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MCCCD EMT 104 - Medical Emergencies

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Class 20 (Substance Abuse and Behavioral Emergencies) Ch10 (Partial), Ch17 & Ch19Slide 2Identifying the Patient and the PoisonDetermining the Nature of the PoisonInhaled PoisonsAbsorbed PoisonsIngested PoisonInjected PoisonsEmergency Medical CareActivated CharcoalActivated Charcoal (1 of 3)Activated Charcoal (2 of 3)Activated Charcoal (3 of 3)Specific PoisonsAlcohol (1 of 3)Alcohol (2 of 3)Alcohol (3 of 3)Opioids (1 of 2)Opioids (2 of 2)Sedative-Hypnotic DrugsAbused Inhalants (1 of 2)Abused Inhalants (2 of 2)SympathomimeticsMarijuanaHallucinogens (1 of 2)Hallucinogens (2 of 2)AnticholinergicsCholinergic AgentsSigns and Symptoms of Cholinergic PoisoningCare for Cholinergic PoisoningAspirinAcetaminophenOther AlcoholsFood PoisoningCare for Food PoisoningPlant Poisoning19: Behavioral EmergenciesMyth and RealityDefining Behavioral EmergenciesCauses of Behavioral EmergenciesCauses of Organic Brain SyndromeSafety GuidelinesSuicideCritical Warning Signs of SuicideAdditional Risk Factors for SuicideMedicolegal ConsiderationsConsentLimited Legal AuthorityRestraintsPotentially Violent PatientsOther Factors to Consider for Potential ViolencePoisoning & Suicide Walk ThroughYou are the ProviderYou are the provider (continued)Scene Size-upInitial AssessmentAirway and BreathingCirculationTransport DecisionYou are the Provider (continued) (1 of 2)You are the Provider (continued) (2 of 2)Focused History and Physical ExamFocused Physical ExamInterventionsYou are the Provider (continued) (1 of 4)You are the Provider (continued) (2 of 4)You are the Provider (continued) (3 of 4)You are the Provider (continued) (4 of 4)Detailed Physical ExamOngoing AssessmentSlide 71Slide 72Slide 73Slide 74Slide 75Slide 76Slide 77Slide 78Slide 79Slide 80You are the Provider (continued)Slide 82Slide 83Class 20 (Substance Abuse and Behavioral Emergencies)Ch10 (Partial), Ch17 & Ch19Poison •Any substance whose chemical action can damage body structures or impair body functionsSubstance Abuse•The knowing misuse of any substance to produce a desired effectIdentifying the Patientand the Poison•If you suspect poisoning, ask the patient the following questions:–What substance did you take?–When did you take it or (become exposed to it)?–How much did you ingest?–What actions have been taken?–How much do you weigh?Determining the Natureof the Poison•Take suspicious materials, containers, vomitus to the hospital.•Provides key information on:–Name and concentration of the drug–Specific ingredients–Number of pills originally in bottle–Name of manufacturer–Dose that was prescribedInhaled Poisons•Wide range of effects–Some inhaled agents cause progressive lung damage.•Move to fresh air immediately.•All patients require immediate transport.Absorbed Poisons•Many substances will damage the skin, mucous membranes, or eyes.•Substance should be removed from patient as rapidly as possible.•If substance is in the eyes, they should be irrigated.•Do not irrigate with water if substance is reactive.Ingested Poison•Poison enters the body by mouth.•Accounts for 80% of poisonings•May be accidental or deliberate•Activated charcoal will bind to poison in stomach and carry it out of the body.•Assess ABCs.Injected Poisons•Usually result of drug overdose•Impossible to remove or dilute poison once injected•Prompt transportEmergency Medical Care•External decontamination is important.•Care focuses on support: assessing and maintaining ABCs.•You may be permitted to give activated charcoal for ingested poisons.Activated Charcoal•Suspension used to absorb ingested poisons•Often combined with a laxative•Administered orally as a suspensionActivated Charcoal (1 of 3)•Names–InstaChar–Actidose–LiquiChar•Dosage–1 g/kg–Adult: 25-50 g–Peds: 12.5-25 gActivated Charcoal (2 of 3)•Charcoal is not indicated for:–Ingestion of an acid, alkali, or petroleum–Patients with decreased level of consciousness–Patients who are unable to swallow•Usual dosage is 25 to 50 g for adults and 12.5 to 25 g for pediatric patients.Activated Charcoal (3 of 3)•Obtain approval from medical control.•Shake bottle vigorously.•Ask patient to drink with a straw.•Record the time you administered the activated charcoal.•Be prepared for vomiting.Specific Poisons•Tolerance–Need for increased amount of drug to have same desired effect•Addiction–Overwhelming desire or need to continue using an agentAlcohol (1 of 3)•Most commonly abused drug in the US•Kills more than 200,000 people a year•Alcohol is a powerful CNS depressant. •Acts as a sedative and hypnotic•A person that appears intoxicated may have a medical problem.Alcohol (2 of 3)•Intoxicated patients should be transported and seen by a physician.•If patient shows signs of serious CNS depression, provide respiratory support.•A patient with alcohol withdrawal may experience delirium tremors (DTs).Alcohol (3 of 3)•Patients with DTs may experience:–Agitation and restlessness–Fever –Sweating–Confusion and/or disorientation–Delusions and/or hallucinations–SeizuresOpioids (1 of 2)•Drugs containing opium •Most of these, such as codeine, Darvon, and Percocet, have medicinal purposes.•The exception is heroin, which is illegal.•Opioids are CNS depressants causing severe respiratory distress.•Pinpoint pupilsOpioids (2 of 2)•Care includes supporting airway and breathing.•You may try to wake patients by talking loudly or shaking them gently.•Always give supplemental oxygen and prepare for vomiting.Sedative-Hypnotic Drugs•These drugs are CNS depressants and alter level of consciousness.•Patients may have severe respiratory depression and even coma.•The main concern is respiratory depression and airway clearance, ventilatory support, and transport.Abused Inhalants (1 of 2)•Common household products inhaled by teenagers for a “high”•Effects range from mild drowsiness to coma •May often cause seizuresAbused Inhalants (2 of 2)•Patient is at high risk for sudden cardiac arrest.•Try to keep the patients from struggling or exerting themselves.•Give oxygen and use a stretcher to move patient.•Prompt transport is essential.Sympathomimetics•CNS stimulants cause hypertension, tachycardia, and dilated pupils.•Amphetamine and methamphetamine are commonly taken by mouth.•Cocaine can be taken in may different ways.–Can lead to seizures and cardiac disorders•Be aware of personal


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MCCCD EMT 104 - Medical Emergencies

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