By Richard I., M.D. Shader
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Hearing or Visual Loss Acute hearing loss can result from simple causes, such as cerumen impaction, or from serious disorders. Visual loss can be from neurologic or ophthalmic causes. , retinal detachment, acute glaucoma). H. Acute Neurologic Signs and Headache The American Heart Association and the National Institute of Neurological Disorders emphasize the following signs of stroke in their public education programs: • Alteration in consciousness; • Intense headache or any headache associated with a decreased level of consciousness, neurologic deficit, and severe neck or facial pain; • Aphasia (incoherent speech or difficulty understanding speech); • Facial weakness or asymmetry; • Incoordination, weakness, paralysis, or sensory loss in one or more limbs; • Visual loss; • Dysarthria (slurred or indistinct speech); • Intense vertigo, double vision, unilateral hearing loss, nausea, vomiting, photophobia, or phonophobia.
The appeal of synthetic glues is great, but their application is limited to small nongaping lacerations that are not near the eyes and that are not subject to skin tension. Most lacerations will require suturing or stapling. After suturing, instructions should be provided for the timing of suture removal. Staples require a separate instrument, a staple remover; if the institution does not have these in stock, the patient may have to be returned to the emergency facility for staple removal. Distal limb injuries, such as those involving the arms, hands, legs, or feet, require emergency evaluation and possibly radiography if attempted function causes pain.
Cardiac Arrest The acute management of a cardiac arrest is the same whether it occurs in the home, community, or hospital setting. The American Heart Association has delineated the following response steps as the Chain of Survival: 1. Activate the EMS system (call 911). 2. Begin cardiopulmonary resuscitation (CPR). 3. Assess cardiac rhythm and defibrillate. The best survival after a cardiac arrest is seen in the group of patients with a witnessed arrest, bystander CPR, and immediate defibrillation.
