EMERGENCY

By: Gerlie Mhae Cueto

Emergency
• Emergency has been defined as
a condition determined
clinically or considered by
patient or his/her relatives as
requiring urgent medical
services failing which it could
result in loss of life. (WHO)

• Sudden and unlooked for

condition requiring immediate
action
TYPES OF EMERGENCY
1. ENVIRONMENTAL EMERGENCY

A. Heat Related Emergencies

-Heat cramps
-Heat Exhaustion
-Heat stroke
 B. Cold Related Emergency
-Frostbite
-injury due to freezing tissue
Management
-rewarming in warm water and local care
(40-42C)
-narcotic pain medication
-Penicillin G
-Tetanus prophylaxis
-whirlpool bath at 37C 3x a day followed
by gentle drying rest, and time are best
long term management

-Hypothermia
-core tempreature is 35C or less
Management
-continuous monitoring, rewarming,
removal of wet clothing, and supportive
care
 D. Bites and Stings

- animals, insect cause injuries

and even death by biting or stinging
-morbidity Is a result of either
direct tissue damage or lethal
toxins.

- Hymenoptera Stings
• includes bees, hornets , fire
ants.
- Scorpion Stings
• Although all scorpion in North
America stings, most are
relatively harmless the sting
usually cause:

• Localized pain and swelling
• Some lymphangitis with regional
lymphadenopathy
-This species is venomous and can
cause more serious injury and illness.
Management
• treatment of non venomous
scorpion stings is non specific; ice
pack over the wound and oral
NSAIDs to reduce pain
- Stringer removal if the sting is
from the bee because the venom
is associated with sacs around the
barb of the stringer itself
-Anaphylactic shock
inject epinephrine (aqueous)
subcutaneously and the injection site
is massage to hasten absorption
• Tick Bite
-emergencies associated includes
Lyme disease
-can cause paralysis

Management
- Remove as soon as possible to
reduce cutaneous immune
response
- use forceps or tweezers to safely
remove the tick by grasping at
the point of entry and pulling
upward in a steady motion
- After removal, antiseptic should
be applied
• Spider Bite
1. Black widow spider- female
venom are poisonous to
people.
Sign And Symptoms
- 10-20 mins, pain and throbbing
at the bite site
- 2-3 hours, musculoskeletal
symptoms (myalgias, gen.
sweating, muscle spasms)
- Cardiopulmonary symptoms
(chest pain and tightness,
dyspnea)
- Gastrointestinal Symptoms
(board like rigidity , N/V)
- Facial (muscle twitching)
- Neurologic symptoms
(paresthesias, seizure)
• Management

- Diazepam(valium)- 10ml slow

IV infusion
- Methocarbamol (rovaxin)-
10-30 mL, IV infusion
- Analgesics
- Antivenom for severe reaction
2. Brown Recluse spiders
- the venom is cytotoxic , so local
tissue effects can be dramatic

Sign and Symptoms

-hemorrhagic, erythematous,
central necrosis
-mild coagulopathy
-sever intravascular hemolytic
syndrome
-hematuria

Management
-provide cold compress
-analgesia, antibiotics, tetanus
prophylaxis
-elevate the affected extremities
-debride the necrotic tissue
• Snake Bite
- Poisonous snakes include
Crotalidae and Elapidae family
- Venom is a poison that snake
puts into its prey through fangs

Sign and symptoms of

envenomation may be local ,
systematic coagulophatic
depending on the type on the type
of the snake.

- Some rattle snake bite victims

develop a rubbery, or metallic
taste and shock
• Management
- Pressure immobilization to delay
systematic absorption of venom
- First responder should support
airway and breathing administer
oxygen and establish IV in
unaffected site and immediately
transport to the nearest hospital
- Treatment may include
Respiratory support
Benzodiazepines for anxiety and
sedation
-Antivenom therapy for mild to
moderate envenomination
Initial dose:4-6 vials infused over 1hr.
Infusion should be initiated slowly
for the first 10mins.
Additional regimen; 2 vials every 6-
18hr.
• Management
-examine the wound
-clean the wound
-Assess the animal, kept away from
the people and other animals for 10
days to make sure it doesn’t start
signs of rabies
-If the animal gets sick during 10
days period or die, you will need to
get a series of rabies shot
 Human Bite
• Management
-calm and reassure the person,
wash your hands
-if the site is not bleeding severely
wash the wound 3-5mins with mild
soap and cover the bite with a
clean dressing.
-if the site is actively bleeding
cover the wound with a dry cloth
and elevate the site and get
medical attention.
- Doctors usually suture a bite
wound and make sure that the
patient is immunize against tetanus
 C. Submersion Injuries
-it results when a person
become hypoxic due to submersion
in a substance, usually in a water.
 E. Poisonings

-chemicals that harms the body

-Poisons can be swallowed,
inhaled, absorbed or injected

-option for decreasing absorption

of poison includes gastric lavage,
activated charcoal, eye irrigation and
dermal cleansing
 2. Agents of Terrorism and
Bioterrorism

-treat of terrorism is an on going concern

-involves overt action such as the

dispensing of disease or pathogens or
other agents (nuclear exposure devices)
as weapon for the express purpose of
causing harm.
Terrorism
 3. Accidents
-wounds hemorrhage, trauma, multiple
trauma

- FIRE
• Class A Fires
- composed of normal solid
elements
• Class B Fires
-consist of element whose vapor
are sent off at normal temperature or
when heated
• Class C Fires
-results from electric power
• Class D Fires
-burning metals
 4. Natural Disaster

-loss of communication, water,

electricity are the greatest
obstacle to a well coordinated
response.
 5. Psychiatric emergency

- An urgent serious disturbance of

behaviour affect or thought that
makes the patient unable to cope
with the life situation and
interpersonal relationships

-Violent Behaviour
-Suicidal Patient
-Post traumatic Stress disorder
Thank you
 Reference
Smeltzer, S., Bare, B., Hinkle, J. & Cheever, K.
2006. Brunner and Suddarth's Textbook of
Medical-Surgical Nursing, 11th Edition. New
York: Lippincott Williams & Wilkins.
Udan, J. 2017. Medical-Surgical Nursing, Concepts
and Clinical Applications. Ermita, Manila:
APD Educational Publishing House.