heat stroke.
• Heat exhaustion is more serious and can lead
to heat stroke.
• Heat stroke is an emergency and can lead to
coma and death if the body is not cooled.
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Heat Emergencies
• Heat emergencies can worsen rapidly once
they appear.
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Heat Emergencies
• When the air temperature is high, the main
source of cooling is the evaporation of sweat.
• Sweating increases when the body is very
warm.
• However when the humidity is high, sweat
does not evaporate as quickly and has little of
no cooling effect.
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Causes of Heat Emergencies
• Air temperature, humidity, and wind all affect
body heat. Heat or activity in the hot
environment increases the risk.
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Causes of Heat Cramps
• Heat cramps, painful spasms of muscles
usually in the calf or abdomen are caused by
fluid and salt loss resulting from heavy
exercise or work outdoors in warm or even
moderate temperatures
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Causes of Heat Exhaustion
• Heat exhaustion, the most common heat
illness leading to fluid depletion, is caused by
exercise or work in a hot environment.
• Heat exhaustion affects anyone wearing
heavy clothing such as cruiser suits, in a hot
humid environment.
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Causes of Heat Exhaustion
• Fluid loss from excess seating is not being
adequately replaced, leading to low blood
volume, and blood flow is reduced to vital
organs as the body tries to give off heat by
increasing blood flow to the skin.
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Causes of Heat Stroke
• Heat stroke occurs when the symptoms of
heat exhaustion are ignored.
• The body cannot cool itself and gradually
stops working.
• Sweating stops as the body stops cooling
itself and body temperature rapidly rises.
• Body temperature soon reaches a level at
which the brain, heart and kidneys cannot
function properly.
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Signs and Symptoms of Heat
Cramps
• Severe muscle contractions especially in the
legs or abdomen
• Usually normal body temperatures
• Moist skin
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Signs and Symptoms of Heat
Exhaustion
• Normal or slightly elevated body
temperatures
• Cool, moist, pale or red skin
• Headache
• Nausea
• Dizziness and weakness
• Exhaustion
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Signs and Symptoms of Heat
Stroke
• High body temperatures, often as high as
41°C (106°F)
• Red, hot, dry skin
• Irritable, bizarre, or combative behaviour
• Progressive loss of consciousness
• Rapid, weak pulse becoming irregular
• Rapid, shallow breathing
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Treatment of Heat Emergencies
• Start with the emergency action principles.
• If you suspect that the casualty is suffering
from overexposure to heat, follow these
additional first aid steps immediately:
1. Cool the body
2. Give fluids if the person is conscious
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Treatment of Heat Cramps
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Rest in a cool place
Lightly stretch the affected muscles.
Drink cool liquids.
Resume activity with care.
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Treatment of Heat Exhaustion
• Move the casualty to a cool or shady place.
• Drink cool water slowly, to replace fluids water is less likely to cause vomiting.
• Loosen tight clothing and remove perspiration
soaked clothing.
• Put cool water on the skin and fan to increase
evaporation.
• Monitor any changes.
• Rest for the day.
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Treatment of Heat Stroke
• If the heat exhaustion progresses, body
temperature will climb, and the casualty’s
condition will worsen, vomiting and show
changes in level of consciousness, signaling
heat stroke.
• Cool the body any way you can.
• Sponge the body with tepid or cold water, and
fan to increase evaporation.
• Use ice packs in the armpits and groin.
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Treatment of Heat Stroke
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Get the casualty to EHS
Keep the airway open, and monitor ABCs.
Place in recovery position
A person in heat stroke may stop breathing or
have a heart attack. Be prepared for rescue
breathing or CPR.
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Hypothermia
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Hypothermia
• Hypothermia is a general body cooling when
the body cannot produce enough heat to stay
warm.
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Hypothermia
• The body reacts to cold by contracting blood
vessels near the skin to move warm blood to
the centre of the body.
• This provides some conservation of body
heat.
• If heat loss continues, shivering starts and the
body produces heat through muscle action.
• Hypothermia results as the entire body cools
as the warming system fails.
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Hypothermia
• In hypothermia body temperatures fall below
35°C(95°F).
• As the body continues to fall, the heart begins
to beat unevenly and eventually stops.
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Hypothermia
• Hypothermia is one of the major causes for
problems on rescue vessels, and our own
crews have to be aware of the causes.
• Air temperature, the humidity, whether skin is
wet and dry, and wind all affect how the body
maintains its temperature.
• The rapidity of onset of hypothermia is
affected by the types of clothing in all layers
for the skin to the outside.
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Hypothermia
• In the marine environment, exposure to cold
spray or immersion greatly increase the
chances of hypothermia.
• A body immersed will lose heat 25 times
faster that in air of the same temperature.
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Prevention of Hypothermia
• Avoid being outside in coldest part of the day.
• Wear a hat and layers of clothing, to trap
warm air against the skin.
• Drink plenty of warm fluids to help the body
maintain its temperature. No alcohol or
caffeine.
• When shivering starts, get out of the cold.
• Avoid falling in the water.
• If clothes become wet, change immediately.
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Signs and Symptoms of
Hypothermia
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Shivering (may stop when body gets too cold)
Numbness
Lack of coordination
Confused or unusual behaviour
Body temperature below 35°C (95°F)
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Stages of Hypothermia
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1st Stage of Hypothermia
• Body Temperature drops by 1-2°C below
normal temperature (35-37°C).
• Mild to strong shivering.
• The victim is unable to perform complex tasks
with the hands; numb hands.
• Breathing becomes quick and shallow.
• Victim may feel sick to their stomach, and
very tired.
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Transition to 2nd Stage of
Hypothermia
• Often casualty will experience a warm
sensation, as if they have recovered.
• A test to see if the casualty is entering stage 2
is if they are unable to touch their thumb with
their little finger.
• The casualty might start to have trouble
seeing.
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2nd Stage of Hypothermia
• Body temperature drops by 2 - 4°C below
normal temperature (33-35°C).
• Shivering more violent.
• Muscle mis-coordination apparent.
• Movements - slow and laboured, stumbling
pace and mild confusion.
• Casualty pale.
• Lips, ears, fingers / toes may become blue.
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3rd Stage of Hypothermia
• Body temperature drops below about 32°C.
• Shivering usually stops.
• Difficulty speaking, sluggish thinking, and
amnesia start to appear
• Inability to use hands.
• Stumbling is also usually present.
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3rd Stage of Hypothermia
• Below 30 °C, exposed skin is blue and puffy
• Muscle coordination becomes very poor,
walking becomes almost impossible.
• Casualty exhibits incoherent/irrational
behaviour including burrowing or stupor.
• Pulse and respiration rates decrease
• Fast heart rates can occur.
• Major organs fail.
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3rd Stage of Hypothermia
• Clinical death occurs.
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Treatment for Hypothermia
• Monitor airway, breathing and circulation.
• Remove wet clothing and dry the casualty.
• Warm the casualty gently - use ResQ Air/
Heat Treat where trained - if casualty alert,
give warm liquids.
• Handle gently.
• With severe hypothermia, pulse may be slow.
Administer rescue breathing, and start CPR if
necessary.
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