bubbles at the nose and mouth and distinctive rattling
sounds (known as rales) in the chest. Increased blood
pressure may also cause body fluids to pool in the
Emergency treatment for congestive heart failure
is essentially the same as that for acute myocardial
infarction. Do not start CPR unless the patients heart
function ceases. If an intravenous line is started, it
should be maintained at the slowest rate possible to
keep the vein open since an increase in the circulatory
volume will make the condition worse. Immediately
transport the patient to a medical treatment facility.
Convulsions, or seizures, are a startling and often
f r i g h t e n i n g p h e n o m e n o n .
C o n v u l s i o n s a r e
characterized by severe and uncontrolled muscle
spasms or muscle rigidity. Convulsive episodes occur
in one to two percent of the general population.
Although epilepsy is the most widely known form
of seizure activity, there are numerous forms of
convulsions that are classified as either central nervous
system (CNS) or non-CNS in origin. It is especially
important to determine the cause in patients who have
no previous seizure history. This determination may
require an extensive medical workup in the hospital.
Since epilepsy is the most widely known form of
seizure activity, this section will highlight epileptic
Epilepsy, also known as seizures or fits, is a
condition characterized by an abnormal focus of
activity in the brain that produces severe motor
responses or changes in consciousness. Epilepsy may
result from head trauma, scarred brain tissue, brain
tumors, cerebral arterial occlusion, fever, or a number
of other factors. Fortunately, epilepsy can often be
controlled by medications.
Grand mal seizure is the more serious type of
epilepsy. Grand mal seizure may bebut is not
alwayspreceded by an aura. The victim soon comes
to recognize these auras, which allows him time to lie
down and prepare for the seizures onset. A burst of
nerve impulses from the brain causes unconsciousness
and generalized muscular contractions, often with loss
of bladder and bowel control. The primary dangers in a
grand mal seizure are tongue biting and injuries
resulting from falls. A period of sleep or mental
confusion follows this type of seizure. When full
consciousness returns, the victim will have little or no
recollection of the attack.
Petit mal seizure is of short duration and is
characterized by an altered state of awareness or partial
loss of consciousness, and localized muscular
contractions. The patient has no warning of the
seizures onset and little or no memory of the attack
after it is over.
First aid treatment for both types of epileptic
seizure consists of protecting the victim from
self-injury. Additional methods of seizure control may
be employed under a medical officers supervision. In
all cases, be prepared to provide suction to the victim
since the risk of aspiration is significant. Transport the
patient to a medical treatment facility once the seizure
Drowning is a suffocating condition in a water
Water seldom enters the lungs in
appreciable quantities because, upon contact with
fluid, laryngeal spasms occur, and these spasms seal
the airway from the mouth and nose passages. To
avoid serious damage from the resulting hypoxia,
quickly bring the victim to the surface and
immediatelyeven before the victim is pulled to
shorestart artificial ventilation. Do not interrupt
artificial ventilation until the rescuer and the victim are
ashore. Once on dry ground, quickly administer an
abdominal thrust (Heimlich maneuver) to empty the
lungs, and then immediately restart the ventilation
until spontaneous breathing returns.
enrichment is desirable if a mask is available.
Remember that an apparently lifeless person who
has been immersed in cold water for a long period of
time may be revived if artificial ventilation is started
A psychiatric emergency is defined as a sudden
onset of behavioral or emotional responses that, if not
responded to, will result in a life-threatening situation.
Probably the most common psychiatric emergency is
the suicide attempt. A suicide attempt may range from
verbal threats and suicidal gestures to a successful
suicide. Always assume that a suicide threat is real; do
not leave the patient alone. In all cases, the prime
consideration for a Hospital Corpsman is to keep
patients from inflicting harm to themselves and to get
them under the care of a trained psychiatric
professional. When dealing with suicidal gestures or
attempts, treat any self-inflicted wounds appropriately.