Life Threatening Emergencies

If after the primary survey you detect any life threatening conditions such as
these
Breathing Emergencies
Cardiac Emergencies
Bleeding
Shock
First check to see whether the patient is conscious. Then complete the
primary survey y checking the !BC"s
1. Airway.
2. Breathing.
#. Circulation.
Since o$ygen is vital for life% you must always ensure that the victim has an
open airway and is reathing.
Breathing Emergencies
It can occur in two ways&
Breathing can ecome difficult ' Respiratory Distress.
Breathing can stop Respiratory Arrest.
The Breathing (rocess re)uires respiratory% circulatory% nervous% and
musculoskeletal system to work together. !ny in*ury or illness in any of
these systems can impair reathing. For e$ample '
If the heart stops eating% the victim will stop reathing.
The in*ury or disease in areas of rain that control reathing may
impair or stop reathing.
+amage to muscles or ones of the chest and ack can make reathing
difficult or painful.
The ody re)uires constant o$ygen for survival. ,hen you reathe air into
lungs the o$ygen is transferred to lood. The lood transport o$ygen to the
rain% organs% and other parts of the ody where it is used to provide energy.
This energy is used to provide functions such as reathing% walking% talking%
digesting food% and maintaining ody temperature.
+ifferent functions re)uire different levels of energy and% therefore% different
amount of o$ygen. For e$ample% sitting on a chair re)uires less energy than
*ogging around a lock. ! ody attling disease% even the common cold%
uses more energy than a ody in its normal healthy state ecause it may
carry out all normal functions of life and simultaneously fight the disease.
,ithout o$ygen% cells egan to die in -'. minutes. Some tissues% such as the
rain% are very sensitive to o$ygen starvation. /nless the rain receives
o$ygen within minutes% rain damage or death will result. The reathing
emergencies can e caused y the following
!n ostructed !irway 0Choking1
Illness 0such as pneumonia1
2espiratory conditions 0asthma1.
Shock.
+rowning.
3eart attack or heart disease.
!llergic reactions to foods% insect stings% and so on.
In*ury to the chest or lungs.
+rugs.
(oisoning% such as inhaling or ingesting to$ic sustances.
0 minutes& Breathing stops% 3eart
will soon stop eating.
!" minutes& Brain damage
possile.
"!10 minutes& Brain damage likely.
#$er 10 minutes& irreversile rain
damage certain.
Time is critical in starting lifesaving measures. Si$ minutes without o$ygen will generally
cause Brain %eath.
Electrocution.
Respiratory %istress is not always cause% &y in'uries or illnesses( such as
those liste% in the list. )t may also result from e*citement or an*iety.
+ignals of Respiratory Distress
Con%ition +ignals
!normal
Breathing
Breathing slow or rapid.
Breaths are unusually deep or shallow.
4ictim is gasping for reath.
4ictim is whee5ing% grunting or making high
pitched noises such as crowing.
!normal skin
appearance
Skin ecomes unusually moist.
Skin has a flushed% pale% or luish
appearance.
3ow the victim
feels
Short of reath.
+i55y or light headed.
(ain in the chest or tingling in hand and feet.
Asthma
It is the condition that narrows the air passages and makes the reathing
difficult. This may e due to spasm of muscle lining of ronchi or swelling
of ronchi themselves.
It can e triggered y allergic reaction to food% pollen% a drug% or an insect
sting.
Causes ,
For some people% physical activity may induce asthma.
Emotional stress may also trigger it.
6ormally% someone with asthma easily controls attacks with
medication.
+ignals ,
,hee5ing when e$haling 0it occurs ecause air ecomes trapped in lungs1.
-yper$entilation
It occurs when someone reaths faster than normal. This rapid reathing
upsets the ody"s alance of o$ygen and caron dio$ide.
Causes ,
It is often caused due to fear and an$iety.
It is likely in people who are tense and nervous.
3ead in*uries.
Severe leeding.
Illnesses such as high fever.
3eart failure.
7ung disease
+iaetes emergencies.
It can also e triggered y asthma or e$ercise.
+ignals ,
8. Shallow% rapid reathing.
9. +espite their effort to reathe% the victims state that they cannot
get enough air or they are suffocating.
#. 7ook fearful and apprehensive or may appear confused.
-. They may feel di55y.
:. Their fingers and toes feel num or tingly.
Anaphylactic +hoc.
It is a severe allergic reaction. !ir passages may swell and restrict the
victims reathing. It may e caused due to insect stings% food% or
medications% such as penicillin. Some people who know that they have
severe allergy due to any of these things must avoid these sustances.
+ignals of Anaphylactic +hoc..
8. ! rash may appear on the ody.
9. Feeling of tightness in the chest and throat.
#. Swelling of face% neck and tongue.
-. The person may also feel di55y and confused.
:. If not cared for )uickly it can ecome a life threatening emergency.
/irst ai% for Respiratory %istress
2espiratory +istress may signal the eginning of a life threatening
condition.
If the victim is reathing we know the heart is eating.
;ake sure that the person is not leeding severely.
3elp him to sit in a comfortale position% as reathing is easier.
(rovide enough air y opening the window and clearing the crowd.
If the victim is unale to speak% due to reathlessness ask the
ystanders aout history.
;ake sure that someone has called the Emergency 0e%ical +er$ices
1E0+2 i.e. 8<= or any other amulance services or the near y
hospital.
Calm and reassure the victim and help him to take the medicine if he
uses.
3elp maintain normal ody temperature y chilling on cool day or
providing shade on a hot day.
;onitor vital signs 0Temperature% (ulse and 2espiration1
In case of hyperventilation% if the person does not slow down% have the
victims cup oth the hands around the mouth and nose and reathe into
them. ,hen the victim rereathes e$haled air% the condition will usually
correct itself. If the condition does not correct itself and victim ecomes
unconscious due to hyperventilating call emergency services immediately.
Respiratory Arrest
In this condition% the person gets no o$ygen to continue ody functions%
therefore the ody systems may fail. 3owever you can keep the person"s
respiratory system functioning artificially y Rescue &reathing. It works
ecause the air you reathe into the victim contains more than enough
o$ygen to keep the person alive. The air you take in contains 98 percent
o$ygen% ut your ody uses only a small part of that. The air you reathe out
of your lungs and into the lungs of the victim contain aout 8. percent
o$ygen. That is enough to keep some one alive.
-ow to Rescue Breathing for an A%ult
8. Check for Consciousness.
9. (hone E;S personnel for help.
#. >pen airway 0use head tilt ack?chin lift1
-. Check for reathing 0look% listen and feel for reathing for aout :
seconds1
:. If person is not reathing% give 9 slow reaths
@eep the head tilted ack.
(inch nose shut.
Aive 9 slow reaths% each lasting aout 8
8?9
seconds.
,atch the chest to see that your reath go in.
Check for pulse.
7ocate !dam"s apple.
Slide fingers down into groove of neck on side closer to you.
Feel for pulse for aout : to 8< seconds.
.. If the airway is ostructed Aive up to : A&%ominal thrusts
(lace the heel of one hand against middle of person"s adomen.
(lace other hand directly on the top of first hand.
(ress into person"s adomen with upward thrusts.
3. Do finger sweep 1stimulate2
Arasp oth tongue and lower *aw etween your thum and
finger and lift *aw.
Slide finger down inside of the cheek to ase of the tongue.
!ttempt to sweep o*ect out.
=. If the person is choking
,rap your arm around person"s waist.
;ake a fist.
(lace thum side of the fist against middle of person"s adomen
*ust aove the navel and well elow lower tip of reast one.
Arasp fist with your other hand.
(ress the person"s adomen with a )uick upward thrust.
Each thrust should e a separate and distinct attempt to dislodge
o*ect.
Do You Suffer With Back Pain?
The pain was horrible. It felt as if someone had
taken a match and set my back on fire! All I
remember was bending down to move my small
nephew away from some broken glass, and
suddenly my whole back ignited, as it were. I
remained in that position for days, unable to
straighten up. I never experienced pain like that
before, relates !aren, "#, a housewife and mother
of two.
$A%! pain ranks second to headache in the number of
people it affects in the &nited 'tates. It is the leading cause of
long(term disability in people younger than )* and the third
leading cause among those older than )*. 'ufferers spend some
#) billion dollars a year seeking relief+four times what was
spent on AI,' treatment in -..-.
According to ,r. Alf /. 0achemson, a scientific researcher in
back problems, two billion patients worldwide have suffered from
low back pain in the past decade. 'ometime during our active
lives 12 percent of us will experience back pain to some extent,
he said.
A Cycle of Pain
$ack pain does not discriminate. $oth blue(collar and white(
collar workers are prone to back in3uries. 4en and women,
young and old, can fall victim to this pain. 5hen the pain is
recurrent and unremitting, it can affect employment, income,
family, and one6s role in the family, producing emotional suffering
as well. 7ow8
9eople find themselves in a pain cycle, notes the book The
Fight Against Pain. 9hysical pain induces anxiety and
depression that may in turn lead to even more intense and
persistent pain. :or example, a young parent or breadwinner
may have to deal with pressure from 3ob, family, and friends
because of the disability that can result from back problems.
I find the biggest problem to be a lack of understanding and
empathy on the part of my family and friends. 9eople tend to
minimi;e the pain, not understanding how much you are really
suffering, said 9at, "*, a secretary who had her first of many
attacks of back pain in -.1<. 'ince you do not know when or
where the pain will flare up, you tend not to make a lot of plans.
=ou can appear to be >uite unsociable, not accepting invitations,
not picking up someone6s newborn baby, not smiling, all because
you6re hurting. The pain, if you let it, can control you.
Why the Back Hurts
Is back pain inevitable8 5hat can you do to alleviate it or to
prevent it8 5hen should you seek medical help for your back8
Although back pain that is persistent can signal many internal
diseases, this discussion will focus on two sources of back pain
+herniated disks and muscle spasms.
7erniated disks are a ma3or cause of back disease among
young and middle(aged adults. 'uch disks are often referred to
as slipped disks, a misnomer, since they cannot be slipped in
or out of place.
$y the time a person reaches his #26s, the spongy interior of
the disks begins to lose its elasticity and moisture, causing the
disk to shrink. $ut this does not usually result in pain. :or some
people, however, intense pain occurs when part of the spongy
interior herniates, or bulges, through the outer ring of fibrous
tissue.
Fortune maga;ine comments regarding the disks? @nce
they6ve degenerated past a certain point, the slightest stress+
something as trivial as a snee;e or bending over to move a
stereo+can be the straw that breaks them.
,isks act as shock absorbers between the first #) vertebrae,
or bones of the spine. These bones are stacked atop one
another and form a vertical tunnel, the spinal canal, through
which the spinal cord runs. $etween each pair of vertebrae,
there is a small opening through which a bundle of nerves, called
a nerve root, leaves the canal, one bundle on either side. A disk
may herniate and press against a particular nerve. This pressure
can interrupt nerve signals that convey sensations to and from
other parts of the body.
A very painful condition known as sciatica, for example, can
occur if there is pressure exerted on the roots of the sciatic
nerve. 'everal that emerge from the lower part of the spine form
the sciatic nerve. There is one on each side, running down the
back of each thigh as far as the knee and then branching into
other nerves. 'ciatic pain usually begins in the low back and
shoots out into the hip and buttock and on down the back of the
thigh, sometimes as far as the calf and foot. As a result, a person
may experience foot drop+a condition in which the foot drags
because the leg muscles cannot raise the toes. A sufferer may
also experience sensations of pins and needles, numbness, and
muscular weakness in the affected leg.
If the disk presses on nerve roots in the cauda equina, a
group of nerves 3ust below the waist that service the bladder and
the bowels, a person may have problems urinating or defecating.
9ersons with any of these symptoms should consult a doctor
immediately, as they may be signs of serious neurological
problems.
5hen contracted and relaxed, the muscles in the back 3oin
the ligaments in supporting roles, keeping the spine from
collapsing and enabling it to bend and twist. &nder strain,
however, an out(of(shape muscle can go into a spasm, tensing
up so much that it becomes a hard lump. @ccurring without
warning and temporarily immobili;ing a person, episodes of back
spasms can be agoni;ing. @ne sufferer describes the pain as a
series of earth>uakes erupting in your back.
,octors agree that muscle spasms occur to guard a person
from incurring further damage to weakened muscles. A Time(/ife
book, The Fit Back, observes? $y immobili;ing the back, the
spasm forces you to take the best course of action and lie down.
This position not only places the least amount of stress on your
back, but it allows inflamed tissue to repair itself.
In order to prevent back strain that often triggers spasms, the
muscles of the back, abdomen, and thighs need to stay toned
and firm. /ax abdominal muscles, for example, may create back
strain because they do not give proper support and are less able
to resist the pull of the body6s weight on the spine. If abdominal
muscles are well(conditioned, they create a muscular girdle
that prevents the lower back from arching into a swaybacked
position. 'wayback, an excessive curvature of the lower back,
pulls the vertebrae of the lower back out of alignment.
What You Can Do to Ease Pain
9oor posture, obesity, weak muscles, and stress are four
factors that contribute to the likelihood of pain in the lower back.
%ommon activities that are done improperly, such as sitting,
standing, or lifting, are other predisposing factors.
A mutual relationship exists between good posture and strong
abdominal and back muscles. %orrect posture allows the
muscles to work properly, while good muscle tone is vital for
proper posture. An alignment that follows the spine6s natural '
curve is re>uired for good posture. It does not mean a rigidly
straight spine.
If improper posture is corrected, pain of postural origin can be
eliminated, indicates Aobin 4c!en;ie in the book Treat Your
Own Back, adding? As time passes, however, if uncorrected, the
habitual poor posture causes changes to the structure of the
3oints, excessive wear occurs, and premature ageing of the 3oints
is a conse>uence.
Bxcess weight, especially in the abdomen, can also strain the
back because it creates a gravitational pull on the muscles that
support the back. A regular exercise program is a key to a fit and
healthy back. Bven if pain is no longer experienced, exercise is
essential because back pain that has gone away tends to
resurface unexpectedly. A complete medical evaluation is
recommended before beginning a program. A doctor may
suggest the proper exercises for an individual6s back problem, or
he may refer a patient to a physical therapist.
4any researchers believe that stress can also make a person
vulnerable to back trouble. 'tress may trigger spasms in some
people because unrelieved tension tightens muscles, resulting in
back pain. 4anaging or eliminating sources of stress can help
reduce the risk of back pain.
9eople who spend a great deal of time sitting at work or when
traveling for long distances may experience back strain. 4uch
more weight is exerted on the lower back when sitting, according
to a 'wedish study. &nfortunately, this risk is increased by the
use of office chairs with insufficient back support. It may be
helpful to interrupt sitting at regular intervals by standing and
walking around for a few minutes.
5hen lifting heavy or even light ob3ects, people should guard
against using their back muscles. $ending the knees is
suggested when lifting so that back muscles do not bear all of
the pressure.
A person who works in awkward positions is also likely to be
sub3ect to back problems. Assembly(line workers, nurses,
electricians, housekeepers, and farmers are all re>uired to bend
forward for long periods in carrying out their work. To minimi;e
the risk of back in3ury, physical therapists recommend resting
regularly or changing positions. 9eople who stand for a
prolonged period of time are advised to use a small stool or other
footrest and to slightly elevate one foot so as to straighten the
lower back.
The Search for Treatment
:or the ma3ority of those who experience back pain of
muscular origin, doctors recommend conservative treatment+
bed rest, use of heat, massage, exercise, and, initially, anti(
inflammatory pain(relieving drugs. As regards the latter, ,r. 4ark
$rown of the &niversity @f 4iami 'chool @f 4edicine offers a
word of caution. 7e notes that in the &nited 'tates, the
prolonged use of drugs is a ma3or cause of back pain suffering,
that is, from the side effects of medications. 9eople need to
guard against developing a tolerance for a drug, which could
result in increased dosage, possibly causing addiction.
9hysical therapy and chiropractic visits may also offer help
and relief to some sufferers. %hiropractic care accounts for about
two thirds of all patient visits for back pain in the &nited 'tates,
notes the 3ournal Health Facts.
'urgery may be necessary to correct problems or relieve pain
associated with herniated disks. 4ore often, however, doctors
will first recommend conservative treatment for the ma3ority of
back(pain sufferers. 9eople who are told they need surgery
would do well to obtain second or third opinions.
:or millions of sufferers, constant but bearable back pain is a
part of life. 4any resign themselves to the pain but endeavor not
to let it interfere with day(to(day activities. They are aware of
factors that induce pain and take measures to prevent or
counteract it. They exercise regularly, maintain proper weight,
improve their posture, and reduce stress in their lives. ,espite
bouts of recurring pain from a herniated disk and from muscle
spasms, !aren, mentioned at the outset, cheerfully maintains a
busy schedule, spending much time in the preaching and
teaching activity of Cehovah6s 5itnesses. /ike !aren, many
sufferers maintain a positive attitude and work toward controlling
their back pain.
[Box on pae !"#
Some Helps in Pre$entin Back Pain
D Avoid picking up something in a >uick, 3erky motion. Instead
of bending from the waist, bend at the knees.
D Ask for help when lifting heavy items.
D 5hen carrying several packages, balance the load on each
side. If carrying one heavy item, carry with both arms in front,
next to the body. If carrying to the side, alternate sides.
D :or travel, use a collapsible luggage carrier andEor lightweight
luggage with shoulder straps.
D 5hen lifting packages out of a car trunk, position the
packages close to the body before lifting them.
D 5hen vacuuming, use a long(handled vacuum cleaner.
Instead of bending from the waist to vacuum underneath items,
kneel on one knee, using knee pads. If you must bend from the
waist, then, when possible, use one hand to support yourself on
something.
D 5hen doing office work, alternate sitting at a desk with
standing at a waist(high work surface.
D !neel down when gardening, and break up the work into
shorter segments. 5hen standing do not bend from the waist.
D ,o back exercises on a regular basis even if only for -2 to -*
minutes a day. &se moderate exercises if you are older.
D 5hen making beds, kneel on the bed with one knee, and
brace yourself with one arm when reaching across the bed.
5hen straightening or tucking in sheets, kneel on the floor at
each side of the bed.
D 5hen driving long distances, take rest stops. If the back of the
car seat is not comfortable, use a pillow to fill in the space where
the seat does not fit the small of the back properly.
D ,on6t 3og on hard surfaces. 5ear proper exercise shoes.
D &se a pillow or other back support when sitting in an easy
chair or sofa. Fet up slowly, using your legs to push up.
D If you spend hours sitting at work, get a chair that has a
properly shaped back support. Fet up at times, and move
around.
D ,on6t bend over file(cabinet drawers for any extended period,
but sit on a chair when you can.
D If you have to wear high(heeled shoes during the day, bring a
more comfortable pair to alternate with them when possible.