Common medical problems Dr. Katarina Zadrazilova, Clinic of Anesthesiology, Resuscitation and Intensive Care, University Hospital Brno • First aid – end of course • Fever • Febrile seizures • Abdominal pain • Vomiting, diarrhoea • Chest pain • Headache, meningism • Asthma End of first aid course • Test available after the last lecture on is.muni • Unlimited number of attempts • Time delay in unsuccesful attempt • Once passed, can apply for oral exam • Oral exam – 2 questions + practical BLS – 1 min. …thereafter Fever • Sustained body temperature above 37°C • Infectious: bacterial, viral infection • Non-infectious: drugs, head injury with bleeding • Earache, sore throat, measles, chickenpox, meningitis or local infection – abscess • Palor with goose skin, shivering, chattering teeth • Later : hot, flushed skin, sweating Fever • Cave: dehydration • EMS : seizures, loss of conscioussness, notdecreasing temperature, meningism • First aid – Decrease the temperature – Keep the casualty cool and comfortable – Plenty of cool drinks – Recommended dose of paracetamol/ibuprofen – Do not give aspirin in child under 16 – Monitor vital signs Febrile seizures in children • Often associated with throat or ear infection and high temperature • Violent twitching with clenched fists and arched back • Breath holding, red face, drooling • Loss/impaired consciousness Febrile seizures in children • First aid – Protect from injury during fits – Decrease the temperature – remove clothing, fresh air – Once the seizure stopped – maintain open airway, call EMS and turn to recovery position – Monitor vital signs • Causes: food poisoning, stress, infection of digestive tract, celiakia, liver, gall bladder, pankreatic disease, urinary tract infection, gynae origin, rupture of abdominal aorta, pneumonia, heart attack.. • Symptoms : nauzea, vomiting, diarrhoea, tiredness, blood in stool, melena, obstipation, wight loss, problems with breathing, urinating, blood in urine… Abdominal pain Abdominal pain • Often food poisoning – often mild • Colic pain – comes and goes in waves • Peritonitis – intense pain (appendicitis) – Pain often starts at the centre of abdomen – moving to right lower abdominal quadrant – Vomiting – Nausea, loss of apetite – High temperature • Never underestimate • Call EMS - when unsure, bleeding from digestive tract, jaundice, severe nor prolonged pain + vomiting and fever, weight loss • Nil per os Abdominal pain First aid • Calm down, minimal manipulation • Hot-water bottle – maight help from pain • Causative treatment • Rehydration, diet, antiemetics – suppository, probiotics Abdominal pain • Vomiting: protective repulsive reflex – Irritation of digestive system – Toxines, viruses, bacterias – contaminated food or person to person – Increased intracranial pressure, drugs • Leads to loss of water, salts – dehydration  hypovolemic shock Vomiting and diarrhoea • First aid – Identifing the cause – Rehydration – sips of still mineral water, fruit juice – Diet 48 hours: pasta, potatoes, buckwheat – EMS : severe and prologed vomiting+/- diarrhoea, exhaustion, dehydration, letargy, impaired consciousness Vomiting and diarrhoea • Not allways heart attack • Causes: heart disease, high blood pressure, arytmias, pulmonary embolism, lung disease, vertebral problems – affected intervertebral disk, GI tract, tumors • Other symptoms: shortness of breath, nausea, vomiting, cold and clammy, palpitations, pain on inspiration/expiration/after swallowing, cough, impaired consciousness… Chest pain • Information from patient • A llergies • M edication • P ast medical history • L ast meal • E vent leading to Chest pain Chest pain • Angina – Narrowing of coronary arteries – inadequate blood (O2) supply to heart muscle – Increased demand – exercise, stress – Central chest pain – may spread to jaw, arm – Pain easing with rest – Shortness of breath – Tiredness, anxiety Angina – first aid • Reassure, calm down • Treat in sitting position • The pain should ease within few minutes • Help with angina mediaction – tablets, aerosol • If the chest pain persists or returns suspect heart attack - EMS Heart attack • Sudden obstruction of blood supply to part of heart muscle • Symptoms – Angina-like but persistent, reccurent pain – Faintness, diziness, sweating, ´cold and clammy´ – Rapid, weak, irregular pulse – Gasping for air Heart attack • First aid • Make as comfortable as possible – sitting position • Call EMS • Aspirin 300 mg – chewable • Assist with angina mediaction • Monitor and record vital signs • If loss of consciousness - CPR Headache • May accompany any illeness or for no reason • Causes: tiredness, stress, fever, meningitis, migraine, tumors, intoxications… • Other symptoms : fever, muscle and joint pain, neck stiffness, vomiting, pain can be unilateral, epileptic fit, intolerance of light/noise • First aid – Look for reason – Quiet, dark place – sit, or lie down – Cold compress againts head – Painkillers: paracetamol, aspirin (not under 16y) • Seek medikal help if – Develops very suddenly – Severe, reccurent or persistent – Accompanied by loss of sensation/strenght/stiff neck/head injury, fits Headache Meningism • Inflamed meninges – viral or bacterial • Symptoms : high temp., headache, rash Meningism First aid • Call EMS • Reassure • Keep cool • Monitor vital signs – Level of response – Breathing – Pulse – Tempeture Asthma Asthma - recognision • Difficulty breathing, prolonged expiration • Wheezing • Difficulty speaking, shortness of breath • Coughing • Distress and anxiety • Cyanosis • Exahausion in severe attack Asthma • Trigger – cigarette smoke, pollen • First aid – reliever inhaler +/- spacer – Sitting position – reliever inhaler +/- spacer – Sitting position Asthma – call 112 if • No improvement with inhaler • Breathlessness makes breatging difficult • Getting blue – cyanosis • Is becoming exhausted • Monitor vital sighns till EMS arrives Marry Christmas !