Chapter 15 Medical Overview

Question 1

What do Trauma emergencies involve

Answer 1

injuries resulting from physical forces applied to the body

Question 2

What do Medical emergencies involve

Answer 2

illnesses or conditions caused by disease

Question 3

Respiratory emergencies occur

Answer 3

When patients have trouble breathing or when the amount of oxygen supplied to the tissues is inadequate

Question 4

Cardiovascular emergencies are caused by

Answer 4

conditions affecting the circulatory system

Question 5

Neurologic emergencies involve

Answer 5

the brain

Question 6

Gastrointestinal conditions include

Answer 6

appendicitis,
diverticulitis,
pancreatitis,

and many others

Question 7

A urologic emergency can involve

Answer 7

kidney stones or a bladder infection

Question 8

The most common endocrine emergencies are caused by

Answer 8

complications of diabetes mellitus

Question 9

Hematologic emergencies may be the result of

Answer 9

sickle cell disease or various types of blood-clotting disorders such as hemophilia

Question 10

Immunologic emergencies involve

Answer 10

he body’s response to foreign substances

and can range from fairly minor to life threatening

Question 11

Gynecologic conditions involve

Answer 11

the female reproductive organs

Question 12

Medical patient assessment is focused on what three things

Answer 12

a. Nature of illness (NOI)
b. Symptoms
c. Chief complaint

Question 13

The index of suspicion is

Answer 13

Your awareness and concern for potentially serious underlying and unseen injuries or illness

Question 14

Assessment of the medical patient (steps)

Answer 14

1. Scene size-up (Scene safety)
2. Primary assessment (General Impression, check airway and breathing, check pulse, transport decision)
3. History taking (gather info about medications…)

Question 15

what is the OPQRST mnemonic

Answer 15

The parts of the mnemonic are:
Onset,
Provocation/palliation,
Quality,
Region/Radiation,
Severity, and
Time

Question 16

Can an EMT give a patient medication

Answer 16

Any administration of medication by an EMT requires direct permission from medical control

Question 17

Can an EMT use an automated external defibrillator (AED) on a patient who is pulseless and apneic

Answer 17

Yes, an EMTs can use an automated external defibrillator (AED) on a patient who is pulseless and apneic

Question 18

Critical patients always need rapid transport. They include patients:

Answer 18

a. With altered mental status
b. With airway or breathing difficulties
c. With any sign of circulatory compromise
d. Who are very old or very young

Question 19

Type of transport

Answer 19

1. If a life-threatening condition exists, the transportation should include lights and siren.
2. If the patient is not critical, consider nonemergency transport.
3. Modes of transport ultimately come in one of two categories: ground or air.
   a. Ground transport EMS units are generally staffed by EMTs and paramedics.
   b. Air transport EMS units are generally staffed by critical care transport professionals and paramedics.

Question 20

Destination selection

Answer 20

1. Generally, the closest hospital should be your destination.
2. Sometimes a patient will benefit from going to another hospital that is capable of handling his or her particular condition.

Question 21

General assessment principles (5 steps)

Answer 21

1. Approach the patient with an infectious disease like any other medical patient.
2. Perform scene size-up, take standard precautions, and complete primary assessment.
3. Gather patient history using OPQRST to elaborate on the patient’s chief complaint.
4. Obtain a SAMPLE history and a set of baseline vital signs; pay particular attention to medications and the events leading up to today’s problem.
5. Ask whether the patient has recently traveled or has come in contact with someone who has traveled.

Question 22

Influenza (4 steps)

Answer 22

1. Those with chronic medical conditions, compromised immune systems, and the very young and very old are most susceptible to complications of influenza.
2. Transmitted by direct contact with nasal secretions and aerosolized droplets from coughing and sneezing by infected people
3. Many potentially serious diseases can be passed by the respiratory route:
   a. Always wear PPE (gloves, eye protection, and a HEPA respirator or N95 mask at a minimum).
   b. Wash hands frequently.
   c. Place a surgical mask on patients with suspected or confirmed respiratory disease.
   d. Wear HEPA respirator or N95 mask during aerosol-generating procedures, such as suctioning of airway secretions, performing CPR, or assisting with endotracheal intubation.
4. Annual influenza immunization is important for EMS personnel to protect providers and patients.

Question 23

Herpes simplex

Answer 23

This is a common virus strain carried by humans.
2. Symptomatic infections cause eruptions of tiny fluid filled blisters called vesicles that appear on the lips or genitals.
3. Can cause more serious illnesses like pneumonia and meningitis in the very young, very old, and immunocompromised patients
4. The primary mode of infection is through close personal contact, so standard precautions are generally sufficient to prevent spread to or from health care workers.

Question 24

HIV infection

Answer 24

1. EMTs face a risk of exposure to the virus that causes AIDS on a regular basis.
2. AIDS can still be fatal; however, with treatment, patients can expect a near-normal lifespan.
3. HIV infection is a potential hazard only when deposited on mucous membranes or directly into the bloodstream.
   a. It is not easily transmitted in the work setting.
   b. Your risk of infection is limited to exposure to an infected patient’s blood and body fluids.
4. Many patients with human immunodeficiency virus (HIV) show no symptoms.
   a. Always wear gloves when caring for a patient.
   b. Take great care in handling and properly disposing of needles and other sharp objects.
   c. Cover any open wounds that you have whenever you are on the job.
5. If you think that a patient’s blood or secretions may have entered your system, seek medical advice as soon as possible and notify your infectious disease officer.

Question 25

Hepatitis

Answer 25

1. Inflammation (and often infection) of the liver
2. Can be caused by viruses and toxins
3. There is no sure way to tell which hepatitis patients are contagious.
4. Hepatitis A can be transmitted only from a patient who has an acute infection, whereas hepatitis B and hepatitis C can be transmitted from long-term carriers who have no signs of illness.
   a. A carrier is a person (or animal) in whom an infectious organism has taken up permanent residence and may or may not cause an active disease.
   b. Hepatitis A is transmitted orally through oral or fecal contamination.
   c. Hepatitis B is far more contagious than HIV.
   d. Hepatitis B vaccine is highly recommended for EMTs.

Question 26

Meningitis

Answer 26

1. Inflammation of the meningeal coverings of the brain and spinal cord
2. Most forms of meningitis are not contagious.
   a. One form, meningococcal meningitis, is highly contagious.
3. Take standard precautions.
   a. Gloves and a mask will go a long way to prevent the patient’s secretions from getting into your nose and mouth.
   b. Vaccines are rarely used.
   c. Meningitis can be treated at the ED with antibiotics.
4. After treating a patient with meningitis, contact your employer health representative.

Question 27

Tuberculosis

Answer 27

1. Most infected patients are well most of the time.
2. A chronic mycobacterial disease that usually strikes the lungs
3. Disease that occurs shortly after infection is called primary tuberculosis.
   a. Reactive tuberculosis is common and can be much more difficult to treat.
4. Patients who pose the highest risk almost always have a cough.
   a. Consider respiratory tuberculosis to be the only contagious form because it is the only one that is spread by airborne transmission.
   b. Droplet nuclei: the remnants of the droplets produced by coughing after the excess water has evaporated
   c. N95 or HEPA mask is required to stop droplet nuclei.
5. Absolute protection from infection with the tubercle bacillus does not exist.
   a. According to the Centers for Disease Control and Prevention, one third of the world’s population is infected with tuberculosis.
   b. The mechanism of transmission is not very efficient.
6. Have tuberculin skin tests regularly.
   a. If the infection is found before you become ill, preventive therapy is almost 100% effective.

Question 28

Whooping cough

Answer 28

1. Also called pertussis, whooping cough is an airborne disease caused by bacteria that mostly affects children younger than 6 years.
2. The best way to prevent exposure is to be vaccinated with the DPT or TDaP; you can also place a mask on the patient and yourself.

Question 29

Methicillin-resistant Staphylococcus aureus (MRSA)

Answer 29

1. MRSA is a bacterium that causes infections and is resistant to many antibiotics.
2. In health care settings, MRSA is transmitted from patient to patient by the unwashed hands of health care providers.
3. Factors that increase the risk for developing MRSA include:
   a. Antibiotic therapy
   b. Prolonged hospital stays
   c. A stay in an intensive care or burn unit
   d. Exposure to an infected patient
4. The incubation period for MRSA appears to be between 5 and 45 days.
5. MRSA results in soft-tissue infections.

Question 30

MERS-CoV (Middle East respiratory syndrome coronavirus)

Answer 30

a. First human case of MERS-CoV discovered in 2012 in Saudi Arabia
i. Most human infections found in the Middle East
ii. Cases of MERS-CoV have been found in Europe and the United States.
b. If you suspect MERS-CoV, place a surgical mask on the patient and notify the receiving facility.

Question 31

Ebola

Answer 31

a. In 2014, an outbreak of the Ebola virus in West Africa, which spread when infected people traveled to other countries, caused international concern.
b. Incubation period: 6 to 12 days after exposure
c. Symptoms may not appear for as long as 21 days after infection.
d. Fatality rate can be as high as 70% if treatment in an ICU is not initiated promptly.
e. If you suspect Ebola, place a surgical mask the patient, follow PPE precautions as outlined by local protocols and the CDC, and notify the receiving facility.

Question 32

Travel Medicine

Answer 32

1. You must be aware of travel-acquired infections when assessing a patient who was recently outside of the United States.
2. Patients can present with a variety of symptoms, including fever, cough, vomiting, bloody diarrhea, body aches, and rashes.
3. When you encounter an ill patient with a recent travel history, place a mask on the patient and gather as much information as possible.
4. Important questions to ask the patient should include:
   a. Where did you recently travel?
   b. Did you receive any vaccinations before your trip?
   c. Were you exposed to any infectious diseases?
   d. Is there anyone else in your travel party who is sick?
   e. What types of foods did you eat?
   f. What was your source of drinking water?
5. If you suspect the patient has a communicable illness, follow appropriate PPE precautions and notify the receiving facility.

Question 33

symptoms of meningitis

Answer 33

Symptoms of meningitis develop suddenly and can include:
a high temperature (fever) over 37.5C (99.5F)
being sick.
a headache.
a blotchy rash that doesn’t fade when a glass is rolled over it (this won’t always develop)
a stiff neck.
a dislike of bright lights.
drowsiness or unresponsiveness.
seizures (fits)

Question 34

symptoms of mers cov

Answer 34

Symptoms include fever, cough, and shortness of breath. Other symptoms may include nausea, vomiting, and diarrhea.

Question 35

symptoms of tuberculosis

Answer 35

Typical symptoms of TB include:
a persistent cough that lasts more than three weeks and usually brings up phlegm, which may be bloody.
weight loss.
night sweats.
high temperature (fever)
tiredness and fatigue.
loss of appetite.
new swellings that haven’t gone away after a few weeks.

Question 36

symptoms of hepatitis

Answer 36

The symptoms of hepatitis include:
Pain or bloating in the belly area.
Dark urine and pale or clay-colored stools.
Fatigue.
Low grade fever.
Itching.
Jaundice (yellowing of the skin or eyes)
Loss of appetite.
Nausea and vomiting.

Question 37

Factors that increase the risk for developing MRSA include (4)

Answer 37

a. Antibiotic therapy
b. Prolonged hospital stays
c. A stay in an intensive care or burn unit
d. Exposure to an infected patient

Question 38

virulent definition

Answer 38

Virulence is a pathogen’s or microorganism’s ability to cause damage to a host. In most, especially in animal systems, virulence refers to the degree of damage caused by a microbe to its host.

Question 39

The best way to prevent exposure to whooping cough

Answer 39

is to be vaccinated with the DPT or TDaP; you can also place a mask on the patient and yourself