Lec 9

• This reviewing of the events is completely normal and you can expect it to happen. But if thoughts of the incident continue for many weeks, or if they affect your day-to-day life, you may be experiencing the negative effects of critical incident stress (CIS)
• Critical incident stress (CIS)


  A common reaction to a stressful emergency situation. The effects of CIS can interfere with your daily life—your job, your relationships, your peace of mind
• What to do if experiencing CIS


  1. Talk to your family doctor or a doctor at a walk-in clinic

  2. A doctor will understand what you are going through and will suggest a course of action
• The effects of critical incident stress can appear many weeks, months or years after the event
• Shock


  A circulation problem where the body's tissues don't get enough oxygenated blood
• Shock is a danger because any physical injury or illness can be accompanied by shock, and it can quickly progress into a life-threatening condition
• Pain, anxiety and fear do not cause shock, but they can make it worse, or make it progress faster
• Medical shock should not be confused with electrical shock or being shocked and surprised. Medical shock is life-threatening, as the brain and other organs cannot function properly
• Causes of severe shock


  • Severe bleeding - internal or external (includes major fractures)
  • Severe burns
  • Crush injuries
  • Heart attack
  • Spinal cord or nerve injuries
  • Severe allergic reactions
• How causes of shock lead to a circulation problem


  • Not enough blood to fill blood vessels
  • Loss of blood plasma (fluid) into tissues—not enough blood to fill blood vessels
  • Loss of blood and blood plasma into tissues—not enough blood to fill blood vessels
  • Heart is not strong enough to pump blood effectively
  • Brain can't control the size of the blood vessels—the blood can't get to the tissues properly
  • Many things can be affected—breathing, heart function, etc.
• Signs of shock


  • Pale skin at first, turns blue-grey*
  • Blue-purple lips, tongue, earlobes, fingernails
  • Cold and clammy skin
  • Breathing shallow and irregular, fast or gasping for air
  • Changes in level of consciousness
  • Weak, rapid pulse—radial pulse may be absent
• Symptoms of shock


  • Restless
  • Anxious
  • Disoriented
  • Confused
  • Afraid
  • Dizzy
  • Thirsty
• First aid for shock


  1. Give first aid for the injury or illness that caused the shock

  2. Reassure the casualty often

  3. Minimize pain by handling the casualty gently

  4. Loosen tight clothing at the neck, chest and waist

  5. Keep the casualty warm, but do not overheat — use jackets, coats or blankets if you have them

  6. Moisten the lips if the casualty complains of thirst. Don't give anything to eat or drink. If medical help is delayed many hours, give small amounts of water or clear fluids to drink — make a note of what was given and when

  7. Place the casualty in the best position for their condition

  
• Positioning a casualty in shock


  1. No suspected head/spinal injury; fully conscious: Place the casualty on their back, if injuries permit. Once the casualty is positioned, cover them to preserve body heat, but do not overheat.

  2. No suspected head/spinal injury; less than fully conscious: Place the casualty in the recovery position. When there is decreased level of consciousness, airway and breathing are the priority—the recovery position ensures an open airway.

  3. Conscious with a breathing emergency and/or chest pain: If a conscious casualty is experiencing chest pain or is having difficulty breathing, have them sit in a semi-sitting position, or any position that makes breathing easier for them.

  4. Suspected head/spinal injury: If you suspect a head or spinal injury, steady and support the casualty in the position found. This protects the head and spine from further injury. Monitor the ABCs closely.

  5. As injuries permit: A casualty's injuries may not permit you to put them into the best position. Continue to support the head and neck and, if needed, use a head-tilt chin-lift to maintain the open airway. Always think of the casualty's comfort when choosing a position.

  
• Fainting


  A temporary loss of consciousness caused by a shortage of oxygenated blood to the brain
• Common causes of fainting


  • Fear or anxiety
  • Lack of fresh air
  • Severe pain, injury or illness
  • The sight of blood
  • An underlying medical problem
  • Fatigue or hunger
  • Long periods of standing or sitting
  • Overheating
• First aid for fainting


  1. Ensure a supply of fresh air and loosen tight clothing at the neck, chest and waist.

  2. Make the casualty comfortable as consciousness returns and keep them lying down for 10 to 15 minutes. Continue to monitor breathing and consciousness.

  
• Do not assume a person has "just fainted," unless there is a quick recovery. If the recovery is not quick or complete, stay with the casualty until medical help takes over.

  
• If you have to leave to get medical help or you have to give first aid to other casualties


  Turn the casualty into the recovery position being as careful as you can if there are any injuries.

  
• Feeling faint or "impending faint"


  Warning signs include: Pale, Sweating, Feels sick, nauseous, dizzy or unsteady
• First aid for an impending faint


  1. Place the casualty on their back.

  2. Ensure a supply of fresh air—open windows or doors.

  3. Loosen tight clothing at the neck, chest and waist.

  4. Stay with the casualty until they has fully recovered.