In case of heat stroke, what is the recommended first aid measure?

Move to a cooler place and cool the body rapidly

Encourage vigorous physical activity

What should be the approach to exercise in hot weather to prevent heat injury?

Gradually increase intensity and duration, take breaks, and stay hydrated

Engage in intense physical activity

Exercise during the hottest part of the day

Why is it important to be aware of the signs of heat injury during physical activities?

To seek prompt medical attention and prevent serious complications

To impress others with knowledge

To ignore symptoms and push through discomfort

Heat Injury | Quizalize

Food and other form of poisoning - some substances when consumed can be dangerous to the health of human beings and can even cause death. Some substances are called poisons or toxins. Poisons can get into the body by swallowing, inhaling, by injection or via absorption through skin. Management of Food and Other Form of Poisoning • Ensure safety • If possible, find poison consumed • Avoid contact with the poison • Do not give drink or eatables • Do not induce vomiting • Arrange urgent transport to nearest healthcare facility Choking - Foreign body airway obstruction (FBAO) is one of the more common life-threatening emergencies that is seen and can be treated by the lay public. Management of Choking • Encourage to cough • Bend forward and give up to 5 back blows • Give 5 abdominal thrusts if still choking • Call for medical help Wounds are injuries that cause a break in the skin such as cuts, scrapes, or punctures. Management of Wounds • Wash hands or wear gloves if available. • Stop the bleeding by applying gentle pressure with a clean cloth or bandage. • Clean the wound using clean running water to remove dirt. • Apply antiseptic or antibiotic ointment if available. • Cover the wound with a clean bandage or gauze. • Observe for signs of infection such as redness, swelling, pain, or pus. • Seek medical help for deep, large, or heavily bleeding wounds. Hyperventilation is rapid or deep breathing often caused by anxiety, fear, or stress. Management of Hyperventilation • Stay calm and reassure the person. • Encourage slow, deep breathing through the nose and out through the mouth. • Ask the person to sit or lie down in a comfortable position. • Move the person to a quiet and well-ventilated area. • Loosen tight clothing around the neck or chest. • Do not give food or drinks during the episode. • Seek medical help if symptoms persist or the person becomes unconscious. Heat-related conditions include heat cramps, heat exhaustion, and heat stroke caused by exposure to high temperatures. Management of Heat-Related Conditions Move the person to a cool, shaded, or air-conditioned place. Loosen or remove tight clothing. Cool the body by fanning or applying cold compresses. Give cool water to drink if the person is conscious. Let the person rest in a lying position. Seek immediate medical help if there is confusion, fainting, vomiting, or very high body temperature.

1. Flammable materials, like alcohol, should never be dispensed or used near A. an open door. B. an open flame. C. another student. D. a sink. 2. If a laboratory fire erupts, immediately A. notify your instructor. B. run for the fire extinguisher. C. throw water on the fire. D. open the windows. 3. Approved eye protection devices (such as goggles) are worn in the laboratory A. to avoid eye strain. B. to improve your vision. C. only if you don’t have corrective glasses. D. any time chemicals, heat or glassware are used. 4. If you wear contact lenses in the school laboratory, A. take them out before starting the lab. B. you do not have to wear protective goggles. C. advise your science instructor that you wear contact lenses. D. keep the information to yourself. 5. If you do not understand a direction or part of a lab procedure, you should A. figure it out as you do the lab. B. try several methods until something works. C. ask the instructor before proceeding. D. skip it and go on to the next part. 6. After completing an experiment, all chemical wastes should be A. left at your lab station for the next class. B. disposed of according to your instructor’s directions. C. dumped in the sink. D. taken home. 7. If a lab experiment is not completed, you should A. discuss the issue with your instructor. B. sneak in after school and work alone. C. come in during lunch and finish while eating lunch. D. make up some results. 8. You are heating a substance in a test tube. Always point the open end of the tube A. toward yourself. B. toward your lab partner. C. toward another classmate. D. away from all people. Science Laboratory Safety teSt 9. You are heating a piece of glass and now want to pick it up. You should A. use a rag or paper towels. B. pick up the end that looks cooler. C. use tongs. D. pour cold water on it. 10. You have been injured in the laboratory (cut, burn, etc.). First you should A. visit the school nurse after class. B. see a doctor after school. C. tell the science instructor at once. D. apply first aid yourself. 11. When gathering glassware and equipment for an experiment, you should A. read all directions carefully to know what equipment is necessary. B. examine all glassware to check for chips or cracks. C. clean any glassware that appears dirty. D. All of the above. 12. You want to place a piece of glass tubing into a rubber stopper after the tubing has been fire polished and cooled. This is best done by A. lubricating the tubing with water or glycerin. B. using a towel or cotton gloves for protection. C. twisting the tubing and stopper carefully. D. all of the above. 13. Personal eyeglasses provide as much protection as A. a face shield. B. safety glasses. C. splashproof chemical goggles. D. none of the above. 14. Long hair in the laboratory must be A. cut short. B. held away from the experiment with one hand. C. always neatly groomed. D. tied back or kept entirely out of the way with a hair band, hairpins, or other confining device. 15. In a laboratory, the following should not be worn. A. loose clothing. B. dangling jewelry. C. sandals. D. all of the above. 16. The following footwear is best in the laboratory. A. sandals B. open-toed shoes C. closed-toed shoes D. shoes appropriate for the weather3 © 2017 Flinn Scientific, Inc. All Rights Reserved. 17. Horseplay or practical jokes in the laboratory are A. always against the rules. B. okay. C. not dangerous. D. okay if you are working alone. 18. If a piece of equipment is not working properly, stop, turn it off, and tell A. the custodian. B. your lab partner. C. your best friend in the class. D. the science instructor. 19. If an acid is splashed on your skin, wash at once with A. soap. B. oil. C. weak base. D. plenty of water. 20. When you finish working with chemicals, biological specimens, and other lab substances, always A. treat your hands with skin lotion. B. wash your hands thoroughly with soap and water. C. wipe your hands on a towel. D. wipe your hands on your clothes. True—False T F 22. ■ ■ Hot glass looks the same as cold glass. 23. ■ ■ All chemicals in the lab are to be considered dangerous. 24. ■ ■ Return all unused chemicals to their original containers. 25. ■ ■ Work areas should be kept clean and tidy. 26. ■ ■ Pipets are used to measure and dispense small amounts of liquids. You should draw the liquid into the pipet using your mouth. 27. ■ ■ Laboratory work can be started immediately upon entering the laboratory even if the instructor is not yet present. 28. ■ ■ Never remove chemicals or other equipment from the laboratory. T F 29. ■ ■ Chipped or cracked glassware is okay to use. 30. ■ ■ Read all procedures thoroughly before entering the laboratory. 31. ■ ■ All unauthorized experiments are prohibited. 32. ■ ■ You are allowed to enter the chemical preparation/storage area any time you need to get an item. 33. ■ ■ Laboratory aprons should be worn during all lab activities. 34. ■ ■ It’s okay to pick up broken glass with your bare hands as long as the glass is placed in the trash. 35. ■ ■ Never leave a lit burner unattended. 21. Draw a diagram of your science room and label the locations of the following: ■ Fire Blanket ■ Fire Extinguisher(s) ■ Exits ■ Eyewash Station ■ Emergency Shower ■ Closest Fire Alarm Station ■ Waste Disposal Container(s)4 © 2017 Flinn Scientific, Inc. All Rights Reserved. Name: ________________________________________________ Date: ______________________________________________ 1. Flammable materials, like alcohol, should never be dispensed or used near A. an open door. B. an open flame. C. another student. D. a sink. 2. If a laboratory fire erupts, immediately A. notify your instructor. B. run for the fire extinguisher. C. throw water on the fire. D. open the windows. 3. Approved eye protection devices (such as goggles) are worn in the laboratory A. to avoid eye strain. B. to improve your vision. C. only if you don’t have corrective glasses. D. any time chemicals, heat or glassware are used. 4. If you wear contact lenses in the school laboratory, A. take them out before starting the lab. B. you do not have to wear protective goggles. C. advise your science instructor that you wear contact lenses. D. keep the information to yourself. 5. If you do not understand a direction or part of a lab procedure, you should A. figure it out as you do the lab. B. try several methods until something works. C. ask the instructor before proceeding. D. skip it and go on to the next part. 6. After completing an experiment, all chemical wastes should be A. left at your lab station for the next class. B. disposed of according to your instructor’s directions. C. dumped in the sink. D. taken home. 7. If a lab experiment is not completed, you should A. discuss the issue with your instructor. B. sneak in after school and work alone. C. come in during lunch and finish while eating lunch. D. make up some results. 8. You are heating a substance in a test tube. Always point the open end of the tube A. toward yourself. B. toward your lab partner. C. toward another classmate. D. away from all people. Science Laboratory Safety teSt 9. You are heating a piece of glass and now want to pick it up. You should A. use a rag or paper towels. B. pick up the end that looks cooler. C. use tongs. D. pour cold water on it. 10. You have been injured in the laboratory (cut, burn, etc.). First you should A. visit the school nurse after class. B. see a doctor after school. C. tell the science instructor at once. D. apply first aid yourself. 11. When gathering glassware and equipment for an experiment, you should A. read all directions carefully to know what equipment is necessary. B. examine all glassware to check for chips or cracks. C. clean any glassware that appears dirty. D. All of the above. 12. You want to place a piece of glass tubing into a rubber stopper after the tubing has been fire polished and cooled. This is best done by A. lubricating the tubing with water or glycerin. B. using a towel or cotton gloves for protection. C. twisting the tubing and stopper carefully. D. all of the above. 13. Personal eyeglasses provide as much protection as A. a face shield. B. safety glasses. C. splashproof chemical goggles. D. none of the above. 14. Long hair in the laboratory must be A. cut short. B. held away from the experiment with one hand. C. always neatly groomed. D. tied back or kept entirely out of the way with a hair band, hairpins, or other confining device. 15. In a laboratory, the following should not be worn. A. loose clothing. B. dangling jewelry. C. sandals. D. all of the above. 16. The following footwear is best in the laboratory. A. sandals B. open-toed shoes C. closed-toed shoes D. shoes appropriate for the weather5 © 2017 Flinn Scientific, Inc. All Rights Reserved. 17. Horseplay or practical jokes in the laboratory are A. always against the rules. B. okay. C. not dangerous. D. okay if you are working alone. 18. If a piece of equipment is not working properly, stop, turn it off, and tell A. the custodian. B. your lab partner. C. your best friend in the class. D. the science instructor. 19. If an acid is splashed on your skin, wash at once with A. soap. B. oil. C. weak base. D. plenty of water. 20. When you finish working with chemicals, biological specimens, and other lab substances, always A. treat your hands with skin lotion. B. wash your hands thoroughly with soap and water. C. wipe your hands on a towel. D. wipe your hands on your clothes. 21. Draw a diagram of your science room and label the locations of the following: ■ Fire Blanket ■ Fire Extinguisher(s) ■ Exits ■ Eyewash Station ■ Emergency Shower ■ Closest Fire Alarm Station ■ Waste Disposal Container(s) True—False T F 22. ■ ■ Hot glass looks the same as cold glass. 23. ■ ■ All chemicals in the lab are to be considered dangerous. 24. ■ ■ Return all unused chemicals to their original containers. 25. ■ ■ Work areas should be kept clean and tidy. 26. ■ ■ Pipets are used to measure and dispense small amounts of liquids. You should draw the liquid into the pipet using your mouth. 27. ■ ■ Laboratory work can be started immediately upon entering the laboratory even if the instructor is not yet present. 28. ■ ■ Never remove chemicals or other equipment from the laboratory. T F 29. ■ ■ Chipped or cracked glassware is okay to use. 30. ■ ■ Read all procedures thoroughly before entering the laboratory. 31. ■ ■ All unauthorized experiments are prohibited. 32. ■ ■ You are allowed to enter the chemical preparation/storage area any time you need to get an item. 33. ■ ■ Laboratory aprons should be worn during all lab activities. 34. ■ ■ It’s okay to pick up broken glass with your bare hands as long as the glass is placed in the trash. 35. ■ ■ Never leave a lit burner unattended.

[t comes from the GREEK name "Epilepsia" which means "taking hold of or seizing". - It is a disorder characterized by: recurrent seizures. SEIZURES R ectment transient attacks of: R epresent: R esult from: ASSOCIATED WITH: somatic, psychic, or, autonomic clinical featmes. clinical features of abnormally hyperexcitable cortical neurons. paroxvsmal and excessive electrical neuronal discharges. EEG changes & may be disturbance of consciousness. same causes of convulsions 1. Idiopathic epile~ • It is the commonest cause. no cause can be detected ( 65 % ) • It may be associated with positive family history in some cases. • It starts in the l st & 2nd decades in the form of: -- Grand ma! epilepsy. Petit mal epilepsy. Myoclonic epilepsy. Atonic seizures. 2. Secondary epilepsy A. Local causes in the brain: l. Congenital: 2. Traumatic: cerebral palsy. a cause can be detected cerebral contusion or laceration. 3. Inflammatory: 4. Neoplastic: 5. Degenerative: 6. Vascular: encephalitis, brain tumours. mening1t1s, presenile dementia. brain abscess. stroke (especially hemon-hagic), hypertensive encephalopathy. B. General causes with secondary effects on the brain: I. Toxic: 2. Iatrogenic: 3. Metabolic: 4. Endocrinal: 5. Organ failure: 6. Heart disease: 7. Nutritional: - Alcohol, cocaine, lead. - Lidocaine, INH. - j glucose & ! glucose. - Hypoparathyroidism. - Hepatic failme. - Adam's Stoke's attacks. - Pellagra. - Botulism, tetanus. - Ambilhar, Amphetamine, Aminophylline. - j Ca & ! Ca. - Hype1thyroid crisis. - Renal failure. - Fallot's tetralogy. - j Na & ! Na. - Vitamin B6 deficiency. 8. Physical: 9. HYSTERICAL. - High fevers. - Heat stroke. 136 137 CLINICAL PICTURE 1. GENERALISED SEIZURES " Excessive electrical discharges from cortical neurons in BOTH hemispheres simultaneously " I. II. 1. Grand Mal Epile~: 1. Pre-ictal stage "attacks of tonic-clonic convulsions " (aura) It is a warning sign of a coming attack. It may be: • Somatic: • Psychic: • Autonomic: 2. Ictal stage Myoclonus, Hallucinations. Tachycardia, (seizure) Sudden loss of consciousness: Parasthesias. Sweating. for seconds to minutes. -- Tonic phase (few seconds) o The UL & LL: o o o o The HEAD: The JAWS: CYANOSIS: are extended. is retracted to one side & the eye balls rolled up. are firmly clenched, with biting of the TONGUE. due to impaired respiration. There may be incontinence of urine. Clonic phase (few minutes) o The UL & LL: o The HEAD: 3. Post-ictal stage - It may be: • Somatic: • Psychic: • Autonomic: Drug of choice: contract & relax repeatedly & rapidly. jerks forcibly. (sequelae) Todd's paralysis(< 24 hours, due to neuronal exhaustion). Confusion. Vomiting. Carbamazepine (Tegretol) or Phenytoin (Epanutin) Petit Mal Epilepsy: "attacks of loss of consciousness " " Absence " It starts in childhood & improves at puberty & usually disappears at the age of 20. 2. It is NOT PRECEEDED by aura & NOT FOLLOWED by sequelae. 3. It is usually PRECIPITATED by: hyperventilation 4. It is characterized by: or photic stimulation. sudden loss of consciousness of short duration (few seconds). 5. It may be associated with: • High frequency ( 50 attacks / day). • Falling to the ground without warning. • Jerky movements of the head & UL Drug of choice: (myoclonic petit mal). Valproate (Depakine) or Succinimide (Zarontin) 137 138 Ill. M oclonic Seizures: "attacks of involuntary clonic movements " - It is characterized by: sudden, jerky, shock-like INVOLUNTARY muscle contraction. • The jerks are bilateral contractions, mainly of the shoulders and arms. • However, some patients repmtjerking in the lower limbs, trunk, or head. - It may be of 2 types: - Occurs singly • Simple: • As a pait of: I Drug of choice: IV. Atonic seizures: (no loss of consciousness). - Grand mal epilepsy (aura). - Petit mal epilepsy. Valproate (Depakine) or Clonazepam (Rivotril) I - Transient attacks of brief loss of postural tone, often resulting in falls and injuries. 2. PARTIAL SEIZURES "Excessive electrical discharges from cmtical neurons in a ce1tain area in ONE hemisphere" A. Simple seizures: " No disturbance in consciousness " - The CP depends on the site of the hyperexcitable neurones in the cerebral cortex, whether in: "Motor area or Senso,y areas". 1. Motor fits: • Focal fits: • Motor jacksonian fits: 2. General Sensory fits: • Focal fits: • Sensory jacksonian fits: 3. Special Senso1y fits: • Visual hallucinations: • Auditory hallucinations: • Olfactory hallucinations: B. Complex seizures: - SITE: movement of part of a limb or the whole limb. movement of one side of the body (see before). parasthesia of part of a limb or the whole limb. parasthesia of one side of the body (see before). irritation of the visual sensory area. irritation of the auditory sensory area. initation of the uncus. " disturbance in consciousness " The hyperexcitable neurons are in the Temporal lobe "Temporal lobe epilepsy". - DURATION: The seizure lasts few seconds to few minutes. - The seizure starts with A ura, followed by A bsence, Automatism, Amnesia: 1. 2. 3. 4. A ura: A bsence: Automatism: A mnesia: Olfactory hallucinations, Deja-vu phenomenon, Sensation of fear. Absent patient with staring eyes (with no response to conversation). Involuntary Purposeless acts: motor ( eg, lip smacking, chewing) or verbal. No recalling of the seizure. 138 139 3. PARTIAL SEIZURES ~ GENERALISED SEIZURES " Partial seizures may spread to involve the whole brain .- secondarily generalised seizures " . HY-sterical epilepsY • Usually: • The cause: • Incidence: young neurotic Sj2 . psychological & there is no organic lesion. usually occurs in the presence of people. • It is associated with: • EEG: • It is not associated with: normal. • Missed ttt. • Menses. • Alkalosis. anxiety, palpitaion & hyperventilation. tongue biting or incontinence of urine. • Alcohol use & Drug abuse ( e.g. cocaine ). • S timulation by photons & Hyperventilation. • S leep deprivation & Stress & sudden withdrawal of antiepileptic drngs. INVESTIGATIONS 1. EEG: • It is the most specific test for epilepsy because it records the electrical activity of the brain. • It shows specific pattern: 2. LOCAL INVESTIGATIONS: "Epilepsy waves". "CT & MRI of the brain" • To identify or exclude a LOCAL CAUSE of seizures in the brain. 3. GENERAL INVESTIGATIONS: "Laboratory investigations" • To search for a GENERAL CAUSE of seizures, e.g. blood glucose. 139 140 TREATMENT A. General Measures: 1. 2. Moderation of the patient's physical activity. A void the precipitating factors ( Alcohol, hyperventilation, photic stimulation ...... ). 3. A ketogenic diet is encouraged because it will induce acidosis: - Acidosis is beneficial as it raises the threshold of stimulation of the brain cells. B. Specific Treatment: 2. 1. Treatment of the cause in secondary epilepsy. Anti-epileptic drugs: a) Always sta1t with one drug, then add another drug if there is no response. b) Always stop the drugs ONLY if: • The patient stays free of symptoms for at least 2 years. • The patient has a normal EEG. 3. Side effects of Anti-epileptic drugs: I . Skin rash. 2. 3. Bone marrow depression. Ataxia. Drug 1. Barbiturates (Pbenonobarbitone) 2. Hydantoin (Epanutin) 3. Carbamazepine 4. Clonazepam 5. Valproate 6. Succinamide ANTI-EPILEPTIC DRUGS NEW ANTI-EPILEPTIC DRUGS - These drugs are new dtugs that may be used in resistant seizures. 1. Lamotrigine: 200 - 400 mg/ day. 2. Felbamate: 3. Gabapentin: 400- 800 mg/ day. 600 - 1200 mg/ day. \ " General rules for use ": Dose 100-600 mg I day 100-600 mg / day 200-600 mg I day 2-6 mg I day 500-1500 mg I day 500-1000 mg / day Best indicated - Broad spectrum. - Not for petit mal. - Grand mal. - Motor Jacksonian fits. - Grand mal. - Motor Jacksonian fits. - Complex seizures. - Not for petit ma!. - Myoclonic. - Grand mat. - Broad spectrum. - Petit mat. 140 141 STATUS EPILEPTICUS DEFINITION - A medical emergency: 1. Repeated attacks of generalized convulsions, with lack of recove,y of consciousness, 2. Persistent attack of seizure lasting for at least 30 minutes. OR, - If the convulsions are not stopped rapidly, coma deepens & death may occur due to: heart failure or respiratory failure or brain damage or hyperpyrexia. - The most common causes are: sudden withdrawal of anti-epileptic drugs & stroke. TREATMENT A. General Measures: l. Take care of: " ABC " • Place the patient on the ground, to guard against falling from bed. • Mouth gag & 02 inhalation ( endo-tracheal intubation may be needed). • Record the vital signs regularly. 2. Take a sample of: - Venous blood: for the level of: - A.tierial blood: for the level of: 3. a nti-epileptic drugs, a lcohol. pH, p0 2, pC02, HC0 3. Give cerebral dehydrating measures: e.g. Frusemide, cone. Mannitol, Dexamethazone. B. Specific Treatment: - Phenytoin with diazepam (or clonazepam) immediately: 1. Phenytoin: 2. Diazepam: Clonazepam: seizures recur: 15 mg I Kg slow infusion. 5 mg slowly IV, to be repeated after 5 minutes if seizures recur: maximum dose: 20 mg. OR: 2 mg slowly IV, to be repeated after 5 minutes if maximum dose: 6 mg. - If seizures persist after 20 min. of Phenytoin & diazepam: 3. PHENOBARBITONE: - In resistant cases: 200 mg infusion. 4. GENERAL ANAESTHESIA: may be used.

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