other hand on top.

Press down firmly and smoothly (compressing

EMERGENCY to one third of their chest depth) 30 times. Give two breaths. To
get the breath in, tilt their head back gently by lifting their chin.
CONDITIONS Pinch their nostrils closed, place your open mouth firmly over
their open mouth and blow firmly into their mouth. Keep going
TOPIC OUTLINE
with the 30 compressions and two breaths at the speed of
• DRSABCD
approximately five repeats in two minutes until you hand over to
• Shock
the ambulance officers or another trained person, or until the
• Systemic Inflammatory Responses Syndrome (SIRS) person you are resuscitating responds. The method for CPR for
Medical Emergencies children under eight and babies is very similar and you can learn
these skills in a CPR course.
• Foreign Body Obstruction
• Defibrillator – for unconscious adults who are not breathing,
• Inhalation Injury
apply an automated external defibrillator (AED) if one is available.
• Anaphylaxis
An AED is a machine that delivers an electrical shock to cancel
• Thoracis Emergency Trauma any irregular heart beat (arrhythmia), in an effort get the normal
• Cardiac Arrest heart beating to re-establish itself. If the person responds to
• External Hemorrhage defibrillation, turn them onto their side and tilt their head to
• Head Injury maintain their airway. Some AEDs may not be suitable for
• Stroke children.

• Heat-Related Emergencies
SHOCK
• Submersion Injuries - Drowning and Near Drowning • Shock is a critical condition brought on by the sudden drop in
• Stings and Bites blood flow through the body. Shock may result from trauma,
• Poisoning heatstroke, blood loss or an allergic reaction. It also may result
• Diving from severe infection, poisoning, severe burns or other causes.

• Lightning • Shock keeps organs from getting enough blood or oxygen. If

shock is not treated, it can lead to permanent organ damage or
DRSABCD even death.
• Danger – always check the danger to you, any bystanders and WHEN TO SEEK EMERGENCY CARE
then the injured or ill person. Make sure you do not put yourself • If you suspect a person is in shock, call local emergency
in danger when going to the assistance of another person. number.
• Response – is the person conscious? Do they respond when
SYMPTOMS
you talk to them, touch their hands or squeeze their shoulder?
• Symptoms of shock vary depending on circumstances:
• Send for help – call triple zero (000). Don’t forget to answer the
o Cool, clammy skin.
questions asked by the operator.
o Pale or ashen skin.
• Airway – Is the person’s airway clear? Is the person breathing? o A gray or bluish tinge to lips or fingernails.
o If the person is responding, they are conscious and their o Rapid pulse.
airway is clear, assess how you can help them with any injury. o Rapid breathing.
o If the person is not responding and they are unconscious, you
o Nausea or vomiting.
need to check their airway by opening their mouth and having
o Enlarged pupils.
a look inside. If their mouth is clear, tilt their head gently back
o Weakness or fatigue.
(by lifting their chin) and check for breathing. If the mouth is
not clear, place the person on their side, open their mouth o Dizziness or fainting.
and clear the contents, then tilt the head back and check for o Changes in mental status or behavior, such as anxiousness
breathing. or agitation.
• Breathing – check for breathing by looking for chest movements TREATMENT
(up and down). Listen by putting your ear near to their mouth and • After calling 911 or your local emergency number, take the
nose. Feel for breathing by putting your hand on the lower part of following steps right away:
their chest. If the person is unconscious but breathing, turn them o Lay the person down and elevate the legs and feet slightly,
onto their side, carefully ensuring that you keep their head, neck unless you think this may cause pain or further injury.
and spine in alignment. Monitor their breathing until you hand o Keep the person still.
over to the ambulance officers. o Begin CPR if the person shows no signs of life, such as not
• CPR (cardiopulmonary resuscitation) – if an adult is unconscious breathing, coughing or moving.
and not breathing, make sure they are flat on their back and then o Loosen tight clothing and, if needed, cover the person with a
place the heel of one hand in the center of their chest and your blanket to prevent chilling.

GILLIAN MERYL DIAZ 1

 o If the person vomits or is bleeding from the mouth, and no CAUSES:
spinal injury is suspected, turn the person onto a side to • Anxiety
prevent choking. • Fluid Loss
WHAT TO AVOID • CNS Lesions
• Don't let the person eat or drink anything. • Aspirin Toxicity
• Don't move the person unless it's needed. • Pain
• Pulmonary Infection
SYSTEMIC INFLAMMATORY RESPONSES SYNDROME
(SIRS) • Pulmonary Embolism
• There is no first aid for Systemic Inflammatory Response
SIGNS AND SYMPTOMS
Syndrome (SIRS), but if you think someone has sepsis, you • Numbness and tingling sensation in the distal extremities and
should call emergency services immediately: around lips.
o Call emergency services: If you think someone has sepsis,
• Carpal and pedal spasms.
call emergency services immediately.
• Sensation of chest pain
o Reassure the person: While waiting for help, reassure the
person and keep them comfortable.
o Give fluids: If the person is able to tolerate fluids, you can
give them fluids.
o Give paracetamol: If the person has a fever, you can give
them paracetamol. Let the healthcare professionals know
what you gave and when.
• SIRS is an abnormal inflammatory reaction to injury, infection, or
other stress. Treatment for SIRS depends on the underlying
cause and may include:
o IV fluids to maintain blood flow and blood pressure
o Antibiotics if there is a bacterial infection
o Vasopressor medications to reach healthy blood pressure
o Corticosteroids to prevent or reverse shock
o IV insulin to manage blood sugar levels
o Surgery to drain a wound infection, remove damaged tissue,
or perform exploratory surgery

FOREIGN BODY OBSTRUCTION

CHOKING
• If someone is choking, you can perform 5 back blows or the
Heimlich maneuver, also known as abdominal thrusts:
o Stand behind the person and wrap your arms around their INTERVENTION
midsection • Instruct client to take slow deep breaths through the nose and
o Clench one fist and place it between their navel and rib cage slowly exhale through the mouth.
o Grasp your fist with your other hand o There are also those who hyperventilate when experiencing
o Bend over a hard surface and give five to ten sharp, upward hysteria.
thrusts • Having client breath into a paper bag. Rebreathe their own CO2
o Repeat until the obstruction is gone, the person loses maybe helpful.
consciousness, or you get help • Administer O2.
• If the person becomes unresponsive,
o Have the patient lie down on bed with head elevated
o lower them to a firm, flat surface and begin CPR (starting with
compressions) according to your level of training. HYPOVENTILATION
o Trained responders: After each set of compressions and • occurs when an adult client’s RR falls below 20 breaths/minute
before attempting breaths: Open the person's mouth. Look for or for a child’s RR below 25 breaths /minute.
an object. • Not enough O2 is available to maintain adequate tissue
oxygenation. Co2 is retained and respiratory acidosis develops.
INEFFECTIVE BREATHING PATTERN
CAUSES:
HYPERVENTILATION OR TACHYPNEA:
• Brain stem lesion; head injury
• Respiratory rate faster than normal
• Drug induced depression of respiratory center.
• Excessive and prolonged hyperventilation causes decrease in
• Impaired respiratory muscle innervation from spinal cord
CO2 level and respiratory alkalosis results.
• Presence of neuromuscular disease.

GILLIAN MERYL DIAZ 2

CLINICAL MANIFESTATIONS MANIFESTATIONS:
• Decreased level of consciousness. • Constricting of bronchi.
• Pallor; cyanosis. • Accumulation of fluid.
• Pulse oximetry reading of less than 96% • Lung consolidation.

MANAGEMENT: • Abnormal lung sounds like wheeze, rales and rhonchi.

• Administer high flow O2 via bag valve mask device. • Pulmonary infection.
• For infants, use the pediatric size bag valve mask and monitor • Blunt force traumatic injury. This happens in hazing
vital signs
MANAGEMENT
• Administer O2 with flow rate of 2 – 10 liters.
• Administer bronchodilators:
o Albuterol (Ventolin) – to open constricted upper and lower
bronchi.
o Epinephrine 1:100 subcutaneously to relax constricted
bronchi and to reduce bronchial edema.
o Steroid medication P.O. or I.V. depending on the situation
of the patient
o Heparin to prevent the formation of new emboli.
Enoxaparin to treat deep venous thrombus to prevent
pulmonary emboli development.
• Antibiotics to minimize infection.
• Isolate patient, personnel’s or nurse wear mask
IMPAIRED GAS EXCHANGE
• obstruction, infection and injury within the pulmonary system can o If there is MI then clopidogrel 4 tablets stat during MI.
lead to the development of gas exchange abnormalities.
o In the hospital the drug of choice is salbutamol plain 3 doses
• caused by pulmonary edema which results from acute damage every 15 minutes interval then budesonide after. If there is still
to the alveolo-capillary membrane leading to increase its a complication, they administer salbutamol + ipratropium.
permeability so fluid collects in the interstitial spaces. Surfactant
level decreases and alveoli eventually collapsed. INEFFECTIVE AIRWAY CLEARANCE
• Maybe due to either complete or partial airway obstruction:
o Presence of foreign body in the airway.
o Airway edema; airway infection
o Facial or airway injury; tongue obstruction

MANIFESTATIONS
• Absence of respiration; drooling; cyanosis.
• Stridor; agitation; decreased level of consciousness; intercostal
or substernal retractions.

OUTCOME MANAGEMENT:
• Remove obstruction:
o CHIN LIFT MANEUVER - opens the client’s airway, patency
is maintained via insertion of oral airway or nasopharyngeal
COMMON CAUSES device.
• Asthma; COPD; Pneumonia; TB o JAW THRUST MANUEVER - preferred method of opening
• Flail chest; Pulmonary embolism; Pneumothorax; Reactive the airway for clients with head or cervical neck injury
airway disease. o CHEST THRUST- the method used to remove the aspirated
foreign object.
o ABDOMINAL THRUST
• Suctioning the oral cavity to remove the secretions or visible
foreign body.
• Intubating via the oral route
• Using laryngeal mask airway
• Assisting with creating a surgical airway via a
cricothyroidectomy (a temporary opening into the trachea and
is maintained with a small plastic tube).

GILLIAN MERYL DIAZ 3

 • Get the person to safety. Move them into fresh air if you can do
it safely. Sit or lay them down on their side, not their back, to
reduce choking risks.
• Give cardiopulmonary resuscitation (CPR). If the person is
not breathing, give CPR.
• Look for shock. Signs of shock include pale and clammy skin,
rapid and shallow breathing, glazed eyes, sweating, weakness,
dizziness, and vomiting. Do what you can to treat the person for
shock until help arrives.

MEDICAL TREATMENT
• Oxygen: You might get oxygen through a nose tube, mask, or
tube down the throat. You might need a breathing tube if you
have a lot of trouble breathing due to a swollen throat or other
problems.
• Bronchoscopy: A doctor may put a scope down your throat to
get a better look at your airway and to suction out mucus and
other debris. Usually, this is done after you get medications to
sedate you and relieve pain.
• Hyperbaric oxygenation: If you have carbon monoxide
poisoning, you might spend time in a chamber where high air
pressure allows your lungs to take in extra oxygen. It may speed
up your recovery.
• Medications: These can include drugs to clear up mucus and
inhaled medicines called bronchodilators to ease wheezing and
airway spasms. You might need painkillers, too.

INHALATION INJURY
ANAPHYLAXIS
SYMPTOMS
• Give Atropine instead of Epinephrine (5ml) for anaphylaxis/
• Cough: When the airway linings get irritated, they secrete more
anaphylactic shock
mucus. The muscles of your airways also may tighten up. These
reactions can cause coughing. • Mas safe an atropine. Delikado mag give epi if may pulse an pt
kay bangin mag tachycardia lugod an pt.
• Shortness of breath: You may have trouble breathing because
of low oxygen levels. • Remove sting using card/ ID

• Hoarseness or noisy breathing: Fluids may collect in your • Kun wa meds like atropine, move to the nearest hospital
airways and cause a blockage. Also, chemicals may irritate your • Epi effects is fight or flight so less likely an effect nga ‘no pulse,
vocal cords, causing spasms, swelling, and tightening of your no breathing’
airways. • Give Epi IM in vastus lateralis kay mas dako it muscle compared
• Eye irritation and burns: Your eyes may become red and ha deltoid
irritated from the smoke. Your corneas may also have burns on • Benadryl syrup lang ighahatag for allergic reactions ha peanut or
them. common allergens then epi if not managed by benadryl.
• Skin color changes: Your skin might look unusually pale or turn • can cause Severe anaphylactic shock: bee stings, BT
bluish or cherry red. • do not give drink to avoid aspiration or airway compromise
• Soot marks: Soot might collect around your nose and mouth.
• Facial burns and singed nasal hair: These kinds of outward • Lay the person flat – do not allow them to stand or walk.
signs suggest that you've inhaled a lot of smoke. • Give adrenaline injector (such as EpiPen® or Anapen®) into the
• Headache, nausea, and vomiting: People in fires often inhale outer mid-thigh.
carbon monoxide, which can cause these symptoms. • Phone an ambulance
• Mental changes: Low levels of oxygen can lead to confusion, • Phone family or emergency contact.
fainting, seizures, and coma. • Further adrenaline may be given if there is no response after 5
FIRST AID minutes.
• Call for medical help • Transfer person to hospital for at least 4 hours of observation.
• Get health information. If the person is alert, ask if they have a
lung disease such as COPD and asthma. If they do, see if they
have an inhaler to use.

GILLIAN MERYL DIAZ 4

 THORACIC EMERGENCY TRAUMA OPEN PNEUMOTHORAX:
• Call Emergency medical assistance • chest wound that allows air to move freely into and out of the
• Begin CPR, if Necessary – If the person is unresponsive, has thoracic cavity during inspiration and exhalation.
stopped breathing, or is gasping for air: SIGNS AND SYMPTOMS
• Cover an Open Wound • Pain and tachypnea are present.
o Use a cloth, pad, piece of clothing, plastic, aluminum, or • Breath sounds are diminished or absent on the side of injury.
whatever is at hand. MANAGEMENT
o If possible, cover two inches beyond the edge of the wound. • High flow O2 via face mask at least 5-10 L/min.
o If blood bubbles up from the wound or you hear air passing • Apply occlusive dressing.
through the chest cavity, tape cover down on three sides to
o In emergency situations, a patient having a wound in the chest,
prevent air from building up in the chest.
we suspect that there is negative pressure due to the air from
o Do not remove any objects that have penetrated the chest.
the environment that has penetrated to the lung cavity. To
• Stop Bleeding, if Necessary prevent lung collapse immediately apply an occlusive dressing
o Apply pressure over dressing to control bleeding. on the wound site to prevent further change in pressure.
o If blood soaks through the dressing, apply additional dressing
TENSION PNEUMOTHORAX:
on top of old one.
• when air continues to become trapped in the pleural cavity with
• Position Person to Make Breathing Easier
no mechanism of escape during the exhalation process.
o If possible, place on the injured side or sitting up.
SIGNS AND SYMPTOMS
• Monitor Breathing – If breathing becomes weak, apply CPR
• Extreme respiratory distress.
• Follow Up
• Distended jugular neck veins
o The medical team will assess the injury and stabilize the
• Mediastinal shift of the heart, trachea, esophagus and great
person.
vessels to the side
o A blood transfusion may be necessary if there is significant
blood loss. • Hypotension and decreased cardiac output
o A temporary chest tube may be placed to remove air • Pneumothorax on chest x-ray.
surrounding the lung, which could cause the lung to collapse. o Air that was once penetrated due a previous open wound is
When a lung collapses, it is called pneumothorax. now trapped within the thoracic space and cannot be expelled;
o Surgery is likely for a serious chest injury. this causes tension within the space causing the lungs to sway
• If open pneumothorax, auscultate the lung fields do not percuss or cannot expand properly. As an emergency measure we open
the wound again to release the trapped air within the cavity
o okay la magdressing if open an wound and if waray fracture.
o occlusive dressing (nonporous) ha open wound to manage NURSING MANAGEMENT:
the bleeding. Tape 3 sides to avoid tension pneumothorax • Remove occlusive dressing immediately. Once we remove the
o give Oxygen of 6-10L/min dressing and as the air is expelled out, we then again place the
occlusive dressing to prevent air from going in and out of the
TRAUMATIC PNEUMOTHORAX cavity.
• Most commonly found with vehicular accidents • Release trapped air by inserting a 14 – 16 gauze catheter needle
CLASSIFIED INTO 3 CATEGORIES: immediately into the client’s anterior chest wall on the affected
SIMPLE PNEUMOTHORAX: side at the second mid-clavicular intercostal space. If we cannot
• Air from the bronchus or alveoli escapes into the pleural space remove the occlusive dressing.
and diminishes lung expansion. • Place a chest tube. This measure aids in re-expansion of the
• Associated with penetrating injury forces delivered to the chest lungs.
or blunt forces causing rib fracture. FLAIL CHEST
SIGNS AND SYMPTOMS • Involves serious rib fractures of 2 or more ribs in two or more
• Pain with respiration. places on the same chest wall side or when the sternum is
• Unequal breath sound upon auscultation detached from the ribs.
• Pulse oximetry reading of less than 94 %. SIGNS AND SYMPTOMS
MGT: HIGH FLOW O2 VIA FACE MASK • Respiratory distress; cyanosis; skin pallor.

o There is a blunt force that penetrates to the chest of the patient • Non- cardiac pulmonary edema.
but there is no wound present. If there is a wound present like a • Pulmonary contusion.
stab wound it is now called open pneumothorax. The air from the TREATMENT
environment will enter the lungs going to the thoracic cavity, due • Nasal or tracheal intubation.
to the difference in pressure this will cause atelectasis or lung • Mechanical ventilation with positive end expiratory pressure
collapse. (PEEP)

GILLIAN MERYL DIAZ 5

 o Victims of domestic violence are prone to flail chest; like kicking o The defibrillator will give voice prompts on what to do.
or a blunt object hitting on the victim's rib cage. rib fractures are • They should attach the pads to the casualty’s chest by removing
seen. Rib fractures cannot be surgically operated but only do the backing paper. Applying the pads in the positions shown.
strapping; Placing an elastic bandage around the chest of the o The first pad should be on the upper right side below the
patient, placed for several days until fracture has been healed. collarbone.
But the downside to this is when the patient is breathing, they o The second pad should be on the casualty’s left side below
can feel pain due to the fractured parts of the rib hitting the and in line with the arm pit.
lungs and other intra thoracic organs. • The defibrillator will analyze the heart's rhythm. Stop CPR and
make sure no one is touching the casualty. It will then give a
CARDIAC ARREST series of visual and verbal prompts that should be followed.
• cardiac arrest happens when the heart stops o If the defibrillator tells you that a shock is needed, tell people
to stand back. The defibrillator will tell you when to press the
• If you find someone collapsed, you should first perform shock button. After the shock has been given, the defibrillator
a primary survey (check for a response, open their airway, and will tell you to continue CPR for two minutes before it re-
look for normal breathing and signs of life for no more than 10 analyses.
seconds). o If the defibrillator tells you that no shock is needed, continue
CPR for two minutes before the defibrillator reanalyzes.
o If they are unresponsive and not breathing normally, shout for
help. Ask a helper to call 999 or 112 and ask for an • If the casualty shows signs of becoming responsive such as
ambulance while you start CPR. Ask a helper to find and bring coughing, opening their eyes, speaking, or starting to breathe
a defibrillator, if available. normally, put them in the recovery position.
o If you are on your own, use the hands-free speaker on o Leave the defibrillator attached. Monitor their level of
a phone so you can start CPR while speaking to ambulance response and prepare to give CPR again if necessary.
control.
o Do not leave the casualty to look for a defibrillator yourself. If • Give O2 at 10 L/min
there's someone else there, they can go and collect one. o Secure IV access, give digibind (OMNA)
Otherwise, the ambulance will bring one. o Sequence: O2, IV, digibind, Defib
• Start CPR. Kneel by the casualty and put the heel of your hand • Labetalol then Nicardipine
in the middle of their chest.
o Put your other hand on top of the first. Interlock your fingers EXTERNAL HEMORRHAGE
making sure they don't touch the ribs. MINOR BLEEDING
o Keep your arms straight and lean over the casualty. Press • Small cuts and abrasions that are not bleeding excessively can
down hard, to 4-6 cm, then allow the chest to come back up. be managed at home. First aid suggestions include:
o Push at a rate of 100-120 per minute o Clean the injured area with sterile gauze soaked in normal
• After 30 chest compressions, you should ideally give two rescue saline or clean water. Do not use cotton wool or any material
breaths. This is done by placing one hand on the forehead and that will fray or leave fluff in the wound.
two fingers (of your other hand) underneath the tip of the chin. o Apply an appropriate dressing such as a band aid or a non-
adhesive dressing held in place with a hypoallergenic tape.
Using the hand on the forehead, pinch the casualty's nose with
This dressing must be changed regularly.
your finger and thumb, allowing the casualty's mouth to fall open.
o See your doctor if you can’t remove the dirt yourself. A dirty
Take a breath and place your lips around the casualty's mouth,
wound carries a high risk of infection.
forming a seal. Blow into the casualty's mouth until the chest
o If you have not had a booster vaccine against tetanus in the
rises.
last five years, see your doctor.
o Repeat 30 chest compressions at a rate of 100-120
compressions per minute, to two breaths. If you can't give NOSEBLEEDS
two rescue breaths, just give continuous chest compressions. • Bleeding from the nose is usually not severe. First aid
• Continue to perform CPR until: suggestions include:

o emergency help arrives and takes over o Sit the person upright and ask them to lean forward.

o the person starts showing signs of life and starts to breathe o Using the thumb and forefinger, squeeze their nostrils shut.
normally o Hold for at least 10 minutes.
o you are too exhausted to continue - if there is a helper, you o Release the hold gently and check for bleeding. If the
should change over every one to two minutes. Try to minimize bleeding has stopped, advise them to avoid blowing their
interruptions to chest compressions. nose or picking at it for the rest of the day.
o a defibrillator is ready to be used. o If bleeding continues beyond 20 minutes, seek medical aid.

• When the helper returns with a defibrillator, ask them to switch it o If the nose bleed occurs again, seek medical aid.
on and take the pads out while you continue with CPR. They SEVERE EXTERNAL BLEEDING
should remove or cut through clothing to get to the casualty's • Even a small injury can result in severe external bleeding,
bare chest. They also need to wipe away any sweat. depending on where it is on the body. This can lead to shock. In

GILLIAN MERYL DIAZ 6

 medical terms, shock means the injured person no longer has HEAD INJURY
enough blood circulating around their body. Shock is a life- • A head injury is any trauma to the scalp, skull, or brain.
threatening medical emergency. • Head injury can be either closed or open (penetrating).
o Check for danger before approaching the injured person. Put o A closed head injury means you received a hard blow to the
on a pair of gloves, nitrile ones, if available. head from striking an object, but the object did not penetrate
o If possible, send someone else to call for an ambulance. the skull.
o Lie the person down. If a limb is injured, raise the injured area o An open, or penetrating, head injury means you were hit with
above the level of the person’s heart (if possible). an object that broke the skull and entered the brain. This is
o Get the person to apply direct pressure to the wound with more likely to happen when you move at a high speed, such
their hand or hands to stem the blood flow. If the person can’t as going through the windshield during a car accident. It can
do it, apply direct pressure yourself. also happen from a gunshot to the head.
o You may need to pull the edges of the wound together before HEAD INJURIES INCLUDE:
applying a dressing or pad. Secure it firmly with a bandage.
• Concussion, most often in which the brain has been shaken, is
o If an object is embedded in the wound, do not remove it. Apply
the most common type of traumatic brain injury.
pressure around the object.
• Scalp wounds.
o Do not apply a tourniquet.
o If blood saturates the initial dressing, do not remove it. Add • Skull fractures.
fresh padding over the top and secure with a bandage. HEAD INJURIES MAY CAUSE BLEEDING:
INTERNAL BLEEDING – VISIBLE • In the brain tissue
• The most common type of visible internal bleed is a bruise, when • In the layers that surround the brain (subarachnoid
blood from damaged blood vessels leaks into the surrounding hemorrhage, subdural hematoma, epidural hematoma)
skin. Some types of internal injury can cause visible bleeding
from an orifice (body opening). For example: CAUSES
• Accidents at home, work, outdoors, or while playing sports
o bowel injury – bleeding from the anus
o head injury – bleeding from the ears or nose
• Falls

o lung injury – coughing up frothy, bloodied sputum (spit) • Physical assault

o urinary tract injury – blood in the urine. • Traffic accidents

INTERNAL BLEEDING – NOT VISIBLE

FIRST AID
• It is important to remember that an injured person may be
• call 911 or the local emergency number right away.
bleeding internally even if you can’t see any blood. An internal
• Get medical help right away if the person:
injury can sometimes cause bleeding that remains contained
o Becomes very sleepy
within the body; for example, within the skull or abdominal cavity.
o Behaves abnormally, or has speech that does not make
• Listen carefully to what the person tells you about their injury –
sense
where they felt the impact, for example. They may display the
o Develops a severe headache or stiff neck
signs and symptoms of shock. In the case of a head injury, they
o Has a seizure
may display the signs and symptoms of concussion. Therefore,
o Has pupils (the dark central part of the eye) of unequal sizes
it is important to ask the right questions to collect the relevant
o Is unable to move all or part of an arm or leg
information.
o Loses consciousness, even briefly
THINGS TO REMEMBER o Vomits more than once
• Always call for medical help or ambulance in an emergency.
• Check the person's airway, breathing, and circulation. If
• First aid for severe external bleeding includes direct pressure on necessary, begin rescue breathing and CPR.
the wound maintained by using pads and bandages, and raising
• If the person's breathing and heart rate are normal, but the
the injured area above the level of the heart if possible.
person is unconscious, treat as if there is a spinal injury. Stabilize
• First aid for internal bleeding includes laying the person down, the head and neck by placing your hands on both sides of the
raising their legs above the level of their heart and not giving them person's head. Keep the head in line with the spine and prevent
anything to eat or drink. movement. Wait for medical help.
o Apply cervical collar if mayda, then log roll pt
• Give IV PLR, tranexamic acid, pain reliever, antibiotic, vaxx for
• Stop any bleeding by firmly pressing a clean cloth on the wound,
tetanus prophylaxis
unless you suspect a skull fracture. If the injury is serious, be
• Suture/ close the wound.
careful not to move the person's head. If blood soaks through the
• Pressure dressing (roll a gauze then directly lapat ha wound then cloth, do not remove it. Place another cloth over the first one.
paliboti lwat hin dressing tas ma apply adto hin pressure emerut.
• If you suspect a skull fracture, do not apply direct pressure to the
bleeding site, and do not remove any debris from the wound.
Cover the wound with sterile gauze dressing.

GILLIAN MERYL DIAZ 7

• If the person is vomiting or about to vomit, to prevent choking, roll o Severe headache — a bolt out of the blue — with no known
the person's head, neck, and body as one unit while stabilizing cause.
the head and neck onto their side. This still protects the spine, o Trouble walking, dizziness, loss of balance or a sudden fall.
which you must always assume is injured in the case of a head TREATMENT
injury. Children often vomit once after a head injury. This may not • Don't drive to the hospital.
be a problem, but contact your health care provider for further
• Call local emergency number and wait for healthcare
guidance.
professionals to arrive. They can begin lifesaving treatment right
• Apply ice packs to swollen areas (cover ice in a towel so it does away. If someone you're with has signs of a stroke, stay with the
not directly touch the skin). person until an ambulance arrives.
DO NOT • Note the time when symptoms first appear. Share this
• Do not wash a head wound that is deep or bleeding a lot.
information with emergency healthcare professionals when they
• Do not remove any object sticking out of a wound. arrive.
• Do not move the person unless absolutely necessary.
PREVENTION
• Do not shake the person if they seem dazed. • You can lower your risk of having a second stroke by taking these
• Do not remove a helmet if you suspect a serious head injury. steps:
• Do not pick up a fallen child with any sign of head injury. o Get information on what caused your stroke. Talk with your
• Do not drink alcohol or use illicit drugs within 48 hours of a serious healthcare professional about how to prevent a stroke from
head injury. happening again.
o Take medicines recommended by your healthcare team.
CALL 911 OR THE LOCAL EMERGENCY NUMBER RIGHT o Manage your blood pressure, cholesterol and blood sugar.
AWAY IF:
o Stay active and exercise.
• There is severe head or face bleeding.
o Eat a healthy diet.
• The person is confused, tired, or unconscious.
o Maintain a healthy weight.
• The person stops breathing.
o Quit smoking if you smoke.
• You suspect a serious head or neck injury, or the person
o Talk with your healthcare team about your treatment plan.
develops any signs or symptoms of a serious head injury.
o Join programs to help you reach lifestyle goals or for
education or counseling.
STROKE
• A stroke occurs when there's bleeding in the brain or when blood
• Oxygen of 6-10L
flow to the brain is blocked. Within minutes of being deprived of
• Pag abot ha hospital – labetalol for bp then ct scan
essential nutrients, brain cells start dying.
• Dont give t-PA if pt has an open wound or bleeding
• A stroke is a true emergency. The sooner a stroke is treated, the
less damage may occur. Every moment counts. • Nicardipine drip if decreased an BP, then give IVF

WHEN TO SEEK EMERGENCY HELP HEAT-RELATED EMERGENCIES

• Call local emergency number right away if you or someone you're HEATSTROKE OR SUNSTROKE
with has signs or symptoms of a stroke. • A true life-threatening emergency that occurs when the body’s
• Use F.A.S.T. to help remember warning signs. heat regulating mechanism breaks down or fails to cool the body.
o Face. Does the face droop on one side when the person tries • The body becomes overheated and body temperature rises
to smile? dangerously high
o Arms. Is one arm lower when the person tries to raise both • Don’t give the patient beverage that contain caffeine
arms? Is one arm weak or numb? • Half of all victims do not sweat
o Speech. Can the person repeat a simple sentence? Is
speech slurred or hard to understand? TYPES OF HEAT STROKE
CLASSIC HEAT STROKE
o Time. Every minute counts during a stroke. Call 911 or your
local emergency number right away if you see any of these • People lose the ability to sweat
signs. • Generally affecting the elderly or chronically ill
• Other stroke symptoms that come on suddenly and need o This is a dangerous type of heat stroke because the patient’s
emergency care include: temperature continues to rise without having the ability to
o Weakness or numbness on one side of the body, including sweat.
either leg.
EXERTIONAL HEAT STROKE
o Confusion and having trouble speaking or understanding
someone speaking. • victims involved in physical exertion or muscle stress retain the
ability to sweat. However, they may dehydrate thereby losing the
o Having trouble seeing in one or both eyes. This may include
dimming, blurring or loss of vision. ability to cool through evaporation
CHARACTERISTICS OF HEAT STROKE

GILLIAN MERYL DIAZ 8

• Extreme fever • Monitor the victim's temperature until ED personnel arrive. If
• Delirium temperature starts to rise, start cooling procedure again
• Hot or dry skin • Temperature must drop below 100°F, stay this low until danger
• Coma has passed

SIGNS & SYMPTOMS OF HEAT STROKE SUBMERSION INJURIES

• Body temperature of 105°F or more • occur when a person is submerged in water, leading to potential
• Hot, red skin harm. These injuries can range from mild to severe, depending
• Initially rapid, strong pulse, later rapid weak pulse on factors such as the duration of submersion, water
temperature, and the individual's health. Common types of
• Initially constricted pupils, later dilated pupils
submersion injuries include:
• Tremors; Irritability; headache; dry mouth
o Drowning: The critical condition where water interferes with
• Mental confusion or anxiety
breathing, potentially leading to death if not addressed
• Initially deep, rapid breathing, later shallow, weak breathing immediately.
• Shortness of breath; loss of appetite o Near Drowning: A survival scenario where the individual
• Nausea and vomiting; dizziness and weakness experiences significant health issues but survives the
incident.
• Seizure or sudden collapse Dry Drowning: A condition where water inhaled into the airway causes breathing problems without entering the lungs.

MANAGEMENT FOR HEAT STROKE THE IMPACT OF SUBMERSION INJURIES

• Remove the victim from the source of heat • Respiratory Complications: Such as acute lung injury and
pulmonary edema.
• Establish an airway
• Neurological Issues: Including hypoxic-ischemic brain injury due
• Remove the clothing of the victim as possible
to lack of oxygen.
• Elevate the victim’s head and shoulder slightly
• Other Potential Injuries: Like cervical spine injuries and
• Put the victim in a tub of cool water (less 60° F)
hypothermia from prolonged submersion.
• Then stir the water gently so the body doesn’t produce heat
IMMEDIATE STEPS TO TAKE AFTER A SUBMERSION
• Do not cause the victim to shiver since this produces heat INCIDENT
o If heat stroke happens at home, remove the clothes of the INITIAL ASSESSMENT AND SAFETY
patient. If a bathtub is available, fill it with water and add ice. • Ensure Safety: Before attempting any rescue, make sure the
Put the patient in the tub and gently whirl the ice cool water. Do scene is safe for both you and the victim. If the situation is
not whirl the water too much because it can produce heat in the hazardous (e.g., strong currents, electrical hazards), wait for
body which defeats the purpose of the ice cool water. professional rescuers.
o If tub is not available, wrap the body of the patient with a • Check for Responsiveness: Gently tap the person and shout to
moistened blanket and continuously spray with water. The heat see if they respond. If the person is unresponsive, you need to
from the patient’s body absorbs the water from the blanket and act quickly.
causes it to dry which is why we need to continuously spray it
to keep it moist. Ice bags can also be used to lower the PERFORMING RESCUE AND FIRST AID
temperature of the patient. • Remove the Victim from Water: If you can safely do so,
• Pour cool water over the victim’s body or spray the victim with carefully remove the victim from the water. Use a reaching or
cool water throwing technique if you are unable to enter the water safely.

• Place cold packs or wrapped ice bags under the victim’s arms, in the groin, • Check for Breathing: Once the victim is out of the water, check
around the neck, behind each knee, and around the ankles to cool large for breathing. If the person is not breathing, begin CPR
surface blood vessels. immediately.
o Place ice packs specially in hotspots area (armpits, groin, back o CPR: Perform chest compressions at a rate of 100-120 per
of the knee, back of the head and around the neck). Placing ice minute and provide rescue breaths if trained to do so.
packs at the back of the head is important because the Continue CPR until professional help arrives or the person
hypothalamus is located at the back of the head. shows signs of life.
• Alternate wet towels soaked in cool water on the body. Do not • Position the Victim: If the victim is breathing but unconscious,
allow the towel to absorb and hold in heat place them in the recovery position to keep their airway clear.
• Fan or direct an electric fan at the victim This position helps prevent choking if they vomit.

• If victim shivers, slow the cooling method • Monitor Vital Signs: Check the victim’s pulse and breathing
regularly. Be prepared to resume CPR if necessary.
• Never give the victim stimulants or hot drinks
o because it can produce heat in the body MANAGING SPECIFIC SITUATIONS
• Dry Drowning: If the victim shows signs of dry drowning (e.g.,
• Position the victim for easy drainage if seizure or vomiting occurs
coughing, difficulty breathing), monitor them closely and seek
medical attention immediately.

GILLIAN MERYL DIAZ 9

• Secondary Drowning: This occurs when water that has been NEAR DROWNING
inhaled causes delayed respiratory issues. Watch for symptoms • at least temporarily surviving, near suffocation due to
such as difficulty breathing or chest pain after the incident. submersion. Prognosis is best when victims are submerged for
• Hypothermia: If the victim has been submerged in cold water, fewer than 5 minutes, CPR started within 10 minutes.
monitor for signs of hypothermia such as shivering, confusion,
DRY DROWNING
and weakness. Warm the person gradually with blankets and
• occurs when severe muscle spasm of the larynx cuts off
seek medical help.
respiration but does not allow aspiration of significant amount of
SEEKING PROFESSIONAL HELP fluid into the lungs. 10%-15% are dry drowning.
• Contact Emergency Services
WET DROWNING
• Call 911: Inform the dispatcher of the situation and provide
• occurs when a victim aspirates fluid or foreign body into the lungs
details such as the location, the victim’s condition, and any
actions already taken. SECONDARY DROWNING
• Follow Instructions: Listen carefully to the dispatcher and follow • the victim is resuscitated but dies within 96 hours from the
any instructions provided until help arrives. incident, usually as a result of breathing water into the lungs and
develop aspiration pneumonia.
TRANSPORTING THE VICTIM
• Stabilize During Transport: If you need to transport the victim TWO BASIC TYPES OF DROWNING
to a medical facility, ensure they are stabilized and monitor their ACTIVE DROWNING
condition during transport. • vertical to the water, is not kicking, still breathing and is usually
• Provide Information: When medical professionals arrive or you moving his or her arms in an effort to bob out of the water and
reach the hospital, provide them with detailed information about get a breath of air.
the incident, including the duration of submersion, water • cannot call for help., because all energy is expended on the effort
temperature, and any symptoms observed. to breath.

IMMEDIATE MEDICAL EVALUATION PASSIVE DROWNING

• Emergency Department Care: Upon arrival at the hospital, the • a victim who is not breathing, face down in the water, either
medical team will perform a thorough evaluation, including submerged or near the surface.
assessing respiratory function, neurological status, and potential
o the person is horizontal to the water
injuries.
SAFETY PRECAUTION TO PREVENT NEAR DROWNING
• Critical Interventions: Treatments may include oxygen therapy,
• Children should be under constant supervision if a lake, pool or
medications to manage pulmonary edema, and other critical care
part of water of any size is nearby.
measures depending on the severity of the submersion injuries.
• Never mix water sports and alcohol.

• hypothermic blanket • Life preservers or life jacket should always be worn when boating

• Sea water, give PLR FIRST AID FOR NEAR DROWNING

• Tab-ang, give PNSS • Remove the victim from the water quickly.

• Ranitidine to prevent aspiration since decreased peristalsis • Minimize movement of the victim’s head, neck and back.

• Antibiotic for prophylaxis • Keep the victim’s head in line with the body.

• Dexamethasone for inflammation • Never pull on the victim’s head.

• Potassium inside, sodium outside • Position the victim’s face up quickly.

• Sodium it nagagawas if ada ha saltwater that’s why gin uuhaw • Support the victim at the shoulder and hips to help keep the face
kita pag naliligo sa dagat. out of the water.
• Maintain in line immobilization, and secure the victim to the
DROWNING backboard before removing the person from the water.
• Death from suffocation due to submersion
o Sometimes we use the spine board to rescue a person that was
• Drowning victims are young adults between the ages of 15-24 drowned.
and children under the age of 5. • Apply a cervical collar.
• Signs that suggest that an emergency is developing.
o Sudden splashing. STINGS AND BITES
o Screams. • Move to safety: Avoid more bites or stings by moving to a safe
o Call for help.
area.

o Swimmer is thrashing. • Remove the stinger: If the stinger is still in your skin, remove it
to prevent more venom from being released. You can use a
fingernail, credit card, or plastic ruler to scrape it off sideways.

GILLIAN MERYL DIAZ 10

 Don't use tweezers, as this could squeeze more poison into the because the lymphatic system relies on muscle movement to
wound. squeeze lymph through its vessels.
• Clean the area: Wash the affected area with soap and warm o Splint the limb. You can use any hard objects (such as wood
water. planks or magazines) gently tied or bandaged to the limb. This
• Reduce swelling and pain: Apply a cold pack or cloth filled with is to ensure there is no or minimal movement of the limb.
ice around the area for 10–20 minutes. You can repeat this every Tie the legs together to further limit movement
hour. If the sting is in your mouth or throat, you can try sucking
on an ice cube or sipping cold water. STEPS
• Relieve itching: Apply calamine lotion, a paste of baking soda • Follow DRSABCD.
and water, or 0.5% or 1% hydrocortisone cream to the area • Call for help and ask for an ambulance.
several times a day. You can also take an oral antihistamine, • Lie the person down, ask them to keep still and reassure them.
such as cetirizine, fexofenadine, or loratadine.
• Remove jewelry on the limb (if you are able to do so).
• Take pain medication: If you're experiencing significant pain,
• If the bite or sting is on a limb, apply a broad pressure bandage
you can take an over-the-counter pain reliever, such as
over the site. Mark the site where the bite is on the bandage with
paracetamol.
an X.
• Seek immediate medical attention if you or someone else is
• Apply a further elasticized roller bandage (10–15 cm wide),
experiencing symptoms of a severe allergic reaction, such as:
starting just above the fingers or toes and moving upwards on the
o Hives bitten limb as far as can be reached. Apply the bandage as firmly
o Abdominal cramps as possible to the limb. You should be unable to easily slide a
o Nausea and vomiting finger between the bandage and the skin.
o Swelling of the face, lips, or throat
• Immobilize the bandaged limb using a splint.
o Breathing problems
• Keep the person lying down and completely still (immobilized).
o Shock
• Continue to check the color, temperature and feeling in their
• Dog Bite – wash with soap and runny water fingers or toes.
o Let it bleed • Write down the time of the bite and when the bandage was
o Tetanus toxoid applied. Try to mark the location of the bite site (if known) on the
• Don’t give water if snake bite since it’s not advisable skin with a pen, or photograph the site. Do not wash venom off
• Hypotension, DOB, Dz, Rash, N/V, S/S of anaphylactic shock the skin or clothes because it may assist identification.
then give Epi then Pain reliever • Stay with the person until medical aid arrives.
• If an bee sumulod ha talinga use flashlight kay naayon hra hit • Do not make the person walk to the rescue vehicle – bring the
light. For flushing, use NSS. vehicle as close to them as you can.
• For spider bites – do not put bandage bc pressure will increase SNAKE BITE
pain • Severity of snake bite is gauged by how rapidly symptoms
• Sea Urchin - Not supposed to mobilize (alsaha it pt) develop, which depends on how much poison was injected.
o Remove the spike, buhos hin salt water and hot water (then o Adult snakes – inject more venom.
hot compress to reduce swelling) o Young Snakes – inject more venom, 3x more poisonous.
PRESSURE BANDAGING AND IMMOBILIZATION ASSESSMENT:
• snakes (including sea snakes) • Location of the bite:
• funnel-web and mouse spiders o Fatty tissues absorb the venom more than muscle tissue.
• blue ring octopuses • Whether disease causing organism are in the venom.
• cone shells. • The size and weight of the victim.
• The general health and condition of the victim.
o Pressure bandaging and immobilization slows the movement
of venom through the lymphatic system. The lymphatic • How much physical activity the victim engaged in immediately
system is a network of tubes that drains fluid (lymph) from the following the bite?
body’s tissues and empties it back into the bloodstream. o physical activity helps spread venom.
o Bandaging the wound firmly tends to squash the nearby NON-POISONOUS SNAKES
lymph vessels, which helps to prevent the venom from
• leaves a horseshoe shaped bite pattern.
leaving the puncture site. If you don’t have any bandages on
• their venom that can cause discomfort.
hand, use whatever is available such as: clothing, stockings,
towels • burning pain develop when he has been poisoned. If no burning
o Immobilizing the limb is another way to slow the spread of
pain within one hour, then he has not been poisoned.
venom, sometimes delaying it for hours at a time. This is

GILLIAN MERYL DIAZ 11

SIGNS & SYMPTOMS • Absorbing through the skin. (Absorbed poison)
• Two distinct fang marks half an inch apart at the bite site
INGESTED FOOD
which may or not bleed. Others maybe only one fang.
• taking a substance into through the mouth. Especially those with
• Immediate and severe burning pain and swelling around the
suicidal tendency and mental illness
fang marks usually develop within 5 minutes and as longer
• usually remains in the stomach only for a short time
as 4 hours. Swelling may affect the entire arm or leg.
• most absorption takes place after the poison has passed into the
• Purplish discoloration and blood-filled blisters around the
small intestines.
bite develop, usually within 2-10 hours.
• Followed by numbness around the bite. GOAL OF FIRST AIDER:
• Get rid of the body with poison before it enters the intestinal tract.
o Prevent this poison to travel to small intestine because it is in
the small intestine that absorption of poison takes place.

ASSESSMENT
o During assessment you should ask these ff questions. When
patient (if conscious) comes to ER, you ask “Ano na klase hin
poison an imo na swallow?”
• What was swallowed? When was it swallowed?
SEVERE REACTIONS • How much was swallowed?
• Nausea and vomiting
• Has anyone tried to induce vomiting?
• Rapid heartbeat; decreased BP
• Has anything been given as an antidote?
• Weakness and fainting; excessive sweating.
• Does the victim have a history that suggest a possible suicide
• Numbness and tingling sensation of tongue and mouth. attempt?
• Fever and chills; muscular twitching. • Does the victim have an underlying medical illness, allergy,
• Convulsions; Dimmed vision; headache. chronic drug use or addiction?
• A minty, metallic taste in the mouth.
SIGNS AND SYMPTOMS
SIGNS & SYMPTOMS FOR POISONOUS SNAKES • Nausea, vomiting and diarrhea.
• Blurred vision and drooping eyelids. • Excessive salivation.
• Slurred speech; dyspnea; nausea and vomiting • Varying level of consciousness.
• Increased salivation; drowsiness; paralysis • Abdominal pain, tenderness, bloating or cramps.
• Swelling at bitten area • Burns or stains around the mouth.
• Ecchymosis and pain at bitten area. • Pain in the mouth or throat.

NURSING CARE: • Pain during swallowing.

• Clean the wound area gently. • Corrosive poison may burn or destroy the tissue of mouth, throat
• Do not apply ice on bitten area to reduce swelling. and stomach.
• Antivenom given IV (skin or conjunctival testing is done first • Unusual breath or body odor of chemicals.
before administration of antivenom).
MEASURES OR MANAGEMENT
• Clean the wound area gently • Maintain airway and monitor the victim’s ABCD.
• Ice should not be applied to the wound to reduce swelling o (Airway, Breathing, Circulation and Disability)
• Administer antivenom I.V. after skin and conjunctival testing • Wear gloves in removing any remaining pill, tablet, capsules or
other fragments from the victim’s mouth.
• For profuse secretions, keep the victim’s face pointed downward
POISONING
• POISON is any substance liquid, solid or gas that impairs health to facilitate drainage.
or causes death by its chemical action, when it enters the body • For corrosive poison, give victim 1-2 ounces of cold water or
in relatively small amount or comes in contact with the surface of milk to dilute poison.
the body. • Place victim on the left side so that gravity will delay the poison
from entering the small intestines where most substances are
FOUR WAYS BY WHICH POISON ENTERS THE BODY:
absorbed into the bloodstream.
• Swallowing (Ingested poison)
• Never give a victim anything to eat or drink unless you are told to
• Inhaling noxious dusts, fumes, gases or mists. (Inhaled poison)
do so.
• Penetrating the skin. (Injected poison)

GILLIAN MERYL DIAZ 12

• Never induce vomiting unless you are told to do so. Use syrup of DOSE
Ipecac (you can buy prepared Ipecac in Pharmacy) if you induce • Adult and Children - 1 gram of activated charcoal/kg of BW
vomiting. o Adult dose = 25 - 50 grams

NEVER INDUCE VOMITING IF THE VICTIM IS AN: o Infant and children = 12.5 - 25 grams

• Infant DONT’S
• Unconscious • Don’t give to victims with altered mental status.
• With seizure • Has swallowed acids or alkalies.
• last trimester of pregnancy • Victims unable to swallow.
• Has swallowed corrosive poison. • Has taken syrup of ipecac.
o Send suspected poison container or specimen for examination. o If your patient has already taken ipecac syrup, wait if he/she will

FOOD POISONING vomit. Because if you mix it with activated charcoal, your
• ingestion of food that contains bacteria or toxins that bacteria patient will get dehydrated, and your patient will vomit all
produce or has been contaminated by chemicals {including lead throughout the day.
in water pipes delivering water used for cooking, toys and drinks. INHALED POISON
• bacterial contamination occurs when food is allowed to sit at • toxic inhalation or taking toxins into the body through the lungs
room temperature for too long. as a result of fire.
• foods containing raw eggs, meat and dairy products. • chemicals at industrial sites, fumes from drugs, liquid chemicals
like chlorine and ammonia, gases used for medical purposes,
GENERAL SIGNS AND SYMPTOMS BEGIN 1-48 HOURS
AFTER EATING THE CONTAMINATED FOOD solvents used in dry cleaning.
• Fever, Nausea &/ Vomiting • critical because the body absorbs inhaled poison rapidly.
• Abdominal pain • protect yourself from inhaling the same poison while you are
• Diarrhea giving first aid.
• Loud or frequent bowel sound o If you are from a building that is burning, you always crawl when

o Botulism - results from improperly processed canned foods moving outside. Why? Because the smoke is floating above
you. For you not to inhale any of the poisonous smoke, crawl
TREATMENT
down the floor towards exit.
• NPO
CARBON MONOXIDE POISONING
• Antibiotics for severe cases. You give antibiotics 3x a day. It depends
• incomplete combustion of gasoline, coal, kerosene, plastic, wood
what kind of antibiotics and you give it for 1 week.
and natural gas.
ACTIVATED CHARCOAL • common in the environment and is completely non-irritating,
• Medication of choice in the first aid for swallowed poison.
tasteless, colorless and odorless.
• A special distilled charcoal made of organic vegetable matter {wood pulp}
• it reduces the amount of O2 carried to cells in the body by the
that is burned at high temperatures and exposed to strong acids and
RBC; instead of binding to O2 in the bloodstream, they are 200X
intense steam.
more likely to bind to any Carbon Monoxide in the bloodstream.
• odorless, tasteless powder or liquid that works best when used promptly.
Once inhaled in large amounts, the patient immediately will
• Still effective after 4 hours after ingestion of some poison.
become unconscious.
o Note: You have to ask your patient “How long did you swallow
SIGNS AND SYMPTOMS
the poison?” Because activated charcoal is only usable within
• Dyspnea
4 hours after the ingestion of the poison, but if it is beyond 4
hours, it has no use already. That’s the reason why other • Chest pain or tightness; burning sensation in the chest or throat.
patients in the hospital, the management for them is NGT tube • Muscle weakness
and gastric lavage. • Cough, harsh vibrating sound when breathing, wheezing or other
USES OF ACTIVATED CHARCOAL abnormal breath sounds.
• Binds to poison in the stomach. • Hoarseness; Seizure.
• Prevents absorption of poison into the body. • Dizziness and severe headache.
• Enhances the elimination of poison from the body. • Ringing in the ears {tinnitus}
• Has a laxative effect that helps speed the charcoal through the • Altered mental status or confusion.
intestinal tract, further limiting any absorption into the body. • Respiratory tract burns.
• Used for victims who have ingested poison by mouth.
FIRST AID
• First Aid: Use activated charcoal premixed with H2O. It contains • Get victim into fresh air at once, at least 150 feet into open air.
12.5 grams/bottle.
• Monitor the A B C D’s.

GILLIAN MERYL DIAZ 13

 o Conscious Victim - have them lie down with heads elevated. • 20 minutes until medical help arrives.
Loosen all tight-fitting clothing around neck and over chest. • Check hidden areas like the nail beds, skin creases, areas
o Unresponsive Victims - place on left side between fingers, toes and any hairy areas.
o Non-breathing Victims - start artificial ventilation stat.
• Pesticide ingestion
INJECTED POISON o Rinse for 15 mins, include monitoring for pulse oximetry
• Injected poisons are those that enter the body through a: o elevate HOB since pt it at risk for aspiration
o break in the skin o induce vomiting when poisoning is caused by red-tide
o sometimes by intentional injection (poisoning)
o This is common in crimes where the perpetrators go inside the o Antidotes for drugs poisons/drugs (Mag Sul, Iron, Aspirin-IV
hospital with the patient to inject the poison Sodium Bicarbonate)
• caused by bites or stings of animals and insects.
• it causes an immediate reaction at the injection site DIVING
• If you suspect a back or neck (spinal) injury, do not move the
• followed by delayed widespread body reaction
affected person. Permanent paralysis and other serious
• following an insect bite, is a severe allergic reaction -
complications can result. Assume a person has a spinal injury if:
ANAPHYLACTIC SHOCK
o There's evidence of a head injury with an ongoing change in
o weakness, dizziness
the person's level of consciousness
o chills and fever, nausea or vomiting
o The person complains of severe pain in his or her neck or
FIRST AID FOR PLANT POISON: back
• Monitor the victim’s airway. o An injury has exerted substantial force on the back or head

o Very harmful for those who are asthmatic. o The person complains of weakness, numbness, or paralysis

• Be alert for vomiting. Keep the victim sitting, if possible, to or lacks control of his or her limbs, bladder or bowels
prevent from inhaling the vomitus. o The neck or body is twisted or positioned oddly

• Protect yourself and the victim from repeated injection or injury. IF YOU SUSPECT SOMEONE HAS A SPINAL INJURY:
• Identify the insect, reptile or animal that has bitten the victim • Get help. Call emergency medical help.
or the animal that causes the injury. • Keep the person still. Place heavy towels or rolled sheets on
both sides of the neck or hold the head and neck to prevent
ABSORBED POISON
movement.
• Absorbed poison is usually dry and wet chemicals or poisons
from plants that enter through the skin. Sometimes, burns turn • Avoid moving the head or neck. Provide as much first aid as
to blisters and become itchy. possible without moving the person's head or neck. If the person
shows no signs of circulation (breathing, coughing or movement),
o Burns, lesions
begin CPR, but do not tilt the head back to open the airway. Use
o inflammation
your fingers to gently grasp the jaw and lift it forward. If the person
o itching, irritation, redness
has no pulse, begin chest compressions.
• chemicals that are splashed into the eyes that causes:
• Keep helmet on. If the person is wearing a helmet, don't remove
o extreme burning pain
it. A football helmet facemask should be removed if you need to
o excessive tearing
access the airway.
o inability to open the eyes
• Don't roll alone. If you must roll the person because he or she
o It is important to wear goggles.
is vomiting, choking on blood or because you have to make sure
FIRST AID FOR ABSORBED POISON: the person is still breathing, you need at least one other person.
• Clean skin with soap and water and rinse well. With one of you at the head and another along the side of the
• For mild reactions, soak the affected part in a lukewarm bath injured person, work together to keep the person's head, neck
sprinkled with 2 cups of colloidal oatmeal to relieve itching and back aligned while rolling the person onto one side.
• Apply calamine lotion IN AMBULANCE & ER
• Take or inject IM diphenhydramine Hcl {Benadryl} • Administer oxygen
• Apply a paste of water and baking soda • IV of PLR / PNSS
• For moderate reactions, soak the affected part in a hot water, • Medication of Corticosteroids (Dexamethasone), Morphine
which offers 8 hours of relief after • Hyperbaric oxygen therapy for (astronaut, scuba divers, high-
FIRST AID FOR CHEMICAL POISON altitude hikers) Only for non-claustrophobic pts.
(UNDER ABSORBED POISON):
• Brush any dry chemicals or solid poison from the skin, but do not
scrape skin.
• Irrigate the area with clean water for at least

GILLIAN MERYL DIAZ 14

 LIGHTING • Stay with victim until seizure has passed: Send someone for help.
• Call emergency medical help – People struck by lightning may • Never try to force anything between the victim’s teeth and never
suffer cardiac arrest, so immediate and aggressive resuscitation give the victim anything by mouth.
greatly improves survival.
• Remove or loosen tight clothing, especially around the neck;
• Help the Person When It Is Safe – If you are at risk from ongoing Remove eyeglasses.
lightning, wait until danger has passed or move to a safer place,
• Turn the victim on his left side with face pointed downward so
if possible.
secretion and vomitus can drain quickly out of the mouth and the
• Begin CPR tongue will not fall back.
o It is safe to touch the person. The body does not retain an • If the victim stops breathing, open the airway, remove anything
electrical charge. that might impair breathing, and provide artificial ventilation.
o If the person is not conscious, does not have a pulse, and
• Do not restrain the victim unless he is in danger of objects that
does not appear to be breathing normally, use an automated
cannot be moved.
external defibrillator (AED), if one is on hand, or:
o Do not remove burned clothing unless necessary. • Cover the victim with a blanket to preserve warmth.

• Treat for Shock, if Necessary – Lay the victim down with head • Keep victim from becoming a spectacle, ask bystanders to leave.
slightly lower than torso and legs. • After the seizure, reorient the victim, speak slowly and calmly in
• Follow Up a normal tone of voice.
o The emergency medical team will assess the person's • Allow the victim to rest in a comfortable position as possible.
condition.
o At the hospital, the person will be examined for internal or
neurological injuries and burns.

• Lightning causes dysrhythmia so use cardioverter (for minimal

effects han lighting)
• meds: Paracetamol, prophylactic antibiotics, rani or omep,
• Wound care, cardiac meds sulfidiazone(?), O2 for respiratory
distress
• Give PNSS
• ECG to check for arrhythmia or V fib

EPILEPSY
• severe prolonged seizure or a series of seizures that occurs
without the victims regaining consciousness between them
• Because of the length and prolonged recurrent seizures, the
brain is deprived of O2. Therefore, irreversible damage can result
• Seizures are self-limiting and last normally 1-2 minutes and
experience residual drowsiness.

ASSESSMENT:
• What the seizure was like?
• Whether the victim have a history of seizure?
• Whether the victim takes medication for seizure?
• How the seizure progressed?
• Whether the victim suffered head injury?
• Whether the victim uses drugs or alcohol?
• Whether the victim has DM?
FIRST AID:
• Do not move the victim unless near a dangerous object that
cannot be moved. Otherwise, move the objects away from the
victim. Place pad under the victim’s head to prevent injury
• Maintain an open airway
• Stay calm. For the responsive victim, reassure him and others
who are with the victim.

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 DEFICIENT FLUID VOLUME • FRACTURE - Cover the open wound (left foot), elevate the leg,
• A decrease in circulating blood volume leads to a deficit in fluid check for signs of hypovolemic shock, give IVF
volume subsequently to decreased tissue perfusion. • Wrap the amputated digits in sterile gauze moistened with
CAUSES saline
• Shock due to acute hypovolemia. Clients can lose blood volume
through either internal or external bleeding. • altered mental status, poor coordination, and hot, dry, ashen skin,
• Dehydration - illnesses leading to prolonged vomiting or diarrhea with an unknown duration of heat exposure. This patient presents
can also produce large fluid losses. with altered mental status, poor coordination, and hot, dry, ashen
skin, which are critical signs of heat stroke, a medical emergency.
• Major burn injuries.
Heat stroke is the most severe form of heat-related illness and
CLINICAL MANIFESTATIONS occurs when the body’s thermoregulation system fails, leading to
• Agitation; Tachycardia; Tachypnea; Pale dangerously high body temperatures, typically above 104°F
• Decreasing level of consciousness. (40°C). The absence of sweating indicates that the body can no
• Diaphoretic skin; decrease urine output. longer cool itself, further suggesting heat stroke. If untreated, this
• Delayed capillary refill (longer than 2 seconds) condition can quickly lead to organ failure, brain damage, or
death.
• Decrease in systolic BP by 20mmHg.
• The altered mental status and lack of sweating indicate the
• Decrease pulse rate by 20 beats/minute.
body's compensatory mechanisms have been overwhelmed, and
MANAGEMENT immediate intervention is required. This includes rapid cooling
• High flow O2 by facial mask to provide additional O2 to tissues. and stabilization of vital functions to prevent further deterioration.
• Position the client in T-position. o Move the patient to a cool environment and start rapid cooling
o Especially in patients who are dehydrated. measures such as applying ice packs to major arteries (groin,
armpits, neck), using a fan, or initiating cold IV fluids if
• Stop or decrease bleeding.
needed.
o Direct pressure for external bleeding.
o Monitor the patient's airway, breathing, and circulation,
o Nasal passages bleeding, place client in sitting position
ensuring immediate support if any of these are compromised.
leaning forward or high fowler's position with nasal packing or
o Prepare for potential intubation if respiratory or neurological
OS.
function continues to deteriorate.
• Replace with fluids (PNSS, LR solutions; blood as whole blood
o Establish IV access and initiate treatment to support organ
or PRBC).
function and reverse the hyperthermic state.
• Autotransfusion.
o It is where the patient's own blood is used for transfusion, • Penetrating trauma, such as a stick injury, can cause damage to
removing the blood from the patient and transfusing it back to blood vessels, organs, or other structures, and removing the
the patient. object can worsen the injury or lead to hemorrhage. Nurse Kelly
must immediately assess the site of injury, control any bleeding,
and notify the physician or trauma team. Stabilizing the wound is
the priority in this scenario.
• In cases of penetrating injuries, the object should not be removed
unless it is done surgically by a healthcare professional to
prevent further damage or complications. The fact that the stick
was removed increases the risk of internal bleeding, infection, or
shock, making this the most urgent piece of information.
o Immediately assess the wound for active bleeding and apply
direct pressure if necessary.
o Monitor the patient’s vital signs for signs of hemorrhagic
shock (e.g., rapid pulse, low blood pressure).
o Prepare the patient for imaging or surgical intervention,
depending on the extent of the injury.
o Ensure the wound is covered with a sterile dressing to
prevent infection until further evaluation.

• caring for a patient with frostbite, the sequence of interventions

is critical to minimize tissue damage and alleviate pain. The
correct sequence is:

GILLIAN MERYL DIAZ 16

 o Move the patient away from the cold environment (3): The
first priority in frostbite management is to remove the patient
from the cold environment to stop the progression of tissue
freezing and prevent further damage. Prolonged exposure to
freezing temperatures worsens the frostbite and can lead to
more severe complications such as necrosis or amputation.
o Administer pain-relieving medication (2): Once the patient is
in a warmer environment, pain management is essential.
Rewarming frostbitten tissue can be extremely painful as
circulation returns, so pain medication helps alleviate
discomfort and prepares the patient for further interventions.
o Immerse the feet in warm water, with a temperature between
100°F and 105°F (4): Rapid rewarming is the most effective
treatment for frostbite, but it must be done carefully to avoid
further injury. The water temperature must be controlled to
avoid burns or thermal injury, which can occur if the water is
too hot. Gradual rewarming in water between 100°F and
105°F restores circulation without causing additional tissue
damage.
o Apply a loose, sterile, bulky dressing to the affected feet
(1): After rewarming, it’s important to protect the injured
areas. Sterile dressings help prevent infection, and a bulky,
loose application minimizes pressure and allows for swelling.
Additionally, separating toes with gauze can prevent tissue
adherence during the healing process.
• Frostbite management requires close monitoring for
complications like hypothermia, compartment syndrome, or
infection. Nurses should also ensure that rewarming is done in a
controlled setting, as inappropriate rewarming techniques (such
as using hot water or dry heat) can lead to more tissue damage.

• When managing care for sexual assault victims, the team must
work collaboratively to provide holistic care, ensuring that both
emotional and physical needs are addressed. Specific tasks for
the LPN/LVN may include:
o Offering a calm, supportive presence and reassurance to help
reduce anxiety and trauma-related stress.
o Communicating in a therapeutic and non-judgmental manner
to build trust with the patient.
o Assisting the RN with basic care tasks, such as vital sign
monitoring or providing comfort measures (e.g., blankets,
food, water).

• In managing a patient with delirium tremens, nurses should focus

on preventing seizures and ensuring patient safety:
o Implement seizure precautions, including padding the bed
rails and maintaining a clear environment to reduce the risk
of injury.
o Administer prescribed medications, such as
benzodiazepines, which are first-line treatment for preventing
seizures during alcohol withdrawal.
o Monitor vital signs and neurological status frequently to detect
early signs of complications like seizures or autonomic
instability.

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