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Think Fast – Who in your office knows what to do in a medical emergency?

1.27.2017
Just after noon one day two decades ago, I walked into my boss’s office and found him sitting at his desk, slumped to his left while attempting to pick up the phone. He was having difficulty using his left arm and I asked if he was alright. He said he was fine. I noticed that he was slurring his words and asked him again if he was ok. He told me he’d just gone out to lunch with a client and had smoked pot, laughing it off.

I knew he would never do that. He was in his 60’s, was in good shape, ate healthily, and was an avid runner and tennis player. I’m not sure why, but my first instinct was to call his wife, which I did immediately. When I described his behavior, she told me to call 911. An ambulance team showed up within 15 minutes. I realized later that I never knew what a stroke looked like until that moment. 

It was a blur. The ambulance came, whisked him away, and over the next few days, I kept in constant touch with his wife and eventually went to the hospital, once visitors were allowed. After all, I’d worked for him for nearly nine years and had become very close to him and his family. I watched his kids go from high school to college, marry, and have children.

The good news is that he made a full recovery. The doctor said that if I hadn’t called 911 as quickly as I did, he likely would have died. From his hospital bed, my boss thanked me profusely and would later tell people I saved his life, something I was always a little embarrassed about. I felt it was his wife telling me to call 911 that saved him. I was just the facilitator.

Alison Finlay, Executive Assistant at The Alexander Group
Recalling this experience, I began to wonder about sudden health incidents in the workplace and whether employees would know what to do in an emergency. The first thing that I discovered is that “an estimated 70% of Americans either don’t know or have forgotten how to administer” lifesaving measures. An internal poll of The Alexander Group’s Houston location revealed that only one other coworker and I have CPR training, and only one has performed the Heimlich maneuver. I received my CPR certification two years ago and I must admit that I’m not certain I remember the details, so researching this material made me realize the importance of refresher courses.



I decided it might be helpful to write about health conditions that would require immediate action by coworkers while waiting for an ambulance.

The following are the symptoms of a stroke, heart attack, seizure, choking, and diabetic shock and what you should do:

Stroke (source)

1. Weakness, numbness or paralysis in the face, arm or leg on either or both sides of the body.  4. Loss of vision, sudden blurred or decreased vision in one or both eyes.
2. Difficulty speaking or understanding. 5. A headache - usually sever and abrupt onset, or a change in the pattern of headaches
3. Dizziness, loss of balance or unexplained fall. 6. Difficulty swallowing.

What to do: 
  • Call 911
  • If the person is unconscious, lay them down on their side with their head raised and supported.
  • Do not give them anything to eat or drink. Loosen restrictive clothing that could cause breathing difficulties. If weakness is obvious in any limb, support it and avoid pulling on it when moving the person.
  • If they are unconscious, check their breathing and pulse and put them on their side. If they do not have a pulse or are not breathing, start CPR right away.
  • If you are unsure how to perform CPR, the emergency dispatcher can give instructions over the phone. 
 
   
   


















Heart Attack (source)

1. Chest Pain 6. Indigestion
2. Discomfort in upper body 7. Fatigue
3. Shortness of breath 8. Dizziness
4. Cold sweat and anxiety 9. Flu-like symptoms
5. Nausea 10. Racing heart








What to do: 

  • Call 911.
  •  Chew and swallow an aspirin, unless the person is allergic.
  • Give nitroglycerin, if prescribed and available.
  •  If an automated external defibrillator (AED) is available and the person is unconscious, begin CPR while the device is retrieved and set up.
  • Begin CPR if the person is unconscious. If you haven't received CPR training, doctors recommend skipping mouth-to-mouth rescue breathing and performing only chest compressions (about 100 per minute).
 
 



Seizures (source)

1. A sudden feeling of fear or anxiousness 5. Jerky movement of the arms or legs that may cause you to drop things
2. Feeling of being sick to your stomach 6. Out of body sensation
3. Dizziness 7. Headache
4. Change in vision  









What to do: 

  • Stay calm.
  • Move away furniture or other objects that might injure the person during the seizure.
  • Call 911 if the person is having her first seizure or is pregnant.
  • If the person is on the ground, try to position them on their side.
  • Seizures usually do not last longer than 60 to 120 seconds. If the seizure lasts longer than 3 minutes, call 911.
  • Do not put anything, including your fingers, into the person's mouth.
  • If the person is standing, prevent them from falling.
  • Do not try to hold the person down. 

















While there's no way to stop a seizure once it's begun, you can provide help. Additional information can be found at the American Academy of Neurology.

Choking (source)

What to do: 

Many experts recommend calling 911 immediately and to then proceed: 

Mild Choking:   
  • Encourage the person to keep coughing to try and clear the blockage. If coughing doesn't work, start back blows.
  • Ask the person to try to spit out the object if it's in their mouth.
  • Don't put your fingers in their mouth to help them as they may bite you accidentally.
 
Severe Choking:  
  • Stand behind the person and slightly to one side. Support their chest with one hand. Lean the person forward so that the object will come out of their mouth.
  • Give up to five sharp blows between the person's shoulder blades with the heel of your hand. 
  • Check if the blockage has cleared.
  • If not, give up to five abdominal thrusts.

Diabetic Shock (source)
1. Sweating 5. Aggression
3. Dizziness 6. Mental confusion
3. Shakiness 7. Unconsciousness
4. Rapid heartbeat 8. Seizures and coma in extreme cases






What to do: 
  • Have the person consume glucose tablets or gel, an 8-ounce glass of milk, 4 ounces of fruit juice or non-diet soda, a handful of raisins, or a tablespoon of sugar or honey.
  • In the event that mental confusion, seizure or unconsciousness has occurred, call 911. 
     
 
  • While awaiting an ambulance, apply a small amount of honey or sugar to the gums, or glucagon gel to the inside of the cheek. 















In conclusion, the FIRST thing you should do in any medical emergency is to call 911. In an office environment, one person should make the call while another starts medical assistance. Although the information above is invaluable, I hope no one ever has the need to use it. Last but not least, it is important that in an office or department to discuss responses to health emergencies and know the number of the nearest hospital.




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