Incidents and Emergencies: Seizures & Shock

• The following are study notes on incidents and emergencies

Seizures

• When someone shows signs of entering a seizure, put them in a safe place away from anything that could cause injury
• Do not try to restrain the person
• Loosen clothing around the neck to keep the airway open
• Do not insert any objects into the person’s mouth because it may cause injury
• Clear away sharp objects to prevent injury
• Roll the person onto their side after convulsions subside to maintain an open airway and prevent aspiration of secretions
• Allow the client to rest after convulsions cease, as they may experience confusion
• Providing a blanket or screen may help to protect privacy
• Get medical help

Shock

• Shock may occur due to excessive bleeding, sepsis, respiratory distress, change from supine to upright position, excessive heat, or anaphylaxis
• Shock causes a drop in blood pressure and inefficient cardiac output, resulting in inadequate perfusion of organs and tissues

Signs and Symptoms of Shock

• Pale and moist skin
• Cool Skin
• Shallow and irregular breathing
• Dilated pupils
• Weak or rapid pulse
• Dizziness or nausea
• Altered level of consciousness

Actions to Take if a Client Exhibits Symptoms of Shock

• Get medical assistance as soon as possible because shock can be life-threatening
• Determine the cause of shock and correct it if possible and also monitor blood pressure, breathing, and pulse rate
• Position the person in a supine position, with the head slightly lower than the legs; elevate the head and chest if there are head and chest injuries or impaired respiration
• Prevent loss of body heat, apply a cool compress to the forehead and covering the client with a light blanket, but do not add heat
• Do not allow exertion and keep the client quiet until emergency medical help arrives.

Bleeding

• A laceration may result in minor or serious bleeding
• First aid treatment to prevent contamination of the wound and to control bleeding
• Wear protective gloves while treating the wound
• Cover the wound with a clean towel or dressing and apply direct pressure and use your gloved hand if no dressing is available.
• Elevate the wound above the level of the heart to reduce blood flow to the area
• Encourage the client to remain quiet and to avoid using the extremity.
• Do not apply a tourniquet unless you have been trained to do so.

Warning Signs and Symptoms of Insulin-Related Illnesses

• Insulin Reaction (Insulin Shock) occurs suddenly, ketoacidosis (diabetic coma) gradually
• Skin is moist and pale during insulin shock and dry and flushed during diabetic coma
• Behavior can be excited and agitated in insulin shock and drowsy in diabetic coma
• Breathing is normal to shallow in insulin shock and deep/labored with fruity breath during diabetic coma
• The tongue is moist with insulin reaction and dry with ketoacidosis
• Vomiting is absent with insulin shock and present with diabetic coma
• Those with insulin reaction will feel hunger and those with ketoacidosis will feel thirst
• Inadequate insulin levels (hyperglycemia, a high blood glucose level) or from excessive insulin (hypoglycemia, a low blood glucose level)
• Too much systemic insulin, too little food or sugar, or too much physical activity can cause an insulin reaction (also called insulin shock)
• Provide the conscious client with some form of sugar (candy, orange juice, etc.)

Respiratory Distress

• Dyspnea control postures may be used to reduce breathlessness in clients in respiratory distress
• High Fowler's position may be used for clients in bed and position the head of the bed at a 90-degree angle
• Bending forward slightly at the waist and support the upper body by leaning the forearms on a table or counter may help
• Pursed-lip breathing (inhaling through the nose and slowly exhaling through pursed lips) can help decrease dyspnea and the respiratory rate.

Body Mechanics

• Maintain a wide base of support with feet shoulder-width apart, one foot slightly ahead
• Squat down, bending at the hips and knees, and put one knee to the floor while positioning the other knee in front, bent at a right angle (half kneeling) if needed
• Look straight ahead, keep your back straight, chest out, and shoulders back to keep the upper back straight with a slight arch in the lower back
• Lift slowly by straightening the hips and knees (not your back), keeping the back straight and not twisting while lifting
• Hold the load close to the body at the level of the belly button
• Use your feet to change the direction in small steps
• Lead with the hips as you change direction and keep the shoulders in line with the hips as you move
• Set down the load carefully, squatting with the knees and hips only
• Bend the hips and knees to squat down to the load, keep it close to the body, and straighten the legs to lift-Do not attempt to lift by bending forward.
• Never lift a heavy object above shoulder level
• Avoid turning or twisting the body while lifting or holding a heavy object

Stabilizing the Back

• Clients thoroughly understand how to use body mechanics to stabilize their backs
• This includes maintaining a straight back, bending from the hip, avoiding twisting, maintaining good posture, carrying objects close to the body, lifting with the legs to promote safe performance, and using a wide base of support.

Study notes on how to manage seizures and shock. During a seizure, ensure the person's safety and prevent injury by clearing the area and loosening clothing. Shock can result from various causes, leading to low blood pressure and poor organ perfusion.