Chest pain, Drowning MUDr. Lukáš Dadák Pain • WHO: an unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage • often difficult to interpret Thorax • chest wall • skin, mm, joits, bones • pleura • parietal = somatic - local - sharp - change during movement - by finger • heart • (lung) • oesophagus • aorta • pleura • visceral - diffuse - dull, crampy and aching - middle line - by hand Heart attack = myocardial infarction • artery supplies oxygen is blocked • The heart muscle becomes starved for oxygen and begins to die. • Heart disease is the leading cause of death (US, EU). during time: Risk factors • age • smoking • diabetes • male gender • high cholesterol level • high blood pressure (hypertension) • family history of heart disease/heart attack • obesity • atherosclerosis (hardening of the arteries) • lack of exercise and physical activity Where it happents? • home (70%) • work (10%) • resting (45%) • sleeping (17%) • daily activity (30%) • hard work (8%) Warning signs and symptoms: • Uncomfortable pressure, fullness or squeezing pain in the center of chest lasting more than a few minutes. • Pain spreading to your shoulders, neck or arms. • Lightheadedness, fainting, sweating, nausea or shortness of breath. First aid: • Have the person sit down, rest, and try to keep calm + ABC + nothing p.os, NO smoking • Loosen any tight clothing. • Ask if the person takes any chest pain medication for a known heart condition. + Help to take the medication (nitroglycerin, which is placed under the tongue). • If the pain does not go away promptly with rest or within 3 minutes of taking nitroglycerin, call for emergency medical help. • (acylpyrin= Anopyrin) • unconscious: local emergency number + CPR. Do not • DO NOT leave the person alone except to call for help, if necessary. • DO NOT allow the person to deny the symptoms and convince you not to call for emergency help. • DO NOT wait to see if the symptoms go away. • DO NOT give the person anything by mouth unless a heart medication (such as nitroglycerin) has been prescribed. Pulmonary embolism ● An embolus is an accumulation of foreign material (usually a blood clot) that blocks an artery. ● Tissue death occurs when the tissue supplied by the blocked artery is damaged by the sudden loss of blood. ● Pulmonary embolism describes the condition that occurs when a clot (usually from the veins of the leg or pelvis) lodges in an artery of the lung. Signs and symptoms of PE: • Sudden, sharp chest pain that begins or worsens with a deep breath or a cough, often accompanied by shortness of breath • Sudden, unexplained shortness of breath, even without pain • Cough that may produce blood-streaked sputum • Rapid heartbeat • Anxiety and excessive perspiration First aid = As with a suspected heart attack • ABC + rest + call for emergency medical assistance immediately. Inflamation of lung and pleura = Pneumonia with pleurisy • chills + fever (tachycardia) • cough • pain – of inflamation of pleura – worsening by deep breath or cough • fatigue Drowning = Near-drowning means a person almost died from not being able to breathe (suffocating) under water • disaster in the lung = H2O Why: • jump to flat water • fall to wildwater – haed trauma / C spine • Inability to swim or panic while swimming • alcohol How it works: • Po ponoření – vůlí potlačeno dýchání ® pokles O[2] v krvi, v mozku ® porušena volní kontola ® ® voda do úst - polykána – voda v horních dýchacích cestách –(20%) ® reflexní stah hlasivek (suché tonutí) – voda dýchána do plic - v alveolu se vstřebává do krve • otok plic, mozku, poškození a rozpad červených krvinek = šok • Safely - Out of water People who have fallen through ice may not be able to grasp objects within their reach or hold on while being pulled to safety. First aid: • Do not place yourself in danger. Do NOT get into the water or go out onto ice unless your are absolutely sure it is safe. • (start the breathing while still in the water) • Move victim to dry land - give CPR if needed. • Assume neck or spine injury • Keep the person calm and still. Seek medical help immediately. • Remove any cold, wet clothes from the person and cover with something warm, if possible. = prevent hypothermia. DO NOT • DO NOT go into rough or turbulent water that may endanger you. • The Heimlich maneuver is NOT part of the routine CPR • Do not go home All near-drowning victims should be checked by a doctor. Even though victims may revive quickly at the scene, lung complications are common. Interesting web pages www.heartfailure.org www.bbc.co.uk/health/first_aid_action/es_drown.shtml www.bbc.co.uk/health/first_aid_action/es_heart.shtml