Lectures Flashcards
1
Q
What is a Simple Pneumo?
A
Partial or complete collapse of a lung due to either blunt or penetrating trauma
- when air is present in the pleural space, a closed or simple pnemo exists
- air enters the pleural space through a opening in the lung
- lungs begin to collapse as the pressure in the pleural space increases
- common causes: rib fractures
2
Q
What are some S&S of respiratory distress?
A
- A-LOC
- Cyanosis
- 1 or 2 word sentences
- Tachy
- Stridor (audible)
- Cough
- Chest pain
3
Q
Abruptio Placenta: What is it? S&S? Tx?
A
- The premature detachment of a normally situated placenta
- May be complete or partial
- any stage of pregnancy (typ 3rd)
- MVC or Cocaine use =high risk
S&S
- acute sever lower abd pain
- dark vag bleeding
- soft tender contracting uterus
- shock
Tx:
- abc
- o2, IV
- tpt
- prepare for delivery
4
Q
What are the steps for treating a chemical burn?
A
1-PPE (most important!!)
2-Remove all clothing with chemical on them
3-Flush MOST chemicals with lots of water.
*if dry chemicals, brush off before irrigation
5
Q
Insulin, In AEIOUTIPS, meaning/S&S/tx?
A
A treatment for pts who suffer from diabetes mellitus whose pancreas is unable to produce enough or any insulin in order for the body to break down sugars
*imporatnat Q (does the pt have too much or too little insulin?)
S&S
- diaphoresis
- tachycardia/ tachypnea
- low BGL (under 4mmol)
- weakness
- confusion
Tx:
- prim and secon asses
- maintain airway
- 02
- pt positioning
- keep pt warm
- TPT
6
Q
What is the difference between Dementia and Alzheimer’s?
A
DEMENTIA
*progressive loss of intellectual function (affect memory, reasoning, orientation )
ALZ
*form of dementia with progressive loss of memory and cognitive function
7
Q
What is a embolus?
A
When a thrombus breaks breaks free from the vessel wall.
*can get caught in lungs,heart, brain
8
Q
What 5 questions do you ask when poisoning occured?
A
1-What did you take? (Its what they took that will kill them)
2-How much did you take?
3-When did you take it?
4-Did you throw up since you took it? (Involuntarily. Or voluntarily ) Yes? How many times, Where did you throw up?
5-Did you take it with anything else? (Alcohol etc
9
Q
What is urticaria?
A
*pale or referenced, irregular elevated patches and severe itching, hives.
10
Q
Name the Thoracic Vessel & Organ Tears
A
(1) Traumatic Aortic Rupture
* Most common cause of immediate death in MVC’s
* Usually caused by deceleration injury
(2) Trachael or bronchial tree injury
* Subcutanous emphysema, possible hemo or pnemo
(3) Diaphragmatic Tears
* Causes Herniation of abdominal organs into thoracic cavity
(4) Esophageal Injury
* Associated airway injury more important than actual injury
11
Q
What do you treat a eviceration?
A
- maintain aseptic technique
- clean wound
- DO NOT replace contents
- cover with saline soaked dressing
- ensure wound is air tight
- c spine
- tpt with knees flexed
12
Q
Psychiatric, In AEIOUTIPS, meaning/S&S/tx?
A
- it’s important to differentiate a psychological reason from a metabolic reason for why this pt is unconscious
- usually on many diff meds for CNS depresssion
- can be unresponsive because of too much stimulus
- Our job to figure out which is the cause and treat appropraitely
S&S
- signs of possible OD
- hypertension, hypotension, normotension
- tachy x2, Brady x2, normal pulse rate, apnea
- pupillary reaction
Tx:
- prim and secon asses
- maintain airway
- o2
- pt posistioning
- TPT
13
Q
What is a Hollow Organ Injury?
A
- Injuries to the hollow abd organs may result in sepsis, wound infection and abscess formation
- Injry to the hollow organs results in symptoms from spillage of their contents, resulting in peritonitis
- The stomach is usually protected during blunt mechanisms because of its location in the abd
14
Q
Is Subdural Hematoma arterial or venous bleed?
A
Venous
15
Q
What are S&S of cocaine?
A
- paranoia
- diaphoresis
- hypertension
- chest pain
- seizures
- headache
- tachycardia/pnea
16
Q
What is, S&S, Tx: Rib Fractures
A
- Most common chest injury
- Occurs mostly on the later aspect of ribs 3-8
S&S
- pain
- shallow breathing
- tenderness to site
Tx:
- 02
- Continually evaluate for more serious underlying injuries
17
Q
What is a seizure and common causes?
A
*a seizure is a sudden explosive discharge or cerebral neurons and is charactized by a sudden alteration in brain function, usually involving motor, sensory automatic or psychic manifest stations
(Seizure is not a disease, but a symptom
Common Causes
- Epilepsy (a generic term for pt’s with no other diagnosis in which to cause seizures)
- OD (causes seizures due to the substances effect on the CNS)
- Withdrawal (causes seizures due to hyper stimulation of CNS when removing the CNS depressant)
- Trauma (causes seizures due to hypoxia, seizures are usually secondary to hypovolemia)
- Febrile (causes seizures in infants 6mths-5yrs)
- usually occurs from rapid body temp (over 38degrees) norm occurs in first 24 hrs)
- infants have a underdeveloped hypothalamus which makes them unable to regulate their body temp
- CVA
18
Q
What are the types of Diabetic Emergencies?
A
(1) Hypoglycemia (low blood sugar)
(2) Hyperglycemia (high blood sugar)
- diabetic ketoacidosis
- hypersmolar coma
* normal blood sugar levels range between 4.0mmol/L-11.0mmol/L
* diabetic emergencies happen to pts who are symptomatic and whose blood sugar levels are below or above normal range
19
Q
Name the 3 signs of increased ICP (Cushings Triad)
A
(1) Increase in BP (hypertension)
(2) Bradycardia
(3) Bradypnea (Cheynes stokes)
20
Q
What is Gravida and Para?
A
Gravida: many many times the pt was pregnant
Para: how many children the pt has
21
Q
When would you use a traction splint?
A
- mid shaft femur fracture
- closed
- no pelvic or lower extremity injury
22
Q
What is muscular Dystrophy?
A
*basic abnormality to produce intracellular metabolites that will sustain muscle tissue
*muscle tissue eventually dies and is replaced with adipose and fibrous tissue
—fatal depending on severity
23
Q
What are chemical burns S&S?
A
- redness/burning/numb at site
- formation of blusters and dead skin
- vision changes (if gets into eye)
- cough
- low BO
- cardiac arrest or irregular heartbeat
24
Q
What are the 3 categories of burns?
A
1-epidermis
2-dermis
3-hypodermics (Subcutanous)
25
What is, S&S: Gastrointestinal Bleeding (GI)
*GI bleeding can rapidly result in life threatening Hypovolemic shock
UPPER GI
*From Mouth-Duodenum
*pt commonly vomits blood
*common cause Peptic Ulcers
LOWER GI
*results in bleeding due to a lesion of the GI track below the duodenum
*blood from lesions always passes rectally
*melenia stool
26
What is anemia?
A reduction of the total number of circulating RBC or a decrease in either quantity or guiltily of hemoglobin
27
What are the 9 types of fractures?
1- Open (compound): break in skin
2- Closed: doesnt break skin
3-Compression: falls/diving
4- Colle’s: Distal wrist fractures (silver spoon)
5-Greenstick: partial fracture form bending
6-Transverse: complete break at 90deg to bone
7-Oblique: complete break from 0-90 deg
8-Simple: bone breaks but is still in alignment with other end
9-Comminuted: break along many lines
28
Stroke, In AEIOUTIPS, meaning/S&S/tx? And causes
Two types of stroke
(1) Hemorrhagic (rupture of a blood vessel within the brain)
(2) Thrombus/ Embolus (a clot either forms in the vessel within the brain an cuts off blood flow to the part of the brain, or a clot from the heart or centre along vessels comes loose and travels to a smaller vessel in the brain, cutting off blood supply to the brain
```
Causes
*blood DO
*medications
*trauma
*anuerysms
*atrial fibrillation
*hypertension
IMPORTANT Q (SAMPLE, OPQRST, time of onset? Progression of symptoms? Similar past experience? If so (what symptoms did they experience? Treatments? Lingering affects?) )
```
S&S
* hemiplegia (paralysis on one side of body)
* hemiparesis (slight paralysis on one side of body)
* facial droop
* slurred speech
* drooling
* unequal pupils
* dysphagia
Tx:
* prim and sec asses
* maintain airway
* o2
* pt positioning
* TPT
29
What is the pathophysiology of Diabetes?
* Pancreas is the primary affected organ
* result of lack of insulin levels or inability to use available insulin
* insulin is produced by beta cells in the pancreas then release into the blood stream and used as a carrier molecule for glucose in order to be transported into cells
* insulin also allows excess glucose to be converted into storage called glycogen within the cell
* the pancreas alpha cell produce a hormone called glucagon
* glucagon is secreted into the bloodstream with the blood sugar levels drop and it causes the breakdown of glycogen (stored sugar) and stored fats back into glucose to where the body can use it for energy (glycogenolysis)
30
What is Hemorrhagic shock?
* Loss of blood from internal or external bleeding
* Inadequate circulation blood volume to perfume tissues
* Usually seen traumatic
31
What is a Aneurysm?
A out pouching of a vessel wall or cardiac chamber
* can be dissecting, leaking, or ruptured
* most commonly appear in the aorta
* Handle pt’s VERY gently
32
What are the 3 types of muscle tissue?
1-smooth
2-cardiac
3-skeletal
33
What is Retroperitoneal Organ Injury?
* The Retroperitoneal space can sustain injury from blunt or penetrating trauma to the anterior/posterior abd or thoracic spine
* Hemorrhage writhin this space may be massive, Usually results from pelvic and or lumbar fractures
* Injuries to kidneys involve contusion fractures and lacerations resuliting in hemorrhage, urine extravasation or both
34
What is, S&S, Tx: Evisceration
* The presence of abdominal contents protruding through a laceration or puncture of the abdoinal wall
* Organs usually involved are the large and small intestines
* Occurs after penetrating injuries when a large opening is created in the abd
S&S
* pain
* tachycarida, bradycardia, tachypnea, bradypnea,
* pale, cool, clammy skin
Tx:
* control airway
* o2
* c spine
* shock position with bent knees
* completely cover wound with STERILE and moist occlusive dressing
* transport
35
What is compartment syndrome?
* when a section of the body has circulation cut off for a period of time and blood sits idle for too long
- toxins build up in stagnant blood
- clots form
- can be caused by something cutting off circulation
36
What are the S&S and Tx for Pnemo’s?
```
S&S
*dyspnea
*tachypnea
*anxiety
*chest pain
*decreased lung sounds
*shock
S&S of (developing tension Pneumo)
*JVD
*tracheal deviations
*hyperresonace
*hypotension
*cyanois
```
Tx:
02
*BVM prn
*rapid transport
37
What is osteoporosis?
* absolute loss of total bone mass as well as reduction in density bone matrix, and minerals
* 2x more likely in women
* hips are generally the first place to be damaged
38
What is Chronic Bronchitis?
Inflammation of the bronchi is characterized by excess mucous production and decreases muscles clearance
* mucous is thicker than normal and body unable to clear it
39
True or False? Female pt of child bearing age w/ abdominal pain are considered to have a Ectopic Pregnancy until proven otherwise?
True
40
Breech Birth: What is it? Tx?
* Babies arms, legs or bum presents first
* if only 1 arm or leg is out, surgery is required
tx:
* delivery normally
* tpt asap
41
What does AEIOUTIPS stand for?
```
A-Alcohol
E-Epilepsy
I-Insulin
O-Overdose
U-Uremia
T-Trauma
I-Infection
P-Psychiatric
S-Stroke
```
42
What is, S&S, Tx: Hemothorax
Blood in the pleural space-more from penetrating than blunt trauma
* each thoracic cavity can hold 300cc of blood
* blood accumulates and puts pressure on lung
S&S
* cyanosis
* flat neck veins
* dyspnea
* decreased breath sounds
* shock
Tx:
* o2
* BVM prn
* rapid transport
43
A Epidural Hematoma is a collection of blood between the _____ & ______ ?
Brain
| Dura
44
Pre Eclampsia: What is it? S&S? Tx?
*Abd state during pregnancy w/ hypertension and fluid retention
S&S
* HTN ( +20 systolic, +10 diastolic)
* fluid signs
* exess weight gain
* headache
* visual disturbances
* decreased urine output
* seizures
Tx:
* ABC
* 02
* IV
* Tpt on left side
* Prepare for seizures
45
What vessels carry 02 poor blood to the lungs?
Pulmonary arteries
46
What happens to the CNS of geriatrics?
* decreased
- cells in brain, size and weight
- dec blood flow with increased cerebral blood flow
- pain perception
- sense of equilibrium
- perception of temp
Increased
-CSF
47
What is a hematoma?
* bruise
* a localized collection of blood (usually clotted) in a Organ, space or tissue due to a break in the wall of a blood vessel.
* typically not life threatening
48
What are the 4 types of burns?
1-Thermal
2-Electrical
3-Chemical
4-Radiation
49
What is a laceration?
* a tearing of the skin or other soft tissues
| * may be from blunt tearing force or sharp object
50
What are the 3 types of brain hemorrhage?
(1) Epidural
(2) Subdural
(3) Intracerebral
51
What is Vascular Structure Injury?
* The major vessels that are frequently injured are
- Aorta
- Inferior vena cava
- Renal, messentric and iliac arteries and veins
* Carries high mortality rate if not surgically repaired soon after the event
* Usually presents as Hypovolemic, and occasionally is associated with a palpable abd mass.
52
What is Shock?
* Inadequate perfusion
* Homeostasis not maintained due to insuffificient perfusion of the tissues
* EVERY DEATH IS CASUED BY SHOCK
53
How to assess for abdominal injury?
* Palpation of the abdominal
* Assess for DRT and guarding
* Avoid deep palpation of a obviously injured abdomen so that hemorrhage or other injuries arent worsened
* MOST RELIABLE S&S is signs of shock
54
What are the order of straps for a KED?
* My Baby Looks Hot Tonight
- Middle
- Bottom strap
- Legs
- Head
- Top strap
55
What are the interventions needed for the APGAR scores?
* -6 = immediate resuscitation
* HR -60bpm = PPV w/ 100% 02 and chest compressions
* HR 6-100bpm = PPV w/100% for 60 secs then reassess pulse
* Hr +100bpm = blow by 02 and supportive care
56
Epiglottitis: What is it? S&S? Tx?
* Inflamation of the epiglottis
* baterial infection of upper airway, typ in children
* develops rapidly (hours)
* usually over 12 months
* can lead to resp compromise
S&S
* +12 months
* appears I’ll
* pain on swallowing
* maybe stridor but no barking cough
* lump in throat
Tx:
* DO NOT AGITATE (rings can close airway)
* high flow 02
* pst of comfort
* BVM if in resp failure
57
What is the definiton of LAW
That body of rules (made by gov) which the courts or other gov agencies will enforces=
58
What is acetominophen and S&S
* antipuretic
* results in hepatocellular death
S*S
* n/v
* RUQ abd pain
* diaphoresis
* pallor
* jaundice
* tachycardia
* hypotension
59
When do bones finish calcifying?
End of puberty
*takes more force to break a child’s bone than a adults
60
What is a Radiation burn?
* Caused by direct exposure to radiation (chemo, tanning beds)
* Most common types are alpha, beta, gamma (in order)
* injury usually from improper handing or transport
61
What is the definiton of asthma?
A inflammatory disease characterized by hyper-ressonsive airways
62
What is poisoning?
*a substance that through chemical action usually kills, injures or impaired a organism
63
What is ventilation?
The process of moving air in and out of the lungs
64
S&S and Tx: Right CHF
```
S&S:
*JVD
*Pedal Edema
*Sacral Edema
Tx:
*provide high flow 02 with NRB @ 15L/min
*transport in posistion of comfort (high Fowler’s)
```
65
What is Deep Frost Bite?
* The skin is white, blotch and or blue
* The tissue underneath has been damaged, and is hard and cold to touch
* May need amputation
* Blistering WILL happen
66
What are the kinds of Pneumothorax’s?
* Spontaneous
* Simple
* Open
* Tension
67
What is the tx for hypothermia?
* handle gently!
* remove from environment, remove wet clothing
* high flow 02, warmed if possible
* dont actively rewarm w/o med control
* do long pulse checks
* aed can be used initially but only re used as CBT increases
* ACLS drugs are less effective in cold pt
68
What are some S&S of Peds cardiopulmonary failure?
* happens when resp failure and shock go untreated
* doesnt always mean Cardiac arrest
S&S
* dec LOC
* seizures
* bray (car/Pena)
* apnea
* hypotension
69
What are the 4 general types of shock?
(1) Hypovolemic
(2) Relative Hypovolemic
(3) Cardiogenic
(4) Obstructive
70
What is, S&S: Appendicitis
```
*Opening between the lumen of the appendix and the cecum is obstructed with fecal mattter causing the appendix to be inflamed
S&S:
*RLQ pain
*N/V
*Low grade fever
*loss of appetite
* abd guarding
```
TRANSPORT BEFORE RUPTURE
71
True or false? *a local infection may also become systemic when the microorganisms gain access to the lymphataic or vascular system?
True
* leads to sepsis
* can be gradual or acute
72
What is a Pulmonary Embolus? S&S?
A embolus that lodges somewhere in the pulminary vasvulature
S&S
* Sudden onset dysonea
* sharp pinpoint pain
* line of demarkation
73
What is a Pulmonary Embolus? S&S?
*A embolus that lodges somewhere in the pulmonary vasculature
S&S
* sudden SOB
* sharp, pinpoint pain
* line of demarkation
74
S&S and Tx: Hypovolemic Shock
*Hypotension
*Tachycardia, Bradycardia
*Apnea
*Severe thirst
*decreasted body temp, LOC, unconc, coma
Tx:
*stop or limit blood loss
*maintain pt warmth
*C spine control
*airway management
*high flow 02 w/ ventilation’s
*Load and go
75
S&S and Tx: Opioid OD
```
S&S
* Miosis (constricted pupils)
*Hypotension
*Decresed heart rate, LOC’s
*Respt depresssion
*Hypothermia
*Slow/slurred speech
Tx:
*Naloxone
*Airway management
```
76
Whats Involved in the Third stage of labour?
* begins at the end of the delivery of the baby and at the delivery of the placenta
* no longer than 30 mins
* dont pull the cord
* expect copious amounts of blood
77
Infection, In AEIOUTIPS, meaning/S&S/tx?
* infection is usually a symptom of a underlying cause
* if it isn’t rectified the pt will go into shock
* for a infection to cause a pt to be unconscious the pt usually has a recent history of illness
S&S
* fever
* rash
* variable skin conditions
* hypotnesion
* tachy x2, bradypnea
Tx:
* prim and secon asses
* maintain airway
* o2
* maintain “normal” body temp
* pt positioning
* TPT
78
Is Epidural hematoma usually arterial or venous bleed?
Arterial
79
What are the S&S and Tx of Frostbite?
S&S
* initially skin looks white and waxy
* skin becomes hard and loss of sensation
* with rewarmingin, skin flushes purple and burgundy and swelling
* blisters begin to form
* necrosis occurs and extremity turns black over next few weeks
* after thawing, intense pain
Tx
* remove pt from cold
* treate hypothermia first before localized frostbite
* do not break blisters or rub affected area
* do not routinely try to reward frostbite in the field
80
What causes blisters in frost bite?
Ice crystals. They take up more room within the cells, and cause the cells to rupture, forming blisters .
81
Describe Petit Mal seizure
* brief lapses of attention and awareness
* more common in childhood but do happen in adults
* can occur frequently in 1 day
* often confused with daydreaming
* pt usually unaware when episodes occur, they continue as if nothing is happening
* may make purposeful movements, (smacking lips or picking at clothing)
82
What are the 2 primary effects of cocaine?
1- blockage of norepinephrine reuptake
| 2- marked release or norepinephrine
83
What is, S&S, Tx: Pericardial Tamponade
Results from a collection of cloud in the pericardial sac, which leads to compression of the heart muscle ineffective pumping
*causes compression of the ventricles causing a significant drop in cardiac output
```
S&S
*Becks Triad (hypotension, JVD, muffled heart sounds)
Tx:
*o2
*rapid transport
```
84
What do the following sounds indicate?
(1) Wheezing: Bonchial spasms
(2) Crackles: Fluid in the lungs
(3) Stridor: FBAO (upper airway)
85
What warrants a automatic trip to a Burn Treatment Centre?
* 2nd and 3rd burn, 10% BSA if -10 or +50
* 2nd and 3rd burns, 20% BSA any age
* Burns to face, hands, genitalia, perineum, and skin over major joints
* 3rd burns, 5% total BSA
* Specialized burns of electrical, chemical. Inhalation, circumferential chest or extremity injury
* pre existing significant medical disorders
* other significant injuries
86
What is Crush Syndrome?
* when muscle has had pressure placed on it for extended periods of time
* ex: sitting on place, car sitting on you
* pt’s are prone to DVT, DIC, PE, AMI, TIA
87
What happens to the respiratory system in geriatrics?
* dec in size and strength of muscles for resps
* calcium builds where ribs join sternum
* degeneration of alveolar membrane
* body becomes less sensitve to hypoxia or inc levels of CO in blood and tissues
* reduced cough and gag reflexes
88
What is Moderate Hypothermia?
* body temp between 33C to 35C
* shivering slows down
* movement is uncomfrotable
* pt can appear drunk wit slowed slurred speech, poor coordination and lack of balance
* confusion, apathy, and inability to make proper decisions
* breathing may become shallow, drowsiness or euphoric urge to sleep
89
What are the 6 rights to medication?
```
D: Dosage/documentation
R: Route
E: Expiry
M: Medication
T: Time
P: Patient
S: Site
```
90
What are Benzos and S&S?
* sedative hypnotic agents
* used for seizures, anxiety, insomnia
* valloum, Ativan
S&S
* nystagmus
* hallucinations
* slurred speech
* ataxa
* Altered metnal status
* amnesia
* resp depression
* hypotension
91
RSV (Respiratory Syncytial Virus): What is it? Risk factors?Tx?
* Most common cause of lower resp trace infections
* almost all children contract RSV by age 3
* leading cause of bronchioles and pneumonia in infants
* role in development of asthma and COPD
* prevalent in 2-6 myths
Risks:
* premature birth
* -6wks of age
* congenital heart defects
* chronic lung defects
* immunodeficiency
* 2nd hand smoke
* not breast fed
* older sibs in same house
Tx:
* symtomatic
* severe case may need hospital and anti viral drug therapy
92
Whats Involved in the Second stage of labour?
* begins w/ full dilation of the cervix and ends with the delivery of the baby
* labour down feel
* contractions are 2-4 mins apart
93
What is Metabolic Shock?
* Caused by fluid loss from body’s reaction to disease or burns, or by fluid shifting out of the cardiovascular system into interstitial or extra cellular spaces
* Ex: diarrrhea, vomitting, sweating, burn blisters, heat exhaustion
94
What is a avulsion?
*tearing away of the skins surface
1-incomplete
2-complete
95
What sources are derived from 4 primary sources?
(1) plants
(2) animals
(3) minerals
(4) synthetic (man made)
96
What is emphysema?
Destruction of the alveolar walls resulting in loss of elastic recoil
*destruction leads to hyperinflation of the lungs (Dead air space)
97
How many bones are in the body?
* Axial (80), Appendicular (126)
* Support for the body
* storehouse for minerals
98
What is the definition of “half life”?
The time required for half the amount of a drudge introduced into a living system to be elimated by a natural process
99
What is normal CBT?
36.9 degC
100
What are some S&S of peds Shock?
* hemorrhage, lots of vomitting/diarrhea
* inc urging output
* tachy (car/Pena)
* cyanosis, pallor
* hypotension
101
What are some common Peds meds?
* tylenol (Control fever)
* tempra (other brand for acetaminophen)
* amoxil (antibiotic)
* ritalin (ADHD)
102
What are some common CHF medications?
* Diuril
* Lasix
* Nitro
* ASA
* Digitalis
103
What are the 2 types of Hypovolemic shock?
(1) Hemorrhagic
| (2) Metabolic
104
What are the 4 routes of entry for Poisoning?
1- ingestion
2-inhalation
3-injection
4-absorption
105
What is a “drug”
Chemical agen used in diagnosis, treatment, or prevention of a disease
106
What is the treatment for Herniation Syndrome?
```
ONLY hyperventilation
—> Adult: 20 breaths/min
—> Child: 30 breaths/min
*Only BLS treatment
*more ventialation because it reduces the amount of Co2 in the blood
```
107
What are some rules of suctioning?
* should be less that 15 secs
* hyperoxygen before and after
* dont activate the suction during insertion of the catheter
* suction as you pull out
108
What is Superficial Frost Bite?
* The skin will be white or blue and will feel har and frozen
* The tissue underneath may still be undamaged. Blistering is likely which is why med tx should be sought out
* Propert tx is critical to prevent damages
109
What are 3 aspects to remember about Chemical burns?
1-Duration of exposure
2-Distance from the source
3-Sheilding between you, pt and source
110
What is a Agonist?
A agent that is antagonistic to the action os sympathetic or orther cholinergic nerve fibres
111
What is Atherosclerosis?
* A disease in which vessel wall harden and thicken
* A disease where the hardening and thickening are due to fat deposits
* Leading cause of Coronary Artery Disease
112
Skull fractures are classified as..
(1) Open ( skin that has been broken)
| 2) Closed (skin has not been broken
113
What does Sp02 measure?
* % of hemoglobin which is saturated in o2
114
Respiration is a combination of what?
(1) Inspiration
| (2) Exhalation
115
What is CO poisoning and what are the S&S?
* by product of combustion and is one of many chemicals in smoke
* Co binds to hemoglobin 257x stronger than 02, which leaves the body hypoxic
* C0 is colourless, odourless and tasteless
S&S
* A-LOC
* Normal skin color (no red or cyanotic skin)
* headache, irritability, diziness
* convulsions, apnea, SOB
116
What is it called when lungs have fluid in them?
Pulmonary Edema
117
What is Cricoid Pressure? (Also known as the Sellick maneuver)
Prevents gastric distension and regurgitation in pt’s receiving artificial ventilation by pushing down the hard trachea down on the soft esophagus.
118
What is Mild Hypothermia?
* Body temp between 36.2-35 degC
* SHIVERING
* rapid pulse to slow and weak)
* normal BP to hypotensive
* breathy rapid to slow and shallow
* skin red to pay and cyanosis
* pupils reactive to sluggish
* stiff muscles and joints
119
Heat Cramps:What is it? S&S? Tx?
* muscle pain in the abd or lower extm due to dehydration and overexertion in hot environment
* caused by excessive loss of salt and water
S&S
* muscle twitching
* spasms
* nausea
* diaphorsis
Tx:
* pt put in cool environ
* o2
* tpt
120
Name the other 5 types of shock
(1) Septic
(2) Spinal/Neurogenic
(3) Anaphylactic
(4) Cardiogenic
(5) Psychogenic
121
The brain suffers from what kind of injuries?
(1) Primary (occurs from the actual injury)
| 2) Secondary (occurs from the accosicated hypoxia
122
What happens to the Musculoskeletal system in geriatrics?
* loss of minerals in bone
* decrease in height
* loss of flexibility
* dec in skeletal muscle mass
123
What is/S&S/Tx: Hypoglycemia
* A reduction in blood sugar lower than 4.0mmoL/L
* A result of two basic problems
(1) decreased food intake
(2) increased insulin levels
* untreated hypo results in death because the tissues of the body need glucose to survive. The brain is most sensitive organ and often 1st affected.
S&S
* usually a sudden onset
* increased hunger
* agitation
* confusion
* tremors
* tachy x2
```
Tx:
*prim and secon asses
*maintain airway
*o2
*admin medication (if applicable)
DOCUMENT
*tpt
```
124
What are some S&S of peds resp failure?
* increased WOB
* acc muscle use
* inc HR
* Incr resps
* cyanosis and pallor
125
What is Diabetes Mellitus?
* A disease which causes a inability for a person to maintain proper blood sugar levels
* it is a endocrine system disease with many systemic effects
- myocardial ischema
- myocardial infarction
- cerebral ischemia
- atherosclerotic blood vessel disease
- peripheral vascular disease
- retinopathy
- neuropathy
- nephropathy
126
What is a abrasion?
* a superficial injury to the skin or orther body tissue caused by rubbing or scraping resulting gin a area of body surface loosing skin or muscous membranes
* no severe blood loss
127
What is Traumatic Asphyxiation?
* Describes a sever crushing injury to the chest and abdomen.
* Usually results from a increase in intrathoracic pressure that forces blood from the right side of the heart into the veins of the upper thorax, neck and face
* Reddish purple discorlation of the face and neck (skin below the area remains pink)
* JVD
* Swelling or hemorrhage of the conjunctiva
128
What is the difference between a Thrombus & Embolus?
A thrombus is when a clot adheres to a vessel wall, and a Embolus is when it breaks free and most likely gets caught in (lungs, heat or brain)
129
What are 3rd degree burns?
* Full thickness burns penetrate the entire dermis, destroying the bodys ability to regenerate
* Affects all 3 layers
* Charring of skin and translucent white color
* site of 3rd degree burns are painless, but will have 1st and 2nd degree burns on the periphery
* may involve blood vessels,nerves, muscle tissue, bone and even internal organs
130
Bconchuilitis: What is it? S&S? Tx?
* Viral infection causing inflammation of the bronchioles
* occurs in early childhood
* most commonly RSV affecting lining of the bronchioles
S&S
* prominent expiration wheezes, resembling asthma
* resp distress
* runny nose
* irritability
* low grade fever
* short periods of apnea
* around mouth or nail bed cyanosis
Tx:
* humidifed 02
* assist w/BVM if needed
131
What are Tricyclics Antidepressants and S*S
*antidepressant
*most severe toxins happen in cardiovascular systems and PNS and CNS
*cardiovascular toxicity results from direct myocardial depression
(Leaving, amitruptyline)
S&S
* anticholenergic
- tachycardia
* hydriasis
* dry skin
* dec your in retention
* coma
* hypotension
* hypoventillation
132
What are the drug routes?
* IV
* IM
* SQ
* ID
* IN
* Inhalation
* Oral
* Rectal
133
What does systolic and diastolic measure?
Systolic: measurement when the heart is fully contracted
Diastolic: measurement when the heart is fully relaxed
134
What are some communication systems used by EMS an dispatch?
* base station radios
* mobile radios
* cell phones
* GPS
* TTY
* computer communication
135
What is Solid Organ Injury?
* Injury to solid organs usually results in rapid and significant blood loss
* Liver and spleen are both primary sources of exsanguinations
* Pt w/ steering wheel injury, Lao belt injury, or history or epigastric trauma =suspect Liver damage
* Pt w/ MVC’s, falls or sports injuries with injury to the lower left chest, flank, or upper left abd =suspect Spleen damage
136
What are the 4 Levels of EMS professionals?
(1) EMR
(2) PCP (EMT)
(3) ACP
(4) CCP
137
What is Hypoxia? What are the S&S’s?
Decreased or inadequate supply of 02
S&S
* changes in pt’s mental status
* Tachycardia
* Sp02 less than 95%
* dyspnea and cyanosis are late signs
* headache/dizziness
* nausea
138
What is frostbite?
* the skin and or tissue under the skin freezes and causes cell damage.
* caused by exposure to cold, either through air or chemical exposure or highly compressed gassses
139
What is, S&S: AAA (abd Aortic Aneurysm)
* Anuersym means “dilation of a vessel”
* Develops at weak points in the wall of a artery
* Some causes include: Arterioscleriosis, genetics, physical trauma
* Over time it will grow in size and may rupture
```
S&S
*unexplained hypotension
*” “ syncope (fainting)
*tearing or ripping pain in abd or back
*pulsating mass usually located belly button left of midline
HANDLE GENTLY
```
140
Overdose, In AEIOUTIPS, meaning/S&S/tx?
* anyone can OD either intentionally or accidentally
* your job to find out (how the pt OD, why the pt OD, what the pt OD on, how much the pt had taken)
* YOU CAN OD ON ANYTHING
S&S
* empty medication containers
* drug paraphernalia
* track marks
* confusion
* tremors
* hypo or hyper tension
* tachy x2, Brady x2
* pupillary change
Tx:
* prim and secon asses
* maintain airway
* o2
* pt position
* TPT
141
Why is Left sided CHF more common than right?
With extreme Left CHF, pulmonary Edema develops. Prolonged pulmonary Edema increase with pulmonary pressures.
*Right ventricle has to work harder and it may eventually fail as well
142
What is involved in Environmental and Situational communication?
Environ:
* topography
* forces of nature
* sudden and drastic temp changes
Situational:
* location of pt
* pt accessibility
* noise
* temp
143
What is in the PAT?
W: Work of breathing (WOB)
A: Appearance
C: Circulation of skin
144
Uterine Rupture: What is it? S&S? Tx?
* Occurs at onset of labour
* sever contraction
* high mortality rate for mom and baby
S&S
* continous server abd pain
* min vag bleeding
* tearing sensation in abd
* nausea
* shock
Tx:
* abc
* o2, IV
* tp left side
* prepare for delivery
145
How many Litres of fluid can the abdominal cavity hold before showing any signs of distension?
1.5 L
146
What are S&S of Acute Abdn and what to you look for in the Assessment?
S&S
* N/V
* changes in Bowel habits
* decreased appetite
* chills, fever,
* Painful urination
* blood in urine, stool, or vomit
* vaginal bleeding or discharge
Asses:
* abd tenderness and guarding
* signs of shock
* fever
* pulsating mass in the abd
147
What is, S&S: Genitourinary Bleeds (GU)
Multiple causes including
* STD’s
* Menstration
* Pregnancy disorders
S&S
* Amound of bleeding, serious vs non serious
* signs of shock
148
What is the S&S acronym for Organo poisoning?
```
S: salvations
L: lacrimation (eye water)
U: urination
D: defecation
G: GI irritation
E: emesis (vomitting)
```
149
What are some potential complications for neonates?
RESPIRATORY DEPRESSION
* mother narcotic use
* gestational age
CARDIOVASCULAR SYSTEM COMPROMISE
*”hole in heart”
THERMO REGULATION
MECONUIM ASPIRATION
150
What is/S&S/tx: Hyperglycemia
*A increase in blood sugar levels above 11.0mmol/L
Includes:
-diabetic ketoacidisis
—>inadequate amount of insulin
—>body senses decrease amount of glucose and it stimulates response by pancreas
—> cant transport glucose because lack of insulin
—> body breaks down fats into fatty acids and produces ketones which produces metabolic acidosis, The Ketones give the acetone breath smell
—>eventually kidneys begin to filter glucose out of the blood stream into urine. Pts’ pees more and becomes deyhdrated
-hyerosmolar coma
—>pt becomes Hyperglycemia w/o producing ketones, no fruity breath
—> slowest and most sever form
—> much more profound dehydration
Tx:
* prim and secon asses
* maintian airway
* 02
* obtain BGL
* TPT
* IV
151
What is Organophosphate Poisoning?
* pesticdes and herbicides
| * dispruptiom in the postssunaptic neural transmission in the CNS and PNS
152
What are S&S of Ectopic pregnancy?
* missed period w/abd pain
* vaginal bleed
* hypotension
* shock
153
What is Frost Nip?
* numbed skin that has turned white in color
* the skin may feel stiff to the touch but the tissue under is still warm and soft
* little chance of blistering/infection/scarring as long as tx properly
154
What is a tension Pneumo?
* may result from Simple, Spontanous, or Open pnemo
* Occures when air is able to enter the pleural space but isnt allowed to leave
* causes complete lung collapse and puts pressure on the mediastinum and opposite lung
* COPD and asthma pts at risk from positive pressure ventilation
155
Prolapsed Cord: What is it? Tx?
*Umbilical cord presents from the vain before the infant and is compressed against the birth canal by the babies head
Tx:
* true Emerg
* ABC
* 02, IV
* elevate moms hips
* knee-chest
* dont allow mom to push
* 2 fingers inside vagina w/sterile gloves to prevent compression
* tpt asap for c section
156
What is the APGAR score?
```
A: Appearance
P: Pulse
G: Grimace
A: Activity
R: Respiration’s
*out of 10
*done 1-5 mins post delivery
```
157
What is, S&S, Tx: Flail Chest
* Occurs when 3 or more adjacent ribs are broken in at least 2 or more places
* Resulting in asymmetrical expansion with chest wall
* risk of developing pnemo or hemo
S&S
* paradoxical chest rise
* sob, cyanosis
* crepitation and tenderness at site
* shock
Tx:
* o2, BVM prn
* manually stabilize flail segment, then bulky dressing
158
What is Herniation Syndrome?
Occurs when the brain is displaced towards the base of the skull through the foramen magnum
*Late occuring, due to massive amount of ICP
159
S&S and Tx: Hyperventilation
S&S
* chest pain
* diziness
* paresthesias (tingling)
* carpopedal spasm
* tachycardia/palpitations
Tx:
* treat underlying cause
* calm, reassure pt
* 02 NC @ 3-4L/min
160
Where should the clamps be placed after the baby is born?
* 4 inches from the newborns belly button
* 6-9 inches from the umbilocus
* *cut the cord between the 2 clamps
161
What are Amphetamines and S&S?
* compunds that produce CNS and PNS stimulation
* Meth is common use
* typically by mouth but can be snorted, smoked or injected
S&S
* over sensitive to sensory stimuli
* euphroria
* dehyrdation
* hyperthermic
* appetite suppressant
* dilated pupils
* insomina
* hallucinations
* hypertenson
* tachycardia
162
What are the rules for Hare and Sagers?
Hare
1-one leg only
2-lengthen until pain is relieved on conscious pt
3-lengthen until legs are same length on concious pt
Sager
1-CMS check before and after
2-Can be used bilaterally
3-Adjust to length of uninsured leg first
4- Mac traction is 10% body weight or 15lbs/leg
163
What is a Thrombus?
A abnormal (stationary) blood clot that adheres to a vessel wall
164
S&S and Tx: Soft Tissue Injuries
S&S
*severe bleeding
Tx
*DO NOT remove dressing to reass wound, add more instead
*AIRWAY, check for FBAO (teeth, vomit, bone fragments)
165
What is, S&S, Tx: Blunt Trauma
* Usually result of compression or shear injuries
* Compression injuries occur when abdominal organs are crushed between solid objects
* Shear injuries cause rupture of the organ or surrounding vessels
* Most frequent organs injured are the liver and spleen
* The degree of injury caused by blunt force is related to the quantity and duration of force applied and the type of abdominal structure injured
S&S
* pain
* distention
* guarding
* bruising
* blood in vomit, stool
* tachycardia, bradycardia, tachypnea, bradypnea
* hypotention
Tx:
* keep pt warm
* o2
* ventialiations
* c spine
* immobilize any fractures
* shock posistion
* transport
166
What vessels carry 02 rich blood to the lung?
Pulmonary veins
167
What are the S&S of Left AND Right sided CHF?
L:
* Dyspnea
* Productive Cough
* Frothy/pink sputum
* Fatigue
R:
* JVD
* Pedal and sacral edema
* hypotensive
168
What is a amputation?
*the cutting away from the body of a limb or protruding structure
1-partial
2-complete
169
What are the 5 ways we control temp?
1-Radiation (“waves,” which is how you can get burned from a house fire)
2-Conduction (direct contact, like microwaving food)
3-Convection (air movement, taking heat away)
4-Evaporation (sweating, )
5-Respiration (ei, breathing)
170
What happens in the Renal system of geriatrics?
* dec kidney function
* dec renal blood flow
* fluid and electorlyte imbalance
* incr drug toxicity
171
What 3 criteria must a PT meet to be submitted under Mental Health ACT?
(1) Must have a Mental DO
(2) A danger to self or others
(3) No Alternative
172
What is the Tx for burns?
* Safety for rescuers!
* remove pt from the source of burning or remove the source form the pt
* ABC’s
* only remove clothing if free and loose
* apply dry and STERILE dressing
* maintian separation of appendages
* passive cooling
* o2
* treat for shock
* rapid tpt
* be prepared for Cariac Arrest
173
What are thermal burns?
* Most common type
| * results from exposure to or contact with steam, flames, flags and hot surfaces or hot liquids with temps about 115degF
174
What is a OD?
*self admin of drugs taken to excess or in combination with other agents to the point where poisoning occurs
175
What are the 4 things that the severity of a Electrical burn depends on?
1-type of current
2-amount of current
3-path of current
4-duration of contact with current
* must be grounded for injury to occur
* #1 concern is cardiac dysthymias (v-fib)
176
What are the rules for the Sender and Reciver?
Sender
* focus
* develop contact w/pt
* communicatie effectively
* explain tx
* use their na,e
* assume understanding
Receiver:
* focus
* allow others to finish
* active listening
* ask questions
* dont discriminate
* don’t judge
177
What are the 3 types of frost bite?
1- Frost Nip
2- Superficial Frost Bite
3- Deep Frost Bite
178
What is the Tx for Hypothermic cardiac arrest?
* remove wet clothing
* passively warm pt
* c spine prn
* inser OPA.NPA
* apply AED and if prompted deliver 1 shock only until CBT increases above 30
* contue CPR until ALS or at hospital
179
What are the 3 most common alcohol poisoning?
1-ethanol (we drink)
2-methanol (anti freeze)
3-isopropanol (hand sani)
180
Lack of Oxygen leads to what 3 things?
(1) Ischemia (reversible)
(2) Injury (reversible)
(3) Infarction (irreversible)
Cell deaths
* Brain/Nerves:4-6min
* Cardiac: 30 mins
* Muscles/Organs: cells up to 1 hr
181
What is scoliosis?
* similar to kyphosis
* spine curves into S shape
* youth are generally congenital
182
How do you Control bleeding?
* direct pressure
* compress proximal artery if possible
* posistion
* tourniquet
* moist sterile dressing (if involved w/ meatus
* NEVER remove bled through dressing
183
What is, S&S: Pancreatitis
* Inflammation of the pancreas due to either stones that block the ducts or alcohol
* Damage to the gland occurs when digestive enzymes are activated and begin attacking the pancreas
S&S:
* swollen and tender abdomen
* severe abdominal pain
* radiating pain straight through to the pt’s back
* N/V
* fever
184
What is a opioid?
Synthetic or natural chemicals that mimic the actin’s of endorphins responsible for sedation and analgesia
*Causes CNS and respiratory depression
185
S&S and Tx: Left CHF
```
S&S:
*Dyspnea
*Orthopnea
*Productive cough, frothy sputum
*Fatigue
*Lung sounds: crackles, wheezes
Tx:
*High flow O2 with NRB @ 15L/min
*Transport in posistion of comfort (high Fowler’s)
```
186
What is cerebral Palsey?
* non progressive disorders affecting the brains and muscular control
* can be caused prenatal and during delivery
* S&S Chang with growth and maturation
* causes can be toxins during pregnancy to postnatal hemorrhage
187
What are some S&S of respiratory emergency?
* A-LOC
* cyanosis
* decreased or absent breath sounds
* audible strider
* 1 or 2 word sentences
* tachycardia
* pallor and diaphoresis
* accessory muscle use
188
Heat Stroke: What is it? S&S? Tx?
* Hyperpyrexia (elevated temp)
* failure of the body’s temp regulation mechanisms
* extreme med emerg
* can occur rapidly or couple of days
* permament brain damage or death can happen
S&S
* sever headache
* vertigo
* fatigue
* pt usually stop sweating
* skin is red hot and read
* tacchy (Cardia.pnea)
* disoreientation
* convulsions (seizures)
Tx
* remove to cool environ
* active cooling
* o2
* tpt
189
What is, S&S, Tx: Penetrating Trauma
* More visible than blunt trauma
* Includes stab wounds gunshot wounds, or impaired objects
* Multiple organ damage can occur
* Trajectory of a missile can frequently be visualized and can help identify possible injured organs
* Blunt trauma, pt dies more
* get size of object, type, how many x pt was impaired, posistion of pt when it entered, how it entered
* GSW: try to obtain type of weapon used
S&S
* Look for exit wound
* blood pooling
* pale, cool, clammy skin
* tachycardiac, bradycardiac, tachypnea, bradypea
* hypotension
Tx:
* keep pt warm
* c spine
* o2
* control bleeding, stabalize object
* shock position
* prepare AED
190
What holds the respiratory control centre which signals the muscles of respiration?
The Medulla
191
What is the tx for poisoning?
* ensure scene safety
* decontamiation
- begin at initial medical management
* remove clothing and irrigate exposed area
* mtn appropraite barrier protection and ventilation
* ABCS
* poision control
* ALS backup
* notify hospital for decon setup
192
What is a Cardiac Contusion?
* MOI can cause significant damage
* Often associated with other chest injuries- cardiac tamponade, cardiac, cardiac rupture
* Even without injuries, myocardial contusion is lethal on its own.
* Presents very similar to AMI
* Assume that any pt who has suffered blunt chest trauma has cardiac contusion
193
What is, S&S: Cholecystitis
* Inflammation of the gallbladder
* Caused by sudden obstruction of the ducts by a gallstone, usually the cystic duct
S&S
* Pain is intermittent (waves)
* usually located in RUQ
* may radiate to posterior scapular or r shoulder
* pain is worse w/ movement
* N/V
194
Trauma, In AEIOUTIPS, meaning/S&S/tx?
*The main cause of decreased LOC and coma in a trauma pt is Hypovolemia
195
What are chemical burns?
* Most chemicals that cause burns are either strong acids or bases
* Tissue damage factors include chemical concentrations, quantity, manner and duration of exposure
* Injuries to skin as well as internal organs (specifically kidney and liver)
* Volatile chemicals can cause damage via inhalation, causing a compromised airway and possibly life threatening
* The burn continues until the chemical is either consumed in the damage process or removed
196
Describe a Partial Seizure
*happens without any impairment of consciousness
*primary localized motor symptom
*autonomic symptoms (involuntary)
*psychic symptoms (different states of consciousness)
Examples
*focal motor (abnormal movements of one part of the body)
*jacksonian (travels in succession, affecting the corresponding muscles, starting in the hands)
197
What are Osteoblasts and Osteoclats?
Osteoblasts: build bone
Osteoclasts: break bone down
*both respond to estrogen
198
What is Pulmonary Contusion ?
* A common chest injury resulting from blunt chest trauma
* More than 50% of pts with blunt chest trauma have a PC
* The confused area of the lung is not able to function properly after a injury, causing profound hypoexmia
* The degrees of respiratory complications is directly related to the size of the confused area
* Pt’s will c/o pain to area with dyspnea, anxiety, tachypnea, cyanosis, hemoptysis
199
What are the main differences between bronchitis and emphysema?
BRONCHITIS
* exercise intolerance
* wheezing
* SOB
* productive cough
EMPHYSEMA
* dyspnea on exertion
* no cough
* barrel chest
200
What are the 3 classifications that connects at joints?
1-immovable
2-slightly moveable
3-highly moveable
201
What are burns a result of?
Water evaporation from the skin, thus denaturing the proteins that make up cell membranes
202
What is a Inhalation injury?
* most are classified as CO poisoning, heat or smoke inhalation
* most freq injuries occur when pt is trapped or confined to small place
203
Epilepsy, In AEIOUTIPS, meaning/S&S/tx?
*A generalized term for the primary reason that causes seizures
SEIZURES: a sudden explosive discharge of cerebral neutrons and unset by a student alteration in brain function, involving motor, sensory, automatic or psychic manifestations
S&S
* medical alert
* medications
* incontinence
* aura
* posturing
* tachycardia/tachypnea
* hypertension
* postical
* cyanosis
Tx:
* prim and sec asses
* pt safety
* maintain airway
* o2
* treat any trauma injury
* TPT
204
What are the ages for Peds pts?
* Infant: 0-1
* Child: 1-Puberty
* Adult: Puberty and up
205
Alcohol, In AEIOUTIPS, meaning/S&S/tx?
* Alcohols primary effect on the body is a CNS depressant
* It affects the medullary centres in the brain stem by depressing it and decreasing the respirator drive at higher levels consumed
* Important Q (has the pt been drinking? If so, how much? What type? For how long?)
S&S
* empty bottles and cans
* unkept house
* disheveled look
* smell
* slurred speech
* tachy x2, Brady x2
* hypotension
Tx:
* primary asses and secondary asses
* maintain airway
* o2
* posistion, keep pt warm
* TPT
206
Placenta Previa: What is it? S&S? Tx?
* Abornmal posistioning of the placenta within the uterus
* first presenting part
* once crevice dilates, placenta will detach (baby will no longer get 02)
S&S
* painless
* profuse bright red blood
Tx:
* abc
* if able, delay delivery
* 02, IV
* left side
207
When is splinting done?
Always in secondary!!
* enroute after mangled abcs
* on scene after vitals and HX
* delegate if possible
208
S&S: Intracerebral Hematoma
* headache
* nausa vomitting
* Slurred speech
* Fixed, dilated pupils
* Abnormal flexsion/extension
209
What is a Open Pneumo?
“Sucking Chest Wound”
*caused by penetrating wound through chest wall
*air flow enters pleural space but not the lung
Tx (specific)
*cover w/ occlusive dressing and taps on 3 of 4 sides
210
True or false?
| When exposed to cold, blood vessels constrict to prevent body heat loss and hypothermia?
TRUE!
211
What are 1st degree burns?
* usually red and sensitive to touch
* min tissue damage and ONLY involves epidermis
* Dry and W/O blisters
212
What are the rules for splinting?
*assess CMS distal injury BEFORE and AFTER splinting
-if no CMS, you have 1 attempt to realign to anatomical position
-if intact CMS, splint in position found
-revival on constrictive clothing around site
-immobilize joint above and below Injury
-pad splint
-joints are splinted in position found unless.......
—>extreme distal cyanosis
—>extremity lacks distal profusion
*dont reduce a dislocation!! (Out of scope)
213
What is the difference between a Info patch and a Order patch?
Info:
*ysed when we want to let the ER staff know what we are bringing in
Order:
*Used when you require to get online medical direction for a emergency physician
214
What are heat inhalation injuries and what are the S&S?
* damage the upper airways, since breathing in flame and gases does not transport down to the lungs
* tissue swelling
* supraglottic is where the swelling occurs, airway capture is crucial once noted swelling happens
S&S
* Brassy, NP cough
* hoarse voice
* stridor
* mouth, nose burn
* airway edema
* singed face or nose hairs
* sooty sputum
215
What are electrical burns?
* Damage is done by electricity entering the body and traveling through the tissues
* extremities suffer the most tissue damage because their small size results in high local current density
216
S&S of cerebral contusions
* Loss of consciousness, may last hours to days
* Seizures hemiparesis, aphasia, personality changes, vomitting
* May be Increased ICP
217
What are the drugs that a EMR can Admin and Patient Assist
(1) ASA (admin)
(2) Oral Glucose (admin)
(3) Naloxone (Admin)
(4) Epi (patient assist)
(5) Ventolin (pt assist)
(6) Atrovent (pt assist
* (7)Oxygen (admin)
218
What is Severe hypothermia?
* body temp less than 32.2 C
* NO SHIVERING
* any other signs of mild hypo
* may take clothes of because they think they are warm
219
What is a Simple Pneumo?
When a lung collapses without the involvement of trauma
* cause is usually due to defect
* Bleb burst and enters pleural space
220
Croup: What is it? S&S? Tx?
* Childhood disease with edema of the upper airway and bar king cough/dyspnea/stridor
* Viral disease
* usually starts by a cold, progressive over days
S&S
* barking seal cough
* stridor
* resp distress
* fever
* worst at night
Tx:
* cool mist, either humidified 02 or nebulized saline (helps reduce inflammation)
* may need to assist ventilation’s
* walk slowly to the ambulance to get air in lungs
221
What is Pelvic Organ Injury?
* Injury to the pelvic organs usually from....
- MVC that produce pelvic fractures
- Penetrating trauma
- Straddle type injuries from falls
- Pedestrian accidents
- Some sexual acts
222
What are 2nd degree burns?
* affects both epidermis and dermis
* Causes redness, pain, swelling, weeping AND blisters
*1st and 2nd degree burns can be referred to as “partial thickness burns” because the dermis is still intact and can regenerate
223
What are the 3 major functions of muscles?
1-motion
2-stabalize
3-thermogenesis
*over 600 muscles in the body
224
What is, S&S, Tx: Trauma in Pregnancy
* Protruding uterus, high blood flow, and its contents are more susceptible to injury including (rupture, penetration, placenta abrupt ion, premature rupture of membranes)
* MVC’s are most common cause of trauma
* due to seatbelt use, there is a sudden increase in pressure that can cause uterine rupture, placental abruption and fetal death
* pelvic fractures, blunt and penetrating trauma, fractured ribs, may cause uterine lacerations that result in substantial blood loss
* the uterine and fetus enlarge above the symphysis pubis and the fetus becomes more susceptible to both blunt and penetrating trauma.
S&S
* pain
* obv signs of trauma
* tachycarida, bradycardia, tachypnea, bradypnea
* hypotension
* vaginal bleeding
* contractions
Tx:
* airway management
* o2
* treat for shock
* place pt on left side (10-15 degres) *takes pressure off inferior vena cava will assis with blood return to the heart
* treat traumatic injury
225
What 3 things is Asthma characterized by?
(1) Swelling
(2) Secreations
(3) Spasms
226
A Subdural Hematoma is a collection of blood ____ the ____
Below (the) dura
227
What is Minute Volume?
The amount of air exchanged over the course of 1 minute
228
What is Congestive Heart Failure? (CHF)
Inadequate tissues perfusion as a result of cardiac dysfunction
*Causes? Hypertension, Previous MI, congenital abnormalities
229
What are the 3 C’s before giving a medication?
(1) Colour
(2) Clarity
(3) Concentration
230
What are 4 things that could hinder effective communication?
1- personal limitations
2- “ “ boundaries
3- professional boundaries
4-personal biases
231
What is included in Cushings Triade?
(1) Increased BP
(2) Bradycardia
(3) Bradypnea
232
What is it called when fluid builds up into the lungs?
Pulmonary Edema
233
S&S and Tx: Skull Fractures
```
S&S
*Altered level of responsiveness
*Pupils sluggish to react or dilated
*Blood or CSF draining from eyes or nose
*racoon eyes
*battle signs
Tx:
*none notes
```
234
Whats Involved in the First stage of labour?
* begins with the first true contraction and ends with full dilation of the cervix
* amnoatic sac usually ruptures
* true contractions typ 5-15 mins apart
235
Paediatric Seizures: What is it? S&S? Tx?
* can be epileptic seizures
* most commonly febrile seizures
- occur to sudden rise in body temp
- most common b/w 6 mo-6 years
S&S
*usually temp above 39.2degC
TX:
* same as for adult seizures
* o2
* remove extra clothes, but not too quickly
* prevent shivering
* maybe tepid water in armpits and groin
* careful of ambulance cooling system
236
What is kyphosis?
*sofetening of the vertebrae anterior aspect causing the curve/hunching forwards (problems with SMR)
237
S&S for Acute Abdomen? What should you focus on for the physical exam?
* N/V
* chnges in bowel habits (diarrhea, constipation, stool or color consitancy)
* decreased appetite
* chills, fever
* painful uriniation
* vaginal bleeding or discharge
Exam
* abd tenderness and guarding
* signs of shock
* fever
* pulsating mass
238
What happens to the Cardiovascular system in geriatrics?
* cardiac output drops
* dec HR
* inc calcium deposits in heart
* inc fibrous tissues throughout heart muscle and peripheral vascular system
* walls of heart thicken
* conduction system degenerates (arrhythmia, heart blocks)
**heart gets weaker even though it has greater resistance **
239
How do you treat seizures?
* prim and secon asses
* protect pt
* keep pt warm
* maintain airway
* Obtain BGL
* treat pt presentation (any trauma, dont force mouth open, dont put anything in mouth)
240
What is hypothermia? What are the causes?
* CBT of less than 35 degC as a result of increased heat loss or decreased heat production
Causes
1- cold water immersion
2- cold weather exposure
3-urban hypothermia
*hypothermia chances increase with alcohol, CNS depressants, infection, diabetes, brain dysfunction and burns
241
What are the Specific Kinds of Abdominal Injuries?
* Solid Organ
* Hollow Organ
* Retroperitoneal organ
* Pelvic organ
* Vascular injury
242
What is Tital Volume?
The amount of air inhaled and exhaled in 1 ventillation
243
Heat Exhaustion: What is it? S&S? Tx?
* A more serious condition than cramps with more serious fluid loss
* If you ignore the cramps it will go to heat exhaustion
S&S
* inc fatigue
* sever cramps
* weai
* dec LOC
* drenching sweats
* dilated pupils
* hypotension
* profound thirst
Tx:
* remove from environ
* passively cool, using cold packs and fanning
* possible airway mgmt
* high flow 02
* treat for shock
244
S&S: concussions
* brief altered level of consciousness (less than 5 mins)
* Periods of drowsiness, restlessness, confusion, amnesia
* Vomitting, combativeness
245
What are, and describe the 2 kinds of Diabetes
(1) IDDM (Insulin Dependent Diabetes Mellitus, Type #1)
* normally childhood onset
* results when pancreas produces no insulin
* glucose levels get very high
* requires insulin for survival
(2) NIDDM (Non Insulin Dependent Diabetes Mellitus, Type #2)
* normally diagnosed in pts over 40 yrs
* pts can produce insulin but not enough for the bodies need
* these pts can usually control their diabetes with oral medication or diet
246
What is, S&S: Renal Colic
* ”Kidney Stones”
* Developed from crystals that separate from the urging and build uo on the inner surfaces of the kidney
S&S
* extreme intermittent pain
* sharp cramping pain in the back and side in the area of kidney and lower abd
* dysurea (cant pee)
* N/V
