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hello all right so let's get started in the chapter 7 emergency care and disaster preparation lecture I am your lecturer your host um Dr Knox and I will help you as you navigate through this PowerPoint lecture um while you are
Dr Knox's Chapter 7 lecture on emergency care and disaster preparation for nursing assistants covers emergency response steps, injury recognition, EMS reporting, CPR, burns, seizures, strokes, and dis
Key Takeaways
- Following a consistent sequence of assessment, calling for help, and staying calm is the foundation of emergency response.
- Accurate, detailed incident reports and clear information for EMS improve outcomes.
- Recognizing early signs of injury, stroke, seizure, and sepsis allows faster intervention.
- Facility policies and procedures should be reviewed and followed in every emergency.
What the video covers
- Introduces the chapter objectives: recognizing and responding to medical emergencies, with students encouraged to take notes and use flashcards for terminology.
- Outlines the core emergency response sequence: assess the scene for safety, note the time, assess the victim's needs and level of consciousness, call for help without leaving the victim, and remain calm.
- Explains how to complete an incident report detailing date, time, events, people and equipment involved.
- Describes signs of injury to watch for: severe or mild bleeding, fluctuating consciousness, irregular breathing, abnormal skin color, swelling, and medical alert tags.
- Lists information to give Emergency Medical Services: facility phone number, address and landmarks, victim's condition, breathing and pulse status, medical history, and first aid given, and stresses staying on the line with the dispatcher.
- Covers first aid and CPR, including checking for breathing and pulse before starting resuscitation.
- Discusses sepsis as a body-wide infection that can lead to low blood pressure and organ failure.
- Addresses bleeding control, burn classification (first, second, and deeper degrees), and steps to take if clothing catches fire.
- Teaches how to manage seizures safely, recognize stroke signs, and check for dizziness or lightheadedness before a patient stands.
- Concludes with disaster preparedness: evacuation floor plans, staying informed, documentation protection, and hurricane preparation steps.
Chapters
- 00:00Introduction and Note-Taking Guidance
- 04:14Emergency Response Steps and Incident Reporting
- 12:20Recognizing Symptoms of Injury
- 16:40Information to Give Emergency Services
- 19:18First Aid and CPR Basics
- 25:00Bleeding, Sepsis, and Burns
- 35:00Seizures, Strokes, and Dizziness
- 53:20Disaster Preparation and Post-Lecture Discussion
Full Transcript — Download SRT & Markdown
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listening to this lecture I do advise that you have a pen and paper ready so you can take notes there will be some post lecture questions that I would want you to respond to in the discussion so please make sure that you are taking
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notes and um you know as we navigate through this and let's get started all right so we're first going to demonstrate um how to recognize and respond to Medical emergencies that's one of the main objectives for this chapter
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we're going to define a few terms throughout um but I'm not going to touch on every term specifically as it is your responsibility as a student to write down the terms and to study them or to try to find ways to remember them um I
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will touch on a few terms here and there but again it is your responsibility to come back through the PowerPoint and run through those um terms and one way to study terms as I have mentioned before is to use flash cards where you w write
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the word on one side of the flash card and then the other side the back side of the flash card could be where you put the definition so all right let's move along um as a nursing assistant you
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should memorize these steps in responding to an emergency you're going to always assess the situation make sure that you are not putting yourself in danger you're going to also note the time that the emergency has started if you have a watch handy or it could be a
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work phone or a work pager um you're going to assess the victim so if there's any victims involved in that emergency you're going to also assess their needs make sure they're safe check their level of Consciousness so are they alert do
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they know where they are they oriented are they able to um communicate with you effectively and appropriately and answer um and respond to you because that will give us cues to know that this person is conscious you want to call for help or
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send someone to get help they're never going to leave someone who's in an emergent situation by themselves this is your time where you want to shout probably at the to the top of your voice and Shout Shout until help arrives
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hopefully you're never working by yourself so that you can um you know Bank on the fact that someone could hear you and we'll then come to your rescue you're then going to also remain calm remember anytime there is an emergency
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situation it's very hard as you know as humans it's natural for us to um get worked up to be afraid um to to be um you know unsure as to how the outcome will turn out but it is uh in your best
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interest to remain calm and confident you've gone to the course you know um what you should and should not do you can always refer back to your facilities policy and procedure manual with any questions um to help guide you through
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processes but you ultimately want to remain calm and know that you have what it takes in you to carry out and to coordinate these um emergency procedures as um it it may come come up after the emergency is over complete an incident
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report so the incident report will house things such as the time the date um the incident or the emergency happened um what took place so the events that maybe led up to the incident um it will also have information about who was all
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involved what was involved if there was some equipment that was involved where someone might have gotten hurt on um a piece of equipment maybe something was broken and it was used those kinds of things so you want to get a really
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detailed overview as to what happened um so you can put that in that incident report okay as a nursing assistant and your as you're responding to any emergency you need to recognize the following symptoms of injury so you need
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to be alert and aware as to what is emergency what is um you know what are some of those outcomes or the result of an emergency well the patient or the resident could be having bleeding right they could be bleeding severely could be
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mild where it's not too much but they're still bleeding there could be changes in their Consciousness so they're kind of what we call in and out where sometimes they are there they're able to respond to you but then they kind of dip back
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into being unconscious and it just kind of fluctuates or goes up and down they may have changes in their breathing where it's irregular it's sporadic all over the place um it's not really predictable they can have unusual uh
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color um In Their Skin where their color maybe looks pale right if their skin is more pale they're losing that nice colors it could because they're losing a lot of blood they're bleeding out and we know that our blood in our bodies does
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help give some color to our skin tone besides our um our what we call melanites um which can also give color to um certain individuals that is as we know there's different race and we have to be mindful of that um swollen places
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on the body could also point to a possible injury um medical alert tags so these are just like like fancy bracelets that people will wear when there is a um uh you know in need of a emergency that they would wear so just some things
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to keep in mind um see here all right um let's move along here to O one second here all right so let's move along to pain if the patient is or the resident is complaining about pain again those are
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symptoms and signs of uh injury underlying injury as a nursing assistant you should be prepared to give the following information to Emergency Services or EMS we call it Emergency Medical Services is also another way to say emergency services when you're reporting an
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emergency so the phone number of the facility that you're at the address if you can find the address quickly great give it to the EMS folks any directions any landmarks things that will help Point them to the right direction to
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where you are so that you can help um expedite or speed up the process so the person who is the victim can be quickly attended to our goal is to make sure we protect their life we um we make sure
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that you know they get the treatment care they need to to live um we also want to make sure we let EMS know the condition of the victim okay things like are they bleeding we want to let them
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know um did you check a pulse did you check for breathing because those could be reasons why we wouldn't want to start CPR on a patient any nonmedical background like do they have a history of seizure do they have a history of
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passing out um f fainting spells um do they have a you know like a bleeding disorder where they um tend to bleed a lot if they are to get cut or injured what's their name what's uh what's your
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name what's your position um any first aid that was given to them did you have to stop the bleed on someone did you have to um you know any kind of other treatments that you had to do while you
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were um responding to this individual remember when speaking to Emergency Services dispatcher it is very important that you don't hang up the phone and they usually will tell you please stay on the line um while we you know get help so just keep that in
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mind um all right let's move along here first aid this is the emergency care that's given immediately to an injured person by the first people to respond so that first responder will usually start or initiate the first aid
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um cardiopulmonary resuscitation also known as CPR this is a medical procedure used when a person's heart or lungs have stopped working so that's why we check breathing and we check pulse make sure then we um if we don't feel breath on
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our face or we don't see the chest rise and fall that will show that person's breathing and if we don't feel that pulse we're usually assessing that kateed pulse so the pulse on the neck um if it's their a baby we would be
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checking the breaking post so just to keep that in mind all right important things to remember um not all facilities permit nursing assistants to start CPR so make sure even if you're trained to do so that it is something that's within your
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facility policy for you to carry out um here's some CPR review content here please read through that it's very important um for those that have taken um CPR as a nursing assistant you will be required to complete a basic life
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support class um it has to include a Hands-On inperson skills session so it can't be something that you have done online and you got a certification online you have to do the inperson Hands-On um practical on a mannequin so
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um make sure you you haven't signed up to take that class make sure you do so so you are work ready because we know um nurs assistant positions do require that you actually complete the CPR or the basic life support for healthcare
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providers course um so just something to keep in mind more review read through that um very good to know um remember facilities often use codes to inform staff of emergencies so it's important for you to know your your facilities um
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code um whatever signal they use or whatever intercom message that they use to um inform staff that there's an emergency or that there's some kind of event taking place um you want to make sure you are familiar with that um some
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places will have like for instance cold gray would be like a missing um residence so just some things to keep in mind all right next we're going to define the following terms there's obstructed Airway this is a condition in which
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something is blocking the tube through which air enters the lungs um abdominal thrust this is the method of attempting to remove that obstructed object from the airway so in the sense of someone choking this is the um the procedure
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that you'll do to help open up or take the object out of that Airway so we can ultimately open it up um this is how you would carry out that abdominal thrust you can see the steps are listed here
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please do read through those steps um in this lecture I won't go through everything verbatim but it is here for you to reference okay more about abdominal fres shock this is another term that I want to highlight because I think it's very
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um important stock is a condition that occurs when organs and tissues in the body do not receive an adequate blood supply um so it could be that that person in emergency situation was losing a lot of blood um in that case they can
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go into shock and if the organs and tissues are not getting adequate blood flow they can start to shut down and ultimately that person could pretty much die so it's important for us to learn and know how to stop any bleeding and if
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a person is in shock um sometimes it it can happen even if that person's not losing a lot of blood it could be that have a bad infection and it's it's in their blood um what we talked about
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sepsis sepsis is a body wide infection that can um it's like where a infection starts one location of the body and then it spreads throughout the entire body and now that person is um you know having low blood pressure or blood
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pressure is dropping their heart rate or can go up or they experience what we call tacac cardia and um eventually the or orans will then begin to shut down and ultimately the person can die and and that sepsis is very deadly it's
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something that can take place and settle in within like 24 to 48 hours it's a pretty quick way um if we're not um it's a pretty quick uh outcome if the if we're not intervening and correcting the problem that's causing them to um to go
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into that or stay into that phase um some signs of shock so we have low blood pressure like I mentioned extreme thirst increased pulse and respiration um staring so the person could be staring you know just blankly out nowhere pale
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or cyanotic skin cyanotic remember that is that turning blue that bluish color skin tone which tells me that they're not getting enough blood uh uh transfusion they're not getting enough blood um not transfusion but circulation all right responding to
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shock here are the steps I will hold you um accountable ble to know the steps for shock and how to respond if someone is showing those signs that we just covered notify the nurse immediately remember stay with the victim um and victims of
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shock should always receive Medical Care as soon as possible and if you're controlling any bleeding let's say they're in shock because of a bleeding issue they're bleeding out you're going to put on gloves protect yourself and um have the person lie down on their back
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if the person is bleeding from the mouth or vomiting place them on their side so that the vomit or or the blooding um the bleeding sorry does come out of their mouth and we can help protect that Airway because we don't want them to
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ingest that blood um again more tips on responding to shock I'm not going to go through that um myio cardiio infarction this is a term that occurs when the um this is a actually a a medical condition in which
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the heart muscle does not receive enough oxygen because blood flow to the heart is blocked which is also called a heart attack this is a fancy way of saying heart attack myocardial infarctions or Mi for short um the
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symptoms of heart attack are here listed okay and they can slightly vary depending on if you're women or man you can see here women can have Mi without chest pressure so they may not complain of pain in the chest they are most
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likely to have shortness of breath nausea light-headedness stomach pain sweating fatigue and back neck or jaw pain some women symptoms are more like flu-like symptoms so again women do not always manifest like the men unfortunately so they can go in um you
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know addressing this chest pain or this discomfort later than the guys unfortunately because the symptoms don't just they're not as evident as with our our male patients but anytime someone's complaining about chest pain you want to let the nurse know immediately call 911
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if you're working in their home call your supervisor um place the person in a comfortable position encourage them to rest and reassure them that you will not leave them alone loosen any um clothing around their neck do not give a person food or
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fluids um and yeah so if the heart stops the pulse stop breathing stop you know you're going to have to start CPR if you're trained to do so and allowed to do so um once you get that uh
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certification the BLS or the basic life support certification remember that is a part of CPR that's under the umbrella of CPR um you should be able to be able to act in that situation if needs be but ultimately it's up to your facility what
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they expect or want nursing assistants or other staff to do and how they want them to respond to emergencies so definitely familiarize yourself with your facility policy all right remember severe bleeding must be controlled immediately but nursing assistants must
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take the time to put on gloves before trying to control bleeding so you're not just going to um you know someone's wounds uh or blood with your bare hands because you're panicking and and want to save them no
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you're going to protect yourself first and foremost be quick about it put the gloves on and just apply pressure to help stop that bleeding hopefully that person's blood can clot um can you know notify the nurse immediately like I said
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put on gloves take that time to do so if the resident is able to he or she can hold on with their bare hands over the wound until you put on on your glove so you can put that person to work if needs
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be put a nice clean towel or um something that's clean over that site to help um apply pressure to stop that bleed once bleeding is under control secure the dressing to keep it in place check for symptoms of shock so things
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like pale skin staring increasing pulse and respiration rates low blood pressure and extreme thirst these are all signs of blood is is um tanking the blood tanking the blood flow is tanking meaning it's dropping they're going to stay with the
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person until help arrives remove any and discard gloves and wash your hands thoroughly with soap when you're finished touching your patient your residents who have um you just helped the ones you just helped with um any emergency responses report and record definitely
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check to make sure you document thoroughly and that you are um your documentation matches up what truly happened it it matches it goes together you support what you did in it's reflected in your documentation so for this lecture I want you to um think
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about these questions what is the phone number for Poison Control where should this number be posted okay what do you think um you can just think about this this is not part of your post lecture response but I do want you to think
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about this and I have mentioned this um before so but just think back um if you've already gotten this number beforehand great but just think about where where is the poison control number supposed to be posted and what number do
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I contact to reach Poison Control in the event let's say your patient ingested um some poisonous um chemical or got some Splash in their eye that was a chemical that was irritating what would you do um symptoms of poisoning can vary widely
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but may include vomiting heavy difficult breathing acting drowsy or confused Burns or red areas around the mouth those are all kind of can point to like chemical burns um the breathing can be like maybe they ingested some or inhaled
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some kind of chemical or powder something some kind of um powdered chemical or substance into their respiratory system and so we may see shortness of breath difficulty breathing um if they took it in by mouth we may see more vomiting so those are symptoms
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to look out for if you're concerned about someone ingesting or taking in some type of poison or getting some poison um you know item in their body remember the nursing assistant should notify the nurse immediately if the if you suspect uh
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poisoning okay different burn types um so in emergencies we may come across uh seeing our patients um experience Burns there's different levels of burns so you can see there's first degree which is the more superficial burn it's more on
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the top part of the skin um not fully on the top of the skin because this will be the top but it is um like kind of that close to the top layer of the skin um so that's superficial or
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first degree burn second degree now you've got some of that superficial layer and you're down to that um you know kind of we those um like deeper in the hair follicle area you can see this is considered hair hair from the skin um
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third degree is kind of getting into that fatty tissue layer as you can see so all right uh burns are categorized like I said in the following way so first degree is superficial second degree is partial thickness third degree
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is full thickness so you kind of I always look at it like a nice cake so first degree is kind of like yeah right in here second degree we're getting deeper into the cake um cutting of the cake you can see we're now we're down
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proba like by the the um muscle area and then last but not least the full thickness is going through all layers of that cake this is supposed to be like fatty tissue if you will all right um care of the burn does it does depend on
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the size and the depth of the burn so um that's something that if the when the person's getting that um treatment that's some things that we usually take into consideration remember and remember as Healthcare Providers We Do no harm to
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severe burns um we don't want to you know put things like ice and ointment and salves and grease on the burned area we also want to remember not to um pull away any clothing or rubbing the burned area because that can damage the skin
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further and you can also pull some of that skin off if you're trying to peel back anything that was um unfortunately burned to that person's skin and that can eventually lead to contributing to infection later on treating turns again notify the nurse
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for any kind of emergency put on gloves protect yourself we don't want you to get contaminated with any kind of infectious disease and we always want to think about a standard precautions where that means we are treating everybody as
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if they're infected we wear gloves for everybody when we're coming in contact with body fluids or any kind of um you know anything that's unclean um we're going to use cool clean water to decrease the skin temperature and
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prevent further injuries so take that patient or resident to the sink have the water run on that area and help to um you know slow that that heating process down do not use ice or ice water as ice
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may cause further skin damage stampen a cloth clean cloth with cool water and place it over the burn once the pain has eased you may cover the area with a dry clean dressing or not adhesive sterile bandage we don't want anything to adhere
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to the skin because that can again pull it off and stick to it and the skin is already kind of compromised we say where it's already um you know damaged to a certain extent so we put anything that's
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going to adhere to the skin or stick to the skin when it's time to remove it it's going to stick and also pull some of that skin off um probably not not always but it has it increases the
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chances of that happening but that's why we don't want adherence or anything adhesive um when you remove your gloves after you um you're going to watch your hands never use any kind of ointment or again solved or greased on a burn report
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and document the incident properly for more serious Burns we're going to remove the person from the heat Source or the burning Source if clothing if their clothing is caught on fire we're going to have the person stop drop and roll
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okay and we're going to help smother that fire with a blanket or towel to put out the Flames protect yourself from the source of the fire of the burn um remember stop drop and roll is what going to let the person do um or let
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them um know to do in the event that their clothing is on fire that they're wearing um all right and here's some more steps on treating the burns I'm not going to get more in depth with that but
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it's here listed out for you so please read the steps for treating the burns as I will hold you accountable for that uh we got more terms you can see the word Syncopy this is the loss of consciousness also so calleded fainting
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so if someone had a stinkle episode that means they fainted um could be that their blood pressure might have just Tink or dropped a little bit once they stood up too fast sometimes that happens and I personally have experienced that
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where I popped out of bed fast and um unfortunately I fell right away like I didn't give myself time to sit at the edge of the bed and kind of let things kind of settle I just popped up and then
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boom I I went I hit my head on the on the I think it was the bed at the time I think this was like when I was 15 or so but you don't want to have people just
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pop up out of bed um when you're getting them up to get them dressed for the day you want them to kind of ease their way and to getting up you know have them sit on the side of the bed a little bit kind
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of balance out get their blood balanced and then they can stand up so that they can we can reduce the chances of synop but it does happen even with those kinds of um you know safety mechanisms that we
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try to put in place sometimes people will still have copy but those are ways we can reduce it orthostatic hypotension this is the sudden drop in blood pressure so um it can be a result of Syncopy um or it can
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cause the Syncopy to happen where the blood pressure doesn't have time to um it's not enough maybe it's probably already low as is so when the person stands up quickly and doesn't let their blood kind of settle they can become um
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you know where they lose the loss of uh the Consciousness or Syncopy and then they can fall or faint um but yeah when the person sits or stands up we can see some changes in their blood pressure um
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orthostatic hypotension it's called Remember hypotension hypo is low tension is pressure so where they changing positions and their their blood pressure it's changing as well um so yeah all right signs and symptoms of fainting the person can feel dizzy lightheadedness
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nausea or their stomach kind of feels like they have throw up perspiration is just another fancy way of saying sweating their skin can become pale um where they kind of lose the color of their skin um they can look kind of
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Dusky we say or kind of grayish bluish color sometimes their pulse can be weak so when you feel that radial pulse which is the pulse on the wrist they it may be feeling very weak hard to really capture
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and feels shallow respirations meaning their their breathing is very shallow it's it's low or it's um not as evident to see that their chest is rising it can be like their chest is rising but you barely can see and that's called Stow
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respirations Blackness and visual Fields okay again all these symptoms are part of the signs and symptoms of fainting um responding to fainting again let the nurse know immediately have the person lie down or sit down before fainting occurs okay as soon as and
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that's why we ask the patient when we're doing our bed to wheelchair transfer or we're going from bed to ambulation with the patient okay that's why we have that gate belt that we put on them because we want them to be safe we want to make
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sure if they feel um like if they're right when they get up I ask the question do you feel lightheaded or dizzy right then that will tell you whether you need to sit the person's back um sit the person back down or if
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you can safely um get them to move get them you know walking if they say they feel laded or dizzy you want to sit them back down on the bed and have them take a break similar to this guy here loosen
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any tight clothing around the neck so that they can um you know and everything counts with helping them to breathe nothing should be restricted um and so just keep that in mind how you will be responding to someone who's
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fainting um I'm not going to go through this part too much in depth but it is here for you to read so I do encourage you after the lecture here that you come back and you read through the notes as
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again the tests and um my ability to make sure you understand content is based off of you know you um going through all the information so don't just Bas off you know you're learning off of me telling you um what I told you
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in the lecture but you also want to do your own due diligence and read through the content so you feel polished and ready to take the exam for this chapter um another term here pretty interesting term but this is another fancy way of
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saying nose bleed it's called epistaxis um or epy stasis um but this is uh again the fancy way to say nose bed the person's having a nosebleed okay so if you see it you hear that word just know it means nose
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bleed remember gloves should always be worn whenever you're helping a resident with any emergency situation because you just never know how that e emergency is going to end I mean it may start off looking clean no gloves needed but then
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after some time you're going to be like oh shoot I need to put some gloves on because now this person is starting to bleed or throw up or cough or do something that will warrant that you need to put gloves on so just always
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have your gloves ready I like to put my you know fill my pockets up put my gloves in my pockets um when I am working with um patients or when I'm working at all period um I don't leave my um like the nurses
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area where the gloves are and the alcohol wipes are I don't leave the area until I put some gloves and stuff in my pocket because I just never know when I'm going to have to respond to an emergency it could be someone is in the
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hallway and I'm walking down the hallway and now I have to respond and be ready um remember again notify the nurse immediately okay stay with your patient don't leave them call for help let someone else like a coworker call the
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nurse if that nurse is not able to hear you or tell the person to remain in a sitting position when their nose is bleeding lean them forward okay up front not back it used to be where people will
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they learn to lean the person back and have their the blood kind of go back into their nose but the the recommendation the guidelines say that we want our um residents our patients to lean forward lightly offer tissues or
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clean cloth because that's it's it's going to get pretty bloody do not touch blood or body uh or bloody clothes or tissues or clothes without your gloves remember there's bloodborne pathogens so things that actually live in the blood
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that can easily be transmitted and if you're not ready to touch those things with gloves hands you can get whatever that person has and sometimes you just don't know and even if you don't know again we always want to do our standard
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precautions so here's a picture of the guy he's leaning forward this can this is an example of um what we would do if a person's nose was bleeding we would apply pressure firm pressure at the kind of at the
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bridge of the nose a little bit but more on the the sides of the nose on the soft part up near the bridge of the nose Okay squeeze the sides of your nose with your thumb and your forefinger and have have
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the resident do this until you are able to put on gloves so you can see this person has gloves apply pressure until the bleeding stops and even the patients themselves if they are able to follow instruction you can even have them also
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apply the pressure with on the sides of their nose just direct them um sometimes is it's better for you to do it for them because it's just you know you just decrease the chance of the blood getting everywhere but make sure you have gloves
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on make sure you have enough tissue because it can become a pretty bloody um scene um for certain people but use a cool cloth or ice wrapped in a cloth on the bridge of the nose you can put a
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little piece of um like a bag of ice um create a barrier between the ice and the person's skin to slow the the flow of blood because that ice that coldness is going to constrict the blood flow to the
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nose and that's what we want to do we want to cause those those blood vessels to um to constrict meaning get smaller so that the bleeding can slow down versus dilate where that will be um what we'll see if we were to apply heat to
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the sight never apply ice directly to the skin like I mentioned you want to have a barrier between the ice s in the baggie and the skin so it could be you know you wrap the ice in a towel on top
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of that already being in the in the um the baggie all right remove the gloves wash your hands document and report in the incident properly um so yeah some other terms you can see insulin reaction or hypoglycemia this is a complication of
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diabetes that can result from either too much insulin or too little food but hypo again it means low just like hypotension when we talked about low blood pressure hypoglycemia whenever you see the word gly think of glucose or sugar and then
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emia think of blood so like if someone has anemia think of the a a in front of this would be the person is low on blood or has no blood um so let's move along the signs of insulin reaction um the person can
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have um symptoms like hunger headache weakness a rapid pulse so that tacac cardia where the heart rate is above 100 um some places you'll see above 150 beats per minute low blood pressure um is also a sign that you may see um
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perspiration remember my the last time I mentioned perspiration that I mentioned it would meant sweating um cold and clammy skin so it's kind of like their skin is kind of sticky that can be a sign of like their blood sugar again is
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low and that's what insulin reaction does it makes their makes the person hypoglycemic or having low blood sugar okay um let's see here this is loading but this is um how insulin and diabetes um kind of works how insulin works in the
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body um so you can watch this at your leisure I'm not going to play the video now you have it in the PowerPoint side deck so feel free to come back and watch through the video and we'll continue
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on all right other symptoms and signs of insulin reaction we have confusion trembling so the person's kind of shaking we have nervousness we have blurred vision where they just say oh my eyes I can't see much I can't see too
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well numbness of the lips and the tongue unconsciousness so if we're not responding to this and we're not able to notice these symptoms the person can eventually become unconscious where they're not able to respond they're just laying there
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and that is Um this can be a a a deadly situation so we want to make sure our patients who are on insulin that um we if they're taking insulin make sure they're eating um just so that their
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blood sugar doesn't just ttin on them or decrease significantly to the point where they start getting these symptoms of insulin reaction because remember this can set in if there's too little food or too much insulin so all right diabetic keto acidosis this
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is term that is a complication um of diabetes so it's a complication of diabetes that is caused by having two little insulin in the body okay um the signs of symptoms of diabetic keto acidosis we also abbreviate this as
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dka um this is a uh the symptoms that you'll see in the patient with dka would be increased hunger or thirst increase urination so they're just peeing a lot abdominal pain deep or labored breathing kind of breathing fast and deep breath that
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smells fruity or sweet headache and then weakness this is also one of those medical emergencies they can also have rapid weak pulse low blood pressure dry skin their cheeks can look a little flush or rened they can become very
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drowsy they can have nausea and vomiting shortness of breath or air hunger and unconsciousness so we don't want this to be something that we ever Miss so it's always good practice to know who are your diabetic patients that's one of the
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things as a nurse that I really um make sure I do as soon as I'm getting report from another nurse and I'm coming on to care for my patients I always make sure I know okay who are my diabetics who
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needs blood sugar checks because those are people that I'm going to prioritize and make sure that before they eat I'm checking their blood sugars I'm also making sure that they're eating a meal because I don't want to give anybody
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insulin and they don't eat or they don't eat much and now we have that insulin reaction so here's a quick little video um a nice cartoon that explains diabetic keto acidosis or dka and it's um very interesting it's something that I think
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will help you understand what's happening in that person's um body when they have dka all right moving along into our next um uh medical emergency situation we have the term here epileps y this is a brain disorder that results from A
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disruption in normal electrical impulses in the brain which causes repeated seizures so again just think of it as a seizure activity it's um a condition that can be longterm seizures can happen in this these situations here if a person has
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high fever especially young children if we are not um responding well enough if we're not giving them something like a Tylenol or something to bring down their fever they can go into what we call febr seizures where the the fever itself can
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cause them to kind of seize where they're shaking uncontrollably um serious illnesses can also bring on fever head injury seizure disorder such as epilepsy in itself can cause somebody to always have seizures um and yeah it's not a fun thing to have
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at all especially for the kids um signs of seizure they again severe shaking they can have thrusting arms and legs uncontrollably so they kind of just jolt or jerk um kind of shake again uncontrollably um their jaw can be
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cleansed they can start to drool they um develop the inability to swallow we don't want to ever stop somebody that is sething don't ever Force anything into their mouth um the goal of the caregiver again you are the caregiver you're going
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to try to keep that Resident safe make sure there's no um furniture near them that they can hit hit by accident make sure that they're just you know things are out of their their way so they can seize in peace we don't want people to
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have a seizure and be hitting things and hitting their head and you know we don't want any injuries added to um to them okay another um video what to do when someone is having a seizure so this is a nice video to watch um just to kind
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of help bridge any misunderstandings or to help you know make this information a lot easier to pain so take a time to watch that um responding to a seizure please do read through this um know that it's a medical emergency if a person has
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a history of seizures they're usually on some type of anti-seizure medication already but if it's been a long time since they've had a seizure and they were off their anti-seizure medication then um they you know they may have not been on anything so um
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definitely that's something with any kind emergency like this we're going to let the nurse know and um remember not to ever restrain them don't force anything in their mouth don't open up their mouth don't try to force their
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teeth their mouth open and you know pry up their mouth don't place your hands in their mouth you know because you could get bitten remember this is uncontrollable activity that they're doing don't put food in their mouth no
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liquids things like that when is the seizure over when it's over you'll know because then they'll stop shaking right so if they stop shaking or moving uncontrollably you're going to note the time that they stopped and it's also
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good to know when it started so we can actually get a good um understanding of the the length of time it took for them to get out of it gently turn the person to their uh left unless he has a head
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neck or back spinal or abdominal injury breathing difficulties or fractures turning the person reduces the risk of choking on vomits or saliva so just put them on their side left is best if the person begins to choke get help
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immediately check for adequate breathing and pulse if the person is not breathing and has no pulse begin CPR if you are trained to do so you know don't begin CPR during a seizure wait until it's done remember to
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put gloves on right away because you just never know what you're going to get yourself into report document the incident properly including how long the seizure lasted that's always something that um when EMS arrives if we have to
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call um EMS or the Emergency Medical Services they always want to know the time it start um and what events took place if anything um you know extra happened outside of the seizure activity CIA or transient ischemic stroke or a transient
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es schic attack or Tia this is a warning sign of a CVA or stroke it results from a temporary lack of oxygen in the brain symptoms can last up to 24 hours so if a person out of nowhere just starts to
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kind of have speech and kind of gets confused kind of gets you know having that unsteady gate that can be a sign of a stroke that's about to go full-blown so it's transient meaning it's just kind of like the starter stroke in a sense
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where you know we see some of that residual stroke like symptoms but then it quickly resolves but just know that that can be that's transient to tell you hey there's a bigger attack coming up so we want to get that checked out by the
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um Healthcare facility the hospital um folks that are having transient ishemic attack or Tia it's only a matter of time before they go into a full-blown um uh stroke and have absolutely non-temporary lack of oxygen in the brain so and again
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know when it starts know the symptoms the signs here are the signs and symptoms please understand and know that that is your responsibility signs that a stroke is occurring know what that um looks like I'm not going to go through
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the entire list because you have it here um know that women may also experience the following associated with the Tia or CVA women can experience pain in their face in their arms their legs they can have hiccup weakness chest pain
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shortness of breath palpitations which is another way of saying um their their heart race is um is beating very fast um those are all some of the different ways that women manifest um when it comes to a Tia or CVA CVA also known as cerebral
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vascular accident again these are both Strokes one is just transient one is more like the full-blown um stroke attack the way we can recognize and respond to a stroke effectively we use an acronym called Fast an acronym is
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just another way of think um this is how we abbreviate so um a way to to intervene so we can remember the steps so the acronym for responding to a stroke is called fast so f s stands for face so we're going to
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look at the person's face we're going to say does one side of the face droop or fall down or is the person smile uneven when they try to smile we tell them to smile and it looks like one side of
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their lip is falling down um a is arms is one arm numb or weak and what we will typically do is have them raise their both their arms up and we will have them rais it in front of them so we'll say
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okay put your arms out and we'll see whether one of the arms start to drop and not stand leveled up with the other arm if that happens we can kind of bet okay there's a stroke happening here um
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speech is um s it's uh abbreviation uh for speech this is the person's um ability to let us know hey can you respond or repeat a simple sentence that I give you if I tell you to say Ball
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Park shower can you say that effectively and clearly um is the person's speech slurred like does it sound like they're kind of you know kind of lisping their lips or not saying things clear like how I'm doing now but that's all kind of
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like that th spee um time you want to look at the time time is the most important aspect of when we're responding to a stroke um report to the nurse immediately if the person shows any signs of these symptoms because
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timing is everything if that brain is not getting enough oxygen and blood flow like it should to carry on um if we wait too long to call 911 to get help to get this person to a certified stroke center
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who can treat them their outcomes of survival are slim things start to um deteriorate um the patients or the resident may may survive right they may have the stroke but when they um are to come back and we are to help them you
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know heal they may not be um like they may not have like a good quality of life any longer so we may see some deficits some things that that um are a result of the stroke so if you ever know if you
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think of about somebody who's had a stroke before most of the times they're not coming out of that stroke the same anymore their personality can change their um their ability to talk to eat to do things independently for themselves
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can also change it can go away um they can have a hard time coming back and being independent a lot of times there may be that one s side weakness that just hasn't come back and it won't come
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back where we um as healthc Care Professionals will have to help the person get dressed and that's where too that the skill about dressing a client with a W with a weak right side or weak left side comes into play knowing which
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side to dress and if you already know it's always the weaker side is what we dress first to undress we're going to take off on the strong side first and then to put on to dress we're going to
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dress on the weak side and support that weak side all right next term is emesis okay I'm not going to read again everything verbatim but you can see it it's Act of vomiting from the stomach so the stomach contents are coming through
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the mouth or nose that's emesis um when someone's vomiting let the nurse know put on gloves turn them on their side if they're laying on their backs we don't want people's um vomit to go in their Airway and cause what we
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call aspiration where the fluid is going into the lungs um remove any soiled Linens or clothes and set aside replace with fresh Linens so if they throw up on their bed and things we definitely want to change out their Linens their could
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be their hospital gown could be their bed sheets their blankets if the resident is on an intake and output order where we're supposed to monitor their intake and output you want to measure the amount of vomit that actually you know that actually came out
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and that's why too it's nice if you know your patient has um some concerns about becoming nauseous it's good to have a what we call emesis basin or um a uh emesis bag to help them vomit in the little bag
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so we can measure it that could be part of again that's be part of your fluid that your output that may be something again if the resident is on an intake and output monitoring order not everybody is on an intake and output
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monitoring order um when you vomit or when you vomit no not you but when your patient or resident vomits you want to look at the vomit you want to stay um you know not get too involved in looking
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at it but you definitely want to take a peek at it and see whether when you throw it into the toilets or empty the bag into the contents into the toilet you want to see whether the vomit is red
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because that can be indication of blood in it or uh if it's like wet coffee ground because that can also be a sign of blood bleeding in the in the GI track um if these are some things that you are
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seeing you want to let the nurse know before you discard it and I would even keep it handy um and don't throw it out until the nurse actually sees it and then once they see it then they'll tell
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you whether they want you to you know have it stored around keep it a little longer maybe they want to show the provider the doctor the Norse practitioner or what have you um but then you will you know then be told when
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to get rid of it so remove your gloves wash your hands when you're handling again body fluids and put on clean gloves if needs be um provide Comfort to your resident wipe their mouth or face I can't stress this
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enough make sure you're doing mouth Care on somebody who's just vomited you don't want to just have them vomit and then say okay now go go to bed lay down you want to do some oil cares brush your
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teeth make sure their teeth are nicely brushed their tongues sprin their mouth out really good um just really do some really good mouth care because you don't want that taste in their mouth of vomit and um the acid from their stomach that
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they grew up that can also e away their teeth enamel which is the hardening on their teeth to keep the um you know the teeth protected we don't want anything to break down that tooth en enamel so make sure you are doing your part to um
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look out for your folks moving along when a resident is falling okay as a nursing assistant um you should do the following try to you know help balance that person widen your um stance and bring the resident's body
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close to the uh to use the nursing assistant body you should have your knees bent to support the resident as he lowers um as he or she is lowered to the floor um you should not try to stop or
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reverse a okay you're not going to be Superman or Superwoman to help them prevent them from falling you are just to try to protect them and prevent it altogether but if they start to fall I mean you're just going to let them fall
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but protect their head make sure they don't just plump on the floor hold their head um make make sure that they you're you're guiding them to the ground uh kind of slowly and um as much as you can
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to show that you're protecting their head and notify the nurse immediately um it's very important for as a nursing assistant to report all falls to the nurse and to complete an incident report incident report is not to make you look
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bad and say oh you just don't know your job or you caused it to happen incident report is mainly um it's mostly to evaluate the inside s the inside systems or policies that are in place sometimes you know if there's a certain amount of
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incident reports on the same thing the facility will do their own due diligence to see whether hey do we need to change how we do this type of care or do we need to make this a two person or three
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person um you know type of care so it's not to make you look that but it's more so to evaluate the different systems that might have been failed that have um that might have caused this to to um
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occur so never take it as you know I want to avoid doing incident reports altogether they happen it's inevitable you're always G to have you know issues with um it could be it's always an incident let's just say there's always
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incidents it could be an incident report because um two residents started fighting or arguing or could be an incident report where someone lost their Dentures or um you know something got broken from the from the resident or the
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or the facility you know there's things like that can also go into an incident report so just keep that in mind get your details get the time the date get the events that led up to it and what
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you did and who you told if you told the nurse put that in there um usually if it's depending on what type of incident the the nurse may have you kind of start the incident report because you were you
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may have witnessed it or was there at the time but then they will you know um they will come in and and add to the the details because you want that nurse to know so that they can come in and do
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their assessment and follow up on you know what may have been an um injury or or what have you but that nurse should be laying eyes on that patient after an incident um describe disaster guidelines if any disasters take place you're
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working it's important to follow these General guidelines remain calm know where your exit points are and stairways are know where your alarm systems are your fire extinguishers are no appropriate actions to take so if there's a flooor plan or somewhere near
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the exit doors and things you follow that floor plan it usually will tell you where you are and then you can also see what's around you by looking at that floor plan stay informed if you have a radio or TV or Internet or your phone
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with you at the time make sure you're listening so you can um you know hear what's happening on the outside world if you're in a building or trapped in um in there so all right here are the following steps that you're going to
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take in case of a tornado see s shelter inside ideally in a steel framed or concrete building stay away from Windows stand in the hallway or in a basement or take cover under heavy Furniture do not stay in a mobile home or a trailer
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because that wind from the tornado can blow it right away lie as flat as possible um and yeah hopefully that torn goes pass and you are safe and don't have to worry much about it but uh tornadoes do carry a lot of wind
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that's why you want to stay away from Windows and things because glass can easily shatter and you don't want to be in a place of where you can get injured um in case of lightning if there's Thunder and there's lightning
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with that or if there's no Thunder there's just lightning and there's rain what have you um if you're Outdoors make sure you follow these guidelines I'm not going to go through them step by step because they're here for you and you can
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read it all right continuing what you would do in case of lightning there you have it okay in case of flood fill the bathtub with fresh water evacuate if advised to do so check the fuel level in automobiles make sure there is enough
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fuel to last through an evacuation if one becomes necessary have a portable battery operated radio flashlight and cooking equipment available do not drink water or eat food that has been contaminated with flood water do not handle electrical equipment because we
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know water and electricity do not mix you can easily get get electrocuted do not turn off the gas yourself ask the gas company to turn off the gas okay we don't want things blowing up um and most places will have some type of uh
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emergency kit and even for yourself personally it's good habit to have a emergency kit with the batteries and a radio that can be battery operated does it need electricity flashlight and some you know temporary burners or uh like
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cooking um like you know those little burners you can cook on um but something like that some kind of cooking equipment so that you can eat in case um and you can be saved if you're outstanded somewhere in a flood zone um
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you'll have something to let people know that there's someone living here and we need help all right in case if there's a blackout so lights out and to get a flashlight take the prompt action to keep calm and provide light use a backup
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pack after um or for electrical Medical equipment such as an IV pump backup packs do not last more than 24 hours so contact emergency services when instructed okay cases of hurricane you have the list of things to do here okay
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know what category uh category hurricane you're working with okay and the track that it's expected to pass um and that's all usually on the news um I think the higher the number the the worse the hurricane um is know which residents
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must need um help going into shelter hospital or other facilities and which need assistance be aware of people with special needs high risk people include an elderly and those unable to evacuate on their own those are people that we
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want to really prioritize getting out of the building first or getting to safety first because they are not able to move unless you move them high-risk areas with places that you don't want to be in case of in Hurricane is a mobile home or
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trailers and call your employer for instructions if you are maybe in the person's home at the time um here's some steps to take in case of a hurricane okay fill the bath with fresh water and that's mainly just to keep I
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think eventually that's to be your drinking Source board up window so most places um folks that have lived in Hurricane zones they know to tape up their Windows um put they they probably uh even go to put um wood frames on the
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window so that in case the glass were to shatter inward it won't come in and hurt anybody but yeah they're they're protecting those windows um checking your fuel and your uh Vehicles having a portable all radio flashlight and
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cooking equipment as well so you can survive if you're not found in time or if you're in a place where you know it's dark the hurricane is it's flooding and you don't have any resource to get out you're stuck inside so um yeah
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earthquake we don't have to worry much about earthquakes here here in Minnesota but I know if you ever were to go to places like California they do have earthquakes so these are the guidelines that you will follow in case you're
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working at a facility who is under um who's having experiencing a earthquake they do happen um pretty often I know in the recent years it's been pretty often out in the California West Coast Area um active shooter so in case there's
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someone coming into a facility with a gun who's trying to shoot um you're going to follow your facilities emergency notification procedures there's an escape path to try to evacuate remember don't put yourself In Harm's Way if the area cannot be safely
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evacuated or you can't leave the area stay where you are um kind of border the room they say and um kind of hide you know turn off the lights put you at the door stay hidden from The View outside
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the view turn off all phone ringers so that if the person is coming they you don't you know make them look toward your direction and find that you're there hiding make sure you're quiet as a mouth if it's safe to do so call 911 and
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notify the operator of your exact location in the building so they can come and find you and rescue you um here's some more guidelines on active shooter okay hopefully you never have to be in a situation like that but in
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today's world nothing is surprising anymore so we do cover this in the course um Home Care Focus so if you're ever working in a client's home directly um make sure for the disaster uh if you're in a a disaster situation locate
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disaster supplies ideally a disaster Supply kit should meet your needs for at least three days so it should be assembled before disaster strikes and should include the following and this is something too you can take personally right if you want to get a Survivor Kit
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or a disaster Readiness kit here's the some of the things that they'd recommend a three-day supply of water one gallon per person per day and food that will not spoil one change of clothing and Footwear per person and one blanket or
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sleeping bag per person a first aid kit that includes your family's prescription medications always good to have there's some other items to putting your disaster Supply kit emergency tools like battery powered radio flashlight plenty of extra batteries extra set of car keys
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and credit card or debit card or cash sanitation supplies you know things get kind of messy dirty so it's nice to have something to clean your hands with could be hand sanitizer or just regular soap and water chargers for your phones your
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tablets your laptops special items for infant elderly or disabled family members extra pair of glasses important family documents and water in a waterproof container because you just never know you're going to need to float those documents right so it's good to
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put those documents in a waterproof container or have them sealed in a way where water can't get them all right here's your post lecture discussion post um these are the questions that I want you to reply to in
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your response how do you determine whether uh someone's conscious or unconscious at the time what information would you expect or would you be would be expected to give if you were to told to call 911 what do you do if you are not
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trained to do CPR and the resident is not breathing do you feel an ethical obligation to do CPR any way if her life is in danger or so so if someone's life is in danger do you feel like you you
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should ethically respond and give them CPR any at any by any means anyway if their life is in danger and hopefully you're thinking okay if if they're DNR meaning do not resuscitate I know I'm not going to perform CPR because that is
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already in their chart that's what the person wishes they don't want to be resuscitated or DNR but if you're not sure what their code status is you don't know if they want to be resuscitated or receive CPR or not we are going to treat
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that person as if they do so we're going to perform CPR so hopefully that helps you kind of think about how you will respond to this last ethical obligation question and remember this is your post lecture discussion post so please listen
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to it and um or not listen to it listen to this part of the lecture of course but um please respond resp to that those questions um the next question you are uh with your friend at a baseball game
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and your friend begins to complain of shortness of breath and sudden pain and pressure in his chest okay here are some questions that I want you to ask in your post lecture discussion what do you immediately suspect is happening what
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other medical information is important to observe at this time what questions do you ask him what is the appropriate emergency action at this time if he complains of thirst do you offer him a drink of water if he stops breathing and
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you cannot find a post what should you do next if you are not properly trained to handle this situation what do you do so think about these questions and put this also in your post lecture discussion post please and that is it now complete any
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assigned uh chapter activities assignments within this um module and thank you for listening have a great day
Topics:emergency careCPRfirst aidnursing assistantincident reportEMSburnsstrokeseizuresepsis
