Emergency care for the elderly

Elder Abuse
The types of physical abuse of elders vary from passive neglect to active insults. Some physically abused elderly report having had something thrown at them; some are pushed, grabbed, or shoved; other are slapped, bitten, or kicked.

When a serious situation occurs, call the EMS first (911 in most communities). Do not call your doctor, the hospital, a friend, or neighbors for help before you call the EMS. Calling anyone else first only wastes time. Calling EMS has several advantages:

• many victims should not be moved except by trained personnel.
• the emergency medical technicians (EMIs) who arrive with the ambulance know what to do. In addition, they are in radio contact with hospital physicians.
• care provided by EMIs at the scene and on the way to the hospital can increase a victim’s chances of survival and rate of recovery.
• An EMS ambulance usually can get a victim to the hospital more quickly.

If you have to call the EMS, be ready to give the dispatcher the following information. Speak slowly and clearly.

1. The victim’s location. Give the address, names on intersecting streets, and other landmarks, if possible. This information is the most important you can give. Also, tell the specific location of the victim (e.g. “in the basement”).
2. Your phone number and name. This prevents false calls and allows dispatch center without the enhanced 911 system to call back for additional information, if needed.
3. What happened. State the nature of the emergency (e.g. “My husband fell off the ladder and is not moving”).
4. Number of persons needing help and any special conditions.
5. Victim’s condition (e.g. “My husband’s head is bleeding”) and any first aid you have tried (such as pressing on the site of the bleeding).

Do not hang up the phone unless the dispatcher instructs you to do so. Enhanced 911 systems can track a call, but some communities lack this technology or are still using a seven-digit emergency number. Also, the EMS dispatcher may tell you how to best care for the victim. If you send someone else to call, have the person report back to you so you can be sure the call was made.

Other tips:
Teach children what 911 is for and how and when to call. Refer to “nine-one-one,” not “nine-eleven,” because children may expect to find an 11 on the dial or on the push button.

• Do not hang up without explanation if 911 is called by mistake, or the dispatcher will have to call back to see if you need help.
• If your area code does not have 911 system, add EMS, fire, and police numbers to a list by your phones. During an emergency , you may not have time or presence of mind to find a number in a directory.

How to Call the EMS

To receive emergency assistance of every kind in most communities, you simply phone 911. Check to see if this is true in your community. Emergency telephone numbers are listed on the inside front cover of al telephone directories. Keep these numbers near or on every telephone. Call “O” (the operator) if you do not know the emergency number. A community 911 number has several benefits:

• There is only one number to remember.
• Calls are received by specially trained persons.
• Response time is reduced.

Generally you will know when an emergency occurs. You can tell by the type of injuries or by how the victim looks that it’s time to call for help. Call EMS whenever a situation seems more than you can handle. In the following instances, calling EMS is definitely the right thing to do:

• Severe bleeding
• Drowning
• Electrocution
• Possible heart attack
• Choking
• Altered mental status
• Poisoning
• Attempted suicide
• Critical burns
• Paralysis
• Spine injury
• Imminent childbirth
• Some seizure cases (most do not require EMS assistance)

Types of Seizures*
The various types of seizures are classified and defined according to their characteristics as noted by a physician and the results of an electroencephalogram (EEG) test (sometimes called a brain wave test). Generalized seizures cause the person to lose consciousness while convulsive movement occurs on both sides of the body. Generalized major seizures, called grand mal seizures, are the ones most commonly see in elderly people.
Fist Aid includes calling the police and the EMS (Emergency Medical Service), if warranted, and treating any injuries.*

Because seizures can be associated with so many different disorders, the physician’s evaluation is comprehensive. A complete medical and neurological examination can sometimes show sudden illnesses that precipitated the seizure.*

There is also an enhanced Web publication that includes:

• Links that are continually updated by the author and monitored by the publisher
• Links to pages that can be printed out and referred to frequently, such as CPR skills
• Significant resource sites to bookmark
• Valuable activities that highlight specific first aid and CPR topics

SOURCE: FIRST AID and CPR - Third Edition
CONTACT:
Jones and Bartlett Publishers
40 Tall Pine Drive
Sudbury, MA 01776
Tel: 800 832-0034
Tel: 978 443-5000
Email: nsc@jbpub.com

*Excerpted from The American Geriatrics Society’s Complete Guide To Aging and Health – Mark E. Williams, M.D. - First Edictyion1995