treatment for severe anaphylaxis is the sub-
cutaneous injection of 0.3cc of epinephrine and
The most characteristic and serious symptoms
of an anaphylactic reaction are loss of voice and
difficulty breathing. Other typical signs are giant
hives, coughing, and wheezing. As the condition
progresses, signs and symptoms of shock develop,
followed by respiratory failure. Emergency
management consists of maintaining vital life
functions. The medical officer must be summoned
A number of heart conditions are commonly
refereed to as heart attacks. These include angina
pectoris, acute myocardial infarction, and con-
gestive heart failure. Together they are the cause
of at least half a million deaths per year in our
country. They occur more commonly in men in
the 50 to 60 year age group. Predisposing factors
are lack of physical conditioning, high blood
pressure and blood cholesterol levels, smoking,
diabetes, and a family history of heart disease.
This condition is caused by insufficient oxygen
being circulated to the heart muscle. It results
from a partial occlusion of the coronary artery,
which allows the heart to function adequately at
rest, but it does not allow enough oxygen enriched
blood through to support sustained exercise.
When the body exerts itself, the heart muscle
becomes starved for oxygen, resulting in a squeez-
ing substernal pain that may radiate to the left
arm and to the jaw.
Angina is differentiated from other forms of
heart problems since the pain results from exer-
tion and subsides with rest. Many people who suf-
fer from angina pectoris carry nitroglycerin
tablets. If the victim of a suspected angina attack
is carrying a bottle of these pills, place one pill
under the tongue. Relief will be almost instan-
taneous. Other first aid procedures include
reassurance, comfort, monitoring vital signs, and
transporting the victim to a medical treatment
Acute Myocardial Infarction
This condition results when a coronary artery
is severely occluded by arteriosclerosis or com-
pletely blocked by a clot. The pain is similar to
that of angina pectoris, but is longer in duration,
not related to exertion or relieved by nitroglycerin,
and leads to death of heart muscle tissue. Other
symptoms are sweating, weakness, and nausea.
The pulse rate increases and may be irregular;
blood pressure falls; respirations are usually nor-
mal. The victim may have an overwhelming feel-
ing of doom. Quick or lingering death may result.
First aid for an acute myocardial infarction
. Reassurance and comfort while placing the
victim in a semi-sitting position.
. Loosening of all clothing.
l Carefully maintaining a log of vital signs,
and recording the history and general
. Continuously monitoring vital signs and
being prepared to start CPR.
l Starting a slow intravenous infusion of 5
percent dextrose solution in water.
. Administering oxygen.
. Quickly transporting the victim to a
medical treatment facility.
Congestive Heart Failure
A heart suffering from prolonged hyperten-
sion, valve disease, or heart disease will try to
compensate for decreased function by increasing
the size of the left ventricular pumping chamber
and increasing the heart rate. As blood pressure
increases, fluid is forced out of the blood vessels
and into the lungs, causing pulmonary edema.
This leads to rapid shallow respirations, the ap-
pearance of pink frothy bubbles at the nose and
mouth and a distinctive rales sound in the
chest. Increased blood pressure may also cause
body fluids to pool in the extremities.
Emergency treatment for congestive heart
failure is essentially the same as that for acute
myocardial infarction. Do not start CPR unless
heart function ceases. A sitting position promotes
blood pooling in the lower extremities. If an in-
travenous line is started, it should be maintained
at the slowest rate possible to keep the vein open;
an increase in the circulatory volume will worsen
the condition. Immediate transport to a medical
treatment facility is indicated.