Onset of a cerebrovascular accident is sudden, with little or no warning. The first signs include weakness or paralysis on the side of the body opposite the side of the brain that has been injured. Muscles of the face on the affected side may be involved. The patient's level of consciousness varies from alert to unresponsive. Additionally, motor functions3/4 including vision and speech3/4on the affected side are disturbed, and the throat may be paralyzed.

Emergency treatment for a cerebrovascular accident is mainly supportive. Special attention must be paid to the victim's airway, since he may not be able to keep it clear. Place the victim in a semi-reclining position or on the paralyzed side.

Be prepared to use suction if the victim vomits.
Act in a calm, reassuring manner, and keep any onlookers quiet since the victim may be able to hear what is going on.
Administer oxygen to combat cerebral hypoxia.
Carefully monitor the victim's vital signs and keep a log. Pay special attention to respirations, pulse strength and rate, and the presence or absence of the bilateral carotid pulse.

Transport the victim to a medical treatment facility as soon as possible.

ANAPHYLACTIC REACTION
This condition, also called anaphylaxis or anaphylactic shock, is a severe allergic reaction to foreign material. The most frequent causes are probably penicillin and the toxin from bee stings, although foods, inhalants, and contact substances can also cause a reaction. Anaphylaxis can happen at any time, even to people who have taken penicillin many times before without experiencing any problems. This condition produces severe shock and cardiopulmonary failure of a very rapid onset. Because of the rapidity and severity of the onset of symptoms, immediate intervention is necessary. The general treatment for severe anaphylaxis is the subcutaneous injection of 0.3 cc of epinephrine and supportive care.

The most characteristic and serious symptoms of an anaphylactic reaction are loss of voice and difficulty breathing. Other typical signs are giant hives, coughing, and wheezing. As the condition progresses, signs and symptoms of shock develop, followed by respiratory failure. Emergency management consists of maintaining vital life functions. Summon the medical officer immediately.

POISONS/DRUG ABUSE/HAZARDOUS MATERIALS

As a Hospital Corpsman, you could encounter special situations that include poisoning, suspected drug abuse, or exposure to hazardous materials. Knowledge of these conditions3/4along with the ability to assess and treat them3/4is essential. These situations are discussed in detail in chapter 5, "Poisoning, Drug Abuse, and Hazardous Material Exposure."