Health 4 First Aid/Emergency Medicine I. Goals: a. To prolong life b. Alleviate suffering/pain c. Prevent further injuries II.

History and importance: a. Henry Dunant i. Battle of Solferino Because of necessity brought ii. Red Cross about by war 1. Geneva, Switzerland 2. St. Johns Ambulance b. Still necessary? i. Yes, accidents still happen ii. Control is an illusion iii. Increasing # of lifestyle diseases: 1. Heart Disease (69.8) 2. Vascular Disease (54.1) 3. Pneumonia (47.1) 4. Accidents (39.9) 5. Cancer (37.5) c. Paramedics i. 1970s; Miami, Florida; Department of Transportation ii. First Responder iii. Dispatcher 1. 117 iv. EMT (Emergency Medical Technicians (?)) d. First Aider i. Scene Management/Safety 1. Oncoming traffic 2. Unstable surfaces 3. Leaking gasoline 4. Downed electrical lines 5. Potential for violence 6. Fire/smoke 7. Hazardous materials 8. Other damages at crash/rescue scenes 9. Crime scenes ii. Assessment (& Evaluation) 1. Scene size-up 2. Initial assessment 3. Focused history & physical exam a. Vital signs b. History 4. Detailed physical exam 5. On-going assessment iii. Management (or Appropriate Care)

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iv. Develop General Impression 1. Occurs as you approach the scene & the patient a. Assessment of the environment b. Patients chief complaint c. Presenting signs and symptoms of patient i. Signs able to be perceived through the 5 senses ii. Symptoms feelings of patient v. Obtaining Consent 1. Introduce self 2. Ask patients name 3. Obtain consent (Expressed/Implied?) a. 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 bodys ability to withstand I. Blunt? Penetrating (disruption of homeostasis)? a. Temperature regulation (normal: 36.5oC 37.5oC) b. pH balance c. H2O level II. Chief complaint a. Most serious problem voiced by the patient b. May not be the most significant problem present c. Signs/Symptoms: i. Pain ii. Tenderness iii. Breathing iv. Pulse v. Behaviour vi. Temperature vii. Appearance injured and uninjured side viii. Others (those that appear in my notebook, but I dont know where to classify): 1. Tachycardia 2. Brachycardia 3. 110 blood sugar -> normal 4. Hypoglycaemia ix. Assessing Mental Status 1. Responsiveness a. Response to external stimuli b. Glasgow coma scale c. Testing: i. A Alert ii. V responsiveness to Verbal stimuli iii. P responsiveness to Pain iv. U - Unresponsiveness 2. Orientation

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a. Mental status and thinking ability x. Check Airway 1. Laboured breathing 2. Accessory muscles 3. Noisy breathing 4. Cyanosis 5. Rate and depth 6. Air movement 7. Choking: a. Mechanical b. Anatomical c. Vomitous d. Complete e. Partial f. For pregnant people: middle of chest, intersection of sternum line and line connecting nipples g. Solution: i. Heimlich maneuver 1. Abdominal thrust 2. Intrathoracic pressure Cardiovascular System -regulates body temperature -fights off infection -acid-base buffer system -transport O2 and nutrients: Heart Blood vessels Bloodif Sinoatrial(SA) node Superior vena cava RA Tricuspid valve RV LA Bicuspid valve LV

Inferior vena cava

Atrioventricular(AV) node delays contraction to allow diastolic phase AV valves (tricuspid and bicuspid) if damaged, Stroke volume(SV)

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 Blood vessels o If enlarged: If athelete, GOOD! If not, bigger BV; stress and hypertension; chamber size, muscle of LV, cardiac output; DIE EARLY!!!! Coronary artery (in aorta) blood directly to the heart Normal ECG reading: 60-90 spikes/minute Arrhythmia o Irregularity of electrical conduction system o skip a heartbeat Brachycardia (slow heart rate) Tachycardia (elevated/fast heart rate) Lub -> AV Valves; Dub -> semilunar valves Cardiac arrest: o Cardiac standstill Sudden death Oxygen-deprived heart o Cardiac collapse Activation of Parasympathetic Nervous System (PNS) conserves energy, activity, heart activity Propofol (strong sedative) VS. Epinephrine (activate Sympathetic Nervous System (SNS)) o Ventricular fibrillation Heart -> very, very fast 200-300 beats No more diastolic phase cardiac output Nervous System -Peripheral nervous system (PNS) -Central nervous system (CNS; brain + spinal cord) -brain: -cerebrum -cerebellum -diencephalon Trauma Genetics Causes of complications with the brain O2 deprived Infection Cerebrovascular accidents: o Stroke -> paralysis Test: Smile test Talk test Arm test Types: Ischemic stroke BV obstructed o 80% of strokes -> this kind o Embolic scar tissue -> motile /fbsta.anajr

Arteriosclerosis + scar tissue Thrombotic blood clotting Medication: aspirin Hemorrhagic stroke BV ruptured o Aneurysm Rupture of one of the arteries supplying the brain Leads to stroke/internal bleeding o Concussion Temporary absence/disturbance of neurological function Symptoms: headache, balance problem, confusion o Blood surrounds the brain: intracranial pressure Leading to intracranial hematoma (either epidural or subdural) Symptoms: headache, dizziness and vomiting; signs: heart rate, BP, racoon eyes, battles sign, Cerebrospinal fluid(CSF) leak o

Skull fracture Trauma to the bony structure that protects the brain; break in the continuity of the skull Could be linear, comminuted(jigsaw puzzle), depressed or basilar(base of skull -> circle of willis) Watch out for complications Signs and symptoms: crushings triad, nausea and CSF leak

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