Emergency

• Nursing

Emergency Care and First Aid 

What is the nursing assistants role?

emergency

What are some signs/symptoms
we might see that would indicate an

change in level of consciousness

irregular breathing or not 

     breathing

has no pulse

severely bleeding

unusual color or feel to the skin

choking

poisoning

severe pain

shock

allergic reaction

Match each description to its medical term:  

Epistaxis 

Syncope 

Emesis

Hypoglycemic 

Nose bleed

Fainting

Vomiting 

Low blood sugar 

In an average adult, how much blood can you lose before becoming symptomatic?

1. 2 L
2. .5 L
3. 4 L
4. .75 L

The average adult has around  5 liters of blood circulating through their body at one time. 

Typically, a person can lose about 15% of their total blood volume before they start to show symptoms. 

Stopping the bleed

• Put on gloves
• Have resident sit or lie down 
• Apply direct pressure with clean cloth
• Elevate source above heart if possible
• Maintain direct pressure until bleeding stops. Add more layers of cloth instead of removing saturated cloth. 

Bleeding

.75 liter

 

of blood

Select one of the incorrect methods of treating epistaxis

Which answer is incorrect about helping resident who is throwing up (emesis)?

If sitting, have the resident lay down

Place emesis basin under chin

Sit the patient up, if possible

Turn resident on their side if they are lying down

Note amount, color, consistency of vomit

Syncope

Fainting is due by decreased blood flow to the brain 

Possible causes are an abnormal heart rhythm, dehydration, fatigue, hypoglycemia, or many others

Signs and symptoms of potential syncope

• dizziness
• nausea
• perspiration
• pale skin
• weak pulse 

How to treat:

• Assist resident to floor or into chair
• Place head between knees if seated or elevate legs if on floor (if resident doesn't have physical restrictions)
• Loosen tight clothing
• Take vital signs 
• Turn resident on side if vomiting
• Keep resident in same position for 5 min after symptoms disappear

Level of Consciousness (LOC)

Conscious – mentally alert and aware of surroundings, sensations and thoughts

Confused – disoriented to time, place, and/or person

Unconscious – resident is unable to respond to touch or speech --> This is an Emergency

What is the appropriate response when encountering an unconscious resident.

• know resident’s DNR status 
• activate emergency medical system by calling for help (EMS or 911) or have someone call immediately
• initiate CPR (if facility policy permits) or first aid until EMS or medical personnel arrive

CPR will be covered in this course at a later date

If a resident is able to tell you their name but tells you the year is 1991, what is their LOC?

1. Conscious
2. Confused
3. Unconscious
4. Hilarious

Low blood sugar (Not only in diabetics!)

"Cold and clammy- need some candy"

Signs/Symptoms:

• Cool, clammy skin
• Nervous, anxious feeling
• dizzy
• Rapid pulse
• Disoriented
• Unconscious

High blood sugar

"Hot and dry, sugar high"

Signs/Symptoms:

• increased thirst
• increased urination
• increased hunger
• flushed, dry skin
• drowsy
• nausea, vomiting
• unconscious

Hypoglycemia

Hyperglycemia

What to do:

• Notify nurse immediately
• If conscious and able to swallow, give juice or something with sugar
• Stay with resident
• Know facilities policy on blood sugar emergencies 

What to do: 

• Notify nurse immediately
• Stay with resident
• Document your findings

Hypoglycemia

Hyperglycemia

Burns

• First degree (superficial): red, painful, blanches with pressure, no blistering
• Second degree (partial thickness): blisters, redness, pain, raw surfaces 
• Third degree (full thickness): skin white or charred, not painful 

What are some
appropriate nurse aide
actions for a resident
who has been burned

• notify nurse immediately – assist only as directed by licensed health professional (i.e.-nurse, N.P., physician, P.A.)
• put on gloves to protect resident and self
• lightly cover with dry, sterile gauze, if directed
• never apply butter, oil, or ointment, water or any other solution to a burn
• have resident lie down and wait for EMS to arrive
• stay with resident until help arrives
• remove gloves, wash hands and document what occurred per facility policy

Signs and Symptoms of a Heart Attack

• Take a moment and notice the difference in warning signs.
• Women are more likely to have atypical symptoms.
• Main take away - report any unusual changes in a resident to the nurse or provider.
• You could help save the residents life!

What do we do if a resident is having a heart attack?

1.  Have resident lie down
   
2. Notify nurse immediately
3. Elevate resident’s head to help him/her breathe better
4. Initiate CPR if necessary
   
5. Stay with resident until help arrives
   
6. Document what occurred and the time per facility policy