First Aid for People Living With Cancer
Cancer, also known as malignancy, is not just one disease but a collection of diseases. These conditions often include a disruption in physical and mental wellbeing, side effects from treatment, painful procedures, financial burden, and difficult decision making.
Aside from ensuring that the first aid kit is well stocked, the key to administering first aid to cancer patients is to understand the specialized skills and items needed to manage fear, anxiety, and depression; adverse effects of cancer or chemotherapy; and emergency situations that require cardiopulmonary resuscitation (CPR).
Emotional First Aid For Cancer Patients
Approximately half of the people with cancer exhibit psychological complications. Cancer can cause a variety of emotions that may be overwhelming. These feelings are completely normal and may frequently change. A life-support provider should be aware of the following common emotional difficulties.
Fear and Anxiety
Panic Disorder and Chest Pain – Approximately one-fourth of patients who present to the emergency department for chest pain have panic disorder. This article reviews the mechanisms, morbidity, and management of chest pain in panic disorder.
Hyperventilation – Become familiar with the symptoms of hyperventilation and how to teach pursed-lip breathing to patients having an acute anxiety attack.
Benzodiazepines – Explore the commonly prescribed benzodiazepines, such as alprazolam (Xanax®).
Non-benzodiazepine Options – Review low-dose beta-blockers, antidepressants, anticonvulsants, and antihistamines used for the treatment of anxiety.
Relaxation Techniques to Cope With Anxiety – Learn relaxation techniques, such as deep breathing, guided imagery, and meditation to help guide a patient suffering from anxiety to a more calm state.
Caring for a Person Experiencing an Anxiety Disorder – This resource offers an explanation of the different types of anxiety disorders and how to develop goals for a person with fear and anxiety.
Adjustment to Cancer – Read about the manifestation of anxiety and distress and how anxiety can heighten pain.
Depression and Suicide
Depression – Explore general information and risk factors for depression in cancer patients.
Suicide in Cancer Patients – Cancer patients have a high risk of committing suicide, notably in the first year after diagnosis. Additionally, suicide rates are higher in advanced stage cancers, males, and older age.
Contributing Factors to Suicide – A 2015 Center for Disease Control report ranks physical health problems (22%) just below problematic substance abuse (28%) as a contributing factor to suicide.
Warning Signs of Suicide – View a list of suicide warnings developed by the Substance Abuse and Mental Health Services Administration (SAMHSA).
Suicide Prevention – The National Institute of Mental Health provides an overview of risk factors, signs and symptoms, and how to get help through the National Suicide Prevention Lifeline (NSPL).
A Staff Dialogue on Caring for a Cancer Patient Who Commits Suicide – This article reviews a patient case and the psychosocial issues faced by patients, their families, and caregivers.
Physical First Aid for Cancer Patients
Thinking outside your average first aid kit for a person undergoing chemotherapy can help save their life.
One of the most dangerous side effects of chemotherapy is not always visible. A low white blood cell count, called neutropenia, puts cancer patients at a high risk for infection. Other potentially life-threatening complications of cancer and chemotherapy include bleeding and dehydration. Be prepared by reviewing the following circumstances.
Help Cancer Patients Prevent Infection – This program is designed by the Center for Disease Control to help people suffering from cancer protect themselves from infection and learn how to recognize infection.
How to Use a Thermometer – The Cleveland Clinic provides an overview of how to take a temperature.
Temperature – Watch out for temperatures higher than 99.5 Fahrenheit (37.5 Celsius); in the case of neutropenia, the patient needs antibiotics as soon as possible.
Clean Your Hands – Brush up on how important hand washing is to prevent infection.
Bleeding and Bruising
Thrombocytopenia (low platelet count) – Chemotherapy can lower the number of platelets in the blood putting the patient at risk for bleeding.
Ways to Manage Bleeding and Bruising – The National Cancer Institute provides steps to take for people at risk for bleeding, such as avoiding non-steroidal anti-inflammatory drugs (NSAIDS), using a soft toothbrush and electric shaver, and what to do if they start to bleed.
Internal and External Bleeding – Learn the necessary first aid steps for both internal and external bleeding.
Hypovolemic Shock – Excessive blood loss can lead to hypovolemic shock. This resource explores causes of hypovolemic shock and how to recognize this emergency condition.
Signs and Symptoms of Dehydration – Review information regarding dehydration.
Skin Turgor – Learn how to perform a skin turgor test to assess for dehydration.
Urine Output – Understand adult urine output and how dehydration affects it.
Nausea and Vomiting – Explore tips to help cancer patients manage nausea and vomiting.
Anti-nausea drugs or antiemetics – Become familiar with medication for the treatment of acute or delayed nausea and vomiting.
Diarrhea – Review tips to help cancer patients manage diarrhea.
Antidiarrheal Medication – This article discusses the conventional first-line treatments for chemotherapy-induced diarrhea, which are the opioids loperamide and diphenoxylate.
Food Safety – Take a look at these food tips for during and after cancer treatment to help prevent an infection.
Cardiopulmonary Resuscitation (CPR) for Cancer Patients
Cardiac toxicity is the injury to the heart by harmful chemicals. Chemotherapy is a known toxin (drug) that can damage cancer cells; however, it can also damage healthy cells in the body, such as those in and around the heart. Cardiac toxicity can lead to the following:
- Arrhythmias (abnormal heart rhythms) – Learn how to interpret basic arrhythmias.
- Chest Pain (Angina) – Explore the different types of angina.
- Cardiomyopathy – a condition that makes it difficult for the heart to deliver blood to the body; this can lead to heart failure.
- Myocarditis – Inflammation of the middle layer of the heart wall.
- Pericarditis – Irritation and swelling of the thin saclike membrane that surrounds the heart.
- Congestive Heart Failure (CHF) – A chronic condition in which the heart does not pump blood as well as it should.
One of the most critical factors before considering CPR on a person with cancer, terminal or not, is to determine their resuscitation wishes.
DNR Order – Review an explanation of DNR orders by the National Institute of Health.
DNR Bracelet – Check for a DNR bracelet; it may either be plastic or metal.
Hospital Do-Not-Resuscitate Orders: Why They Have Failed and How to Fix Them – Read these strategies to help overcome existing communication barriers between healthcare providers and patients about end-of-life decisions.
Return of spontaneous circulation (ROSC) among cancer patients undergoing cardiopulmonary resuscitation (CPR) in a comprehensive cancer center comparing Group 1 (2002 – 7) and Group 2 (2008 – 2012). (© Miller et al.; licensee Springer/Creative Commons/CC BY 4.0)
Although cancer patients have a lower survival rate following CPR than patients with conditions other than cancer, the life-support provider must honor the patient’s wishes for resuscitation in the event of a cardiac arrest. The return of spontaneous circulation is possible, especially when the CPR is done by a trained provider.
Basic Life Support (BLS) Algorithm – Review the latest 2015 BLS algorithm from the American Heart Association.
ACLS Online Library – This library presents heart-related health news that are helpful for all patients.
Standard first aid training is still necessary to make sure the person with cancer is safe; however, it is wise to remember that the care requires careful consideration because of their sensitive body systems.
How do you go beyond the standard first aid kit? Let us know! You can contact us at firstname.lastname@example.org.
Written by Sarah Gehrke, MSN, RN and last updated Dec 15, 2017