(armpit), and aural (ear) temperatures. In emergencysituations, taking a traditional body temperature maynot be indicated, so a relative skin temperature may bedone. A relative skin temperature is a quickassessment of skin temperature and condition. Toassess skin temperature and condition, feel thepatient’s forehead with the back of your hand. In doingthis, note if the patient’s skin feels normal, warm, hot,cool, or cold. At the same time, see if the skin is dry,moist, or clammy. Also check for “goose pimples,”indicating chills.BASIC LIFE SUPPORTLEARNING OBJECTIVE: Recall basic lifes u p p o r t t e c h n i q u e s f o r u p p e r a i r w a yobstruction, respiratory failure, and cardiacarrest.Basic life support is the emergency technique forrecognizing and treating upper airway obstruction andfailures of the respiratory system and heart. Theprimary emphasis should be on the ABCs of basic lifesupport: maintaining an open airway to counter upperairway obstruction; restoring breathing to counterrespiratory arrest; and restoring circulation to countercardiac arrest.UPPER AIRWAY OBSTRUCTIONThe assurance of breathing takes precedence overall other emergency measures. The reason for this issimple: If a person cannot breathe, he cannot survive.Many factors may cause a person’s airway tobecome fully or partially obstructed. A very commoncause of obstruction with both adults and children isimproperly chewed food that becomes lodged in theairway (an event commonly referred to as a “cafecoronary”). Additionally, children have a disturbingtendency to swallow foreign objects while at play.Another cause for upper airway obstruction occursduring unconsciousness, when the tongue may fallback and block the pharynx (fig. 4-1). When the upperairway is obstructed, the heart will normally continueto beat until oxygen deficiency becomes acute.Periodic checks of the carotid artery must be made toensure that circulation is being maintained.Partial Airway ObstructionThe signs of partial airway obstruction includeunusual breath sounds, cyanosis, or changes inbreathing pattern. Conscious patients will usuallymake clutching motions toward their neck, even whenthe obstruction does not prevent speech. Encourageconscious patients with apparent partial obstructions4-11Figure 4-1.—Tongue blocking airway.
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