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GOOD SAMARITAN INFORMATION - BLOOD OR BODY FLUID EXPOSURE

Blood and body fluids from one person may be capable of transmitting certain diseases to another person. Some of the diseases that are of special concern include human immunodeficiency virus (HIV) infection (which causes AIDS), hepatitis and tetanus.

A person may become exposed to disease if they get blood or body fluids  into their eyes, mouth, nose or other mucous membrane, on non-intact skin such as rashes or cuts, or exposed to them by puncture of the skin with a needle or other contaminated object. If you believe that you have been exposed to someone else’s blood or body fluids, it is important for you to be promptly evaluated by a doctor. Most exposures will not cause an infection, but it is important to determine the risk of your exposure. There are medications available that can reduce the likelihood that you will become infected if your exposure was significant. The sooner you are evaluated and treated, the more likely a doctor will be able to prevent or reduce the risk of your exposure. If there is a chance that you have been exposed, you should take the following actions immediately:

Actions:

1. If you were exposed in your mouth, eyes, nose or other mucous membrane, flush the areas with lots of water as soon as possible. If you were exposed through non-intact skin, wash the area with soap and water as soon as possible.
2. Seek medical attention at a hospital emergency room as soon as possible. Inform the doctor treating you that the patient you were exposed to was transported by ambulance. You will be given instructions for how to follow-up on your test results and the results of the source patient with your own doctor. It will be helpful to the hospital if you know which vaccines (such as tetanus and Hepatitis B) you have had.

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WOUNDS AND LACERATIONS

Lacerations are cuts that leave a smooth or jagged wound in the skin. They may affect the top layer of skin, tissues below the skin, muscles, nerves and blood vessels. Good wound care and sutures (stitches), if required, will improve the healing of your wound, help prevent an infection, and may prevent permanent difficulty or inability to use an arm or leg normally. You have decided not to be transported by ambulance to a medical facility following a laceration or wound. Please contact your doctor if any of the following signs or symptoms develop:

ü       Increased pain, Swelling, numbness or tingling,, Redness or red streaks around the wound, Pus or drainage coming from the wound, Fever (101° F. or higher) or chills • Bleeding that cannot be controlled

Actions:

1.        If the paramedics/EMTs have recommended, or you feel you should be evaluated for possible stitches, you should seek medical attention as soon as possible, and within 6 hours of the injury.

2.        Clean the wound and keep it clean. Wash the wound with soap and water 2 - 3 times a day. Do not soak.

3.        After washing, you may apply a small amount of an antibiotic ointment such as bacitracin or (available without prescription). Do not apply any ointment if you will be seeking immediate medical attention.

4.        Cover the wound with gauze dressing. Band-Aids make the skin wet and increase the chance of infection.

5.        Ibuprofen (such as Advil) or acetaminophen (such as Tylenol), if you are not allergic, may be taken as directed for pain or discomfort. Avoid taking aspirin (check with your doctor if you are currently taking aspirin on a regular basis).

6.        Contact your doctor if it has been more than five years since your last tetanus shot or if you are uncertain when your last shot was. If needed, a tetanus shot should be given within 24 hours.

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FAINTING AND DIZZINESS

You have had a period of unconsciousness or near-unconsciousness. Fainting or dizziness episodes have a number of causes, some of which can be serious. It is very difficult to determine the exact cause without further testing or evaluation by a physician.

You have decided not to be transported by ambulance to a medical facility following an episode of fainting or dizziness. Please contact your doctor to notify him/her of this episode and if any of the following signs or symptoms develop:

ü       Chest or abdominal pain, Recurrent episodes, Bleeding anywhere, Headache or neck pain, Palpitations, Problems with your vision, Nausea and vomiting, Numbness or tingling, Problems walking,  Weakness, Slow heart rate (less than 60 beats/min, Fast heart rate (greater than 100 beats/min).

Actions:

1.        If you have not been getting enough food or fluids, eat a good meal and drink plenty of non-alcoholic fluids.

2.        If you feel overheated, move to a cool place with fans or air-conditioning.

3.        Lay down until you feel better. If you feel faint, elevating your legs may help.

4.        Stay with a competent caregiver until your symptoms go away.

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HEAD INJURY

Head injuries can be potentially dangerous if bleeding or swelling results inside the head. You have decided not to be transported by ambulance to a medical facility following a possible head injury. Please contact your doctor if any of the following signs or symptoms develop:

ü       Drowsiness or increased irritability, Nausea and vomiting, Persistent or bad headache , Vision problems, Unequal pupils  Speech or hearing difficulty, Weakness or loss of feeling in arms or legs, Difficulty walking, Bleeding or discharge from the nose or ears, Twitching or convulsions, Neck or back pain, Confusion, loss of memory, or loss of consciousness

Actions:

1.        Awaken the patient every hour for the next 24 hours to make sure he/she can be easily aroused and can

2.        answer simple questions (name, birthdate, etc.).

3.        Do not take any sedatives, alcohol, or pain medications without checking with a doctor. Check with your

4.        doctor if you are taking aspirin on a regular basis.

5.        Apply cold to any tender/painful area on the head.

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FOREIGN OBJECT INGESTION/CHOKING

Sudden airway obstruction in an adult usually occurs during a meal. In a child, it generally occurs during mealtime or at play (choking on small objects placed into the mouth). Ingested objects/food can be dangerous if they block the passage of air into the lungs. Some ingested items that originally cause someone to choke are cleared by coughing, and then swallowed or spit out. Treatment depends on the size and location of the swallowed object. An object that gets stuck in the esophagus (food tube) must be removed as soon as possible. Once the object is in the stomach, it probably will pass through the body by itself without causing problems. This usually takes several days but may take 2 or 3 weeks. Pointed objects such as needles, nails, and toothpicks are more dangerous than round or smooth ones. Objects may be stuck in the lungs without causing current problems breathing. You have decided not to be transported by ambulance to a medical facility following a choking episode or the swallowing of a foreign object. Please contact your doctor if any of the following signs or symptoms develop:

ü       Vomiting, gagging, choking, or drooling, You do not see the swallowed object in the stool within a few days, Fever over 100°, Neck or throat pain, or the inability to swallow, Coughing, wheezing, or very noisy breathing,, Abdominal pain, bloody bowel movement, cramping, or bleeding from the rectum

Actions:

1.        If the swallowed object was not removed, you should check the stools until the object has passed. Putting the stool in a strainer and running water over it may make the job easier.

2.        There is no need to change your diet while waiting for the object to pass. Do not take any medicine such as laxatives to make the object pass sooner.

3.        Keep small objects, including coins, out of the reach of infants and young children.

4.        Contact an ambulance again by calling 911 if your condition worsens.

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MOTOR VEHICLE CRASH

Accidents involving motor vehicles can cause injuries that are sometimes not apparent at the time of the accident. Some of these injuries can be serious and are difficult to detect unless there is further testing and evaluation by a physician. These injuries include, but are not limited to head, neck, back, chest or abdominal injuries. Lacerations (cuts) and bruising are common and may require further care and evaluation. Good wound care and sutures (stitches), if required, will improve the healing of your wound, help prevent an infection, and may prevent permanent difficulty or inability to use an arm or leg normally. You have decided not to be transported by ambulance to a medical facility following a motor vehicle accident. Please contact your doctor if any of the following signs or symptoms develop:

ü       Increased pain to any body area, Swelling, numbness or tingling, Drowsiness or increased irritability, Nausea and vomiting Persistent or bad headache, Vision problems, Unequal pupils, Speech or hearing difficulty, Weakness or loss of feeling in arms or legs, Difficulty walking, Bleeding or discharge from the nose or ears, Twitching or convulsions, Neck or back pain, Confusion, loss of memory, or loss of consciousness.

Actions:

1.        Awaken the patient every hour for the next 24 hours to make sure he/she can be easily aroused and can answer simple questions (name, birth date, etc.).

2.        Do not take any sedatives, alcohol, or pain medications without checking with a doctor. Check with your doctor if you are taking aspirin on a regular basis.

3.        Apply cold to any tender/painful area.

4.        If the paramedics/EMTs have recommended, or you feel you should be evaluated for possible stitches, you should seek medical attention as soon as possible, and within 6 hours of the injury.

5.        Clean the wound and keep it clean. Wash the wound with soap and water 2 - 3 times a day. Do not soak.

6.        After washing, you may apply a small amount of an antibiotic ointment such as Bacitracin (available without prescription). Do not apply any ointment if you will be seeking immediate medical attention.

7.        Cover the wound with gauze dressing. Band-Aids make the skin wet and increase the chance of infection.

8.        Ibuprofen (such as Advil) or acetaminophen (such as Tylenol), if you are not allergic, may be taken as directed for pain or discomfort. Avoid taking aspirin (check with your doctor if you are currently taking aspirin on a regular basis).

9.        Contact your doctor if it has been more than five years since your last tetanus shot or if you are uncertain when your last shot was. If needed, a tetanus shot should be given within 24 hours of the injury.

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SPRAINS AND CONTUSIONS

Sprains are painful injuries to joints that result from partial or complete tearing of ligaments. Contusions are collections of blood under the skin caused by damage to blood vessels. Fractures (broken bones) can present in similar ways and cannot be diagnosed without an x-ray. Signs and symptoms of sprains (and fractures) include pain or tenderness, swelling, bruising, and inability to use the joint.

You have decided not to be transported by ambulance to a medical facility following a possible sprain or contusion. Please contact your doctor if any of the following signs or symptoms develop:

ü       Bluish discoloration, Coldness to the injured area, Numbness or loss of feeling, Excessive pain or swelling, Continued inability to use or move the joint.

Actions:

1.        For the first 24 hours, keep the injured joint elevated on pillows while lying down.

2.        For the first 24 hours, apply cold every 2 hours for 20 - 30 minutes.

3.        Ibuprofen (such as Advil) or acetaminophen (such as Tylenol) may be taken as directed for pain or discomfort. Avoid taking aspirin (check with your doctor if you are currently taking aspirin on a regular basis).

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LOW BLOOD SUGAR

You have had a period of unconsciousness or altered level of consciousness that may have been caused by a low level of sugar and may be related to your diagnosed condition of diabetes. The paramedics or EMTs from the ambulance service may have administered medication or sugar to improve your condition, but this improvement is often only temporary. It is important to have regular check-ups so that your doctor can help you control your blood sugar level, which can be controlled with medication and proper diet. Staying as healthy as possible can also help keep your blood sugar in the normal range. You have decided not to be transported by ambulance to a medical facility following a probable low blood sugar episode. Please contact your doctor to notify him/her of this episode and if any of the following signs or symptoms develop:

ü       If the frequency or severity of your low blood sugar episodes increases.

Actions:

1.        Take your medicine exactly as prescribed and eat right away. The sugar/medicine you were given is short acting.

2.        Wear a medic alert tag at all times.

3.        Have a responsible person wake you every 2 hours for the next 12 hours.

4.        Check your blood sugar again in 1 – 2 hours to make sure it is okay and then test your urine or blood sugar as directed.

5.        If you feel like your blood sugar is getting low, test it and eat as directed.

6.        Stay with a competent caregiver, and teach family members and others close by how to help you when your blood sugar becomes too low.

7.        Discuss with your doctor whether there should be any restrictions on your job or activities.

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Contact an ambulance again by calling 911 if your condition worsens.