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Emergency care: Medical emergencies

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Medical emergencies are conditions that endanger an individual's life or threaten to leave permanent disability; they require immediate medical care.

As a nursing assistant, you need to know how to recognize these life threatening situations and follow your facility’s policy to provide proper care and first aid until help arrives. Let’s go over some of the most common medical emergencies.

Heart attack, also known as myocardial infarction or MI, is a condition that develops when an artery that supplies the muscular wall of the heart gets blocked by a blood clot, stopping the normal blood flow.

The part of the muscle that is supplied by the affected artery is now deprived from the oxygen and starts to die, losing its ability to contract.

Smaller damage can decrease the heart’s ability to pump out blood, while extensive damage can lead to cardiac arrest.

Signs and symptoms of a heart attack include severe chest pain that feels like pressure or squeezing, and the pain can radiate to the left arm, neck and jaw, back, or stomach.

Your client could also have an increased heart rate; shortness of breath; cold, pale, and sweaty skin; nausea; and fear of death.

If you recognize these signs and symptoms, assist your client to lie down and elevate the head to facilitate breathing. Because time is of the essence, immediately call the nurse and activate the emergency medical services system.

While waiting for the help, try to calm your client down, monitor vital signs, and be ready to provide basic life support if needed.

Now stroke, also known as a brain attack or cerebrovascular accident, CVA for short, is similar to a heart attack, but this time, parts of the brain get cut off from the blood supply.

There are two types of stroke: hemorrhagic stroke, where a blood vessel in the brain ruptures and bleeds into the brain, and ischemic stroke, where a blood vessel gets obstructed by a blood clot, stopping the blood flow.

In both types, brain cells get deprived of oxygen and die, leading to the loss of function that the affected area of the brain was in control of.

A stroke has sudden onset signs and symptoms, such as confusion; slurred speech; trouble understanding speech; dropped eyelid and corner of the mouth; weakness or paralysis of the arm or leg, usually on one side of the body; tingling or numbness of the extremities or the face; drooling; loss of eyesight in one or both eyes; severe headache; loss of balance; and problems walking.

In general, a useful acronym to remember some common stroke symptoms is FAST: facial drooping, arm weakness, speech difficulties, and time.

Time is obviously not a symptom, but it’s a reminder to get help as quickly as possible to minimize cell injury and maximize the chance of a full recovery.

If you recognize these signs and symptoms, have your client lie down, and you should immediately call a nurse or emergency medical services.

Keep your client warm and calm, monitor vital signs, and be ready to provide basic life support if needed. Try to find out when the signs and symptoms started, so you can inform the nurse.

Syncope, or fainting, is a condition that usually occurs when the blood supply to the brain gets so low that it causes sudden loss of consciousness.

Some of the most common causes are fatigue and hunger, causing low blood sugar level; emotions, like fear; pain; crowded and warm places; standing for too long; and side effects of medication.

There are also some underlying medical conditions, like heart problems or hemorrhage, that can cause syncope. Signs and symptoms that should raise suspicion of a possible fainting episode are dizziness and lightheadedness, blurred vision, pale and sweaty skin, shallow breathing, and weak pulse.

If you recognize these signs and symptoms, and you think the client may faint, you should try to prevent possible injuries from a fall by positioning your client in a way that increases blood supply to the brain.

You can help your client lie down with legs raised above the head level, or you can help your clients sit down, bend forward, and place their head between their knees.

Loosen any tight clothes, like a belt or a tie, and monitor your client for at least 5 minutes. If fainting does occur, lower them to the floor, then position your client in the recovery position with their head turned to a side in case your client vomits.

Call the nurse and monitor your client’s vital signs. Make sure you tell the nurse the time of fainting, signs and symptoms that your client experienced, and the measures that you performed.

A seizure, or convulsion, is where normal brain activity gets disrupted and neurons fire over and over again when they’re not supposed to.

Seizures cause jerking movements or the muscles can rapidly contract or relax. The client may develop urinary or fecal incontinence.

Other types of seizures can cause strange sensations, like hearing or tasting something, or a sudden, brief loss of consciousness without any change in the muscle tone.