R&M Urgencias y Emergencias

R&M Urgencias y Emergencias

• Vocabulary, first aid, circulatory alterations, convulsive disorders, hemorrhages, burns and frostbite, traumatisms, bites and stings, intoxications and poisoning, triage

Vocabulary

• First Aid: Actions taken by the helper at the scene of an accident with improvised material until specialized personnel arrive; not medical treatments, but emergency actions.
• Urgency: Situation where a patient needs prompt action from healthcare personnel due to potentially severe health problems.
• Emergency: Urgent situation where the health or life of a patient may be severely compromised and requires immediate medical attention.
• Etiology: Cause of a disease.
• Sign: Manifestation of an organic or functional alteration noticeable by the patient and observer.
• Symptom: Alteration noticeable by the patient.
• Fomites: Contaminated objects that transmit infection.
• Hemoptisis: Blood coming from the airways, expelled through the mouth.
• Eupneic Respiration: Normal respiration.
• Tachypnea: Rapid breathing rate.
• Bradypnea: Slow breathing rate.
• Dyspnea: Difficulty breathing.
• Apnea: Absence of breathing.
• Pneumothorax: Air in the pleural cavity.
• Cyanosis: Bluish skin coloration indicating lack of oxygen.
• Hematemesis: Vomiting blood from the digestive system.
• Hematuria: Blood in the urine.
• Melena: Blood coming out through the anus.
• Otorrhagia: Blood coming out from the ear.
• Epistaxis: Blood coming out from the nose.
• Sputum: Mucus secreted by the lungs, bronchi, and trachea.
• Hemothorax: Hemorrhagic pleural fluid.
• Bradycardia: Decreased heart rate below 60 bpm.
• Tachycardia: Increased heart rate above 100 bpm.
• Fibrillation: Rapid and ineffective contractions.
• Anoxia: Lack of oxygen.
• Hypoxia: Oxygen deficiency.
• Febricula: Slight fever between 37.1 and 37.9 degrees Celsius.
• Pyrexia: Temperature above normal, also called fever or hyperthermia.
• Miosis: Contracted pupils.
• Mydriasis: Dilated pupils.
• Fracture: Total or partial break in a bone.
• Luxation: Displacement of one bone end from its joint.
• Sprain: Ligament injury due to excessive stretching.
• Contusion: Trauma with no skin rupture, but possible fractures or organ damage underneath.

First Aid

• First aid is the initial assistance given to a person or persons who have suffered an accident.
• Assessing the scene for safety is crucial.
• Follow the "PAS" protocol: Protect, Alert, and Succour.
• Protect includes accident prevention.
• Alert involves calling emergency services.
• Succour means providing care based on priority.

Fundamental Concepts

• Utstein Style: A set of unified concepts and nomenclature for CPR.
• Cardiac Arrest (CA): Cessation of mechanical cardiac activity, confirmed by absence of detectable pulse, unconsciousness, and apnea.
• Witnessed Cardiac Arrest: CA that is seen, heard, or occurring in a monitored person.
• Unwitnessed Cardiac Arrest: Uncertain starting time.
• Respiratory Arrest (RA): Absence of breathing (Apnea) with heart activity.
• Etiology of CA: Origin considered cardiac except in traumatic, or other non-cardiac arrest.
• CPR: Act of attempting to restore the circulation (basic or advanced).
• Basic CPR: Restoration of circulation using external chest compressions and lung inflation with exhaled air.
• Advanced CPR: Invasive procedures including ventilation maintenance with bag-valve-mask, endotracheal intubation, etc.
• Vital Support: Concept integrating classic maneuvers along with preventing CPR and spreading knowledge. Includes basic or advanced levels.
• External Cardiac Massage: Chest compressions performed to reestablish spontaneous circulation.
• CPR by bystanders: CPR initiated by individuals, not part of the healthcare system.
• Emergency Personnel: Those responding to a health emergency as part of an organized system—not bystanders.
• Defibrillable/Non-defibrillable Rhythm: initial rhythm.
• AED/DEA: Defibrillators, analyzing electrocardiogram rhythm for ventricular fibrillation or rapid tachycardia
• ROSC: Return of spontaneous circulation.
• Maintained ROSC: Absence of need for MCE for 20+ minutes with circulation.

Survival Chain

• Early activation of health emergency services.
• Basic CPR.
• Early defibrillation.
• Advanced vital support.
• Recognize CPR state.
• Number for entire Europe is 112.
• Start giving CPR ASAP - it buys time.
• Fibrillation common in PCR- so defibrillate early.

Basic Life Support Sequence

• Assess using conscious and respiration.
• Check if victim responds: shake shoulders and ask oudly "what's wrong". Check trauma.
• Unconscious: call for help and monitor, and ventilate.
• Open the airway.
• Manoeuvre is head-chin lift.
• Check ventilation: observe chest rise and fall, listen for breathing for 5-10 seconds.

Airway Obstruction: Asphyxia

• OVACE from foreign body can cause death
• Partial obstruction: person shows agitation, is ventilating, coughs. Encourage them.
• Complete obstruction: person cannot speak or cough.

Heimlich Manoeuvre

• Conscoius patient:
• 5 inter-scapular blows.
• Next, do abdominal compressions, up and in.
• If overweight, use chest compressions.
• Repeat until foreign body is expelled.
• Unconcious: give RCP basicly.

Rautek Maneuver

• The patient will be moved outside the car to where life is preserved

Automatic External Defibrillator

• Most frequent causes of cardiorespiratory failure are ventricular fibrillation and SVT.
• Automated external defibrillator applies electricity to the heart.
• Apply algorithm.

When to Stop Basic CPR

• Recover of circulation, so continue in order.
• Doctor tells you to.
• Body is terminal.
• Or too long has stopped after heart arrest.
• Rescuer exhaustion.
• Appraise the scene.
• Follow the given instructions.

Asphyxia

• Suspension or deficultry breathing as a cause of a lack or oxygenation.
• Causes are inadequate ventilation, diminished amount of O2, inadequate transfer of oxygen, or a toxic environment.
• Classifications; Livid or pale (signs).
• Protocol Rescue, Airway clear, Transfer.

Asphyxia due to Carbon Monoxide

• Carbon Monoxide is an odorlesss, colorless gas that can damage or kill.
• Protocol to take is to clear the scene, ventilate, and transfer to center.

Circulatory Alterations

• Lipothymia, syncope, myocardial infarction, shock/state of shock, coma.

Lipothymia

• Sudden loss of conciousness, caused by decreased flow of bloody to the brain.
• Accompained by dizziness, paleness, weakness.
• In terms of Protocol , get bloody to the brain, place under air and check for vomiting/injuries.

Syncope

• Similar, as well as rapid haert, paleness and rapid breath.
• Place head to the side, get oxygen, check for injuries and transfer immediately to clinic.

Myocardial Infarction

• Necrotic lesion of heart.
• Seeks medical assistance ASAP, do not elevate knees.
• Inconscious, place in recovery positition.
• Conscious, be aware and monitor vitals.

State of Shock

• Deficient circulation from the lack to bloody
• Characterized by low BP, rapid rate, cold, increased rate of breath, and confusion.
• Protocol: Position as a recovery. keep warm, watch. NO alcoho, but add sugar and soda.

Coma

• Prolonged unconsciousness, caused by annhilation.
• Check antecedents, or ask.
• Inconscious, so check air, and vitals.

Hypoglycemia

• Alteration of awareness: do not give solids or liquids.
• Give glucagom.

Convulsive Disorders

• Convulsions are strong, involuntary contractions of skeletal muscles, generally sudden, due to stimulus of nerve signals.
• Can be tonic, clonic, generalized, unilateral, or partial (descriptions).
• Epilepsy is a chronic disorder due to increased electrical activity in the neurons.
• Patient will emit a scream and a cry.

Hemorrhage

• Hemorrhage is the exit of blood from the body.
• Exteranal, Internal, Exteriorized are the types.
• Treat the wounds is the protocol.

Symptoms of External Hemorrhage

• Paleness, sweat, fast pulse, tiredness, and decreased awareness.
• In external haemorrhages, apply tumour.

Burns

• Burns are lesions of the skin and tissues.
• Severity correlates to depth and extent of damage.
• Causes can be chemical, heat or something biological.
• Deep, extent, and age of the patient determine burns.

First Degree Burns

• Are of the surface and affect pidermis.

Secong Degree

-Affects the dermis and is of the medium severity.

Third Degree

• Affects below the dermis.

Management of Burns

• Rescatr from fire, shock management, and seek medical attention.
• Remove from burn, and apply clean towel.
• No clothes and provide what to dink.
• The treatment of such depend on the medical professional and the extent.

Wounds

• Interruption of the tissue
• Does it affect the artery or tendions?
• The priorities is always that in the less critical ones, it will be enough disifenction to give attention to it.

Manouvering Wounds

• Clean the wound
• Close the wound with an aterile bandage
• Move and take to center

Sprains, dislocation, fracturs

• Sprains, luxations affect especially ligmanentos.
• Sprain will affect muscule and create a biger open situation that does no have psysiological action. _