Medical Emergencies

Anaphylaxis (Allergic Reaction)

What is it?

A life-threatening allergic reaction (anaphylaxis) can cause shock, a sudden drop in blood pressure and trouble breathing. In people who have an allergy, anaphylaxis can occur minutes after exposure to a specific allergy-causing substance (allergen). In some cases, there may be a delayed reaction, or anaphylaxis may occur without an obvious trigger.

Symptoms:

Possible Triggers:

Plan of Action:

If you're with someone having symptoms of anaphylaxis, don't wait to see whether symptoms get better. Seek emergency treatment right away. In severe cases, untreated anaphylaxis can lead to death within half an hour.
An antihistamine pill, such as diphenhydramine (Benadryl), isn't enough to treat anaphylaxis. These medications can help relieve allergy symptoms, but they work too slowly in a severe reaction.

Breathing Problems/Asthma

What is it?

Mild or severe blockage of the air passages for many different reasons.
One possible cause for breathing problems is asthma, a disease of the air passages. One possible cause of breathing problems is asthma, a disease of the air passages. A person who is having an asthma attack will have trouble breathing. 
Someone experiencing a heart attack, stroke, or certain injuries may also having breathing problems. Your actions in the first few minutes after you see the signs of any of these conditions could help save a life.

Signs/Symptoms:

Plan of Action:

Someone with a medical condition involving breathing problems, such as asthma, often carry an inhaler. The inhaler helps them breathe more easily within minutes of using it.
At times, a person can have such a hard time breathing that they need help getting and/or using their inhaler.

Using an Inhaler:

Inhalers have a medicine canister (often albuterol), a mouthpiece, and sometimes a spacer. The spacer can be attached to make it easier and more effective for the person to inhale all the medicine.

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Call 911 if the person has no medicine, does not get better or worsens, has trouble speaking, or becomes unresponsive.

Choking

What is it?

When an object lodges in the throat or windpipe blocking the flow of air.

Signs/Symptoms:

Plan of Action:

The American Red Cross recommends the following steps:
Some sources only teach the abdominal thrust. It's OK not to use back blows if you haven't learned the back-blow technique. Both approaches are acceptable for adults and children older than age 1.
To give abdominal thrusts to someone else:
If you're the only rescuer, give back blows and abdominal thrusts first. Then call 911 or your local emergency number for help. If another person is there, have that person call for help while you give first aid.
If the person becomes unconscious, start standard cardiopulmonary resuscitation (CPR) with chest compressions and rescue breaths.
If the person is pregnant or if you can't get your arms around the stomach, give chest thrusts:
To clear the airway of an unconscious person:
To clear the airway of a choking infant younger than age 1:
If you're alone and choking:
Call 911 or your local emergency number right away. Then, give yourself abdominal thrusts, also called the Heimlich maneuver, to remove the stuck object.
To prepare yourself for these situations, learn the Heimlich maneuver and CPR in a certified first-aid training course.

CPR

CPR

Cardiopulmonary Resuscitation (CPR)

What is it?

A lifesaving technique that's useful in many emergencies, such as a heart attack or near drowning, in which someone's breathing or heartbeat has stopped. The American Heart Association recommends starting CPR with hard and fast chest compressions. This hands-only CPR recommendation applies to both untrained bystanders and first responders.

Plan of Action:

If you're afraid to do CPR or unsure how to perform CPR correctly, know that it's always better to try than to do nothing at all. The difference between doing something and doing nothing could be someone's life.
Here's advice from the American Heart Association:
The above advice applies to situations in which adults, children and infants need CPR, but not newborns (infants up to 4 weeks old).
CPR can keep oxygen-rich blood flowing to the brain and other organs until emergency medical treatment can restore a typical heart rhythm. When the heart stops, the body no longer gets oxygen-rich blood. The lack of oxygen-rich blood can cause brain damage in only a few minutes.
If you are untrained and have immediate access to a phone, call 911 or your local emergency number before beginning CPR. The dispatcher can instruct you in the proper procedures until help arrives. To learn CPR properly, take an accredited first-aid training course, including CPR and how to use an automated external defibrillator (AED).

Before you begin, check:

The American Heart Association uses the letters C-A-B to help people remember the order to perform the steps of CPR.
Chest compressions
Open the airway
Rescue Breathing

Compressions: Restore blood flow

Compressions means you'll use your hands to push down hard and fast in a specific way on the person's chest. Compressions are the most important step in CPR. Follow these steps for performing CPR compressions:
  1. Put the person on his or her back on a firm surface.
  2. Kneel next to the person's neck and shoulders.
  3. Place the lower palm (heel) of your hand over the center of the person's chest, between the nipples.
  4. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands.
  5. Push straight down on (compress) the chest at least 2 inches (5 centimeters) but no more than 2.4 inches (6 centimeters). Use your entire body weight (not just your arms) when doing compressions.
  6. Push hard at a rate of 100 to 120 compressions a minute. The American Heart Association suggests performing compressions to the beat of the song "Stayin' Alive." Allow the chest to spring back (recoil) after each push.
  7. If you haven't been trained in CPR, continue chest compressions until there are signs of movement or until emergency medical personnel take over. If you have been trained in CPR, go on to opening the airway and rescue breathing.

Airway: Open the airway

If you're trained in CPR and you've performed 30 chest compressions, open the person's airway using the head-tilt, chin-lift maneuver. Put your palm on the person's forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway.

Breathing: Breathe for the person

Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can't be opened. Current recommendations suggest performing rescue breathing using a bag-mask device with a high-efficiency particulate air (HEPA) filter.
  1. After opening the airway (using the head-tilt, chin-lift maneuver), pinch the nostrils shut for mouth-to-mouth breathing and cover the person's mouth with yours, making a seal.
  2. Prepare to give two rescue breaths. Give the first rescue breath — lasting one second — and watch to see if the chest rises.
  3. If the chest rises, give a second breath.
  4. If the chest doesn't rise, repeat the head-tilt, chin-lift maneuver and then give a second breath. Thirty chest compressions followed by two rescue breaths is considered one cycle. Be careful not to provide too many breaths or to breathe with too much force.
  5. Resume chest compressions to restore blood flow.
  6. As soon as an automated external defibrillator (AED) is available, apply it and follow the prompts. Give one shock, then resume chest compressions for two more minutes before giving a second shock. If you're not trained to use an AED, a 911 operator or another emergency medical operator may be able to give you instructions. If an AED isn't available, go to step 5 below.
  7. Continue CPR until there are signs of movement or emergency medical personnel take over.
CPR

CPR on a Baby 4 Weeks or Older

What is it?

A lifesaving technique that's useful in many emergencies, such as a heart attack or near drowning, in which someone's breathing or heartbeat has stopped. The American Heart Association recommends starting CPR with hard and fast chest compressions. This hands-only CPR recommendation applies to both untrained bystanders and first responders.

Plan of Action:

Cardiac arrest in babies is usually due to a lack of oxygen, such as from choking. If you know that the baby has an airway blockage, perform first aid for choking. If you don't know why the baby isn't breathing, perform CPR.
First, evaluate the situation. Touch the baby and watch for a response, such as movement. Don't shake the baby.
If there's no response, call 911 or your local emergency number, then immediately start CPR.
Follow the compressions, airway and breathing (C-A-B) procedure (below) for a baby under age 1 (except newborns, which include babies up to 4 weeks old):
If you saw the baby collapse, get the AED, if one is available, before beginning CPR. If another person is available, have that person call for help immediately and get the AED while you stay with the baby and perform CPR.

Compressions: Restore blood flow

  1. Place the baby on his or her back on a firm, flat surface, such as a table or floor.
  2. Imagine a horizontal line drawn between the baby's nipples. Place two fingers of one hand just below this line, in the center of the chest.
  3. Gently compress the chest about 1.5 inches (about 4 centimeters).
  4. Count aloud as you push in a fairly rapid rhythm. You should push at a rate of 100 to 120 compressions a minute, just as you would when giving an adult CPR.

Airway: Open the airway

After 30 compressions, gently tip the head back by lifting the chin with one hand and pushing down on the forehead with the other hand.

Breathing: Breathe for the baby

  1. Cover the baby's mouth and nose with your mouth.
  2. Prepare to give two rescue breaths. Use the strength of your cheeks to deliver gentle puffs of air (instead of deep breaths from your lungs) to slowly breathe into the baby's mouth one time, taking one second for the breath. Watch to see if the baby's chest rises. If it does, give a second rescue breath. If the chest does not rise, repeat the head-tilt, chin-lift maneuver and then give the second breath.
  3. If the baby's chest still doesn't rise, continue chest compressions.
  4. Give two breaths after every 30 chest compressions. If two people are performing CPR, give one to two breaths after every 15 chest compressions.
  5. Continue CPR until you see signs of life or until medical personnel arrive.
CPR

CPR on a Child

What is it?

A lifesaving technique that's useful in many emergencies, such as a heart attack or near drowning, in which someone's breathing or heartbeat has stopped. The American Heart Association recommends starting CPR with hard and fast chest compressions. This hands-only CPR recommendation applies to both untrained bystanders and first responders.
The procedure for giving CPR to a child age 1 through puberty is essentially the same as that for an adult — follow the C-A-B steps. The American Heart Association says you should not delay CPR and offers this advice on how to perform CPR on a child:

Before you begin, check:

The American Heart Association uses the letters C-A-B to help people remember the order to perform the steps of CPR.
Chest compressions
Open the airway
Rescue Breathing

Compressions: Restore blood flow

If you are alone and didn't see the child collapse, start chest compressions for about two minutes. Then quickly call 911 or your local emergency number and get the AED if one is available.
If you're alone and you did see the child collapse, call 911 or your local emergency number first. Then get the AED, if available, and start CPR. If another person is with you, have that person call for help and get the AED while you start CPR.
  1. Place the child on his or her back on a firm surface.
  2. Kneel next to the child's neck and shoulders.
  3. Place two hands (or only one hand if the child is very small) on the lower half of the child's breastbone (sternum).
  4. Using the heel of one or both hands, press straight down on (compress) the chest about 2 inches (approximately 5 centimeters) but not greater than 2.4 inches (approximately 6 centimeters). Push hard and fast — 100 to 120 compressions a minute.
  5. If you haven't been trained in CPR, continue chest compressions until the child moves or until emergency medical personnel take over. If you have been trained in CPR, open the airway and start rescue breathing.

Airway: Open the airway

If you're trained in CPR and you've performed 30 chest compressions, open the child's airway using the head-tilt, chin-lift maneuver.

Breathing: Breathe for the child

Follow these steps for mouth-to-mouth breathing for a child.
  1. After using the head-tilt, chin-lift maneuver to open the airway, pinch the child's nostrils shut. Cover the child's mouth with yours, making a seal.
  2. Breathe into the child's mouth for one second and watch to see if the chest rises. If it rises, give a second breath. If the chest doesn't rise, repeat the head-tilt, chin-lift maneuver first, and then give the second breath. Be careful not to provide too many breaths or to breathe with too much force.
  3. After the two breaths, immediately begin the next cycle of compressions and breaths. Note: If there are two people available to do CPR on the child, change rescuers every two minutes — or sooner if the rescuer is fatigued — and give one to two breaths every 15 compressions.
  4. As soon as an AED is available, apply it and follow the prompts. As soon as an AED is available, apply it and follow the prompts. Use pediatric pads for children older than 4 weeks old and up to age 8. If pediatric pads aren't available, use adult pads. Give one shock, then restart CPR — starting with chest compressions — for two more minutes before giving a second shock. If you're not trained to use an AED, a 911 operator or another emergency medical operator may be able to give you directions.
Continue until the child moves or help arrives.

Fainting

What is it?

When your brain temporarily doesn't receive enough blood supply, causing you to lose consciousness. This loss of consciousness is usually brief.
Fainting might have no medical significance. Or the cause can be a serious disorder, often involving the heart. Therefore, treat loss of consciousness as a medical emergency until the signs and symptoms are relieved, and the cause is known. Talk to your doctor if you faint more than once.

Symptoms:

Plan of Action:

If you feel faint:
If someone else faints:
If the person was injured in a fall associated with a faint, treat bumps, bruises or cuts appropriately. Control bleeding with direct pressure.

Heart Related Emergencies

Heart Related Emergencies

Angina

What is it?

Chest pain or discomfort caused by reduced blood flow to your heart muscle.

Symptoms:

It can be hard to tell the difference from angina and other types of chest pain, such as indigestion.
Angina can be stable or unstable.
If your angina gets worse or changes, seek emergency medical help immediately.
Heart Related Emergencies

Aortic Dissection

What is it?

A tear in the inner layer of the aorta, the large blood vessel branching off the heart. Blood rushes through this tear into the middle layer of the aorta, causing the inner and middle layers to separate (dissect).

Symptoms:

If you are having any of these signs or symptoms, they could be caused by an aortic dissection or another serious condition. Seek emergency medical help immediately.
Heart Related Emergencies

Cardiac Arrest vs. Heart Attack

Heart attacks and cardiac arrest are not the same thing.

Heart Attack:
Cardiac Arrest:
Heart Related Emergencies

Chest Wall Pain

What is it?

A type of muscle pain in the chest.

Types of Chest Wall Pain:

If you have costochondritis, pressing on a few points along the edge of your breastbone often triggers considerable tenderness. If gently touching the area with your fingers causes chest pain, it's unlikely that a serious condition, such as a heart attack, is the cause of your chest pain.
Heart Related Emergencies

Heart Attack

What is it?

A blockage of blood flow to the heart muscle due to a clot.

Symptoms:

A heart attack generally causes chest pain for more than 15 minutes. The pain may be mild or severe. Some heart attacks strike suddenly, but many people have warning signs hours or days in advance.
Someone having a heart attack may have any or all of the following:

Symptoms in Women:

Women often experience less obvious warning signs

Plan of Action:

Heart Related Emergencies

Pericarditis

What is it?

Swelling and irritation of the thin, saclike tissue surrounding your heart (pericardium).

Symptoms:

Pericarditis is usually mild and goes away without treatment. If it's severe, you may need medication or, rarely, surgery.
It may be difficult to tell the difference between sudden (acute) pericarditis and pain due to a heart attack. If you have sudden, unexplained chest pain, seek emergency medical help.
Heart Related Emergencies

Pneumonia with Pleurisy

What is it?

Inflammation of the membranes that surround the lung (pleura).

Symptoms:

Unlike a true heart attack, pleurisy pain is usually relieved temporarily by holding your breath or putting pressure on the painful area of your chest.
If you've recently been diagnosed with pneumonia and then start having symptoms of pleurisy, contact your health care provider or seek immediate medical attention to determine the cause of your chest pain. Pleurisy alone isn't a medical emergency, but you shouldn't try to make the diagnosis yourself.
Heart Related Emergencies

Pulmonary Embolism

What is it?

A blood clot in the lung.
It occurs when a clot, usually in the leg or pelvis, breaks free and gets stuck in a lung artery (pulmonary artery). The clot interrupts blood flow, making it more difficult for your lungs to provide oxygen to the rest of your body.

Symptoms:

Pulmonary embolism can be life-threatening. If you have symptoms of a pulmonary embolism, seek emergency medical help immediately.

Stroke

What is it?

Occurs when there's bleeding into the brain or when blood flow to the brain is blocked. 
When brain cells are deprived of essential nutrients, they start dying within minutes.
Seek immediate medical help. A stroke is a true emergency. The sooner treatment is given, the more likely it is that damage can be minimized. Every moment counts.

Symptoms:

In the event of a possible stroke, use F.A.S.T. to help remember warning signs:
Other signs and symptoms of a stroke, which come on suddenly, include:
Having a stroke puts you at higher risk of having another. Risk factors also include having high blood pressure, smoking, having diabetes and having heart disease. Your risk of stroke increases as you age.

Diabetes and Low Blood Sugar

What is it?

A disease that affects the levels of sugar in the blood.
Too much sugar or too little sugar causes problems. Some people with diabetes take medication, such as insulin, to maintain their sugar levels. Low blood sugar can occur if someone with diabetes has not eaten or is vomiting, has not eaten enough food r the level of activity, or has injected to much insulin

Signs/Symptoms:

If the person's blood sugar gets too low, their behavior can change. Signs of low blood sugar come on quickly:

Plan of Action:

If the person can't sit up or swallow:
If the person can sit up and swallow:

Seizures

What is it?

Abnormal electrical activity in the brain.

What causes it?

Signs/Symptoms:

Seizure symptoms may differ from person to person.

Plan of Action:

During:
After: