Week 1 PPT FA 112 2024 Medical Emergency Procedures PDF

“Where Education Comes To Life” COP FA 112 Week 1  Critical Thinking Question What is the first thing you do in an emergency situation? Medical Terminology Review  Cardio - heart  Arterio - artery  Neuro - nerve  Hemo - blood  Hyper - high  Therm - h...

“Where Education Comes To Life” COP FA 112 Week 1  Critical Thinking Question What is the first thing you do in an emergency situation? Medical Terminology Review  Cardio - heart  Arterio - artery  Neuro - nerve  Hemo - blood  Hyper - high  Therm - heat  Hypo - low  Vaso - vessel  Naso - nose  Tachy - fast  Oro - mouth  Brady - slow  Medical Emergencies in the United States  US Emergency Department (ED) – over 70 million visits each year  Medical Emergencies  Occurboth inside or outside of the workplace  When emergency situations occur in the medical office:  If available, the physician provides immediate care, First Aid  Most medical offices maintain a crash cart  Emergency Resources Medical Office  For conditions that pose no immediate danger to life or limb  Minor emergencies  Physician group practices may have an emergency clinic where emergency service is provided both during and after office hours. Emergency Resources Critical Care Center  For life-threatening conditions that require specialized critical care  Emergency Resources Freestanding Clinic/Urgent Care Center  For conditions that need to be treated quickly but that are not life threatening  Provide emergency care during regular hours until late in the evening and often on weekends  Many do not offer critical-care intervention for life-threatening conditions  Emergency Resources Critical Care Center  Have specialty-trained physicians, surgeons, anesthesiologists, and other critical care staff on duty at all times ▪ Trauma ▪ Cardiac ▪ Burn ▪ Surgical Center Emergency Medical Services System EMS - Emergency Medical Services provide pre-hospital emergency care and safe, prompt transportation from any location to a hospital or other appropriate facility  Includes a network of community services, equipment and Emergency Medical Technicians (EMT) that provide emergency care  EMT will offer pre-hospital emergency care at the scene and during transport to the hospital  Medical Assistant’s Role During Medical Emergency  If an emergency occurs in the office, notify the physician  If a physician cannot be located, contact the local EMS team  The Medical Assistant must perform only the emergency procedures they have been trained to do and are in the scope of practice in their state  Emergency Resources Hospital emergency departments  For most emergencies, including those that are life threatening  Hospitals usually have 24-hour emergency departments (EDs) that are open seven days a week.  "24-7 EDs" can handle most emergencies and arrange transport of patients to a critical care trauma center. Emergency Resources Role of Emergency Medical Services  Transport the patient to the emergency facility (ambulance, helicopter, fixed- wing aircraft)  Transfer the patient to medical personnel at the receiving facility Emergency Resources Emergency Medical Services (EMS)  Nationally recognized levels of EMS practitioner 1. Emergency Medical Responder (EMR) 2. Emergency Medical Technician (EMT) Certified to perform basic life support measures 3. Advanced Emergency Medical Technician (AEMT) 4. Paramedic Qualified to perform Advanced life support care  Emergency Resources Advanced Emergency Medical Technician (AEMT)  Provides basic emergency medical care, some advanced care, administration of a somewhat broader range of medication, and transport  Emergency Resources Paramedic Qualified to perform Advanced life support care ▪ Advanced airway maintenance – intubate ▪ Cardiac monitoring and interpretation ▪ Administering medication, oxygen ▪ Starting IV drips ▪ Cardiac defibrillation  Emergency Resources First responder  Used to be but is now called the EMR (Emergency Medical Responder)  Often a policeman or firefighter trained as an EMR  Sometimes used to mean any EMS practitioner at any level of training who is first to respond to an emergency Emergency Resources Specialized Resources  Poison control  Pediatrics  Trauma  Burns  MA should ensure specialists' telephone numbers are readily accessible. Emergency Resources Good Samaritan Laws  State laws states that under certain circumstances it will not hold the medical professional legally liable when rendering first aid ▪ Outside the medical facility, only ▪ NOTE: inside a medical facility, this law will not protect a healthcare worker from legal liability Emergency Resources  Medical professional must remain with the patient, as long as the scene is safe, until relieved by another health care professional with an equal or higher level of training  Be aware of laws within your own state; remember that you must meet the standard of care within your license, certification, or training. Good Samaritan Law (Sample) "Any person who in good faith renders emergency care, without renumeration (money paid for a work or service) or expectation of renumeration, at the scene of an accident or emergency to the victim of the accident or emergency shall not be liable for any civil damages resulting from the persons acts or omission, except for such damages as may result from the persons gross negligence or wanton acts or omissions.“  Activating EMS  THE MOST IMPORTANT STEP in an emergency is Activating EMS  Rapid arrival of EMTs increases the patients chance of surviving a life threatening emergency  How to activate EMS: Call 911 ▪ Some cities have local seven digit phone numbers to call  Activating EMS  When calling EMS, you speak to a Emergency Medical Dispatcher (EMD)  The EMD answers the emergency call, obtains critical information, determines what is needed and sends the appropriate personnel and equipment.  The EMD relays instructions to the caller about providing emergency care until the EMTs arrive. Activating EMS  Speak clearly and calmly to the EMD  Identify the problem as accurately and concisely as possible.  What does the EMD need to know? 1. How many victims 2. The condition of the victim(s) 3. Emergency care that has already been administered  DO NOT HANG UP until you are told to do so… Going Above and Beyond Providing EMS information they need to know will increase the likelihood of survival of the victim.  Current patient condition (critical, serious, fair, good)  Patient’s age and sex  Chief complaint (chest pain, SOB, pain)  Brief, pertinent history of what happened  How you found the patient  Major past illnesses (HTN, DM, previous MI or Stroke)  Vital signs  Pertinent findings of the physical exam  Emergency medical care given and response to care First Aid  Immediate care that is administered to an individual who is injured or suddenly becomes ill before complete medical care can be obtained  Purpose  To save a life  Reduce pain and suffering  Prevent further injury  Reduce the incidence of permanent disability  Increase the opportunity for an early recovery First Aid Kit  Contains basic supplies to provide emergency care, such as:  Adhesive tape, Elastic wrap bandages, Bandage strips and "butterfly" bandages in assorted sizes, Nonstick sterile bandages and roller gauze in assorted sizes, Eye shield or pad, Gauze pads, Antibiotic ointment or cream, Large triangular bandage-which may be used as a sling, Aluminum finger splint, Instant cold packs, Cotton balls and cotton-tipped swabs, Disposable nonlatex examination gloves, saline eye wash, Petroleum jelly or other lubricant, Plastic bags (for bandages etc), and Safety pins in assorted sizes.  Kits come specialized for the environment they will be in (classroom has fewer supplies than an industrial plant with heavy machinery)  It should contain a list of phone numbers:  Local emergency medical services (EMS)  Poison control center  Police & Fire department First Aid Kit  CRASH CART  Itis a specially equipped cart that holds and transports medications, equipment and supplies needed to perform life-saving procedures in an emergency Crash Cart Supplies  Hot & Cold Packs  Defibrillator   Manual Resuscitator Slings, Splints  Tourniquets (Ambu-bag)  Intubation Equipment/  Sterile/Unsterile Endotracheal Tubes Dressings  Oxygen Supply  Alcohol Wipes  Emergency  Bandages, Gauze, Medications  Airways, suction Scissors, Tape  Tongue Blades devices  Assorted Small  Syringes & needles  Instruments IV Supplies  Gloves Emergency Medical Box Drugs ommonly Stocked in an Emergency Medical Box  Crash Cart Medications Epinephrine (Adrenalin)  Drug Category: Sympathomimetic / adrenergic  Relaxes muscles in the airway,  Peripheral Vasoconstrictor  ↑BP  Tx: Anaphylaxis (allergic reaction) Atropine  Drug Category: Parasympatholytic / anticholinergic  ↑RR & ↑HR  Tx: Bradycardia Nitroglycerin  Drug Category: Coronary vasodilator  Vasodilator (arteries and veins)  Available in transdermal patches  Tx: Chest pain associated with angina & acute MI  Office Emergency Crash Kit The medical assistant completes routine checks of emergency supplies in the crash cart, including:  Restocking/replacing  Replacing expired medications  Replacing/charging batteries in certain items Practice …Practice … Ptractice  List 10 items you can find in a First Aid kit. Practice …Practice … Ptractice  List 10 items you can find in a First Aid kit. Adhesive tape. Elastic wrap bandages.  Bandage strips and "butterfly" bandages in assorted sizes.  Nonstick sterile bandages and roller gauze in assorted sizes.  Eye shield or pad.  Gauze pads  Antibiotic ointment or cream  Large triangular bandage, which may be used as a sling.  Aluminum finger splint.  Instant cold packs.  Cotton balls and cotton-tipped swabs.  Disposable nonlatex examination gloves, several Practice …Practice … Ptractice  What does R A C E mean?  R Rescue  A Alert  C Confine  E Evacuate OSHA Safety  Safety Precautions First aid kit must contain personal protective equipment:  Gloves  Face shield and mask  Pocket mask What is OSHA?  Occupational Safety and Health Administration  Federal Government Agency  OSHA Safety Precautions Wear gloves when it is reasonably anticipated that you will have hand contact with:  Blood and other potentially infectious materials (OPIM)  Mucous membranes  Non-intact skin  Contaminated articles or surfaces Minimize splashing, spraying, splattering, and generation of droplets of blood or OPIM when performing first aid OSHA Safety Precautions, cont. Wear protective clothing and gloves to cover:  Cuts or other lesions Sanitize hands after removing gloves Avoid touching objects contaminated with blood or OPIM  OSHA Safety Precautions Why are blood and OPIM so scary?  OSHA Safety Precautions If hands come into contact with blood or OPIM: wash immediately with soap and water If mucous membranes come in contact with blood or OPIM: flush with water immediately Do not eat, drink, or touch mouth, eyes, or nose when providing emergency care If exposed to blood or OPIM: report incident to physician  Post-exposure measures can be  Fire Safety  Floor plans showing all exits, fire extinguishers, and stairwells and placed in visible areas  Portable ABC fire extinguishers placed no more than 75 feet from any employee area  Fire Safety  Portable ABC fire extinguishers placed no more than 75 feet from any employee area  Knowthe TYPES   Fire Safety Installed smoke detectors and sprinkler systems that have been regularly tested Persons designated to ensure all employees are safe Fire drills conducted at least once a year RACE – Fire Safety Plan RESCUE ALERT CONFINE EXTINGUISH Managing a Fire in the Medical Office  As soon as a fire is discovered, call 911 or the local fire department.  Activatethe established mechanism for signaling fire within the office. Managing a Fire in the Medical Office  Individual charged with ensuring all rooms are cleared should quickly go through the office to ensure that no one is left behind.  After each room is evacuated, the door is to be closed.  Staff and patients should gather away from building at the predetermined area. Managing a Fire in the Medical Office  Allstaff should calmly and quickly assist in getting all patients out of the office in an orderly manner.  Iffire is contained, an attempt should be made to extinguish it using fire extinguisher.  Critical Thinking Question What items are necessary to have in case of a fire? Necessary Items in Case of a Fire  Telephone numbers of fire and police departments attached to all telephones, including extensions  Fire extinguishers with proper documentation of maintenance  Clearly marked exits and stairways that are free of debris  Diagram of all exits  Fireproof file cabinets  Guidelines for Electrical Safety  Allequipment should be grounded  Surge protectors used for all electronic equipment  Electrical cords checked regularly for cracks, loss of insulation, and other problems  Use of GFCI outlets for “wet” areas Guidelines for Mechanical Safety  Read instruction manual before installing or using  Equipment in a medical office includes:  Centrifuge  Autoclave  Sterilizers  Oxygen equipment  Electrocardiograph  Chemical Hazards in the Medical Office  Biohazards are biological substances that pose a threat to human beings and are potentially infectious.  Corrosive materials cause burns. Guidelines for Providing Emergency Care 1. Make sure the scene is safe before approaching the patient 2. REMAIN CALM, speak in a normal tone… why? 3. Obtain information as to what happened.  Patient, family members, coworkers, bystanders 4. If your patient is conscious, obtain consent before starting emergency care.  What if the patient is unconscious and unable to give consent?  Guidelines for Providing Emergency Care 5. Follow OSHA standard (universal) precautions 6. Know how to activate EMS 7. Do not move the patient unnecessarily  Can result in further injury or be life threatening 8. Look for a medical tag on the patients wrist or neck. 9. Continue caring for the patient until more highly trained personnel arrive…  Relay information to the EMT or physician Practice…Practice…Prac tice What information regarding the patient would you mention to the EMS dispatcher? Guidelines for Providing Emergency Care What information regarding the patient would you mention to the EMS dispatcher? How many victims The condition of the victim(s) Emergency care that has already been The Chain of Survival  The Chain of Survival mediate recognition of the emergency and activation of EMS Early CPR Rapid defibrillation Effective advanced life support Integrated post-cardiac-arrest care  Medical Office Emergency Supplies - Waterproof Container Always have emergency supplies available in case of power outages or other environmental disaster Critical Thinking Questions Does your scope of practice change in an emergency situation? Critical Thinking Questions Does your scope of practice change in an emergency situation? Practice, Practice, Practice  Whyis it important to wear gloves, when giving first aid?  When reporting the emergency to the EMS dispatcher, what do they want to know first? Practice, Practice, Practice  Why is it important to wear gloves, when giving first aid? To prevent exposure to:  Blood and other potentially infectious materials (OPIM)  Mucous membranes  Non-intact skin  Contaminated articles or surfaces  When reporting the emergency to the EMS dispatcher, what do they want to know first?  How many victims  The condition of the victim(s)  Emergency care that has already been administered Practice…Practice… Practice  What is OSHA? What does it do? Practice…Practice… Practice  What is OSHA? What does it do? Practice…Practice… Practice  When will the Good Samaritan Law protect you? Practice…Practice… Practice  When will the Good Samaritan Law protect you? State laws -- that under certain circumstances it will not hold the medical professional legally liable when rendering first aid Outside the medical facility, only NOTE: inside a medical facility, this law will not protect a healthcare worker from legal liability. Payment is expected for the medical care  Guidelines for Providing Emergency Care  Emergency plans must be reviewed on a regularly scheduled basis.  Local law enforcement and emergency management agencies direct rescue, treatment, and transportation efforts after catastrophic events.  In an emergency or disaster, health care professionals are expected to provide care with available resources.  Guidelines for Providing Emergency Care  Patientswith little hope of survival may not be treated.  Patients with very severe injuries may be diverted to a trauma facility.  Patientswith mild or non–life-threatening injuries will be deferred until after life- threatening but survivable injuries have been treated.  Guidelines for Providing Emergency Care Medical Assistants handle these emergency situations:  On the telephone, when a patient or patient's relative calls to ask for advice for an emergency that is occurring outside the office  When an emergency occurs near the doctor's office and someone brings the patient to the office  When an emergency occurs in the office setting  Guidelines for Providing Emergency Care  MA must quickly decide if patient requires emergency care  MA may ask physician for advice at anytime or activate EMS by calling 911  Decision tree sometimes created by physician for MA use in triage  In some states, triage is not within the scope of practice for medical assistants.  Guidelines for Providing Emergency Care Primary Assessment  Form a general impression of the patient.  Determine the patient’s mental (cognitive) status.  Assess and manage the airway.  Assess and manage breathing.  Assess and manage oxygenation.  Assess and manage circulation.  Guidelines for Providing Emergency Care Continue to gather information  Determine the patient's name, approximate age, and gender.  Determine the patient's need for intervention.  Obtain the history of the event.  Obtain past medical history  Gather medication information  Determine patient's allergies  Take the vital signs  Guidelines for Providing Emergency Care Life Threatening Conditions Requiring Immediate Intervention:  Extreme shortness of breath  Cardiac arrest  Severe, uncontrolled bleeding  Head injuries  Poisoning  Open chest or abdominal wounds  Shock  Guidelines for Providing Emergency Care Life Threatening Conditions Requiring Immediate Intervention:  Severe burns, including face, hands, feet, and genitals  Potential neck injuries  Guidelines for Providing Emergency Care Not Life Threatening Requiring Immediate Intervention:  Decreased levels of consciousness  Chest pain  Seizures  Guidelines for Providing Emergency Care Not Life Threatening Requiring Immediate Intervention:  Major or multiple fractures  Neck injuries  Severe eye injuries  Burns not on face, hands, feet, or genitals  Guidelines for Providing Emergency Care Not Life Threatening Requiring Intervention as Soon as Possible:  Severe vomiting and diarrhea, especially in the very young and elderly  Minor injuries  Sprains  Strains  Simple fractures Emergency Intervention TABLE 43-1 Emergency Intervention Critical Thinking Question What happens when the batteries in crash cart items are not recharged? First Aid Saves Lives Ready to save a life?