Chapter 16 – Emergency Procedures

    Check out our Audio Lectures, Practice Tests and Study Guide for the ACE CPT to see the specific topics that make it onto the ACE CPT Test from this chapter.

     

    1. Policies and procedures
      1. Par-q
        1. Identify high-risk individuals
        2. May need medical referral or modified exercise programs
      2. Informed consent
        1. Risk stratification
          1. obtain medical clearance when necessary
      3. HIPPA
        1. Health insurance portability and accountability act
        2. Ensures the victim’s privacy by putting him or her in control of who has access to personal health information
    2. Emergency assessment
      1. Check for ABC’s (airway, breathing, circulation and severe bleeding)
      2. Secondary assessment
        1. Head-to-toe assessment (what to look for)
          1. Deformities, abrasions, tenderness, swelling, medical alert jewelry
          2. Take pulse and blood pressure
      3. Calling 911
        1. Life-threatening situation
        2. Anything that requires immediate medical attention
    3. CPR/AED
      1. Ventricular fibrillation: most common rhythm during cardiac arrest (cessation of heart function)
        1. Spasmodic quivering of heart
        2. Too fast to allow chambers to fill and empty
      2. AED
        1. Converts VF back to normal rhythm
        2. Ideal to use in first 3-5 minutes
        3. Good Samaritan law for AED certified
        4. SA node restarts when shock is delivered
      3.  Dyspnea
        1. Difficult and labored breathing
        2. Causes = emotional stress, asthma, airway obstruction, and heart problems
      4. Signs of respiratory distress
        1. Poor movement of chest wall
        2. Flaring of nostrils
        3. Straining of neck muscles
        4. Poor air exchange
        5. Pale/ diaphoretic (sweaty) skin
        6.  Cyanosis
          1. Blue color around lips, nose, fingernails, and inner lining of eyes
      5.  Choking
        1. Airway blocked
        2. Victim becomes hypoxic (oxygen deficient)
        3. Perform Heimlich maneuver
      6.  Asthma
        1. Chronic inflammation of the airway
        2. Wheezing, shortness of breath, tightness in chest, coughing
        3. Avoid triggers
          1. Allergens and higher intensities of exercise
      7. Angina pectoris (heart attack)
        1. Chest pressure or a squeezing feeling
          1. May be mistaken for heartburn or indigestion
          2. Pain can travel to arms (typically left arm), neck, jaw, shoulder, or stomach
          3. Shortness of breath, nausea, cold sweat, lightheadedness
        2. Most common symptoms for women
          1. Chest pain
      8. Syncope (fainting)
        1. Temporary loss of consciousness due to lack of blood flow to the brain
        2. Causes
          1. Emotional stress, sever pain, dehydration/heavy sweating, overheating, exhaustion, sudden postural changes, violent coughing spells (especially in men)
      9. Stroke
        1. 3rd leading cause of death in U.S.
        2. 1st leading cause of disability
        3. Results from blockage in brain blood vessel
          1. Aneurysm
            1. Balloon-type bubble in the vessel at a weak spot that can rupture if left untreated
          2. Malformation of blood vessels may also lead to hemorrhagic stroke
        4. Warning signs
          1. Walking/balance is off
          2. Talking/speech is slurred or face is droopy
          3. Reach/one side is weak or numb
          4. Full or partial loss of vision
          5. Severe headache
      10.  Diabetes
        1. Type 1: insulin-dependent
          1. Pancreas doesn’t make enough insulin
          2. Must inject, pump, or inhale insulin manually (exogenous insulin administration) to have normal levels
          3. May go undiagnosed for years
        2. Type 2: non-insulin dependent
          1. Normal insulin secretion
          2. Body becomes resistant to insulin
        3. What happens
          1. Hyperglycemia – blood sugar too high (insulin too high)
            1. Victims become weak, thirsty, and fatigued
          2. Hypoglycemia – blood sugar too low
            1. Victims show signs of headache, hunger, weakness, sweating, or fatigue
          3. Consume 20-30g of carbs at first suspicion of hypoglycemia
        4. Blood glucose
          1. At least 100mg/dL before resuming activity/prior to exercise
            1. If below a snack high in complex carbs and low in fat is recommended
          2. 250mg/dL w/ketones in urine or 300mg/dL
            1. No exercise until blood sugar is under control
      11. Heat stress
        1. Heat exhaustion signs and symptoms
          1. Weak, rapid pulse, low blood pressure, fatigue, headache, dizziness, general weakness, paleness, cold/clammy skin, profuse sweating, elevated body core temperature (greater than 104 F, 40 C)
        2. Heat exhaustion treatment
          1. Stop exercise, move to cool area, lay down and elevate feet 12-18 inches, give fluids and monitor temp.
        3. Heat stroke signs and symptoms
          1. Hot/dry skin, bright red skin color, rapid/strong pulse, change in mental status (irritable, aggressive, or anxiety), labored breathing, elevated body core temp. (over 105 F, 41 C)
        4. Heat stroke treatment
          1. Stop exercise, remove clothing, cool body immediately any way possible, give fluids, transport to emergency room immediately
      12. Fluid intake during exercise
        1. 2 hours prior
          1. 500-600mL (17-20oz)
        2. Every 10-20 min during
          1. 200-300mL (7-10oz, based on sweat loss)
        3. Following exercise
          1. 450-675mL for every 0.5kg body weight lost (16-24oz for every pound)
      13.  Seizures
        1. Tonic clonic seizure (grand mal seizure): most common
        2. Occurs with abnormal and excessive electrical activity in the brain
      14. Soft-tissue injuries
        1. Abrasion: scrape from fall
        2. Incision: clean cut to skin usually from sharp edge
        3. Laceration: jagged tear caused by shear and tensile forces
        4. Avulsion: sever laceration, skin torn away from tissue
        5. Puncture: penetration of skin by an object
      15.  Fractures
        1. Signs
          1. Deformity, pain and tenderness, grating, crepitus (sound of bone fragments grinding against each other), swelling, disfigurement, severe weakness and loss of function, bruising, exposed bone ends, joint locked in position
      16. Spine and neck
        1. Kyphotic: thoracic spine curves posteriorly (rounding upper back/”swimmers back”)
        2. Lordotic: lumbar spine curves anteriorly, hyperextends low back

     

     

    Check out our Audio Lectures, Practice Tests and Study Guide for the ACE CPT to see the specific topics that make it onto the ACE CPT Test from this chapter.