Medical Emergencies at Public Events

Summer is prime festival, fair and carnival season, and for the most part they go off without a hitch.

But ask yourself this question: If there were a medical emergency in a crowd, would you know what to do to help? If you can’t provide direct aid, would you know how to otherwise help or whom to call?

At Lehigh Valley Health Network (LVHN), we’re always prepared for the unexpected. If you are too, then the odds of helping someone – even saving a life – are greater.

Heart attack symptoms vary from person to person, and women can experience different symptoms than men. The bottom line, however, is that if you or others suspect a heart attack, call 911 immediately and get emergency help on the way. Stay on the line with the 911 dispatcher and provide as much information as possible on your location and the condition of the person in need.

The American Red Cross advises:

• Have the person stop what they’re doing and rest in a comfortable position.
• If they’re awake, can understand simple commands, and can chew or swallow and are allowed to have aspirin, assist them to take two to four low-dose (81-mg) aspirin tablets (162 to 324 mg) or one regular-strength (325-mg) aspirin tablet.
• If they have prescribed medication such as nitroglycerin, offer to assist with taking it.
• Loosen tight or uncomfortable clothing.
• Continue checking them as appropriate to determine if additional care is needed.
• Keep person from getting cold or overheated.
• Give care for shock, if necessary.
• Stay with them until EMS arrives.
• Reassure person you will help and that EMS has been called (if appropriate).
• Watch for changes in condition, including breathing and responsiveness, until EMS arrives, and give care as appropriate and trained.
• Be prepared to give CPR or compression-only CPR based on level of training, and use an AED when available if they become unresponsive and are not breathing (cardiac arrest).

Cardiac arrest is not the same as a heart attack, though a heart attack can sometimes progress to cardiac arrest.

Cardiac arrest is when someone’s heart stops beating. In that case, CPR or AED use is needed. You don’t have to know full CPR – hands-only CPR is good too. Check our blog on CPR that includes a hands-only CPR video.

As with a suspected heart attack, call 911 immediately and check for the availability of an AED.

Not every seizure is connected to epilepsy, however. Some seizures can be triggered by other causes such as high fevers, head injuries or other factors.

Most seizures end very quickly – within seconds – but some can last minutes. Seizures can take a number of forms, from subtle behavior only a trained eye would notice to those that affect movement and produce twitching or muscle rigidity, among other symptoms.

How do you help someone having a seizure? The Epilepsy Foundation’s seizure first-aid instructions come down to three S’s – Stay, Safe and Side. The foundation advises:

Stay: Stay with the person having the seizure until that person is awake and alert. Remain calm and remember to time the length of the seizure because that will be important information for a doctor. Stay calm and check for any medical identification.

Safe: Keep the person safe and guide them away from any harm in the immediate area. Keep people away. Don’t attempt to restrain a person experiencing a seizure and don’t put anything in their mouth. A person can’t swallow their tongue, so don’t worry about that.

Side: If the person is not awake and aware, turn them onto their side with their mouth pointing at the ground and keep their airway clear. This allows for easier breathing and keeps saliva from blocking their airway. Loosen any tight clothing around their neck and if possible, place something small and soft under their head.

The Epilepsy Foundation says you should call 911 for a seizure patient IF:

• The seizure lasts more than five minutes.
• The person doesn’t return to their previous state.
• The person is injured, pregnant or sick.
• There are repeated seizures.
• It is a first-time seizure.
• The person had difficulty breathing.
• The seizure occurred in water.

As the person who had the seizure wakes or returns to their prior state, reassure them they’re safe and let them know what happened. Offer to stay with them or call someone who can.

Someone can bleed to death in as little as five minutes in certain situations, especially those injuries involving an artery.

Knowing what to do in a situation involving life-threatening bleeding can save someone’s life.

The first rule is don’t become a victim yourself. Get away. Call for help and take the victim if you can.

All life-threatening bleeding is not treated the same. It depends in large part on the location.

Arms and legs: For massive blood loss coming from the extremities, the first choice is a tourniquet placed 2-3 inches above the wound. Don’t put the tourniquet directly on a joint, such as an elbow or knee, because it could damage the joint. Try to remember to write the time you applied the tourniquet on the limb.

Neck, underarms and groin: A tourniquet wouldn’t work here. The first choice is packing the wound, meaning to fill it with gauze or some other readily available absorbent material. Get down to the source of the bleeding with the packing. Even a clean sock would work in this situation. After packing, apply pressure.

Core body: Vital organs such as the heart and lungs are in this area, so packing may do more harm than good. Cover and apply pressure, and wait for medical professionals to arrive. Some emergency kits may include a chest seal bandage or a bandage containing a clotting agent.

Impaled object: Never try to remove an impaled object because it could cause more severe bleeding and tissue damage. Take bleeding-control measures as appropriate.

Amputation: Apply a tourniquet above the amputation site, even if the bleeding has stopped.

Calling for help: Stay on the phone when you call 911 and provide as much information you can about the victim and your location. You can always put the phone on speaker to get advice and instructions. Staying on the phone with the 911 dispatcher does not delay emergency response.

Find the bleeding: Always check for bleeding. In colder weather, bulky clothing can conceal the source of bleeding. An injured skier or hiker would be a good example.

Lehigh Valley Hospital–Muhlenberg trauma staff offer a Stop the Bleed^® course. Contact LVH–Muhlenberg Trauma Prevention Coordinator Maria Wescoe at Maria.Wescoe@lvhn.org for details. You also can access an online Stop the Bleed course.