First Aid 1 - Management and Prevention of High Acuity Presentations PDF

First Aid 1 Management and Prevention of High Acuity Presentations SGSCC JNCOs Course Learning Objectives Understand the management AND prevention of: – Asthma – Anaphylaxis Asthma Asthma Asthma Presentations: Signs and Symptoms General o Difficulty breathing o...

First Aid 1 Management and Prevention of High Acuity Presentations SGSCC JNCOs Course Learning Objectives Understand the management AND prevention of: – Asthma – Anaphylaxis Asthma Asthma Asthma Presentations: Signs and Symptoms General o Difficulty breathing o Difficulty speaking in full sentances o Coughing o Wheezing o Chest tightness o Anxiety o They will may know they are having an asthma attack If severe: o Confusion o Drowsiness o Cyanosis o Difficulty speaking in single words Asthma Prevention Common triggers o Exercise o Respiratory infection o Air particles e.g. pollen, smoke, dust o Sudden weather changes e.g. thunderstorms or cold air o Anxiety or emotional stress Triggers may not be known. If cadet has known triggers, PLT staff should be informed. Cadet may be required to regularly take a "preventer" medication... Asthma Preventer Medication It is the responsibility of SGS Staff that cadets take their prescription medication o Not a JNCO's responsibility o This is for your reference only. These medications are regularly taken to PREVENT an asthma attack occurring, in most cases, they DO NOT TREAT an asthma attack. There are many types of preventer medication – Come in many different colours and different designs Following slide only to give you an idea of the variety "Courage, Initiative, Teamwork" Asthma Treatment A reliever (bronchodilator) medication is used to rapidly relax the smooth muscles in the airway. If available, ALWAYS use a spacer. Significantly improves the effectiveness of the medication Asthma Treatment Asthma Treatment: 4 x 4 x 4 Call for help: CASEVAC -> 0A FOUR BREATHS for each puff FOUR PUFFS Wait FOUR MINUTES Continue until help arrives or patient condition improves Asthma Key Points - Cause - Bronchospasm of the small airways in the lungs. - Presentation - Can be mild, severe or life threatening. - Can progress quickly - Prevention - Identify known triggers - Prescribed medications - Treatment - "Reliever" inhaler -> 4 x 4 x 4 Anaphylaxis Definition Hypersensitivity Reaction: o An abnormal and disproportionate immune response to an allergen Anaphylaxis o A life-threatening, systemic response to an allergen which involves multiple body systems. Not all hypersensitivity reactions will cause anaphylaxis A mild hypersensitivity reaction will involve only skin reaction (e.g. rash or hives at the site of contact.) Anaphylaxis Signs and Symptoms RASH Respiratory distress o Cough, wheeze, stridor, difficulty breathing o Can be easily confused with severe asthma. Abdominal symptoms o Nausea o Vomiting Skin/Mucosal symptoms o Hives, welts, itching, facial swelling Hypotension/Shock o See next slide. Examples of Anaphylaxis  Shock Medical Definition o A life-threatening insufficient systemic delivery of oxygen at the cellular level resulting in organ dysfunction. Causes o Lack of blood perfusion to body tissues. o Cardiogenic, Hypovolemic, Obstructive, Distributive. Anaphylactic Shock o Hypovolemic  Immune response causes increased leak of fluid out of blood vessels.  Lower blood volume = lower blood pressure = lower perfusion of tissues o Distributive  Immune response causes blood vessels to dilate and drops blood pressure. Signs and Symptoms of Shock Hypotension (Low blood pressure) Skin: Pale, cool, clammy, or ashen. Delayed capillary refill time. Breathing: Fast respiratory rate (>20 breathes per minute) Pulse: Fast (>100 beats per minute) and weak (sign of low blood pressure). Mental state: Altered, confused, disorientated, anxious or agitated. Urine output: Low or absent Other symptoms: Nausea, vomiting, dizziness, lightheadedness, faintness or thirst. Anaphylaxis Prevention Identify, and limit exposure to known triggers Common triggers o Food (e.g. Peanuts/tree nuts, egg, dairy products, fish/shellfish, soy, sesame seeds) o Insect stings (e.g. Bees, wasps, ants) o Latex o Medications Many other rarer triggers exist (e.g. exercise-induced anaphylaxis) Triggers may not be known if the person has never been exposed previously o New medications or insect stings are good examples. Anaphylaxis Prevention If cadet has anaphylaxis, PLT CDT Staff will be informed by Adult Cadet Staff (ACS). All anaphylactic cadets have a Special Dietary Requirement (SDR) and their ration plan will be overseen by the Food Management Officer (FMO). Greatest risk comes from food brought by other cadets. o Staff have limited control or oversight over this if the cadets choose to break the rules and smuggle food. o Your role is to be vigilant about these risks. Anaphylaxis Treatment - Call for Help (CASEVAC/000) - Lie person FLAT o Do NOT allow them to stand or walk. - Give adrenaline autoinjector (EpiPen) o Intramuscular injection to the outer mid-thigh o If no response after 5 minutes? > Give additional injection Adrenaline Adrenaline works quickly to reverse what is happening in the body during a severe allergic reaction. o Increases blood pressure § Tightens blood vessels and reduces fluid leaking out of them. § Makes the heart beat stronger and faster o Improves breathing § Opens the airways Adrenaline Auto-Injector Contains 500mcg (Anapen) 300mcg (EpiPen) or 150mcg (EpiPen Junior) of Adrenaline. Anapen Demonstration Use of Adrenaline Auto-Injector Summary: Adrenaline Auto-Injector Anapen White end on Leg Press thumb on Red EpiPen Blue to the Sky Orange to the Thigh Anaphylaxis Key Points Cause o Life-threatening systemic hypersensitivity reaction Presentation o R.A.S.H. symptoms Prevention o Be aware of, identify and prevent exposure to known triggers Treatment o Adrenaline auto-injector