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# PLENARY CASE

## When A 25-year-old man returned to his apartment at 5 PM in the evening, he

turned on his old kerosene-fueled space heater. It had been a cold day in late spring and
his third floor apartment was chilly. After spending an hour fixing dinner, he ate while
watching the evening news on TV. He noticed that his vision became progressively
blurred. When he got up to go to the kitchen, he felt lightheaded and unsteady. Entering
the kitchen, he became very disoriented and passed out. The next thing he remembered
was waking up in the intensive care unit of the hospital. Some friends who had stopped
ambulance, which had rushed himtextus, still unconscious, to the hospital.
An arterial blood sample drawn when he first arrived at the hospital showed the following
values:

A measurement of blood reveals that the O 2 content is low (50% of normal) and
hemoglobin is 50% saturated with CO (50% HbCO).
The oxygen-hemoglobin saturation curve in blood (50% HbCO) and under
normal conditions (2% HbCO) is shown below. CO2 binding to hemoglobin is
normal in both instances.

1. Discuss the case with your tutorial group and make your discussion report in
English
2. The time limit collecting plenary discussion report at Wednesday, December 28th
2011
3. Plenary case report will presented at Tuesday, Januari 3th 2012, 09.00-11.00

Problem definition:
1. Why is the man fainted suddenly?
2. Are there any factors affecting the condition of cold air?
3. The content of O2, CO, and CO2 in the blood is normally how much?
4. What is the mechanism that faint?
5. What are the internal factors that can make people faint?
6. Are there any signs or symptoms of fainting?
7. How handlers fainted?
Analazyng the problem:
1. Because
2. There is.
3. 4. Fainting partly originated from the tendency of the accumulation of blood in the veins
under the earth due to gravity. It causes the amount of blood returning to the heart is
reduced so that the bulk of blood to the heart and blood pressure decreased sistoliknya.
In order to overcome this decline, the automatic reflex arising normal compensation, in
the form of increased frequency and strength of heart contractions, with the aim to restore
bulk to the heart to its original level.
In someone who is hypersensitive, the increased strength of contraction that just activates
the receptor mechanics on the left wall of the ventricles, causing a reflex that causes a
slow heart rate, peripheral blood vessels dilate, and there is low blood pressure
(hypotension) so that blood flow to impaired nervous system .
This occurs because the onset of imbalance in the autonomic nervous reflexes to react to
a prolonged standing position.
5. Principal cause of fainting is diverse, including electric shock, epileptic, subject to the
cool / cold for too long, heart attack, a lot of blood came out, a lot of heat, hunger,
poisoning,
Most cases of fainting (in addition to cardiac cases) is mainly due to hypersensitivity of
the vagus. The vagus nerve is tenth of brain mensarafi organs in the body and greatly
affect the heartbeat frequency.
6. There is. Symptoms before fainting: before passing them feel scared, shaking, followed
by the sensation of the surrounding environment was spinning. Besides the eye may feel
dizzy.
When the unconscious: the face becomes pale, saliva and sweat out the cold, limp body
and fell. Awareness can be decreased.
7. The principle of relief against such conditions are:
1. The victim should lie with the head tilted
2. Be careful not to position the head elevated.
3. Loosen tight clothing so that blood flow is not interrupted.

## 4. Head compressed with cold water / ice pack,

5. Never give anything by mouth if the patient is unconscious.
6. If it will move to another place, is expected in a state rests
And for ordinary fainting, then do as above also only covered entities are not taxable to
the cold. And this when there are signs of bleeding / wound in the head, then Dampen
handkerchief with aromatic spirits of ammonia and placed near the nose so that sucked.
As for the faint blue, which is passed out a cover of a little blue. So this needs artificial
respiration.
In the case of fainting on the ground, which you should do:
Capturing the victim's body before falling to the ground.
Her down in horizontal position, with the location of the head lower than heart and hand
over to pumps blood flow to the brain.the level (If the victim can be stretched before it
crashed, he may not lose consciousness).
Changing the position of the head to the side, so that the tongue is not attracted to the
throat.
Loosen all clothing
Provide wet and cold towel on the face or neck of the victim.
Keeping the victim warm, especially if the circumstances surrounding the cold.