Week 3 General Meeting

Medical
Workshop &
Case Reports
Health Fair
Westminster Week 5 Sunday May 7th
Rose Center 10am - 2pm
14140 All American Call Time for UCLA Volunteers: 7:00 AM
Way, Westminster, CA Call time for Home volunteers: 8:30 AM
92683
Volunteer of the Week
Celine Khuu
“I joined VCH to gain more exposure in
the field of healthcare and to become
more involved in efforts to serve my
community. My interactions with
patients at Health Sites/Fairs as well as
the people that I’ve met through VCH
are invaluable, and I hope to continue
making more memories in the coming
quarters. My favorite part about going
to Health Site is exercising my
Vietnamese to communicate with
patients who might be hesitant to
check out our services!”
Office Hours
Medical Skills
Presentation
 First Aid Measures
Medical attention that is administered immediately after injury
occurs and at the location where it occurred. It requires little
technology or training to administer.

● One-time
● Short-term
● Long-term treatment

Disclaimer:

General advice found through research on the internet, further

interventions may require more specific training. Each situation and
individual is unique, and the specifics of what actions are necessitated
depends on the medical history and state of the individual.
 Choking
Symptoms:
● Difficulty speaking
● Trouble breathing
● Congested face turning to a gray-blue color
● Distress signs, such as pointing to the throat or grasping the neck
● Difficulty or noisy breathing
● Skin, nails, and lips turning blue or dusky
● Squeaky sounds when trying to breathe
● Loss of consciousness
 Choking - Conscious Choking
Adults/Children:

American Heart Association 2020 Basic Life Support Provider Manual

 Choking - Conscious Choking

American Heart Association 2020 Basic Life Support Provider Manual

 Choking - Conscious Choking
Infants:

Back blows

Chest thrusts

American Heart Association 2020 Basic Life Support Provider Manual

 Choking - Unconscious Choking

American Heart Association 2020 Basic Life Support Provider Manual

 Choking - Unconscious Choking

American Heart Association 2020 Basic Life Support Provider Manual

 CPR
● During cardiac arrest, heart cannot pump blood to body

● CPR uses chest compressions to mimic the heart pumping

and to help keep blood flowing

● Estimated that 350,000 Americans die from sudden cardiac

arrest each year

● According to the American Heart Association (AHA), the

overall survival rate for out-of-hospital cardiac arrest is
around 10%

○ Survival rates can be improved if bystander CPR is

started immediately

○ However, studies have shown that bystander CPR can

double or triple the chances of survival for someone
with cardiac arrest
 CPR - When is it used?

No breathing/only gasping & no pulse

American Heart Association 2020 Basic Life Support Provider Manual

 CPR - Chest Compressions
Adults Children Infants

*Compression: rescue breath ratio differs for adults, children, and infants and for 1 or more rescuers

American Heart Association 2020 Basic Life Support Provider Manual

 CPR - Chest Compressions

American Heart Association 2020 Basic Life Support Provider Manual

 CPR
● Mouth-to-mouth is no longer
recommended for untrained
bystanders, but there are some
situations in which rescue breathing is
necessary:
○ Babies and young children
suffering cardiac arrest from a
non-cardiac cause
○ Near-drowning victims
○ Drug overdose victims
○ Asthma attacks, poisoning,
choking, and carbon monoxide
poisoning

American Heart Association 2020 Basic Life Support Provider Manual

 What is a tourniquet?
- Any device that is wrapped tightly
around a limb to prevent the flow of
blood to that limb
- Approximately three inches wide

American Heart Association 2020 Basic Life Support Provider Manual

 When to use a tourniquet
- Traumatic injury on arms/legs with
heavy uncontrolled bleeding

- ONLY use when bleeding cannot be

stopped by direct pressure alone
- Or if direct pressure cannot be
applied

- Should be applied immediately

- Only during serious medical

emergencies
- Save lives!
 How to apply a tourniquet

- Wrap the material around limb with

even pressure all around
- Wrap a few times to pad the
tourniquet
- Knot a stick/rigid object on outside of
tourniquet for a torsion device
- Twist the stick
- Should be tight enough to stop
excessive bleeding (< three fingertips)
- Ooze = okay
- Take a note of the time
 Where to apply a tourniquet

- Tie the device upstream of the cut

- Between injury and heart
- DO NOT apply it on a joint
- ONLY on limbs
- No torso/neck
- Can be applied over clothing
- When in doubt, high and tight
- 2-4 inches above wound is ideal
- Should only be removed by medical
professional
Post-treatment
 Stroke vs. Heart Attack
Stroke:
Occurs when blood flow is unable to
reach the brain which prevents the
brain from receiving oxygen

- Commonly due to blockage or

ruptured blood vessel in the
brain

30% of Hispanic Americans have high

cholesterol levels

Vietnamese-Americans have the 2nd

highest stroke mortality rate among sub
Asian-American groups
● 200,000 new cases in Vietnam each
year
Heart attack:
When blood flow is prevented from reaching the heart which prevents the heart from
receiving oxygen and damages the heart muscle

Common cause: coronary artery

disease (plaque builds up in the
arteries) which hinders
blood flow

More common in women than men

 Symptoms
Stroke Heart Attack

Face (Is one side of the face dropping) 1. Chest discomfort

2. Lightheadedness,
Arms (When raising both arms, does nausea
one drift downward?)
3. Jaw, neck, back pain
Speech (Is speech slurred or garbled?)
4. Discomfort, pain in
arm/shoulder
Time (Call 911 immediately)
5. Shortness of breath
 What Can You Do?
Heart Attack: Call 911 | Chew and swallow an aspirin (if not allergic) | CPR

Stroke: Call 911 | Note when you first see symptoms | CPR
● DON’T
○ Let that person go to sleep
○ Give them medication, food, drinks
○ Drive yourself or anyone else to the emergency room

Proactivity Heart attack symptoms masked:

● Heartburn, unusual tiredness, chest pain

Commonly overlooked stroke symptoms:

● Lack of balance, numbness, dizziness

Preventative Healthcare Only 59% of Vietnamese-Americans knew chest pain was a

symptom of heart attack

Hispanics reported to have lower stroke awareness and only

8.5% had knowledge of tPA
Interactive
Case Report
YOUR TURN!

1. We will present you all with a

patient to diagnose
2. Your turn to ask questions
3. Lab results and further details
will be revealed
4. Prepare and present differential
diagnoses
 Case Report #1
A 62-year old male patient was admitted to the emergency department
complaining of severe abdominal pain, vomiting, and loose stools. The
symptoms have progressively worsened over the past 24 hours. He also
mentioned a loss of appetite and a low-grade fever.
 More Details
Diagnostic Imaging Physical Exam

● A CT (computed tomography) scan of ● Appeared to be in moderate pain and

the abdomen and pelvis with contrast discomfort, body temperature of 100.4
was performed, revealing an inflamed degrees F, heart rate of 98 bpm, blood
appendix with a pocket of pus around pressure of 140/90 mmHg, respiratory rate
it was 18 breaths/min. Right lower abdomen
swollen and tender to palpation

Medical History Lab Work

● Type 2 diabetes, high blood pressure, ● White blood cell count of 14,500/mm^3
and high cholesterol (normal range: 4000-11,000/mm^3)
● Poorly controlled for the past few ● Blood glucose levels elevated at 250
months due to non-compliance with mg/dL (normal range: 70-100 mg/dL)
medications and dietary restrictions ● Urinalysis positive for glucose
 Reveal
The patient was diagnosed with acute appendicitis (inflammation of appendix from
infection). The bacteria multiplies rapidly, causing the appendix to become inflamed
and filled with pus.

The infection is evident from the high white blood cell count, and the swollen appendix
is supported by the physical examination on the abdomen.

Treatment: The patient started on antibiotics to treat the infection. He underwent

surgery to remove the appendix. His condition improved after surgery, and he went
home a few days later.
 Case Report #2
A 50-year-old patient was admitted with progressive muscle weakness in all
four extremities and progressive sensory disturbances. He experienced
paresthesia (the sensation of pins and needles) of the tongue, toes, and
fingers 3 days before admission.

Symptoms were then accompanied by lower limb weakness which then

progressed to affect his entire limbs and torso. The patient also experienced
peripheral seventh nerve palsy on the left side, deterioration of visual acuity,
and sphincter dysfunction (uncontrolled urination).
 More Details
Medical History Symptoms & Lab Work
● Patient contracted a mild case of ● Decreased muscle tone in all extremities
COVID-19 17 days before these ● Poorly expressed reflexes of the upper
symptoms presented extremities
○ Experienced musculoskeletal pain ● No reflexes in the lower extremities
low-grade fever, and severe ● Sensory impairments in all extremities
headaches
○ Respiratory rate, heart rate, and ● CT excluded acute ischemic or
blood pressure were normal hemorrhagic stroke and other cerebral
○ Treated COVID with paracetamol lesions
○ Symptoms subsided completely ● Nerve conduction study revealed
after two weeks demyelinating and axonal sensorimotor
● On the day before neurological and radiculopolyneuropathy
muscular symptoms presented, patient ● CSF tap revealed a protein level of 177.9
tested negative for COVID mg/dL and albumin-cytologic
● In the past, has not been treated for dissociation
any chronic diseases ● C-reactive protein level: 5.5 mg/dL
 Reveal
The patient was diagnosed with Guillain-Barré syndrome (GBS), a rare autoimmune
peripheral nervous system disease. It is usually preceded by an upper respiratory or
gastrointestinal infection. At the time of the case study, there have been 100 reports of
GBS associated with COVID-19.

It has a global incidence of 1-2 per 100,000/year. Incidence increases with age and unlike
other autoimmune diseases, it is more prevalent in men.

The most frequent form of GBS is acute inflammatory demyelinating polyneuropathy.

Indicators of inflammatory disease:

Diagnosis was confirmed through analysis of CSF (albuminocytologic dissociation) and
nerve conduction study (demyelinating and axonal sensorimotor polyneuropathy).

The patient treated with plasmapheresis therapy and symptoms improved.

 Case Report #3
A 45-year-old male patient presented to the emergency
department with complaints of severe abdominal pain, nausea,
vomiting, and fever for the past three days. The patient
reported no significant medical history and denied any recent
travel or exposure to infectious agents. Physical examination
revealed diffuse abdominal tenderness with rebound and
guarding, and laboratory workup was ordered.
 More Details
Lab Work Diagnostic Imaging

● Complete blood count (CBC): ● Abdominal ultrasound: Gallstones

Leukocytosis with left shift (WBC count with cholecystitis
20,000/uL with 80% neutrophils)
● Comprehensive metabolic panel (CMP):
Elevated liver function tests (AST 120 U/L,
ALT 150 U/L, ALP 200 U/L, total bilirubin
3.5 mg/dL)
● Urinalysis: Normal
● Coagulation profile: Prolonged
prothrombin time (PT) and activated
partial thromboplastin time (aPTT)
● Serologic testing for viral hepatitis:
Negative
 Reveal
The patient was admitted to the hospital and started on intravenous
antibiotics for acute cholecystitis. Additional testing was performed,
including computed tomography (CT) of the abdomen and pelvis, which
showed evidence of acute pancreatitis.

Treatment: The patient was subsequently diagnosed with biliary

pancreatitis and started on supportive care with pain management, fluid
resuscitation, and correction of coagulation abnormalities.

Follow-up appointments assessed gallstones.