Entry ticket 15 Flashcards by ArcherGirlDaisy Unknown

Tension pneumothorax signs

Tracheal deviation - Very very late sign 
Difficult to ventilate 
Unequal breath sounds 
History of trauma, asthma, COPD 
Pt has shortness of breath 
Possible JVD 
Hyperresonant chest wall from percussion

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What do SSRI’s treat?

SSRI - Selective serotonin reuptake inhibitors

Prescribed to treat: depression
Anxiety disorders
Panic disorders
OCD

Page 1478-1479

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Management of Hypothermic cardiac arrest

Avoid rough and excessive movement cause it could cause the heart rhythm issues
Severely hyperthermia may cause defibrillators to not be effective
Intubation could cause pt to go into VTAC
Metabolism normally works at a specific temperature and can delay medication taking effect - mainly epinephrine

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GABA

Gamma-amino butyric acid

It causes the post synaptic cleft to remain open longer to allow chloride in. The chloride makes it so that there needs to be more stimulation to continue down the nerve

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Vaughn-Williams class 1

Sodium channel blocker

Lidocaine

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Vaughn-Williams class 2

Beta blocker

Metoprolol

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Vaughn-Williams class 3

Potassium channel blocker

Amiodarone

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Vaughn-Williams class 4

Calcium channel blocker

Cardizem - atrial type problems

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Vaughn-Williams class 5

Miscellaneous

Adenosine - we don’t fully understand how it works

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Heat cramps S&S, management

page 1893-1895

S&S: slight ABD cramping, tingling in extremities, severe pain in extremities and ABD, nausea. Pt is alert. Skin pale, moist, temp normal
Management: -Move pt to cool environment.
-If able, give pt some electrolyte liquid slowly PO.
-NS IV if pt is too nauseated.
-Do not massage the cramping muscles as this may aggravate the pain.

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Heat exhaustion S&S, management

page 1896

S&S: headache, fatigue, weakness, dizziness, nausea, vomiting, (sometimes) ABD cramping.
Management: -Remove pt to cool environment, remove excess clothing and place supine
-If pt’s temp is elevated, get pt slightly damp then fan pt. Do not over cool.
-If pt is able, give fluids PO. 1teaspoon salt, 2tablespoons sugar in 1 quart water
-NS IV if pt is nauseous
-If able, determine electrolyte and sodium levels
-If CBT is elevated, treat pt for heatstroke

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Heat stroke S&S

page 1897-1898

Confused, Delirious, Comatose
Change in behavior; irritability, combativeness
signs of pt is hallucinating – this can confuse EMS by thinking its bahavioral or substance related emergency
Suspected stroke S&S – trouble walking, talking or using an arm or leg
Seizures, Constricted pupils, Tachycardia,
Hyperventilation, Low ETCO2
Low peripheral vascular resistance
Dry, red, hot skin for classic heatstroke
Pale, sweaty for exertional heatstroke

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Heat stroke management

page 1898-1899

Management: If uncertain what is causing elevated temp, treat as heat stroke
Remove pt from hot environment
Start rapid cooling - total immersion of the body in cold or ice water
Spray water on pt and have air blowing on them to promote convection
Evaluate ABCDE
Start IV, administer NS, check sugar levels. Be careful with giving to much fluids
Monitor cardiac rhythm and be prepared to treat seizures

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Mild hypothermia S&S, management

page 1903-1906

95F
S&S: Shivering, Fumbles – fine motor control problems
Stumbles, Mumbles
Crumbles – incoherence, hemodynamic collapse
Vague S&S: Increased heart rate, Increased resp rate
Management: Passive rewarming - removing wet clothes, drying skin, taking out of cold environment
If pt is able and depending on condition, consider letting the pt eat something to help the body generate heat
Keep the ambulance warm but not overly hot

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Two types of heatstroke

Classic heat stroke
Usually occurs during heat waves
Most likely to strike very old, very young or people with reduced mobility

Exertional heatstroke
Typically an illness of young people exercising in hot and humid conditions

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Afterdrop

Afterdrop is the continued lowering of the CBT even after the pt is removed from the cold. This happens from the body warming up and vasodilating which brings the cold fluids/blood back to the core.

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Moderate hypothermia management

82-90F
Management:
Active external rewarming - heating blankets, focused hot air
Warmed IV fluids
Heated and humidified oxygen can help rewarm while using another method

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Severe hypothermia management

Less than 82F
Management: 
This really can only be treated in hospital
Warm IV fluids
Warm, humidified oxygen
Cardiopulmonary bypass

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Pharmacodynamic

The study of a drug’s molecular, biochemical, and physiologic effects or actions

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Pharmacokinetic

The study of the time course of drug absorption, distribution, metabo- lism, and excretion

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Dopaminergic receptors

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Is an Alpha 1 agonist

When stimulated Vasoconstriction occurs

Dystonic reaction

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Dystonic - muscle twitching/spasm
This is an Atypical allergic reaction to a medication
Treat with benadryl

Anticholinergics

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Drugs that block the action of acetylcholine

Acetylcholine

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Chief neurotransmitter of the parasympathetic nervous system, part of the autonomic nervous system that contracts smooth muscles, dilates blood vessels, increases bodily secretions, and slows heart rate

Anticholinergic toxicity S&S

S&S: Agitation, dry mucous membranes, flushed skin, hyperthermia, tachycardia, dilated pupils, blurred vision, mild hallucinations, dramatic delirium "Hot as hell, blind as a bat, dry as a bone, red as a beet, and mad as a hatter"

Teratogenic drug

Drug that can cause birth defects. | Medical science cannot always predict how exposure to a teratogenic drug will affect a developing fetus.

Idiosyncratic reaction

Adverse effects that cannot be explained by the known mechanisms of action of the offending agent, do not occur at any dose in most pts, and develop mostly unpredictably in susceptible individuals only

Therapeutic index

A ratio that compares the blood concentration at which a drug becomes toxic and the concentration at which the drug is effective

Vaughn-Williams classification

Used to categorize antiarrhythmic drug therapy into classes based on mechanism of action

Inotropy

Increasing or decreasing the force of musclar contractions

Chronotropy

Adjective. affecting the rate or timing of a physiologic process

Dromotropic

Affects the conductivity of cardiac muscle - used of the influence of cardiac nerves

Snakebite management

Fluids Immobilize where the snake bite is Try to keep pt calm

Hymenoptera order

``` Stinging insects Yellow jacket Fire ants Bees Wasps Hornets ``` page 1927

Simple pneumothorax S&S

``` Difficulty breathing Diminished/unequal breath sounds Agitation AMS Tachypnea Tachycardia Cyanosis Lowered pulse oximetry Lower BP Absent breath sounds on affected side ```

Tension pneumothorax

``` Absent breath sounds on affected side Unequal chest rise Lower BP Tachycardia Dysrhythmias JVD (late sign) Narrow pulse pressure Tracheal deviation (very late sign) Difficult to ventilate Hyperresonant chest wall from percussion ```

Major thermal burn care

Fluids to replenish the plasma that can leak out of burns Keep pts warm Cover burn with something dry that will not stick to the wound to help reduce infection Meds for pain management

insensible fluid loss

is the term for fluid loss from the respiratory system

SLUDGEM

Symptoms of nerve agents ``` Salivation Lacrimation - the flow of tears Urination Defecation / Diarrhea Gastrointestinal distress Emesis - throwing up Miosis - pupils constriction ```

Affinity

An attractive force between substances or particles | The attraction between two things

Efficacy

The ability of an intervention (for example, a drug or surgery) to produce the desired beneficial effect

Duration of action

The length of time that particular drug is effective

Half life

The time needed in an average person for metabolism or elimination of 50% of a substance (medication) in the plasma.

CCB

calcium channel blocker

Schedule 1 medication

High abuse potential; no recognized medical purpose Ex: Heroin, marijuana, LSD

Schedule 2 medication

High abuse potential; legitimate medical purpose Ex: Fentanyl, methylphenidate, cocaine

Schedule 3 medication

Lower potential for abuse than schedule 2 meds Ex: Hydrocodone, acetaminophen with codeine, ketamine

Schedule 4 medication

Lower potential for abuse than schedule 3 drugs Ex: diazepam, lorazepam (ativan)

Schedule 5 medication

Lower potential for abuse then schedule 4 drugs Ex: narcotic cough meds

Med profile

The med profile describes all about the drugs

TCA

Tricyclic antidepressant | Used to treat depression, neuropathy, and chronic pain syndromes

Entry ticket 15 Flashcards

(51 cards)