and severity of the onset of symptoms, immediateintervention is necessary. The general treatment forsevere anaphylaxis is the subcutaneous injection of0.3 cc of epinephrine and supportive care.The most characteristic and serious symptoms ofan anaphylactic reaction are loss of voice and difficultybreathing. Other typical signs are giant hives,coughing, and wheezing. As the condition progresses,signs and symptoms of shock develop, followed byrespiratory failure. Emergency management consistsof maintaining vital life functions. Summon themedical officer immediately.POISONS/DRUG ABUSE/HAZARDOUSMATERIALSAs a Hospital Corpsman, you could encounterspecial situations that include poisoning, suspecteddrug abuse, or exposure to hazardous materials.Knowledge of these conditionsalong with the abilityto assess and treat themis essential. These situationsare discussed in detail in chapter 5, “Poisoning, DrugAbuse, and Hazardous Material Exposure.”HEART CONDITIONSA number of heart conditions are commonlyreferred to as heart attacks. These conditions includeangina pectoris, acute myocardial infarction, andcongestive heart failure. Together these heartconditions are the cause of at least half a million deathsper year in our country. Heart conditions occur morecommonly in men in the 50-to-60-year age group.Predisposing factors are the lack of physicalconditioning, high blood pressure and bloodcholesterol levels, smoking, diabetes, and a familyhistory of heart disease.Angina PectorisAngina pectoris, also known simply as angina, iscaused by insufficient oxygen being circulated to theheart muscle. This condition results from a spasm ofthe coronary artery, which allows the heart to functionadequately at rest but does not allow enoughoxygen-enriched blood to pass through the heart tosupport sustained exercise. When the body exertsitself, the heart muscle becomes starved for oxygen.The result of this condition is a squeezing, substernalpain that may radiate to the left arm and to the jaw.Angina is differentiated from other forms of heartproblems because the pain results from exertion andsubsides with rest. Many people who suffer fromangina pectoris carry nitroglycerin tablets. If thevictim of a suspected angina attack is carrying a bottleof these pills, place one pill under the tongue. Reliefwill be almost instantaneous. Other first aidprocedures include providing supplemental oxygen,reassurance, comfort, monitoring vital signs, andtransporting the victim to a medical treatment facility.Acute Myocardial InfarctionAcute myocardial infarction results when ac 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 yarteriosclerosis or completely blocked by a clot. Thepain associated with myocardial infarction is similar tothat of angina pectoris but is longer in duration, notrelated to exertion or relieved by nitroglycerin, andleads to death of heart-muscle tissue. Other symptomsare sweating, weakness, and nausea. Additionally,although the patient’s respirations are usually normal,his pulse rate increases and may be irregular, and hisblood pressure falls. The victim may have anoverwhelming feeling of doom. Death may result.First aid for an acute myocardial infarctionincludesreassurance and comfort while placing thevictim in a semi-sitting position;loosening of all clothing;carefully maintaining a log of vital signs, andrecording the history and general observations;continuously monitoring vital signs and beingprepared to start CPR;starting a slow intravenous infusion of 5%dextrose solution in water;administering oxygen; andquickly transporting the victim to a medicaltreatment facility.Congestive Heart FailureA heart suffering from prolonged hypertension,valve disease, or heart disease will try to compensatefor decreased function by increasing the size of the leftventricular pumping chamber and increasing the heartrate. This condition is known as congestive heartfailure. As blood pressure increases, fluid is forced outof the blood vessels and into the lungs, causingpulmonary edema. Pulmonary edema leads to rapidshallow respirations, the appearance of pink frothy4-68
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