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First Aid

Being Able to Help in Emergencies

Training goals

Knowledge Basic knowledge about bodily functions and possible risks when they fail Recognition of emergency situations and independent taking of suitable emergency measures Personal protection of the first aider Skills Grips and techniques to avert life-threatening situations Motivation

Reduction of fears and inhibitions


First aid is easy

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Chapter I
Basic information for first aiders

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What is first aid?

All actions performed by an aider from the finding of the victim to the arrival of the ambulance. Goal: Improve or stabilize the condition of the victim. Examples: Make an emergency call, get help

Rescue from a dangerous area


Emotional support Blood stoppage, bandages Comfortable, proper resting position etc. First aid never replaces treatment by a physician!

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Requirements of first aiders

Remain calm! Make a general assessment Quick emergency call Think before you act Protect yourself, if necessary first remove danger

Send away "gawkers" Ask bystanders for assistance Help without hesitation Calm down the victim, if necessary also the bystanders

An emergency call is ALWAYS possible. It however does NOT replace active first-aid assistance.

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Universal emergency measures

LIFE: correct emergency measures for all emergencies

Check vital signs

I F
E

Emotional support (talk, comfort)

Observe the victim

Keep the body warm (blanket)

Emergency call/get help


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What is a medical emergency?

Accident

Illness

Poisoning

Circulation Respiration Consciousness

Oxygen deficiency

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Obligation to help

Section 323c StGB (Criminal code): "Those who don't provide assistance in the event of accidents or general danger or emergency although this is necessary and expected under the circumstances, and is possible without substantial personal risk or infringement of other obligations, will face either imprisonment of up to one year or a monetary fine."

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Rescue chain

Immediate lifesaving measures

Further measures

Ambulance

Hospital

Securing of the accident site Emergency call Life saving

Caring for less serious injuries

First professional treatment

Transportation to the clinic

Optimal medical treatment

First aid
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Emergency medical care


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Rescue chain
Immediate life-saving measures

1.

Safety measures and emergency call Secure the accident site Bring yourself and the victim away from the danger zone Make an emergency call

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Rescue chain
Immediate life-saving measures

2. Life saving Check the victim for vital signs Look for injuries Reanimate persons with cardiac arrest Stop bleeding Fight against shock Place the victim in the side recovery position

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Rescue chain
Further measures

Treatment of non life-threatening injuries Examples: Warming Cooling Treat minor bleeding Immobilize broken bones Continue to check vital signs

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Emergency call
Necessary information for the call

W W W W W

here did it happen?

hat happened?

hat number of victims?

hich injuries are present?

ait for questions!

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Emergency call
Moment of the emergency call with only one first aider

1. Victim unconscious, breathing normal First lay the victim in the recovery position to prevent blockage of the airways during the emergency call. Then call the ambulance. 2. Neither conscious nor with detectable normal breathing First complete the emergency call. Upon return commence with cardiopulmonary resuscitation.

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Using the rescue blanket/cover

BODY

for

silver side

"If silver is on the outside, the heat stays out."

for warming

RESCUE BLANKET

for cooling

"If silver is on the inside, the warmth stays inside."

gold side

for

BODY

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Warming
Laying of a blanket underneath

1. Turn the person on his side. 2. Lay the rolled blanket against the back.

3. Roll the person over the rolled blanket onto the other side.

5. Roll out the blanket. 6. Roll the person onto his/her back.
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4. cover

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Rescue grips
Rauteck grip

Prop up the upper body. Grasp the person under both arms and grip one arm of the victim. The helper's thumbs face forward. Straighten up with the victim and pull him away. When laying down the body pay particular attention to the head.

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Chapter II.
Impaired consciousness

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Impaired consciousness

Normal condition

With normal consciousness the various parts of the nervous system work unhampered together.
The senses perceive the surroundings and allow reaction to dangers. Protective reflexes like coughing, blinking and swallowing are present. Dangers of unconsciousness Failure of protective reflexes risk of suffocation The victim cannot move himself from the hazardous area without help. Consequential injuries

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Impaired consciousness
Recognizing unconsciousness

Check for consciousness by: Speaking Touching Watching if present

if not
present

Check for breathing by: Seeing Hearing Feeling if present

Help if required

Recovery position

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Impaired consciousness
Check for breathing, but how?

Duration: Not longer than 10 seconds

1.
2.

Slightly tilt back the head.


Remove foreign bodies present in the mouth.

3.

Hand on the chest, ear and cheek over mouth and nose. See Feel Hear respiration.

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Impaired consciousness
Help: side recovery position

1. 2.

Aider kneels at the side of the unconscious victim. Bend the arm on the side of the aider in a right angle.

3.

Lay the other arm across the chest. Lay the back of the hand against the cheek.
The leg nearest to the helper is slightly bent with one hand. Carefully rotate the victim onto his side by carefully grasping knee and shoulder. Tilt the head slightly backwards. Open the mouth so that vomit can flow out.
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4. 5.

6. 7.
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Chapter III
Respiratory disturbances

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Respiratory disturbances
Causes of respiratory disturbances

Unconsciousness Illness Poisoning Drowning accident Foreign bodies in windpipe or esophagus Insect bit in the throat area Chest injury

Result: Oxygen deficiency

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Respiratory disturbances
Shortness of breath

Symptoms

Strained or difficult breathing Typical accompanying noises


Anxiety, fear In case of acute shortness of breath: Blue colouring of face and nail bed Help for shortness of breath Calm the victim Quick emergency call Open windows and restraining clothing Position upper body erect

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Respiratory disturbances
Foreign bodies in windpipes - severity level
Assessment of the severity level light airway blockage severe airway blockage

can at least speak a little ability to cough breathing is still present

inability to speak grasps the throat wheezing, whistling breathing sounds quiet, unsuccessful coughing attempts possible loss of consciousness

allow coughing to continue constantly check whether the blockage loosens/dissolves

unconscious begin reanimation

if conscious hit the back 5 times 5 upper abdomen compressions


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Respiratory disturbances
Foreign bodies in the windpipe

Recognize

Risks

Shortness of breath, struggling for air Shortness of breath Whistling respiratory noise Apnoea Coughing Help Loosen restraining clothing and open windows Bend the upper body slightly forward and palpitate the area between the shoulder blades with your flat hand

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Respiratory disturbances
Foreign bodies in windpipes - Heimlich manoeuvre

The helper stands behind the victim. The victim is made to lean slightly forward, allowing the foreign body to be forced out of the mouth cavity. Both arms are laid on the upper abdomen. The helper makes a fist and lays it between navel and breastbone. The other hand covers the fist. Finally the helper jerks the fist up to 5 times forcefully inward and upward. Should the 5 upper abdomen compressions produce no result, then up to five back palpitations are repeated.

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Chapter IV
Circulatory disturbances

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Cardiac arrest
Causes

Cardiac and circulatory diseases (e. g. heart attack, stroke)


Electrical accidents, poisoning Shock, drowning Heavy bleeding, serious burns Apnoea

Result: Oxygen deficiency

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Cardiac arrest
Recognize

Check for consciousness

if not present

Check breathing

if not normal

Cardiac arrest
Begin cardiopulmonary resuscitation (CPR) 30 heartbeats massage

alternating

2-X artificial respiration

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Cardiac arrest
Respiration

Two possible methods: 1. Mouth-to-mouth resuscitation The mouth of the first aider covers the mouth of the victim. 2. Mouth-to-nose resuscitation The mouth of the first aider covers the nose of the victim.

At the same time close the unneeded airway opening of the victim!

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Cardiac arrest
Performance of artificial respiration

1. Tilt the victim's head slightly back.

2. Close his/her mouth with one hand.


3. Breath in. 4. Now the mouth seals his nose. 5. The aider blows his exhaled air into the airways. 6. Repeat the artificial respiration a total of two times. 7. After each exhalation turn your head to the side to inhale fresh air. Example: Mouth-to-nose resuscitation

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Cardiac arrest
Heart massage

1.

Make an emergency call with indication of cardiac arrest.

2.
3. 4.

Lay the victim with his back on a hard surface (e. g. floor).
Kneel at the side of the victim. Uncover his chest.

Begin the reanimation as quickly as possible after determination of the cardiac arrest. Every second counts!

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Cardiac arrest
Heart massage

Finding the pressure point

Chest

Pressure point Breastbone

Localize the middle of the chest on the uncovered upper body. The goal is the compression of the lower half of the breastbone.

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Cardiac arrest
Heart massage

Positioning of the hands

Lay the heel of one hand on the pressure point.

Lay the heel of the other hand on the back of the first hand.

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Cardiac arrest
Heart massage

Demonstration Keep both arms straight. The heart massage is performed 30 times. The pressure and release phases must be of equal length. Proceed by alternating between 30 x heart massage and 2 x respiration.

Heart massage : Respiration

30 : 2

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Cardiac arrest
Heart massage

Further notes: If possible perform CPR with 2 aiders. One gives artificial respiration, the other massages, the ratio 2 : 30 is maintained. Reanimate until the ambulance arrives or the victim exhibits vital signs (e. g. coughing, swallowing, breathing motion). A separate checking of breathing is not necessary. It would interrupt the continuous process of the reanimation.

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Poisoning
Absorption paths of poisons
Airways (respiratory poison, gases)

Skin (contact poisons)

Digestion (e. g. pills) Stomach

Lungs

Blood

Intestines

Circulation Distribution and damage in the entire organism

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Poisoning
Symptoms

Illness, nausea, dizziness, vomiting, diarrhoea

Stomach pain, stomach cramps


Consciousness, respiratory and circulatory disorders

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Poisoning
Unclear situation

Look for chemicals, bottles, glasses, information signs, distinctive odours and ask the victim what has happened.

Important questions: What was taken? When did the poisoning occur? How did the poisoning occur?

How much (concentration) was absorbed/ingested/inhaled from the poison?

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Poisoning
Help

1. Emergency measures + emergency call Self protection Live-saving measures 2. Specials measures to be taken for poisoning Goal: Prevent or delay the absorption of the poison Respiration Digestion give plenty of water to drink do not induce vomiting, especially not in the case of chemical burning/ irritation Skin rinse under running water if no water is available: swab with cloths

ventilate with fresh air open restrictive clothing


deep breathing position upper body erect

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Shock

A shock is a life-threatening disturbance of the circulatory system.

The ratio of required to existing blood quantity shifts, the organs are no longer provided with oxygen.
Decrease of heart output (e. g. illness)

Decrease of blood or fluid quantity (e. g. heavy bleeding)


CAUSES

"Dilation" of the arteries (e. g. anxiety, excitement, pain, fear)

other causes (e. g. poisoning, allergic reaction)

Often the injury itself is not life threatening, rather the shock.
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Shock
Symptoms

pale face, cold sweat, cool skin quick, flat breathing freezing, shivering agitation, nervousness, anxiety, disorientation, subsequent apathy partial insensitivity to pain nausea, dizziness, possible vomiting faster (100 beats/min), however weak pulse Pulse check on the thumb side with 34 fingers. Never measure with the thumb; it has its own pulse.

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Shock
Measures

Shock position raise the legs 2030 cm warm the victim keep the victim awake

Help

remove the cause of shock emergency call


provide emotional support

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Electrical accidents
Low voltage

Recognize anxiety racing heart agitation sweating nausea

Help
break the circuit check vital signs help as required emergency call

Self protection always takes precedence!

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Electrical accidents
High voltage

Recognize

current entrance and exit marks (punctiform burns) strong muscle cramps

Help at least 5 m safety distance emergency call saving and treatment by professionals

Self protection always takes precedence!


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Chapter V
Wound treatment

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Wounds and bleeding


Fundamentals of wound treatment

1. 2. 3.

Never touch the wounds with bare hands! Don't wash out the wounds! Exception: burns, scalds, chemical burns Do not treat wounds with salves, powders, sprays, disinfectants or other "home remedies"!

4.
5. 6.

Do not remove large foreign bodies from wounds!


Cover every wound with sterile dressings! Always have wounds evaluated by a physician!

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Wounds and bleeding


Aid for bleeding on arms and legs

1. Elevate or prop up. Blood flow lessens. 2. For bleeding on the arm, apply pressure to the aorta with four fingers in the muscle gap on the inside of the upper arm. Primary blood flow is reduced.

Never tie off a body part!

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Wounds and bleeding


Aid for bleeding on arms and legs

Bandage Pressure pad

Application of a compress Lay the dressing on the bleeding. Wrap the dressing around the wound 23 times. Apply the pressure pad to the wound area. Wrap the dressing around the wound several more times and fasten.

Dressing

If heavy bleeding occurs through the bandage, a new one should be overlaid.
In the case of blood congestion, slightly loosen the bandage.

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Wounds and bleeding


Help for amputation wounds

1. Wound treatment. 2. Stop the bleeding with suitable material. 3. Secure the body part. Do not clean the amputated member with water or anything else. Wrap the amputated member in a clean towel, place it in a plastic bag and seal it. Place the bag with the amputated member in a plastic bag filled with ice water. Never use pure ice.

Do not put the amputated member in the refrigerator or freezer!


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Wounds and bleeding


Bleeding on or in the abdomen

Recognize hard or arched abdomen discoloration of the abdomen skin stomach pain

Position Lay the person on his side and bend the knees

Help quick emergency call for external bleeding apply bandaging with hand pressure position for relaxing the abdominal wall

or bend the knees using a prop

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Wounds and bleeding


Schematic representation of arrest of bleeding

Arms

Legs

Head/Torso

Amputation wound elevate

elevate apply pressure compress

elevate

apply pressure if possible apply compression apply compression apply compress if possible

compress

apply compress if possible

bleeding from nose, mouth

tilt head forward, apply cold cloths to the neck


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Burns
Recognize

Degree

Identifying features redness, pain, feeling of tension, minor swelling redness, heavy pain, broken or filled blisters white to brown or black skin, no pain

I II III

Risks infection, shock, pain breathing difficulties, possible smoke poisoning

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Burns
Determination of the size of a burn

1. General rule

Estimation of the surface area of a burn occurs by means of the given values.
Values are dependent on age. 2. Palm rule

9% in front 18 % 9 % in back 9 % 18 %

The palm of the victim corresponds to ca. 1 % of his body surface.


Should the palm, for example, cover the burn three times, then the burn covers 3 % of the body.

1% 18 %
18 %

Body surface of an adult


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Burns
Help

If required, extinguish burning clothing. Carefully remove burned clothing. Cool for at least 1520 minutes with cold water. In conclusion cover the burn wound with a sterile dressing. Do not open burn blisters. Quick emergency call. Combat shock.

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Chemical burns

Skin damage to the skin redness coloured scab pain

Eyes redness flow of tears vision disturbances squinting pain

Stomach-intestines increased flow of saliva swollen bloody or white membranes pain

Recognize

Special help

rinse with water or swab the chemicals (if no water is available) remove moistened clothing cover the wound

rinse with water after rinsing, an eye bandage

give plenty of water to drink do not induce vomiting

General help

emergency call, checking of vital signs depending on condition: side recovery position, shock position, reanimation The first aider must in any case protect himself!

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Fractures
Types and risks
Closed fracture no external wound

Open fracture wound, from which the bone part can protrude Risks internal/external bleeding risk of infection shock pain
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Fractures
Recognize

Body part immobile or only partially mobile Intense pain in the fracture region Resting posture Fracture region is sensitive to pressure Swelling, blood flow, discoloration Shortening of limbs Abnormal/false position of a limb

Don't splint the fracture, just protect against motion.

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Fractures
Leg fractures

Help leave the fracture in the discovered position and cushion it with suitable material

in the case of shock symptoms do not elevate the legs, rather lay them flat
apply cooling against pain and swelling

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Fractures
Arm fractures

Help

treat with care (press the broken arm against the upper body) by supporting the arm with a sling
in case of shock shock position cooling

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Fractures
Broken ribs

Recognize pain in the rib area flat breathing the victim tries to straighten up Help provide side support to the affected side of the body prop up and support the upper body

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Fractures
Fractures of skull base

Recognize

head wounds bleeding from nose, mouth and/or ear


dizziness, possible hearing loss effusion around the eye(s)

Help
calmness wound treatment in a face-down position let the blood flow from the face

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Fractures
Pelvic fractures

Recognize pain in lower abdominal or pelvic region victim can not sit up

victim tries to bend his legs


Help support a natural relief posture

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Fractures
Spine injury

Recognize

Help

loss of feeling
numbness or prickling in the limbs uncontrolled release of bowels and/or bladder

don't move (exception: rescue from a dangerous area)


no shock position, lay flat keep warm

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Chapter VI
Acute illnesses

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Illnesses
Heart attack

Recognize pain, tightness in the chest, victim grabs his chest radiating sharp pain above all in the left arm, stomach, back, shoulders, face

anxiety, fear, nausea, shortness of breath pale face, cold sweat


Help quick emergency call if victim is conscious: help him sit up to relieve the heart and to ease breathing loosen restraining clothing and open windows with cardiac arrest: begin reanimation if unconscious: side recovery position
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Illnesses
Stroke

Recognize weakness of the face muscles inability to speak loss of bladder control breathing and swallowing disorders paralysis visual problems, possible headache

Help
immediately call an ambulance calm the victim if victim is conscious: elevate upper body

depending on condition: side recovery position or cardiopulmonary resuscitation

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Illnesses
Epilepsy

Recognize some epileptics can sense an oncoming seizure often initial outcry, moaning falls to the floor, muscle convulsions in the limbs foam (saliva) from the mouth after seizure unconsciousness

Help do not restrain the victim do not place a bite protector in his mouth remove or cushion objects which could cause risk of injury in case of unconsciousness: side recovery position after seizure observe the victim for at least 30 minutes

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Illnesses
Asthma

Recognize whistling, wheezy breathing noise cough attack, which often includes the excretion of stringy mucus strong lack of oxygen: blue colouring of face and nail beds anxiety, fear, cold sweat

Help calm the victim, ventilate with fresh air, loosen tight clothing place upper body erect to ease breathing "pursed lip breathing" deep breathing with lips almost closed assist with taking medicine (spray)

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Illnesses
Diabetic emergencies hypoglycemia

Recognize agitation, concentration difficulties vision disturbances, cravings sweating, anxiety, shaking, paleness

Help if conscious: give food or drinks which contain sugar (e. g. cola, chocolate)

if unconscious: side recovery position, emergency call

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Illnesses
Diabetic emergencies hyperglycemia

Recognize deep breathing which releases a strong fruity smell faintness, thirst, need to urinate possible loss of consciousness

Help in case of unconsciousness: side recovery position

emergency call

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Thank you for your attention!

Contact partner for questions and suggestions is: Mr./Mrs. Telephone:

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