Chest Discomfort

Question 1

What is the treatment plan for Tension Pneumothorax?

Answer 1

Needle decompression with a large bore + long needle in the 2nd intercostal space (or between 4th and 5th intercostal) in the mid-clavicular line.

Question 2

What are the three main LATE signs of a Pulmonary Embolism?

Answer 2

1) absent breath sounds on the affected side
2) Jugular vein distention (JVD)
3) Tracheal deviation

Question 3

What is Deep Vein thrombosis?

Answer 3

Vessel injury or sluggish blood floe in large vessels cause a fibrin formation or a clot.

Question 4

What are three risk factors for DVT?

Answer 4

Immobility
Oral contraceptives
Recent surgery.

Question 5

What is a pulmonary embolism?

Answer 5

When a clot that has formed in those deeper veins and travels through the heart and to the pulmonary arteries.

Question 6

What are three signs of a person with a pulmonary embolism?

Answer 6

• Sharp pain upon inspiration.
• dyspnea
• hypoxia

Question 7

What are five symptoms of a pulmonary embolism? (NOT risk factors)

Answer 7

1) acute SOB (lung not being perfused)
2) lightheadedness (poor blood return to the head)
3) syncope (reduced blood return to brain)
4) tachycardia (compensation mechanism)
5) hypotension (due to poor blood return to R ventricle)

Question 8

In the prehospital setting what are the treatments for suspected Pulmonary embolism?

Answer 8

1) Oxygen
2) Vascular access
3) 12-Lead
4) Aspirin (if the diagnosis is not clear)

Question 9

What is esophageal rupture?

Answer 9

When the esophagus is torn, gastric contents enter into the mediastinum, where an inflammatory infectious process ensues.

Question 10

What are some causes of esophageal rupture?

Answer 10

1) Swallowing sharp objects
2) Caustic burns
3) Blunt or penetrating Trauma
4) forceful vomiting

Question 11

What is the main symptom for esophageal rupture?

Answer 11

Fever

sepsis

Question 12

What is acute pulmonary edema (APE) / Congestive Heart failure (CHF)?

Answer 12

Poor ventricular pumping function leads to overall decrease in cardiac output, and as more blood is left in the ventricle, pressure builds in the left or right heart circulatory pathways; forcing fluid into the lungs.

Question 13

What are four symptoms of CHF?

Answer 13

1) Dyspnea (SOB)
2) Fatigue
3) exercise intolerance
4) FLUID RETENTION (rales)

Question 14

The layer of smooth muscle in the aorta that is weakened with aging, and increases the chance of having an AORTIC ANEURYSM AND DISSECTION. (Intima, _____, Adventitia)

Answer 14

Media

Question 15

What factors increase the chance of having an AORTIC ANEURYSM AND DISSECTION?

Answer 15

1) Hypertension
2) Marfan Syndrome
3) Ehlers-Danlos Syndrome

Question 16

What are three signs of having an AORTIC ANEURYSM AND DISSECTION?

Answer 16

1) Sudden onset of TEARING pain in chest.
2) Sharp pain in JAW or SCAPULA.
3) lightheadedness

Question 17

Fluid accumulation in the pericardial sac surrounding the heart is called what?

Answer 17

Pericardial Tamponade

Question 18

What are the three factors in the presentation of cardiac tamponade?

What affects the way cardiac tamponade presents?

Answer 18

1) How quickly the fluid accumulates.
2) The amount of fluid.
3) The hearts health.

Question 19

BECK’S TRIAD describes the symptoms of which medical emergency?

Answer 19

Cardiac tamponade

Question 20

What are the three characteristics of BECK’S TRIAD?

Answer 20

1) Hypotension
2) JVD
3) Muffled heart sounds

Question 21

What condition has characteristic of decreased pulse (or absent) during inhalation.

Answer 21

Pulsus Paradoxus.

Question 22

What are some symptoms of Cardiac Tamponade?

Answer 22

1) hypotension
2) chest pain
3) dyspnea (SOB)
4) possible cough