Sudden IllnessesAnthraxSmallpoxHeart ProblemsStrokeAsthmaCOPDHyperventilationFainting

Sudden Illnesses #2Seizures

Diabetes

Abdominal distress

Various other problems

Anthrax

Most commonly occurs in hoofed animals

Bacteria spores can live in the soil years

Can infect humans

Three Serious Forms of Anthrax / TransmissionInhalation (breathing spores)Cutaneous (skin)Intestinal (spread by eating undercooked meat from infected animals)Historically, rare in the U.S.

Anthrax Symptoms

Inhaled: Severe cold / flu/ progress to breathing problems and shock

Usually fatal

Cutaneous AnthraxResembles insect biteRaised itchy bumpsDevelops black (necrotic) area in center20% untreated cases result in death

Intestinal AnthraxNausea, vomitingLoss of appetiteFeverAbdominal pain, vomiting blood, severe diahrrhea25%-60% die

Vaccine For AnthraxVaccine has been licensed for humans

93% effective

Recommended for people who work in fields where contact is highly likely

Military personnel

Mild reactions in 30%

Suspicious MailDo not open

Place in a bag

Prevent spills of powder substance

Call authorities

Wash hands

Cautions with aerosol sprays

SmallpoxIncubation: 12 daysHigh fever, fatigue, head and back achesRash: predominately on face, arms, legs in 2-3 days

Flat red lesionsBecome pus filled, crusts and scabsFalls off in 3-4 weeks.

30% death rate

Spread of SmallpoxInfected saliva droplets

Vaccination: some risksGeorge Washington

Ricin

Poison made from waste left over in processing castor beans

Forms: powder, mist, pellet or dissolved in water or weak acid

Accidental exposure highly unlikely

As little as 500 micrograms injected (pin head size) could kill

Larger amounts required if inhaled or swallowed

Ricin

Poisoned victims are not contagious

Was possibly used in the Iran-Iraq war in the 80’s

Ricin found in Al Qaeda caves in Afghanistan

Blocks cells from making proteins

Ricin Signs and Symptoms

Inhalation:Coughing, tightness in chest, difficulty breathing, nausea, aching muscles

Quickly, lungs become inflamed, lung fluids build, skin may turn blue

Ricin Signs and Symptoms

InjestionInternal bleeding of stomach and intestines

Leads to bloody vomit and diarrhea

Liver, spleen, kidneys may stop functioning

May lead to death

Ricin Signs and Symptoms

InjectionAll previously cited signs and symptoms may occur

Ricin: Death

May occur in 36-48 hours – no matter the type of exposure

If one lives longer than 5 days w/o complications, they will probably survive

Ricin Treatment

NONE

No widely available, reliable test to confirm exposure

Information Regarding Terrorist Related Emergencies

DHS.gov

The Cardiovascular System and Disease Prevention

42% of all deaths in the U.S. are related to heart disease

Cardiovascular Disease

1 million deaths each year

275 billion dollars

Cardiovascular disease (CVD) is the number one cause of death in the United States.

Coronary Artery Disease

Primary form of heart disease

A disease involving waxy plaque build-up in the arteries

Coronary Artery Disease

Coronary Risk Factors

Primary Risk Factors: Factors that have been definitively associated with or directly cause coronary artery disease.

Secondary Risk Factors: Factors believed to contribute to or advance the severity of atheroschlerosis and CAD.

Primary Risk Factors (Alterable)

Smoking

Hypertension (high blood pressure)

High serum cholesterol

Physical inactivity

Diabetes mellitus

Obesity

Family History

Secondary Risk Factors

Stress

Age

Gender (male vs. female)

Heart Attack and Partial Blockages

Angina

Chest pain usually brought on by:Physical exertion, exposure to cold

Emotional stress

Due to ischemia• (reduced oxygen to part of the heart muscle)

• Duration of pain: less than 10 minutes

Usually relieved by nitroglycerin

About NitroglycerineGive one dose approximately every 3 to 5 minutes (3 dosages in 10 minutes)

Transport if 3 dosages are necessary

Dosage amounts varyAvailable in tablets, spray, ointment, patch

Victim should be sitting or lying downReduces blood pressure

Reduces work for the heart (dilates arteries which increases blood flow)

Heart AttackBlood supply to a portion of heart muscle is severely reduced or stopped

Heart Attack Signs and Symptoms

Chest pressure, fullness, squeezing or pain

Pain lasts longer than 10 minutes

Radiating pain

Light-headedness, fainting, sweating, nausea, shortness of breath

Indigestion?? (neighbor)

Heart Attack Signs and Symptoms #2

May occur during rest or activityPain not relieved by nitroglycerinNot all signs are always presentVictim will be in denialGet help immediately

Other Causes of Chest Pain

Rib injury

Pneumonia, bronchitis, pleurisy

Lung injury

Indigestion

Nerve impingement

Chest Pain: Heart Attack / What To Do

Call EMS or transportMonitor ABC’s / give CPR if necessaryPlace victim in least painful position

(Usually in half sitting position, knees bent)Loosen tight clothing around neck and mid-section

Maintain composure / reassureDetermine if there is a history of heart diseaseCheck for medications

Nitroglycerine / give one aspirin if not allergic

Stroke: Cerebrovascular Accident (CVA) “Brain Attack”

Occurs as a result of:Clot (80%)

Ruptured vessel (20%)

Lack of oxygen to brain: cells die

Third largest cause of death in U.S.Major cause of disability

Transient Ischemic Attacks (TIA’s)

Mini-strokes

Precursor to major stroke

May last a few minutes to several hours

Function normally returns

Stroke Risk Factors>50 years of ageBirth control pills and > 30 years oldOverweightHypertensionHigh cholesterolDiabetesHeart diseaseSickle cell disease Substance abuse (esp. crack)Family history

Stroke: Signs and Symptoms

Sudden weakness or numbness of face, arm, leg, on one side of the body (Strokes are usually unilateral)Loss of speech, difficulty speaking, difficulty understanding speechBlurred or decreased vision (one side)

Deviation of PEARL

Unexplained dizziness, unsteadiness, loss of balanceSudden severe headache

Stroke: What To DoCheck ABC’sCall EMS

Victim conscious? Have victim lay down with upper body and head slightly elevated

Unresponsive but breathing?Recovery position Chin extended to keep airway open

Do not give liquids or food (throat may be paralyzed)

Asthma

Chronic, inflammatory lung disease

Air passages narrow

Difficulty exhaling

Tends to resolve with age

What Triggers Asthma Attacks?

Respiratory tract infection

Extreme temperatures, especially cold

Strong odors, perfumes, dust, fumes, smoke, allergens, air pollution

Certain drugs (aspirin, beta blockers)

Exercise

Emotional stress

Signs of Asthma Attack

CoughingWheezing or whistling soundFlared nostrilsCyanosis (blue)Difficulty speakingBlue lips / fingertipsThese symptoms may also indicate other health problems such as pneumonia, cystic fibrosis

Asthma: What To DoSit in upright position, leaning slightly forward

Pursed lip breathing Inhaler or other medications

(Child at YMCA / show inhaler / hold 10 sec.)

Monitor ABC’s if necessary

Asthma: What To DoDetermine cause of attack - remove victim from causative environment

Abrupt change in outdoor temperature, dust, feathers, animals, tobacco smoke, paint, etc.

Keep conversations briefSeek medical attention if necessary

Chronic Obstructive Pulmonary Disease: COPD

Primary cause: SMOKINGPrimarily includes chronic bronchitis and emphysema

Chronic bronchitisAffects bronchioles (become thickened)Caused by chronic infections and irritations such as cigarette smokeSymptoms: “Cigarette cough, breathing difficulty, increased sputum and severe coughing

COPD – EmphysemaDestruction of alveoli

Loss of lung elasticity

Coughing, wheezing, shortness of breath

May become dependent on oxygen

COPD: What To DoSitting positionUsually have their own medicationsEncourage fluid intakeIn acute distress? Get medical assistance

HyperventilationUsually brought on by emotional stressShortness of breathCharacterized by extremely fast breathing

Dizziness

Numbness

Tingling of hands and feet

Hyperventilation: What To Do

Encourage slow deep breathing

Inhale through nose and hold for several seconds

Exhale slowly through pursed lips

Calm and reassure the victim

Do not place a paper bag over the head

FaintingA sudden, brief loss of consciousness unassociated with a head injuryOccurs when the brain’s blood flow in interrupted

Often occurs when standing for prolonged periods of time (results in blood pooling) which may result in a drop in blood pressureCan be brought on by hypoglycemia, dehydration, anemia, heat exhaustion, slow heart rate, anxiety and emotional stress

FaintingLook for:

DizzinessWeaknessSeeing spotsVisual blurringNauseaPale skinSweating

Fainting: What To DoPrevent from falling

Have victim lie down on back

Elevate feet 8-12 inches

Loosen tight clothing

After recovery,Give fluid with sugar

Fresh air / cool cloth

Fainting: When To Seek Medical Attention

Over 40 years of ageRepeated attacksLoses consciousness while sitting or lying downDoes not quickly regain consciousness (is out > 4 to 5 minutes)Faints for no apparent reason

SeizuresResults from abnormal stimulation of brain cells

Exact cause is usually not known

Medications are available yet are not easily controlled

Conditions That May Lead To Seizures

Epilepsy

Heatstroke

Poisoning

Electric shock

Hypoglycemia

High fever in children (fever convulsions)

Brain injury, tumor, stroke

Alcohol withdrawal, drug abuse / overdose

Major Classifications of Seizures

Generalized Tonic Clonic Seizures Grand mal

Absence SeizuresBlank stare

Complex partial Seizures Part of brain involvedDazed, may mumble or wobble

Febrile SeizuresHigh fever (cool body / wet cloth)

Generalized Tonic Clonic Seizures Grand mal

Often associated with epilepsy

May experience a “sensation” prior to seizure

Loss of consciousness

Stiff, then jerking motion

Duration: 2 to 5 minutes

Muscle contraction, perhaps tongue biting

Is usually followed by a period of coma or drowsiness, headache, muscle soreness

First Aid Procedures For Seizures and Convulsions

If possible:Cushion head

Remove items that victim may bump into

Loosen tight neckwear

Place on left side

Medical-alert tag

As seizure ends, offer help

First Aid For Seizures #2

Call 911???

Definitely call if:If seizure lasts longer than 5 minutes

If not known to have epilepsy or seizure ID

Slow recovery

A second seizure

Difficulty breathing

Pregnancy or other medical conditions (ID)

Signs of injury or illness

DO NOT’S For Seizure Victims

Do not give food or drink

Do not restrain victim

Do not put anything between victim’s teeth

Do not move to another place (unless to protect from injury)

Status Epilepticus

Two or more seizures with no period of consciousness

Call 911 – This is an emergency

Diabetes MellitusA condition in which glucose is unable to enter the cellsA disease associated with problems in controlling blood glucose or blood sugarThe disease results when the pancreas has problems producing insulin or the body can no longer use insulin properlyInsulin is the “taxi” that carries sugar from the blood to the cells

Types of Diabetes

Type I Insulin dependent or juvenile onset

Congenital

Type II: maturity or adult onset 90% of all cases are this type

Usually non-insulin dependent

Results from obesity and inactivity

Gestational onset

Normal Blood Sugar Levels

Normal blood sugar levels: 65-110

Hypoglycemia

Low levels of blood sugar

Some may experience hypoglycemia but are not diabetic

protein is often recommended, sometimes along with sugar

Hypoglycemia

Sudden onset

Occurs when eating has been delayed or when too much insulin was administered (blood sugar level drops)

May be fatal if left unattended

Hypoglycemia: Signs and Symptoms

Sudden onsetSudden hungerTrembling / ShakingAnger, bad temper (mood change)Staggering, poor coordinationPaleConfusion, disorientation, altered mental statusSweatingEventual stupor or unconsciousness or seizure

Hypoglycemia: What To Do

If victim is known diabetic, has altered mental status, and is awake enough to swallow:

GIVE 10-15 grams of sugar• ½ can regular soda

• 6 jelly beans

• P.275

If no improvement after 15 minutes, give 15 more sugar

If no improvement, take to the hospital• (trim gym, student at ballgame)

Glucagon: injectable medication

Hyperglycemia

The body has too much sugar in the blood

Pancreas fails to produce insulin to lower sugar levels

When sugar levels remain high, over time, it damages the walls of the vessels, leading to impairment of the circulatory system

Affects functioning of most organs

Problems healing (small cuts, amputations)

Blindness

Hyperglycemia

Diabetic coma (ketoacidosis)Levels may rise to 1200

Body begins to burn fat as primary fuel

Fat as fuel results in production of acids and ketones = “fruity breath”

Hyperglycemia: Signs and Symptoms

Gradual onsetDrowsinessExtreme thirst / dry mouthFrequent urinationFlushed skinVomiting / nauseaFruity breathHeavy breathingEventual stupor or unconsciousness

Hyperglycemia: What To Do

Have conscious victim follow physician’s recommendations

If you are uncertain if sugar level is high or low, GIVE SUGAR

If no response in 15 minutes, get to the hospital

Abdominal Distress

Gastrointestinal problemsCramping, aching, nausea, vomiting, diarrhea

May be viral or bacterial

Difficult to determine the cause

Abdominal Distress? Ask These Questions

Cramping pain?Constant pain?

(indicates organ inflammation)

Nausea? Poor appetite? Fever?Diarrhea or vomiting?Is a “virus” going around?Chance of pregnancy?Abdomen rigid to touch?

Emergency (son)

Nausea, Vomiting, Diarrhea: What To Do

Watch for dehydrationPinch test

Wait for nausea to pass before giving liquids and foods

Give clear fluidsSprite, 7-up, water

Jell-o, pop sickles

What To Do #2

Hot water bottle, warm bath

Lay on left side, knees bent

Suppository (by prescription)

Solid food? Crackers, toast

Avoid milk and meats for 48 hours

Let diarrhea run its course Imodium A-D)

What To Do For Infants:

Vomiting or projectile vomiting?

Diahrrea?Pedialite

Abdominal Distress: When To Seek Medical Attention

Constant painUnable to drink for more than 24 hoursBlood or brown grainy matter in vomitVomiting following a head injuryAdditionally:

Black or bloody stoolsRigid, swollen, distended stomachPain when abdomen is pressed then released