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seizure, protect the patient’s dignity by providing some privacy
and asking someone to provide crowd control.
An unconscious person will not be able to give you much
helpful information, but clues may be found in his or her
surroundings or pockets. Odors as well as medical-alert
tags, bracelets or necklaces may also help rescuers figure out
why someone is unconscious. Because a serious injury (such
as a head or spine injury) may not be possible to rule out,
do not move an unconscious person unless their airway is
compromised or you are trained to do so properly. Arrange
an evacuation for anyone who is unconscious or who shows
symptoms that may indicate a stroke or a seizure.
CardiovasCular EmErgEnCiEs
Chest pain in an environment where emergency medical
services are not readily available is cause for decisive action.
Particularly when combined with other symptoms such as
sweating, cool or pale skin, shortness of breath, dizziness or
anxiety, chest pain may be due to angina or a myocardial
infraction (heart attack). Angina is pain due to inadequate
blood flow to the heart that can usually be relieved with rest
or medication; a myocardial infraction is heart-tissue death
resulting from a significant interruption in blood supply.
Overexertion and stress commonly precede such chest
pain, which may be described as crushing or squeezing.
Sometimes the chest pain is accompanied by pain that
radiates into the jaw, arm or abdomen, or the pain may even
be referred — felt in other parts of the body such as the
back. If in doubt, any unexplained upper-body pain should
be considered cardiac in nature.
The first step in addressing chest pain is to encourage
the patient to rest. Help him relax in the shade, take deep
breaths and loosen his collar or other constricting clothing. He
should assume whatever position is most comfortable to him.
Administration of a baby aspirin (81 mg) is a good idea as long
as the patient is not allergic to it. Oxygen is called for, as is
any medication the patient takes for a known heart condition
(nitroglycerin, for example); the medication should be taken
according to a doctor’s instructions. Even if the chest pain
passes, prompt medical attention is recommended.
Part of the challenge in dealing with medical problems
is the sense there is not much that rescuers with limited
resources can do. But do not underestimate the importance of
good judgment, a conservative approach, emotional support, a
well-crafted emergency action plan and the ability to arrange
and execute a speedy evacuation.
AD
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