Health evaluation of life threatening conditions

Evaluation of Life Threatening Conditions

Peter Dajime

Importance of Emergency Medicine

Is there a need for emergency medicine at this point in our history?

How did emergency medicine start?

The Rise of Lifestyle Diseases

5 Leading Causes of Mortality

Cause Rate per 100,000

1.Heart Diseases 69.8

2.Vascular Diseases 54.1

3.Pneumonias 43.1

4.Accidents 39.9

5.Cancer 37.5

Emergency Medicine

• Started in US around 1970• Under the Dept. of Transportation• Several levels of service providers

1. First Responder2. Dispatcher3. EMT

Role and Responsibilities

• Scene Management• Assessment• Management

Scene Safety

• Oncoming traffic• Unstable surfaces• Leaking gasoline• Downed electrical

lines• Potential for

violence• Fire or smoke

• Hazardous materials

• Other dangers at crash or rescue scenes

• Crime scenes

Patient Assessment

• Scene size-up• Initial assessment• Focused history and physical exam

–Vital signs–History

• Detailed physical exam• Ongoing assessment

Develop a General Impression

• Occurs as you approach the scene and the patient

–Assessment of the environment

–Patient’s chief complaint

–Presenting signs and symptoms of patient

Obtaining Consent

• Introduce self.

• Ask patient’s name.

• Obtain consent.

Expressed? Or

Implied?

Good Samaritan Law

Provides immunity from liability to a first responder who stops and helps at the scene of the emergency provided they do all they can, within their knowledge, to sustain life and prevent further injury.

Trauma

Damage caused by an external energy force that dissipated at a faster rate than the body’s ability to withstand

Blunt?Penetrating?

Chief Complaint

• Most serious problem voiced by the patient

• May not be the most significant problem present

Signs?Or

Symptoms?

Signs and Symptoms

Manifestations in the gross anatomy of a patient due to physiologic and structural changes in the tissues and organs

Signs and Symptoms

Pain?Tenderness?Breathing?Pulse?Behaviour?Temperature?Appearance?

Assessing Mental Status

• Responsiveness

–Response to external stimuli

• Orientation

–Mental status and thinking ability

Testing Responsiveness

• A Alert

• V Responsive to Verbal stimulus

• P Responsive to Pain

• U Unresponsive

Check Airway

• Labored breathing

• Accessory muscles

• Noisy breathing

• Cyanosis

• Rate and depth

• Air movement

• Choking

Types of Obstruction

Anatomical Mechanical

Partial Complete Partial Complete

Partial Complete

• weak cough

• wheezing

• strained breathing

• slight cyanosis

• inability to speak

• absence of breath sounds

• flared nostrils

• restlessness

• unresponsive

First Aid

• Back blows

• Heimlich Maneuver

• Chest Thrusts

Cardiovascular Emergencies

A rapid decline in heart

function due to poor

blood flow or electrical

activity.

LIFE THREATENING!!

Examples are cardiac

arrest, heart attack,

and arrhythmia

THREE CONDITIONS OF CARDIAC ARREST

1. Cardio Vascular CollapseThe heart is still beating but its action is

so weak that is not being circulated

through the vascular system to the brain

body tissues.

2. Ventricular Fibrillation

Occurs when the individual fascicles of the

heart beat independently rather than the

coordinated, synchronized manner that

produce rhythmic heart beat.

3. Cardiac standstill

It means that the heart has stopped beating.

Cardiovascular Emergencies

Heart attack is the death

of the heart muscle due

to deficient blood supply.

Usually mistaken for

angina pectoris.

What causes heart

attack?

Cardiovascular Emergencies

Arrhythmia is a broad

classification of heart

disorders that pertain to

irregularity in the sinus

rhythm

1. Bradycardia – too slow

2. Tachycardia – too fast

Neurological Emergencies

Stroke or Cerebrovascular Accident

• Lack of blood flow to the brain due to a clot

or a blood vessel rupture

• Risk factors include

gender, age, smoking, hypertension, obesit

y, and diabetes

• Symptoms include

dizziness, confusion, slurred

speech, sudden numbness, severe

Neurological Emergencies

Cerebral Aneurysm

• Rupture of one of

the arteries

supplying the brain

• Leads to stroke or

internal bleeding

Neurological Emergencies

Subdural Hematoma Epidural Hematoma

Neurological Emergencies

Intercranial Hematoma

• Symptoms include

headache, dizziness, an

d vomiting

• Signs include HR

decrease, BP

increase, raccoon

eyes, battle’s sign, and

CSF leak

Neurological EmergenciesConcussion

• Temporary disturbance in

brain function brought about

by a blow or jolt to the head

• Symptoms include

headache, balance

problem, confusion, and

dizzy

• Signs include

unconsciousness, amnesia,

and clumsy

Neurological Emergencies

Skull Fracture

• Trauma to the bony structure that

protects the brain

• Could be

linear, comminuted, depressed, or

basilar

• Watch out for complications!!

• Signs and symptoms include cushing’s

triad, nausea, and CSF leak