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Unconscious patients[ edit ] In the unconscious patient, the priority is airway management , to avoid a preventable cause of hypoxia. Common problems with the airway of patient with a seriously reduced level of consciousness involve blockage of the pharynx by the tongue , a foreign body , or vomit. At a basic level, opening of the airway is achieved through manual movement of the head using various techniques , with the most widely taught and used being the "head tilt — chin lift", although other methods such as the "modified jaw thrust " can be used, especially where spinal injury is suspected,  although in some countries, its use is not recommended for lay rescuers for safety reasons. Normal breathing rates are between 12 and 20 breaths per minute,  and if a patient is breathing below the minimum rate, then in current ILCOR basic life support protocols, CPR should be considered, although professional rescuers may have their own protocols to follow, such as artificial respiration. If any of these deviate from normal, this may indicate an underlying problem such as with Cheyne-Stokes respiration Chest deformity and movement - The chest should rise and fall equally on both sides, and should be free of deformity. Clinicians may be able to get a working diagnosis from abnormal movement or shape of the chest in cases such as pneumothorax or haemothorax Listening to external breath sounds a short distance from the patient can reveal dysfunction such as a rattling noise indicative of secretions in the airway or stridor which indicates airway obstruction Checking for surgical emphysema which is air in the subcutaneous layer which is suggestive of a pneumothorax Auscultation and percussion of the chest by using a stethoscope to listen for normal chest sounds or any abnormalities Pulse oximetry may be useful in assessing the amount of oxygen present in the blood, and by inference the effectiveness of the breathing Circulation[ edit ] Once oxygen can be delivered to the lungs by a clear airway and efficient breathing, there needs to be a circulation to deliver it to the rest of the body. In modern protocols for lay persons, this step is omitted as it has been proven that lay rescuers may have difficulty in accurately determining the presence or absence of a pulse, and that, in any case, there is less risk of harm by performing chest compressions on a beating heart than failing to perform them when the heart is not beating. In order to simplify the teaching of this to some groups, especially at a basic first aid level, the C for Circulation is changed for meaning CPR or Compressions. Breathing patients[ edit ] In patients who are breathing, there is the opportunity to undertake further diagnosis and, depending on the skill level of the attending rescuer, a number of assessment options are available, including: Observation of colour and temperature of hands and fingers where cold, blue, pink, pale, or mottled extremities can be indicative of poor circulation Capillary refill is an assessment of the effective working of the capillaries, and involves applying cutaneous pressure to an area of skin to force blood from the area, and counting the time until return of blood. This may stand for different things, depending on what the trainer is trying to teach, and at what level.
Renal and Genitourinary Emergencies. Procedures and Skills.
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