EMR CPR Orientation Course

Fundamentals of Occupational First Aid

Goals

  • Identify common medical emergencies
  • Understand how to address medical emergencies
  • First aid for common work-related injuries
  • Know basic EMR CPR Safety Policies
  • Understand responsibilities of a lead

How would you define a medical emergency?

One definition: A medical emergency is an injury or illness that is acute and poses an immediate risk to a person’s life or long term health.

Yet another definition: Emergency medical conditions involve immediate onset of symptoms, including pain, severe enough to lead a prudent layperson with an average knowledge of health and medicine to reasonably believe immediate medical attention is needed:

  • To avoid a serious impairment of bodily functions or serious dysfunction of a bodily organ or part.
  • Because there is a serious threat to the health of the individual or a fetus.

Emergency conditions include:

  • Suspected heart attack or stroke.
  • Sudden or extreme difficulty breathing.
  • Sudden loss of consciousness.
  • Severe bleeding.
  • Severe abdominal pain.
  • Injuries to one or both eyes.

How do I want you to define a medical emergency?

A medical emergency is ANY condition that has the POTENTIAL to result in death, loss of a limb or change in a persons long term function or health.

Is a medical emergency work related? Does it mater? No

  • Causation in an emergency does not matter! We fix our employee and then figure our what the cause is latter!
  • While I am not a lawyer and this does not represent legal advice, not addressing a medical emergency regardless of causation – could represent gross negligence and make you legally liable.

Common Medical Emergencies:

  • Chest pain
  • Stroke
  • Breathing problems
  • Anaphylactic reaction
  • Hypoglycemia in diabetics taking insulin
  • Seizures
  • Reduced level of consciousness

Chest Pain

Feared complication is a Heart attack

  • Definition: a sudden and sometimes fatal occurrence of coronary thrombosis, typically resulting in the death of part of a heart muscle.

What does this mean?

  • A heart attack is when there is lack of blood to a part or all of the heart often resulting in death of heart muscle tissue.

How do you know if your employee is having a heart attack? You dont! So when should you call an ambulance?

  • New or severe chest pain
  • Shortness of breath with chest pain
  • Last more than a few minutes
  • Gets worse when you walk, climb stairs, or do any other types of  physical activity
  • Scares or worries the employee

Bottom line: If heart attack comes to mind then they need a doctor! Remember: Always do the right thing. Call 911.

Stroke

  • Definition of stroke: A stroke is when there is lack of blood to a part of the brain often resulting in death of brain tissue.
  • Stroke cause: Part of the brain is not getting blood often because an artery in the brain gets clogged or an artery starts bleeding.
  • Identify a stroke by thinking FAST

FFace is uneven
AArm is weak
SSpeech is strange
TTime to call an ambulance

Breathing Problems

Many Different causes

  • Asthma
  • Pulmonary Embolism
  • Pneumonia
  • Heart Attack
  • Choking

When is it an emergency?

  • Turning Blue or very pale
  • Has a very hard time breathing
  • Cant speak or cry because the cannot get enough air
  • Seems sleepy or does not respond to you
  • CALL 911

Anaphylactic reaction

Severe Allergic reaction

  • Can have many different presentations over 40 differentSymptoms
  • Average time to cardiac arrest is 5 minutes
  • Key is calling 911 rapidly

Common Symptoms

  • Hives
  • Redness, itching of the skin without hives
  • Runny nose or swelling of the tongue
  • Difficulty breathing
  • Feeling dizzy or passing out

What do you do?

  • Call 911
  • More advanced
  • If you know what they are allergic to you need to remove them from continued exposure
  • Benadryl can be administered
  • If they have an epi-pen you can administer into thigh

Hypoglycemia in diabetics taking insulin

Diabetes is when a person can not control the sugar levels in the blood. When untreated blood sugar levels are usually high.

  • Medications are given to lower blood sugar levels
  • High blood sugar = hyperglycemic
  • Low blood sugar = hypoglycemic
  • Diabetics usually have a blood sugar monitor, a sugar less than 70 is hypoglycemic
  • Sugar levels above 250 regardless of symptoms also require medical attention.

Because medications lower blood sugar people can become hypoglycemic

Symptoms of Hypoglycemia

  • Sweating or trembling
  • Feeling of racing heart
  • Trouble walking or feeling weak
  • Trouble seeing clearly
  • Confusion
  • Passing out or having a seizure

Treatment for mild hypoglycemia is eating sugar then seeking medical attention.

Sources

  • 3-4 Glucose tabs
  • ½ cup of juice or regular soda (not diet)
  • 1 tablespoon of sugar or honey
  • 3-4 packets of sugar, honey should be placed under tongue
  • 4-5 saltine crackers
  • 6-8 hard candies (not chocolate)
  • If sugar cannot be given because it is not available or the unable to respond call 911
  • If sugar is given and they are feeling better, have them taken directly to an emergency room or clinic for evaluation.

More advanced

  • Some people at risk carry a medicine called glucagon, this can be administered under the guidance of the 911 operator.

Seizures

There are multiple kinds of seizures. Some seizures involve shaking of the whole body while others may only involve an arm or result in a stare where they do not respond for a few seconds.

  • Place them on their side, loosen tie if one is worn
  • Protect them from hitting things such as server cabinets and then call 911
  • Traumatic seizures can be a very bad sign 911 needs to be call immediately.
  • New Seizure, regardless of duration, needs to have 911 called.
  • Epileptic seizures that last more than 5 minutes need to have 911 called.

Reduced level of consciousness

Many causes:

  • Hypoglycemia
  • Difficulty breathing – asthma, PE, etc.
  • Heart problems – arrhythmia, etc
  • Intoxication – ETOH, Opioids (Norco), etc.
  • Hyperthermia, Hypothermia
  • Trauma
  • Call 911 – well beyond first aid!

Summary

 

  • Always do the right thing!
  • Make a decision quickly
  • Is this an emergency or not – Yes then call 911
  • You don’t want to call 911 30 min after the incident… you should have called within minutes!
  • If 911 is not needed, it is okay to pull some one off the team to drive the employee to the emergency room for evaluation – take care of each other!