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VET * Patient feclefaint/lightheaded/dizay fe the patient flatand aise the lags recovery will (simple faint) «= Pallor sweating normally berapid «Pulse rateslows + A patent airway must be maintained + Low blood pressure + If recoverys delayed, oxygen (15 itres per minute) ++ Noses and/or vomiting should be administered and other causes ofloss of += Loss of consciousness. consciousness be considered. Sremlesness (ap repiraton-morethan25. + Mostasthna take willrespondtohe patients om bres permite) eee ed Expreory een fer 23 mint seat accessorymusclesof respiration no rpid response or features of severe asthma call Sreeneais ceed [medical earexmentshouldbearrangester tet eager ‘oho require adele ozesofbranchosstereaend Crancaisorsiowresbietoyeetelesthaneist natin breaths permite, 1 spacer decemay need tobe used patient has srayearia “emteutyurnate inhaler Deeresed evlofconeiournencontaion Ite patie sdateazed orton enyefthe sans of Iifethveateningastimo, urzentvansporto hes pee vhlenuatong:ansfer Upto 1 scutonstom the ‘Spd tepeated every 10 minutes Ine BrSh National Formulentatiehngueeeaeribedtora here mace ‘rlasticup.The mouthpiece ofthe inhaler pushed spolietothe mouth when ne inhaler isetvated. ‘Alpatensincludingtosewmohave conic ‘catuctepulmonery dase ahoulcbezies Miah Tom onyen aseven these patina cependent on ‘hypocrite epiaton, thywal _ Hyperventilation Anxiety '* Exclude other causes for the symptoms (ABCDE Light headedness/dizziness approach) ‘Weakness [Encourage the patient torebreathe their own exhaled Paraesthesia air to increase the amount of inhaled carbon dioxide Tetany (see below) =a paper bag placed over nose and mouth allowsthis Breathlessness + If no paper bag i handy, the patient’s cupped hands. Chest pain and/or palpitations could be an alternative. Hyperventilation leads to carbon dioxide being ‘ywashed out’ of the body, producing an alkalosis. If hyperventilation persists, carpal hand) and pedal (foot) spasm (tetany) may be seen. Rebreathing ‘exhaled air helpsto return the situation to normal relatively quickly. Tresrpan "severe, crushing chestpain which may eee eee (perticulry the eft ar ane nt the . ansile “The skin becomes pale snd clammy ceeett eel Pulse becomes weak and patient may become hypotensive (Ren there willbe nauses and vomiting Nor allpatients it this picture, coca ‘The patent may havean ‘ara that a slurelsabost + Tone phse loss consciousness, patenthecomes. ese lois phase etn movements othe ibs, tongue may be ban Fthing atthe mouth, urinary eonsnence “The sete often eaduly bates after few ‘rinutes. The pater may remain unconscious They Hyooehcoemiamey present as aft and shuld be ‘considered nlcing nel patents) —lood [core measurement ta eat tages therfore + Inpatients wth amie bradearso (ple rates ‘hana best pr minute] the non poeta my ‘ro to sch ah extent that eauses rosie ‘cerebral hypo leadngt are Tis at 2 {nse ftand represents assoongelepiode “he procttoner should remain calm Call 913 immediately Most patents willbe best managed in the siting postion but patients who fee faint should be ai fat Administer high ow oxygen (15 lives per minute) Give sings GTN pray ‘Give 200 me asprin orallyto be chewed (if no alley = ensure that hen handing ove to the reeling ambulance crew that they are made aware of thi ‘patient who has had sural dental reatment should be higiigmtedto the ambulance erew a= any significant rskot haemonhage may fect the detsion use ‘trombolyte therapy \fthe paint becomes unresponsive, the practioner Should check for ‘signs off" (oresthing nd culation) and start CPR, ‘+ Afar esposible ersure safety of the patent and practioner (donot tenet testa, + bdsm sven viathe buccal or tanssl rote (10 me for nul) Th buccal partion lmaratd 22 “pate [0mm A pasate fomulatn, Bueclan (5 ml snow icened fou For cients: Gils 1 5yeas.5 mE Child 510 906, 75m [ee eater etal plegey lea rectal daapar, Ao pro pre westment reoeration itisuneto arangevith the arent othe fete eee! inthe shsene a rapid response to veetert. call en ‘marc, ese Clone phaee tongue may be ban Fthing atthe mouth, urinary eonsnence “The sete often eaduly bates after few ‘rinutes. The pater may remain unconscious They Hyooehcoemiamey present as aft and shuld be ‘considered nlcing nel patents) —lood [core measurement ta eat tages therfore + Inpatients wth amie bradearso (ple rates eting moworents othe ibs, ‘+ Afar esposible ersure safety of the patent and practioner (donot tenet testa, + bdsm sven viathe buccal or tanssl rote (10 me for nul) Th buccal partion lmaratd 22 “pate [0mm A pasate fomulatn, Bueclan (5 ml snow icened fou For cients: Gils 1 5yeas.5 mE Child 510 906, 75m [ee eater etal plegey lea rectal daapar, Ao pro pre westment reoeration itisuneto arangevith the arent othe fete eee! inthe shsene a rapid response to veetert. call en ‘marc, ‘hana best pr minute] the non poeta my ‘ro to sch ah extent that eauses rosie ‘cerebral hypo leadngt are Tis at 2 {nse ftand represents assoongelepiode _ Trembling Hunger Headache Sweating Slurring of speech “Pins and needles’ in lips and tongue ‘Aggression and/or confusion Selzures Unconsciousness cy ‘te ashferytnema + Focal fhshing or pallor ‘+ Upper airway (laryngeal) oedema and bronchespasm eaing to stor, wheering and possibly hoarseness 1 Arespator arrest may ocur ening to cariae + Vasodtatatin eadig tow bled pressure and «alps which may progress to cardc acest. ‘Lay the patient fat (remember A,B, C) * IF the patient is conscious, give 10-20. oral glucose (2 lumps of sugar, 2-4 teaspoons of sugar or 100 ml ‘of sugary drink such as Coca Cola) or GlucoGel® + tf the patient is unconscious give 11mg glucagon intramuscularly (or subcutaneously) Get medical help "The ABCDE approach shouldbe employed wale the agnosis 5 being rade {+ Manage airway ad breathing by administering 19 res per ‘minute of oxygen estore bled pressure by hing the patiant flat and alsing the legs. Inffe threatening anaphyoes (hoarseness, stridor, dyspnoea, janes, drowsiness, confusion or coma) adrenaline shoud be dministered. 4 Adminste Olof 2m 3,000 eens Mand peat at 5 ‘minute intervals fro improvement ‘The optimum ste friction isthe anterolateral mith of the then Corry pena If back blows fal, up tofive abdominal thrusts should be given. ‘Stand behind the victim and put both arms around the upper part of thelr ‘abdomen and lean them forwards ‘The rescuer’s fist should be clenched and placed between the umbilicus and. lower end of the sternum ‘The clenched fist should be grasped with the other hend and pulled sharply inwards and upwards This should be repeated up to five times. ‘The back blows and abdominal thrusts should be continued ina cyclical fashion Chest thrusts, similar but quicker than chest compressions using two fingers should be employed in infants (under 1 year of age) rather than abdominal thrusts, _ + Thepationtlosesconsciousnass ‘+ Lay the patient atandraisetheirlegs ‘+ Thepatienthasa rapid, weakorimpalpable + Ensurea clear away ndadministeroxygen 15lites ube perminute) + Theblood presurefallsrapidy. + Callanambulance, {is mportantinthehistoytosscertain ‘hetherthepatienthas recently used aris curently using coticosteris. "+ n208, theStokeAssoationrecommended + FASTapproach toasts likely diaross {ellownatheFASTaporoachtoassessuhetherthe + ABCDE approach. Theaiweysheulabemaintainedandan patienthashada stoke. Theacronymrepresents__ambulancecalled| thefollowne: ‘+ ighor oxen (3 res perminsteshoukibegivenviag fo Facilweskness rom-rebeeathenack © amweshness ‘+ Treputientshouldbecaretull monitored fo any fur © Speccnproblems deterioration AvPUSystom: Ale, Voce responce, Pain © Telephones, any ortnesbove response, uneesperce) «+ tttne patient sr becomes unconstousandisbeathing, ‘they should be placedintherecovery postion

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