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. POISONS/DRUG ABUSE/HAZARDOUS MATERIALS 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.” HEART CONDITIONS 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 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. 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 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 patient’s 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 includes  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 treatment facility. 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 4-68