Lesson Outline
Chapter 17
Lesson 17: Sudden Illnesses
Lesson Objectives
After completing this lesson, participants should be able to:
 Describe the signs and care for a heart attack.
 Describe the signs and care for angina.
 Describe the signs and care for a stroke.
 Describe the signs and care for asthma.
 Describe the signs and care for hyperventilation.
 Describe the signs and care for COPD.
 Describe the signs and care for fainting.
 Describe the signs and care for seizures.
 Describe the signs and care for low blood sugar.
 Describe the signs and care for high blood sugar.
 Describe the signs and care for abdominal pain.
 Describe the signs and care for nausea and vomiting.
 Describe the signs and care for diarrhea.
 Describe the signs and care for constipation.
Points
Heart Attack
 A heart attack occurs when the blood supply to part of the heart muscle is
severely reduced or stopped.
 Heart muscle tissue dies.
 Cardiac arrest occurs if the electrical system of the heart is affected.
 Heart attacks are difficult to determine, and victims often deny the signs.
Recognizing a Heart Attack
 Chest pressure, squeezing, or pain that lasts longer than a few minutes or goes
away and comes back
 Pain spreading to the shoulders, neck, or arms
 Dizziness, sweating, nausea
 Shortness of breath
 Not all warning signs occur with every heart attack.
 Some victims—as many as one third—have no chest pain.
 Prompt action is important.
o Hospital can administer clot-dissolving drugs (thrombolytics).
o The sooner this is done, the better.
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Lesson Outline
Chapter 17
Care for a Heart Attack
 Call 9-1-1.
 Monitor breathing.
 Help victim into most comfortable position.
 If the victim has heart medication (eg, nitroglycerin or aspirin), assist him or her
in taking it.
 Nitroglycerin
o Hospital can administer clot-dissolving drugs (thrombolytics).
o Can relieve chest pain from angina but not heart attack.
o Dilates coronary arteries, increasing blood flow to heart muscle.
o Lowers blood pressure
o Caution: victim should lie down once nitro is taken.
Angina
 Angina is chest pain from coronary artery disease.
 It results when the heart does not get enough blood.
o Angina is brought on by physical exertion and is relieved when exertion
stops.
 It is also brought on by cold exposure and emotional stress.
 Seldom lasts longer than 10 minutes.
 It is relieved by nitroglycerin.
Recognizing Angina
 Signs are similar to heart attack
 Crushing, squeezing pain, or pain like someone is standing on the victim’s chest.
 Lasts 3 to 10 minutes
 Shortness of breath, nausea, sweating
 Victim feels anxious
 Almost always relieved by nitroglycerin
Care for Angina
 If the victim has nitroglycerin, help the victim use it.
 If pain continues beyond 10 minutes, suspect a heart attack, and call 9-1-1.
 Other causes of chest pain:
o Exercise or injury
o Respiratory infections
o Indigestion
Risk Factors of Heart Disease
 Cannot be changed:
o Heredity
o Sex
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Lesson Outline
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Chapter 17
o Age
Can be changed:
o Smoking
o High blood pressure
o High cholesterol
o Diabetes
o Obesity
o Inactivity
o Stress
Stroke (Brain Attack)
 Part of the blood flow to the brain is suddenly cut off
 A stroke results from a blocked or ruptured blood vessel in the brain.
 Nerve cells die within minutes.
 One quarter of victims die; stroke is the third leading cause of death.
 Risk factors include:
o Age older than 50
o Use of birth control pill, age older than 30
o Overweight
o Hypertension
o High cholesterol
o Diabetes
o Heart disease
o Sickle cell disease
o Substance abuse
o Family history of strokes or TIAs
 The most common type of stroke is ischemic.
o A clot forms in an artery in the brain, or travels from the heart to the brain.
 The blood vessel may rupture.
 Other causes include tumors, vessel spasms, and aneurysms.
 Transient ischemic attack (TIA) has similar signs as stroke.
 Symptoms of a TIA last several minutes to several hours, but neurologic function
returns eventually.
 TIAs are a serious warning sign of a potential stroke.
 Signs and symptoms of a TIA should be reported to a physician.
Recognizing Stroke
 Weakness, numbness, or paralysis of the face or one side of the body
 Blurred or decreased vision
 Problems speaking
 Dizziness or loss of balance
 Sudden, severe headache
 Pupils not equal or not reactive to light
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Lesson Outline
Chapter 17
Care for Stroke
 Call 9-1-1. Seek medical care.
 If victim is responsive, lay patient on back with head and shoulders slightly
elevated.
 If victim is unresponsive, open the airway and check the victim’s breathing.
o Give CPR if needed.
 If unresponsive patient is breathing, place in recovery position.
 Do not give anything to eat or drink.
 The Los Angeles Stroke Screen quickly identifies stroke victims with three tests:
o Arm strength
 The victim closes his eyes and holds both arms out with palms down,
and slowly counts to five.
 If one arm does not move and the other drifts down, suspect a stroke.
o Facial smile
 The victim smiles or shows teeth.
 If one side of the face does not move as well as the other side, suspect
a stroke.
o Hand grip
 The victim grips one of your fingers in each of his hands at the same
time.
 If grip strength is not equal, suspect a stroke.
Asthma
 Asthma is a chronic inflammatory lung disease in which the air passages are
overly sensitive.
 Air passages narrow and mucus builds up, resulting in poor oxygen exchange
 During an attack, air passages get narrower and breathing becomes difficult.
 It is common in children and young adults.
 Triggers for asthma include:
o Respiratory tract infection
o Temperature extremes
o Strong odors
o Occupational exposures
o Certain drugs
o Exercise
o Emotional stress
o Allergens
o Air pollution
Recognizing Asthma
 Coughing
 Cyanosis (bluish skin)
 Victim must pause when speaking to catch breath
 Victim’s nostrils flare with each breath
 Difficulty breathing, wheezing
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Lesson Outline
Chapter 17
Care for Asthma
 Help victim into most comfortable position.
 Monitor breathing.
 Assist the patient with an asthma inhaler.
 If victim’s condition does not improve or the attack is extreme, seek medical care.
Hyperventilation
 Rapid, deep breathing often seen with emotional stress
 Hyperventilation can also be caused by:
o Untreated diabetes
o Severe shock
o Certain poisons
o Brain swelling
Recognizing Hyperventilation
 Dizziness, lightheadedness
 Numbness
 Tingling of hands and feet
 Shortness of breath
 Breathing faster than 40 breaths/min
Care for Hyperventilation
 Calm and reassure the victim.
 Have the victim breathe slowly.
o Inhale through the nose.
o Hold for several seconds.
o Exhale slowly.
 Do not have the victim breathe into a paper bag.
o This rarely restores blood gas but often causes dangerous stress to the
heart and respiratory system.
COPD
 COPD stands for chronic obstructive pulmonary disease.
 COPD is a term used for a number of condition, including emphysema, chronic
bronchitis, and lung diseases.
 People with COPD find it hard to breathe because their air flow is obstructed.
 COPD affects primarily older adults.
 Chronic bronchitis
o Caused by chronic infection
o Symptoms include coughing, difficulty breathing, and increased sputum
 Emphysema
o Often occurs with chronic bronchitis
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Lesson Outline
Chapter 17
o Alveoli are partially destroyed
o Symptoms include coughing, wheezing, and shortness of breath
Recognizing COPD
 Wheezing
 Coughing
 Shortness of breath
 Victim has artificially supplied oxygen
Care for COPD
 Assist the victim with any prescribed medications he may have.
 Place the victim in the position of comfort.
 Encourage the victim to cough up secretions.
 Encourage the victim to drink fluids.
 If the situation is acute, seek medical care.
 Administer oxygen.
Fainting
 Fainting is a sudden brief loss of responsiveness associated with decreased blood
flow to the brain.
 It is also called syncope or psychogenic shock.
 It can result from physical or emotional causes.
o For example, it can be precipitated by unpleasant emotional stimuli such
as the sight of blood or strong fear.
 Sitting or standing for a long time without moving can cause blood to pool, which
can lead to fainting as well.
Recognizing Fainting
 Dizziness
 Weakness
 Seeing spots
 Visual blurring
 Nausea
 Pale skin
 Sweating
Care for Fainting
 If the victim is about to faint:
o Prevent the person from falling.
o Help the person lie down with his legs raised 6 to 12 inches.
o Loosen tight clothing at the neck and waist
o Stay with the victim.
 If fainting occurred:
o Monitor breathing.
o Loosen tight clothing and belts.
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Lesson Outline
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Chapter 17
o Raise victim’s legs 6 to 12 inches.
o Have the victim sit and drink cool, sweetened liquids.
o Fresh air and a cold, wet cloth may help
Seek medical care if the victim:
o Has repeated fainting episodes
o Does not quickly regain consciousness
o Loses consciousness while sitting or lying down
o Faints for no apparent reason
Seizures
 Seizures can result from various medical conditions:
o Epilepsy
o Heatstroke
o Poisoning
o Electric shock
o Hypoglycemia
o High fever in children
o Brain injury, tumor, or stroke
o Alcohol withdrawal, drug overdose
 There are four types of seizures:
o Generalized tonic-clonic
o Focal motor
o Complex partial
o Absence
 The typical sequence for a tonic-clonic seizure is for the patient to experience an
aura first.
o This is a strange sensation that lasts a few seconds.
o It can consist of auditory or visual hallucinations, a peculiar taste in the
mouth, or a painful sensation in the abdomen.
o This is followed by loss of consciousness and muscle contractions.
o It usually lasts for 2 to 5 minutes.
 Obtain the following information from the seizure victim:
o Is there a history of seizures?
o Does the victim take medication for seizures?
o What did the seizure look like?
o How long did it last?
o Does the victim abuse alcohol or drugs?
o Has the victim recently had a fever, headache, or stiff neck?
o Does the victim have a history of diabetes, heart disease, or stroke?
Recognizing Seizure
 Generalized tonic-clonic
o These are characterized by a loss of consciousness, muscle contraction,
and sometimes tongue biting, loss of bladder control, and mental
confusion.
o The seizure is usually followed by a period of coma or drowsiness.
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Lesson Outline
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Focal motor
o These usually cause one part of the body, such as one side of the face or
an arm, to twitch.
Complex partial
o Characterized by an altered personality state and often preceded by
dizziness or a peculiar metallic taste in the mouth.
Absence.
o These usually occur in children and are rarely an emergency.
o They are characterized by a brief loss of consciousness.
o The child suddenly stares off into space for a few seconds then returns
immediately to consciousness.
Care for a Seizure
 Protect the victim from injury.
 Loosen any restrictive clothing.
 Place the patient in the recovery position.
 Look for a medical tag (bracelet or necklace).
 Call 9-1-1 if:
o Seizure occurs for unknown reason
o Seizure lasts longer than 5 minutes
o Victim is slow to recover, has second seizure, or difficulty breathing
afterward
o Victim is pregnant or has medical condition
o Signs of illness or injury
 Status epilepticus
o Two or more seizures without an intervening period of consciousness
o This is an emergency situation.
o It can lead to aspiration, brain damage, fractures, severe dehydration.
Diabetic Emergencies
 Diabetes is a condition in which insulin is either lacking or ineffective.
o As a result, excess sugar remains in the blood
 There are two types of diabetes: Type I juvenile-onset or insulin-dependent and
Type II adult-onset or non-insulin dependent.
 When there is too much insulin and not enough blood sugar, low blood sugar
results.
o This may cause insulin shock.
 When there is too much sugar and not enough insulin, high blood sugar results.
o This may cause diabetic coma.
Low Blood Sugar
 Hypoglycemia or insulin reaction: very low blood sugar
 Causes of hypoglycemia include too much insulin, too little or delayed food
intake, exercise, alcohol, or any combination of these factors.
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Lesson Outline
Chapter 17
Recognizing Low Blood Sugar
 Sudden onset
 Staggering, poor coordination
 Anger, bad temper
 Pale color
 Confusion and disorientation
 Sudden hunger
 Excessive sweating
 Trembling
 Seizures
 Unresponsiveness
Care for Low Blood Sugar
 Give 15 g sugar.
 If condition does not improve in 15 minutes, give 15 more g sugar.
 If still no improvement, seek medical care.
High Blood Sugar
 Hyperglycemia or diabetic coma: very high blood sugar
 Causes of hyperglycemia include insufficient insulin, overeating, inactivity,
illness, and stress.
Recognizing High Blood Sugar
 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
 Abdominal pain can be aching, cramping, sharp, or dull.
 It can be constant or can come and go.
 Nausea and vomiting fit into the category of abdominal complaints, as do diarrhea
and constipation.
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Lesson Outline
Chapter 17
Abdominal Pain
 The peritoneum is a thin membrane lining entire abdominal cavity.
 Peritonitis is inflammation of the peritoneum.
 There are many possible causes for abdominal pain, and they are difficult to
diagnose.
Recognizing Abdominal Pain
 When did the pain start? Where is it located?
 Is it constant, or does it come and go?
 Does belching or passing gas relieve the pain?
 Does the victim feel nauseated?
 Is there diarrhea or vomiting?
 Does the victim feel warm (feverish)?
 Does anyone near the victim have similar symptoms?
 For a female, is there any chance of pregnancy?
 Is the abdomen rigid to the touch?
Care for Abdominal Pain
 Give only clear fluids.
o 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.
o Keep victim on left side.
 Place the victim in the position of comfort.
 Seek medical care if:
o Constant pain or more than 6 hours
o Victim unable to drink fluids
o Possible pregnancy
o Rigid, painful abdomen, swollen abdomen
o More pain when abdomen is pressed
o Bloody or black stool
o Fever
o Pain began around belly button, moved to lower right side
Nausea and Vomiting
 There are many potential causes of nausea and vomiting.
 Persistent nausea and vomiting can signal a serious illness.
 If it lasts more than 1 or 2 days, dehydration can occur.
 Young children and the elderly are more seriously affected.
Recognizing Nausea and Vomiting
 Is there abdominal pain?
 Is there blood or brown, grainy material in the vomit?
 Is there diarrhea?
 Are there signs of dehydration?
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Does anyone else near the victim have similar symptoms?
Has the victim had a recent head injury?
Care for Nausea and Vomiting
 Give small amounts of clear fluids.
 If the victim is able to keep the fluids down, offer carbohydrates.
 Have victim rest, avoid exertion.
 Place the patient in the recovery position.
 Seek medical care if:
o Blood or brown, grainy material appears in the vomit
o There is constant abdominal pain
o Victim faints when standing
o Victim is unable to keep fluids down more than 24 hours
o Victim has severe, projectile vomiting
o Vomiting follows a recent head injury
Recognizing Motion Sickness
 Nausea
 Pale skin
 Cold sweats
 Vomiting
 Diarrhea
 Headache
 Fatigue
Care for Motion Sickness
 Sit near midsection of vehicle.
 Do not read.
 Look onto horizon.
 Avoid overeating.
 Try antihistamine 1 hour before traveling.
Diarrhea
 Diarrhea is the passage of loose, watery, or unformed stools.
 Causes include intestinal infection, food poisoning, and food sensitivity or
allergy.
 Dehydration can occur.
 It is important to replace fluids.
Recognizing Diarrhea
 Was the victim recently exposed to untreated, possibly contaminated water or
food?
 Is there blood or mucus in the stool?
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Are there signs of dehydration?
Does the victim have cramping abdominal pain?
Does the victim lose bowel control (sometimes)?
Is the victim feverish?
Does anyone else near the victim have similar symptoms?
Care for Diarrhea
 Have victim drink lots of clear fluids.
 Give mild foods.
 Bismuth can help.
 Seek medical care if:
o Blood stools
o No improvement after 24 hours
o Fever
o Severe, constant abdominal pain
o Severely dehydrated
Constipation
 Constipation is the passage of hard, dry stools.
 Minor changes in diet, fluid intake, activity, or emotional state can cause bowel
movement changes.
Recognizing Constipation
 Bloating
 Hard, dry stools
Care for Constipation
 Have victim eat more fiber.
 Have victim drink fluids.
 Encourage victim to remain active.
 If no improvement, try milk of magnesia or caffeine
 Seek medical care if:
 Severe abdominal pain
 Swollen or painful abdomen
 Fever
 Vomiting
Recognizing Emergencies During Pregnancy
 Vaginal bleeding
 Cramps in lower abdomen
 Swelling of face or fingers
 Severe, continuous headache
 Dizziness or fainting
 Blurred vision or seeing spots
 Uncontrollable vomiting
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Lesson Outline
Care for Pregnancy Emergencies
 Vaginal bleeding or abdominal pain or injury:
o Keep victim warm.
o For vaginal bleeding, place sterile pad over opening of vagina.
o Send blood-soaked pads to hospital with victim.
o Seek medical care.
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Chapter 17