and severity of the onset of symptoms, immediate
intervention is necessary. The general treatment for
severe anaphylaxis is the subcutaneous injection of
0.3 cc of epinephrine and supportive care.
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. Summon the
medical officer immediately.
As a Hospital Corpsman, you could encounter
special situations that include poisoning, suspected
drug abuse, or exposure to hazardous materials.
Knowledge of these conditionsalong with the ability
to assess and treat themis essential. These situations
are discussed in detail in chapter 5, Poisoning, Drug
Abuse, and Hazardous Material Exposure.
A number of heart conditions are commonly
referred to as heart attacks. These conditions include
angina pectoris, acute myocardial infarction, and
congestive heart failure. Together these heart
conditions are the cause of at least half a million deaths
per year in our country. Heart conditions occur more
commonly in men in the 50-to-60-year age group.
Predisposing factors are the lack of physical
conditioning, high blood pressure and blood
cholesterol levels, smoking, diabetes, and a family
history of heart disease.
Angina pectoris, also known simply as angina, is
caused by insufficient oxygen being circulated to the
heart muscle. This condition results from a spasm of
the coronary artery, which allows the heart to function
adequately at rest but does not allow enough
oxygen-enriched blood to pass through the heart to
support sustained exercise. When the body exerts
itself, the heart muscle becomes starved for oxygen.
The result of this condition is a squeezing, substernal
pain that may radiate to the left arm and to the jaw.
Angina is differentiated from other forms of heart
problems because the pain results from exertion and
subsides with rest. Many people who suffer from
angina pectoris carry nitroglycerin tablets.
victim of a suspected angina attack is carrying a bottle
of these pills, place one pill under the tongue. Relief
will be almost instantaneous.
Other first aid
procedures include providing supplemental oxygen,
reassurance, comfort, monitoring vital signs, and
transporting the victim to a medical treatment facility.
Acute Myocardial Infarction
Acute myocardial infarction results when a
c o r o n a r y a r t e r y i s s e v e r e l y o c c l u d e d b y
arteriosclerosis or completely blocked by a clot. The
pain associated with myocardial infarction 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. Additionally,
although the patients respirations are usually normal,
his pulse rate increases and may be irregular, and his
blood pressure falls. The victim may have an
overwhelming feeling of doom. 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;
carefully maintaining a log of vital signs, and
recording the history and general observations;
continuously monitoring vital signs and being
prepared to start CPR;
starting a slow intravenous infusion of 5%
dextrose solution in water;
administering oxygen; and
quickly transporting the victim to a medical
Congestive Heart Failure
A heart suffering from prolonged hypertension,
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. This condition is known as congestive heart
failure. As blood pressure increases, fluid is forced out
of the blood vessels and into the lungs, causing
pulmonary edema. Pulmonary edema leads to rapid
shallow respirations, the appearance of pink frothy