Assessing Changes in Consciousness
Victims can be responsive or unconscious during a medical emergency. However, most cases not all victims are fully alert and might suffer from impairment in his/her level of consciousness and would respond differently when stimulated. Some victims can readily respond to voice stimulation, whereas others can respond better to physical stimulation. A good assessment of a victim with a medical emergency can indicate how well or poor the victim’s brain is functioning.
What to Look For
The mnemonics STOP will provide rescuers clues is assessing the kind of medical emergency the victim is experiencing.
- S – Seizure, sugar, stroke, shock
- T – Temperature
- O – Oxygen
- P – Poisoning, pressure on the brain
What to do
- Perform a quick but comprehensive primary and secondary check and provide appropriate care as needed.
- If victim is unresponsive and not breathing, initiate CPR.
- Roll the victim to the side if the victim is vomiting and unconscious.
- Call for emergency medical services.
A heart attack happens when oxygen-rich blood that supplies the heart is diminished or is blocked. Pain results from the lactic acid build-up of the cardiac muscle due to the lack of oxygen. The pain can be described as a crushing and squeezing that lasts for more than 10 minutes and cannot be alleviated by rest and nitroglycerin. To care for chest pain associated with a heart attack:
- Immediately call for emergency medical services.
- Have the victim rest in a comfortable position.
- If the victim has physician-prescribed nitroglycerin, assist him/her take the medication (usually a small tablet to be placed under the tongue for faster absorption).
- If the victim has no known allergies to aspirin give him/her regular aspirin (325 mg) or chewable aspirin (81 mg).
- Continue evaluating the victim’s level of consciousness.
Difficulty in Breathing
Shortness of breath and difficulty in breathing can result from injuries sustained in the chest or head as well as underlying medical conditions such as asthma and anaphylaxis. Asthma is a severe airway emergency in which the bronchioles in the lungs becomes narrow and mucus builds up severely impairing gas exchange which can result to hypoxia (low oxygen in the body.
Another airway emergency is hyperventilation which causes a victim to breath fast and saturates the body with so much oxygen leading to respiratory alkalosis. Hyperventilation is triggered by emotional stress, anxiety and existing medical condition.
Recognizing Breathing Difficulty
The signs of breathing difficulty include the following:
- Breathing that is abnormally slow or fast.
- Breathing that is abnormally shallow or deep (gasping for air).
- Bluish and pale lips.
- Noisy breathing including wheezing (narrowed airway), crowning, snoring or gurgling sound.
- Inability to speak continuously (need to pause to catch ones breath).
First Aid care for Breathing Difficulty
To care for a victim with difficulty in breathing:
- Contact emergency medical services.
- Do not delay initial treatment for airway emergencies.
- Assist the victim in the most comfortable position (usually seated upright for better breathing).
- If victim has prescribed medications for asthma such as an asthma inhaler, assist the victim in using it.
- If the victim is hyperventilating (breathing abnormally fast) due to panic attacks, have the victim inhale through the nose and instruct him/her to hold breath for several seconds then exhale slowly.
Alton, T. et al (2012). First Aid, CPR and AED Standard 6th Ed. Jones & Bartlett Learning