Medical assisting Administrative and clinical procedures (5e) Chapter 57 Emergency preparedness

After studying this chapter you will be able to: Discuss the importance of first aid during a medical emergency, identify items found on a crash cart, recognize various accidental emergencies and how to deal with them, list common illnesses that can result in medical emergencies, identify less common illnesses that can result in medical emergencies,...

Emergency Preparedness

57.1 Discuss the importance of first aid during a

medical emergency

57.2 Identify items found on a crash cart

57.3 Recognize various accidental emergencies and how

to deal with them

57.4 List common illnesses that can result in medical

emergencies

57.5 Identify less common illnesses that can result in

Learning Outcomes

57.6 Discuss your role in caring for people with

psychosocial emergencies.

57.7 Carry out the procedure for calming a patient who is

under extreme stress

57.8 Discuss ways to educate patients about how to

prevent and respond to emergencies

57.9 Illustrate your role in responding to natural disasters

and pandemic illness

57.10 Discuss your role in responding to acts of

Learning Outcomes

– Disasters

The medical assistant must be prepared to determine the urgency of and handle any

Understanding Medical Emergencies

• Any situation requiring immediate care

• First aid

– Save a life

– Reduce pain

– Prevent further injury

– Reduce the risk of permanent disability

– Increase the chance of early recovery

Apply Your Knowledge

Why is it important to perform first aid in a

medical emergency?

ANSWER: First aid can:

 Save a life  Prevent further injury

 Reduce pain  Reduce risk of permanent disability

 Increase the chance of early recovery

Preparing Medical Emergencies

• Preparing the Office

– Know what is expected of you

– Post emergency telephone

numbers

• At every telephone

• On the Crash cart or first aid tray

Preparing the Office (cont.)

• Provide information to EMS

– Your name and location

– Nature of the emergency

– Number of people needing help

– Condition of the injured or ill patient(s)

– Summary of the first aid already given

– Directions to your location

Preparing for Medical Emergencies (cont.)

• Emergency and first-aid supplies

– Crash cart / tray

• Basic drugs, supplies, and equipment for medical emergencies

• First-aid kit for minor injuries and ailments

– Must be routinely checked and

restocked

Guidelines for Handling Emergencies

• Medical assistants

– Recognize

life-threatening condition – Take appropriate

Guidelines for Handling Emergencies (cont.)

Emergencies (cont.)

• Personal protection

– Take precautions to reduce chance of

exposure during an emergency – Follow Standard Precautions and use PPE

– Minimize splashing

– Wash hands

– Keep PPE in first-aid kit at home and work

Handling Emergencies (cont.)

Apply Your Knowledge

What are the steps of the initial assessment of a

patient in an emergency?

ANSWER: The steps of the initial assessment are:

1 Form a general impression of the patient

2 Determine the patient’s level of responsiveness

3 Assess CABs

4 Determine the urgency of condition

5 Perform a focused exam

6 Document findings/report to physician or EMT

Correct

!

Accidental Injuries

• Provide first aid

• Be able to help in emergency situations

– Bites and stings

– Burns

– Choking

– Eye and ear injuries

– Falls, fractures, dislocations

– Head injuries

Bites and Stings

• Animal bites

– Bruise, tear, puncture

– Cleanse wound, apply ointment and dry,

Bites and Stings (cont.)

• Snake bites

– May need antivenin

– Immobilize and position below heart

• Spider bites

– Refer to physician

– Wash area, apply ice,

and keep below heart level

• Classifications of burns – severity

– Depth and extent – Source of burn

– Age of patient – Body area burned – Other illness or injuries

• Food or foreign object blocks the

trachea or windpipe

• Unable to speak

• Universal sign – hand up to

throat with a fearful look

Be prepared to act promptly!

Accidental Injuries (cont.)

• Ear trauma

– Lacerations, cuts

– Severed ear ~ transport with patient

• Eye trauma

– Care depends on severity

– Foreign object in the eye

Accidental Injuries (cont.)

• Falls

– Have patient examined before moving

– Stabilize neck if injury suspected

– Minor falls, notify the physician

– Document

Fractures and Dislocations

• Fracture – break in the bone

• Dislocation – displacement of bone end

from the joint

• Immobilization

– Cast

Fractures and Dislocations

• Sprain

– Partial tearing of a ligament

supporting a joint – Splint and apply ice

• Strain – muscle injury

from overexertion

Head Injuries

• Concussion – jarring injury of

the brain

• Severe head injuries –

contusions, fractures, and

intracranial bleeding

under skin on head

• Scalp lacerations – often bleed

• Internal

– Keep patient warm,

quiet, and calm – Get medical help

• External

pressure point between wound and heart

Multiple Injuries

• Assess CABs

• Call EMS

• Perform CPR if needed

– Only perform first aid after CABs ensured

– Treat most life-threatening injuries first

• Substance that produces harmful effects if

it enters the body

Poisoning (cont.)

• Ingested poisons

– Only induce vomiting if directed

– Position patient on left side

– Send poison container with patient

• Absorbed poisons

– Remove contaminated

clothing – Wash skin, alcohol,

• Inhaled poisons

– Get to fresh air – Loosen clothing – Check CABs

– Ice crystals form between tissue cells

– Warm with clothing or other

body part

Weather-Related Injuries

• Heat stroke

– Prolonged exposure to high temperatures and

humidity – Move to cool place, cool with whatever is

available

• Sunburn

– Soak in cool water, cold

compresses – Patient education

• Abrasion

– Wash with soap and

water – Remove debris

– Apply dressing if large

Wounds

Apply Your Knowledge

ANSWER: The patient holds his hand to his throat

and looks afraid.

1 What is the universal sign of choking?

2 A patient arrives at the clinic hemorrhaging from the left

thigh What steps should you take to control the

bleeding?

ANSWER: The steps are:

1 Apply direct pressure with sterile gauze

2 Add additional dressing as necessary

3 Elevate the leg

Common Illnesses (cont.)

• Fainting – partial or complete

Common Illnesses (cont.)

Apply Your Knowledge

Matching:

_ Pulse > 100 bpm B Fainting

_ Spasmodic narrowing of bronchi C Dehydration

_ Dehydration and electrolyte imbalance D Tachycardia

_ Epistaxis E Diarrhea/vomiting

_ Rapid and deep breathing F Asthma

_ Lack of adequate water G Hyperventilation

Less Common Illnesses

• Anaphylaxis

– Severe, life-threatening allergic reaction

– Check CABs, perform CPR if needed

• Bacterial meningitis – usually a complication

of another bacterial infection

• Diabetic emergencies

Less Common Illnesses (cont.)

• Gallbladder attack – inflammation

of the gallbladder

• Heart attack

– Myocardial infarction

– Chest pain ~ cardinal symptom

fibrillation

Less Common Illnesses (cont.)

• Hematemesis – vomiting blood

• Obstetric emergencies – office protocols

• Respiratory arrest

– Lack of breathing

– May follow respiratory distress

– Assess CABs, perform CPR, if needed

Less Common Illnesses (cont.)

Less Common Illnesses (cont.)

• Cerebrovascular accident (CVA) – due

to impaired blood supply to brain

• Toxic shock syndrome – acute bacterial

infection

• Viral encephalitis – inflammation of the

brain due to a virus

Apply Your Knowledge

Matching:

_ Hypo- or hyperglycemia A Stroke

_ Myocardial infarction B Diabetic emergencies

_ Vomiting blood C Seizures

_ Impaired blood supply to brain D Hematemesis

!

Common Psychosocial Emergencies

• Spousal, child, and

• Report of rape – chain of custody

Remember legal obligation to report spousal,

child, and elder abuse as well as rape

Apply Your Knowledge

Mrs Jamison tells you that she is very tired of being ill and

often thinks of “ending it all.” She then laughs and says she

was just kidding What is/are your responsibilities in this

matter?

ANSWER: You should allow her to talk about her

feelings and despite the fact that she said she was “just kidding” you should take her seriously The physician

should be told of her comments You may be asked to

provide her with information on community services

available You should document her comments and

your actions.

The Patient Under Stress

• Extreme stress

– Behavior different from normal

– Unable to focus

or follow directions

• Keep victims and

family calm

• Challenges

– Non-English speaking

– Visual and hearing impairments

Educating the Patient

• How to prevent and handle medical

emergencies

• Encourage patients and families to learn first aid

and CPR

• How to access EMS

• Post emergency phone numbers

• How to childproof homes

Apply Your Knowledge

True or False:

_ All people react the same during an emergency.

_ Patients should be encouraged to learn CPR and first aid.

_ Challenges to dealing with patients during an emergency

include visual and hearing impairments and

Disasters and Pandemics

• Be familiar with standard protocols for

responding to disasters

• Participate in practice drills

• Evacuation and Shelter-in-Place Plans

– Means of communication

during and after

an emergency – Alert should distinguish

Pandemic Illness

• Establish a plan

– Identification and isolation patients

– Communication and reporting

– Occupational health

– Education and training

– Respiratory hygiene

• Intentional release of a biologic agent with

the intent to harm individuals

• Biologic agent = weapon

–Easy to disseminate –High potential for mortality –Cause public panic or social disruption –Requires public health preparedness

Bioterrorism (cont.)

• Physician’s offices are the front lines

–Individual cases –Common trends in syndromes/unusual patterns

• Triage – classification of injured victims

–Emergent –Urgent

–Nonurgent

Apply Your Knowledge

1 What is the difference between evacuation and

sheltering-in-place?

ANSWER: When an evacuation is called – everyone leaves the

premises following routes on posted maps For shelter-in-place

everyone in the office take refuge in an internal room with few or

no windows.

2 What criteria does a biologic agent have to meet to be a

biological weapon?

ANSWER: It must be easy to disseminate, have a high

potential for mortality, cause public panic, and require public

In Summary

57.1 Prompt and appropriate first aid can save a life,

reduce pain, prevent further injury, reduce the risk of permanent disability, and increase the chance of early recovery

57.2 The crash cart should include all appropriate drugs,

supplies, and equipment needed for emergencies

57.3 Accidental injuries you may encounter include bites

and stings; burns; choking; ear trauma; eye trauma;

falls; fractures, dislocations, sprains, and strains;

head injuries; hemorrhaging; multiple injuries;

In Summary (cont.)

57.4 Common illnesses that may cause a medical

emergency include abdominal pain, asthma, dehydration, diarrhea, fainting, fever,

hyperventilation, nosebleed, tachycardia, and vomiting.

57.5 Less common illnesses you may encounter in a

medical office include anaphylaxis, bacterial meningitis, diabetic emergencies, gallbladder attack, heart attack, hematemesis, obstetric emergencies, respiratory arrest, seizures, shock, stroke, toxic shock

In Summary (cont.)

57.6 Psychosocial emergencies in the medical office

include drug or alcohol abuse, spousal abuse, child abuse, elder abuse, and rape As a medical assistant, you may be involved in the direct care of someone

suffering a psychosocial emergency or you may arrange for their care at an outside agency

57.7 A medical assistant can help calm a patient under

stress by listening carefully and giving her or his full attention

In Summary (cont.)

57.8 Medical assistants should educate patients about

ways to prevent and handle various medical emergencies

57.9 During a disaster, a medical assistant’s first-aid and

CPR training will be of enormous help A medical assistant also must be familiar with standard protocols for responding to disasters and pandemic illness.

57.10 Physicians’ offices will be on the front lines if a

biologic agent is intentionally released as an act of terror Be aware of unusual patterns of disease in

End of Chapter 57

In the sick room, ten

cents' worth of

human understanding equals ten dollars' worth of

medical science.

~ Martin H Fischer