Acute diseases and

life-threatening conditions
Assistant Professor Kenan Karavdić
 Fainting - Syncope
• A short-term loss of consciousness
-cardiovascular causes
The primary disorder of reduced cardiac volume
displaced by the blood which secondarily
leads to decreased blood flow through brain
arteries, which is a direct cause of the loss of
consciousness.
 Fainting - Syncope
• Stokes - Adams syndrome is caused by transient arrhythmias
(heart rhythm disturbances), mostly bradycardia (slowing of
heart rate) due to complete atrio-ventricular block
implementation.
- loses consciousness
- falls to the ground without prior notice,
- except for the possible palpitations (irregular heartbeat).
- pallor of the skin and often slowed pulse.
- After a few seconds the pulse gets up speed, the skin
reddened and consciousness is recovered.
- The attack can be repeated several times a day and in any
position. Characteristic for these types of attacks are due to
violations of these patients falls to the ground.
 Fainting - Syncope
• Other cardiac causes of syncope include:
-interference displaced blood flow - in an effort
syncope (aortic stenosis)
-reduced filling the heart chambers
-Cardiac tamponade,
-barriers venous confluence of blood to the
heart (tricuspid stenosis)
 Fainting - Syncope
• non cardiovascular causes
• Vasovagal syncope is typically triggered by
unpleasant physical or mental stimuli (fear, the
pain, the sight of blood) and prolonged standing
in a closed, stuffy room. The mechanism of the
reflex slowing of the heart rate and dilation of
blood vessels in the periphery. Start of vasovagal
syncope is gradual and often accompanied by
nausea, pallor of the skin, cold sweating and
blurred vision.
 Fainting - Syncope
• Orthostatic syncope - a sudden loss of consciousness when
standing up from a sitting or lying position more often. It
occurs due to inadequate response for vasomotor reflexes
to increase blood pressure.
• Syncope during seizures (epileptic attacks) has a sudden
onset and is associated with muscle cramps, bite tongue,
incontinence of urine and stool, and amnesia of the event
after the attack.
• Syncope caused by metabolic disorders: hypoglycemia is
the most common cause of syncope in diabetics, especially
those who are treated with insulin. Accompanied by a
tremor, a sense of hunger and sweating.
 Fainting - Syncope
• Syncope during cough - coughing spells are
sometimes cause unconsciousness.
• Compression of hypersensitive carotid sinus
can sometimes result in syncope (sudden turn
of the head, a tight collar or pressure shaving).
 Fainting - Syncope
• First aid
- set up in the lying position interruption syncope
- The effect is faster if the patient elevate the leg.
- Too early withdrawal from the horizontal position
can again cause syncope.
- Treatment of the primary causes of fainting in the
domain of specialists.
- In general, the prognosis of syncope in young
adults without cardiovascular events is good.
 Heart attack (myocardial infarction)

• "Too many people die from

heart which is too good to die,"
American heart surgeon Beck.
• A large number of people from a heart attack die just
because of the failure to recognize the first symptoms of the
disease, and ignorance of the importance of first aid.
 Heart attack (myocardial infarction)
• Causes of myocardial infarction (MI) have a
clot or spasm of one of the arteries that
supply blood to the heart muscle (coronary
arteries).
• Damaged tissue tend to lose the ability to
contraction of that part of the heart muscle.
 Heart attack (myocardial infarction)

• The first hour is critical

• Heart attack develops a longer time, usually for four to six hours.
• During this period, every minute is precious, especially because the
greatest damage occurs in the first hour, and waiting only increases
the extent of damage to the heart muscle cells.
• The re-establishment of blood flow through a blocked coronary
artery in the first hour of the appearance of the first signs of a heart
attack can be crucial to survival.
• Statistics show that more than 50% of people who suffer a heart
attack waiting more than two hours before they seek medical care.
• Timely character recognition stroke is extremely important to be
able to react in time.
 Heart attack (myocardial infarction)
Simptoms
• chest pain beneath the breastbone
• back pain
• abdominal pain
• pain in the chest, arms and shoulders, neck,
jaw and teeth
• angina-like pain that does not stop stationary
• or by taking nitroglycerin
Heart attack (myocardial infarction) –
First aid
• The re-establishment of blood flow in the first
hour after the appearance of the first signs may
be essential for survival
• The presence of a heart attack symptoms is most
important to remain calm and the time for action:
• If a patient with pain in the chest suddenly
dropped to the floor and thereby loses
consciousness immediately be determined ifshe
was breathing and whether his heart work.
Heart attack (myocardial infarction) –
First aid
-Ifthe patient is unconscious he needs
to ensure patency of the airways
- put him in the recovery position and
methods of outpatient medical
services (procedure Basic life support
- BLS) start CPR.
- Call emergency medical care.
Heart attack (myocardial infarction) –
First aid
• If the patient is not breathing and his heart does
not work, it should immediately begin CPR.
• Immediately call an ambulance
• If the patient is unconscious, - urgent call an
ambulance.
-Aspirin prevents blood clotting and so improve the
flow through the narrowed coronary artery,
which can reduce the mortality rate of up to 25%.
 Cerebrovascular accident (stroke)
• Cerebrovascular accident (CVA) or stroke is an acute or
subacute appearance of neurological symptoms caused
by disorders of arterial circulation of the brain.
• Disruption of circulation leads to an insufficient supply
of certain parts of the brain of oxygen and nutrients.
• The lack of oxygen and nutrients leads to damage and
atrophy of nerve cells in the brain that supplies the
damaged blood vessel resulting in damage to those
functions which manage these brain.
Cerebrovascular accident (stroke)
• CVI may result from: narrowing (stenosis) or
obstruction (occlusion) of blood vessels with
consequent interruption of circulation and the
formation of a heart attack in the area behind
the blocked or narrowed blood vessel
thrombosis - the formation of thrombus
within the blood vessels of the brain embolism
- from areas of the systemic circulation of the
heart, major blood vessels.
 Cerebrovascular accident (stroke)
simptoms
• Numbness, weakness or paralysis of the face, arm or leg, especially
if the affected one side of the body,
• Disorders of speech: difficult and incomprehensible uttering a word,
a complete inability to pronounce words and / or heavy, or a
complete misunderstanding of the speech of another person,
• Sudden blurred or loss of vision, particularly in one eye or half of
the visual field,
• Sudden severe headache followed by vomiting without apparent
cause,
• Loss of balance and / or coordination associated with other
symptoms,
• Dizziness or vertigo, uncertainty and drift the fly, sudden drops
associated with other symptoms.
 Cerebrovascular accident (stroke)
• Transportation to the first medical institution
in the event of loss of consciousness and life-
threatening application of the ABCD protocol
 (NATO) side position
• side position of the patient unconscious and
without spinal injury.
 (NATO) side position
The procedure is carried out as follows:
-the patient lies on his back,
- right leg bent at the knee,
- and the left arm at the elbow.
- The right arm is bent at the elbow.
- By accepting the clothing in the hip and shoulder
patients over the left leg kicked in the knee switch on
its side.
- The head gently tosses her back with face down and
bent right arm is placed below the face fixing head in
that position
 Epilepsy
• It is manifested by periodic, transient seizures
that occur suddenly, are soon over and
suddenly stop.
• Seizures are (no matter which kind) always
caused by extreme live transmission of stimuli
in the brain's nerve cells
 Epilepsy
• tonic phase with generalized contracture
-Seizure is a sudden, abrupt and total cessation of
consciousness.
-The patient falls to the ground.
-Before the fall can be heard a cry, which is due to the
simultaneous spasm of the vocal cords and respiratory
muscles and squeezing out the current of air in the
lungs through the narrowed opening.
-The fall to the ground is due to sudden heavy muscle
body
-This muscle tension takes a minute or two,
 Epilepsy
• clonic phase
-After this general spasm begins relaxation of
certain muscle groups, which causes twitching
limbs flailing.
-Twitching procedures and tongue as well as on
their movements displaces spit through
clenched teeth in the form of foam that may
be bloody. In most cases, in fact, the tongue is
during the attack bitten
 Epilepsy
• should be protected from injury, after the
attack to turn it on its side to avoid
asphyxiation by tongue.
• From the mouth should be removed
dentures,
• if attacks repeat more than twice or the
patient is unconscious for a long time, after
the attack patients referred to the hospital.
 HYPERGLYCEMIA
• Glucose (sugar) in the body is used as energy
for growth and life of cells in all parts of the
body.
• The blood is normally at a concentration of
between 3 and 6 mmol / L.
 HYPERGLYCEMIA
-dry mouth and thirst, frequent urination,
fatigue, blurred vision, itchy skin mucosa,
facial flushing. If blood glucose levels are still
rising feels the smell of acetone in breath,
heartbeat has slowed, breathing deeply and
rapidly, there is a disturbance of
consciousness to coma
 HYPERGLYCEMIA-first aid
• mild hyperglycemia, without ketones or with a
large amount of glucose in urine: should drink a
greater amount (1-2 L) of liquid (tea, mineral
water or pure water), in the next meal reduce
level of carbohydrate
• severe hyperglycemia, there are also ketones and
glucose in urine: drink a greater amount (2-3 L) of
liquid (tea, mineral water or pure water), increase
the dose to be taken (increasing the number of
tablets or add 4-6 units rapid-acting insulin), take
2 tablets of baking soda with 1 liter of tea
 HYPOGLYCEMIA
• Signs of hypoglycemia when blood glucose levels
below 3 mg / dL.
• If it is possible, to measure blood glucose levels.
If hypoglycemia is mild, eat additional meal of
carbohydrates (one piece of fruit or a glass of
milk or a slice of bread)
• hypoglycemia weight, it is necessary to
immediately take: 2-3 candies, a cube or a spoon
of sugar and eat extra meal of carbohydrates (1-2
slices of bread or fruit or milk).