NREMT Trigger Words

N/V= nausea/vomitting

uneven BP

peripheral pulses

pulsating mass

sudden severe chest pain (max onset)

Hx of HTN

dizzy / lightheadedness

tearing/ shearing pain and back/ shoulder pain

*common in men over 50

Aortic Aneurysm

thunder clap headache

maximal pain from onset

nausea and vomitting

dizzy/ lightheaded

possible visual changes

hx of HTN

brain aneurysm

sudden sweating

chest, lower jaw, L arm pain

SOB

nausea and vomiting

dysrhythmia

acute myocardial infarction

chest, lower jaw, L arm pain

SOB

nausea and vomiting

dysrhythmia

acute coronary syndrome

crushing/squeezing, mid-chest/substernal pain

SOB

nausea and vomitting

sweating

symptoms are relieved with rest

angina

elevated BP

tachycardia

hx of heart attack/ AMI

cool, diaphoretic, cyanotic

congestive heart failure

crackles/wheezing lung sounds

orthopnea

noctournal dyspnea

pink frothy sputum

Left-sided CHF

JVD

edema (pedal, extremity, peripheral, dependent)

ascites (fluid in the abdomen)

enlarged liver

right sided CHF

hx of AMI

CHF diagnosis ( includes s/s)

s/s of compensated shock

cardiogenic shock

beck’s triad: JVD, muffled heart tones, narrowing pulse pressure

sweating

chest pain that gets worse over time

Cardiac tamponade

severe SOB

tracheal deviation

dimisished/absent breath sounds on one side

subcutaneous emphysema

blunt injury

develops over time

tension pneumothorax

sharp sudden CP

dyspnea

tachycadia

hx of DVT

traveling/sitting for a long time

hemoptysis (coughing blood)

pulmonary embolism

high HR and RR

pale, diaphorteic

abd distention (internal bleeding)

blunt or penetrating trauma

caused by bleeding or dehydration

hypovolemic shock

wheezing/crackles

pulmonary edema

tachypnea

digital clubbing/edema

chronic cough with sputum

cyanotic

chronic bronchitis

“pink puffer”

skinny body/apperance

pursed lips

barrel chest

dyspnea on exertion (like walking)

emphysema

secondary infection

bed rest/ non-ambulatory/ post-surgery

fever/chills

sweating

SOB/pleurtic pain

elevated HR

wet lung sounds

eldetly are easily susceptiabl to AMS

leading cause of death in kids

pnemonia

drooling

fever

stridor

sore throat

difficulty swallowing

tripod/sniffing position

mostly in kids

epiglottitis

restless/irritable/comabative

decreasign LOC

tachycardic/tachypneic

cyanosis (late sign)

hypoxia

seal-bark cough

mostly in kids

stridor

croup

dehydrated

cough

fever

wheezing

common in kids and geriatrics

respiratory syncytial virus (RSV)

sudden weight loss

fatigue

cough

recent travel

fever

Positive skin test after 6 weeks

tuberculosis (TB)

red/purple/black rash on skin

purpura (skin vessels leaking)

fever (febrile seizures in peds)

headache

AMS

neck stiffness

decreased LOC

meningococcal meningitis

received bad news

faint

syncope

rapid pulse

low/normal BP

psychogenic shock

visual, smell, taste changes

numb/weak/dizzy

brief paralysis with little twitching

litte to no change is LOC

repetaive behavior

lip smacking/eye blinking

partial seizure

short/long-term memory loss

decreased attention span

unable to care for self / communicate

incontinent (bowel/bladder)

forgot to take meds or took too many

dementia/Alzheimers

disoriented/AMS

hallucinations/delusions

lack of interest

erratic speech

confusion

tremors

sweating

seizures & dilated pupils

High HR, RR, BP

hopeless, fear, anger, triggered (PTSD)

delirium, delirium triggers, schizophrenia, PTSD

facial drooping

impaired vision

aphasia

slurred speech

seizures

nausea and vomiting

AMS

hypertension (160+/90+)

tachycardia

stroke

facial drooping

impaired vision

aphasia

slurred speech

seizures

nausea and vomiting

AMS

hypertension (160+/90+)

tachycardia

s/s resolved in less than 24 hrs

transient ischemic attack

dilated vessels

does not sweat below the injury line

loss of temperature control (gets cold easily)

spinal cord damage/ neurogenic shock

pale/ pallor

weak and thready pulse

hypotension

hemophilia (does not clot)

weak pulse/ low BP

common in African descent

clammy

extreme pain especially in limbs

Sickle Cell

nausea/vomiting/ diarrhea

tachycardia/tachypnea

AMS/dizzy/ syncope/ coma

cramping

exposure to an allergen

awy obstruction

wheezing/stridor

rapid vasodilatation (low BP)

anaphylaxis

pale cool clammy

dizzy/HA

rapid pulse

weak/low BP

AMS (drunk appearance)

seizure (in severe cases)

hypoglycemia

red hot dru

increased thirst/hunger

kussmaul respiration

DKA

hyperglycemia

polydipsia, polyphagia, polyuria

weight loss

fatigue

kussmaul respirations

develops in kids and young adults

Type 1 diabetes mellitus

overweight

develops later in life

sweat, fruity, acetone breath

warm/dry skin

needs insulin regulation

Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)

dehydration

possible vison changes

type 2 diabetes mellitus

RLQ pain

rebound tenderness

referred pain to the naval

fever

severe/sudden after blunt force trauma

appendicitis

LLQ pain

bright red blood in the stool

hx of constipation

common in asian populations

diverticulitis (large intensities)

RUQ/ upper central abdominal pain

pain may radiate to thr R upper back, shoulder ot flank pain

worsens after eating fatty foods

cardiac hx

cholecystitis

pain with swallowing

heartburn

nausea and vomiting

sores in the mouth

eating greasy food

gastroesophageal reflux disease (GERD)

lower abdominal pain

decreased urine output

cystitis (bladder inflammation)

abd pain, flank pain, and possible genital pain

hx of acidic food

possible side effects of acute kidney injury

kidney stones (renal calculi)

difficulty swallowing

vomiting

hypotension

liver failure/hepatitis

possible cirrhosis

esophageal varices

hx of acidic foods or GERD

pain in the upper abdomen/upper back

hematemesis

ulcers

pain in the upper quadrants (after eating)

nausea and vomiting

abdominal distention

pancreatitis

fatigue

jaundice

cirrhosis

weight loss

right shoulder/ RUQ pain

liver failure/ hepatitis

Intra-abdominal bleeding

left shoulder pain

lymph nodes inflamed

spleen injury

severe abdominal pain (gradual to unbearable)

tender

bowel movements stop

nausea/vomiting. diarrhea

distended

may be caused by hollow organs leaking

peritonitis

HTN

headache

edema (hands and feet)

anxiety

high HR

usually shows in 20th week

preeclampsia

seizures from HTN

possible family hx

eclampsia

severe pain

after blunt injury

high HR

same s/s as shock

little bleeding

abruptio placenta

not a lot of pain

heavy, bright red vaginal bleeding

occurs a few hours after contractions

placenta previa

malaise

body aches & fever

small blisters with skin bleeding

smallpox

burns

itching

redness

blisters

Poisoning (on skin)

tachycardia

poor capillary refill

very high RR

shock in infants and children

pale

weak pulse

delayed capillary refill

cold extremities

Vasoconstriction in infants and children

generally pt is between 14-30 years

lower abdominal pain (mimics appendicitis almost)

can be just following a period

feels like a twisting sharp pain

ovarian cysts

excessive vomiting while pregnant

usually comes on during second trimester

hyperemesis gravidarum

patient recently hospitalized or in nursing home (somewhere close quarters where hand hygiene may not be the best)

skin infection

warm

swollen

bump/ pustule

painful

red

sometimes full of pus

MRSA (methicillin-resistant staphylococcus aureus)

closed space (garage, car, kitchen) in which the gas can build up/fall & winter common times.

S/S of flu - headache "band around my head",

dizziness, nausea & high SPO2 reading but

cyanotic/dyspnea

cyanosis/AMS/ unconscious = late sign

Carbon Monoxide poisoning

jaundice (yellow)

tremors

liver damage, hepatitis, cirrhosis

thin blood

bleed easily

will have higher BP (liver is not getting rid of old blood cells)

alcohol abuse

generalized lower abdominal pain

slight back pain

foul order / discharge

irregular periods / cramps

possible HX of STD

N/V

Pelvic Inflammatory disease (PID)

dermis

partial burn

painful, red blisters

2nd degree burn

below dermis (subcutaneous muscle, bone, etc)

painless or painful

charring

leaking plasma

3rd degree burn

full of nerves, vessels & nutrients for the baby

can cause catastrophic blood loss if injured

Bruising of this organ is comparable to heart bruising

placenta

responsive; older than 1; abdominal thrusts with back blows (chest thrusts of preg or obese)

responsive; younger than 1; 5 back blows, 5 chest thrusts

unresponsive WITNESSED; immediately begin CPR with chest compressions

unresponsive NOT witnessed; quickly open & check airway. remove if you can see it ONLY. if nothing is there, start compressions

Foreign body airway obstruction (FBAO)

lisinopril and amlodipine

high blood pressure

Losartan and Labetalol

high blood pressure

metformin, januvia, humalog

diabetes

novolog, novolin, lantus, toujeo

diabetes

eliquis, plavix, xarelto

blood thinners

viagra, cialis, sildenafil, tadalafil

ED meds

cocaine, ecstasy, meth

illegal stimulants (opioids)

ritalin and adderall

legal stimulants (opioids)

give a CPAP if pt is able to follow commands

COPD tx?

SOB

wheezing or crackles

pulmonary edema

tachypnea

COPD; alveoli are blocked in some form/fashion

croup tx?

humidifed O2

epiglottis tx?

O2

RSV tx?

humidified O2

type 1 diabetes mellitus

insulin-dependent

type 2 diabetes

non-insulin dependent

• MOA: Inhibits platelet aggregation (antiplatelet).

• Indications: Suspected myocardial infarction/chest pain of cardiac origin.

• Dose: 160–325 mg PO

• Route: Oral.

• Side effects: Nausea, vomiting, heartburn, bleeding, allergic reaction (esp. asthma).

asprin

• MOA: Adsorbs toxins in the GI tract, reducing absorption.

• Indications: Certain oral poisonings/overdoses (per poison control/medical direction).

• Dose: 1 g/kg PO (usually 25–50 g adult, 12.5–25 g child).

• Route: Oral.

• Side effects: Nausea, vomiting, constipation, black stools, aspiration risk.

activated charcoal

• MOA: Blocks acetylcholine at parasympathetic sites (anticholinergic).

• Indications: nerve agent poisoning (SLUDGE symptoms).

• Dose: One autoinjector (commonly 2 mg). May repeat per protocol.

• Route: Intramuscular (IM).

• Side effects: Dry mouth, tachycardia, blurred vision, urinary retention.

atropine

• MOA: Beta-2 agonist → bronchodilation.

• Indications: Bronchospasm from asthma, COPD, or anaphylaxis.

• Dose: 2.5 mg via nebulizer (typical). Metered-dose inhaler varies (90 mcg/puff).

• Route: Inhaled (MDI or nebulizer).

• Side effects: Tachycardia, anxiety, tremors, palpitations, headache.

albuterol

• MOA: Alpha + beta agonist → vasoconstriction, bronchodilation, increased HR/contractility.

• Indications: Severe allergic reaction (anaphylaxis).

• Dose:

  • Adult: 0.3 mg IM (EpiPen).

  • Pediatric: 0.15 mg IM (EpiPen Jr).

• Route: Intramuscular.

• Side effects: Tachycardia, hypertension, anxiety, restlessness, headache, dizziness.

epinephrine

• MOA: Vasodilator → reduces preload/afterload, decreases myocardial oxygen demand.

• Indications: Chest pain of cardiac origin (angina, suspected MI).

• Dose: 0.3–0.4 mg SL tablet or spray every 5 minutes as needed, max 3 doses.

• Route: Sublingual (SL).

• Side effects: Headache, hypotension, dizziness, tachycardia, flushing.

• Contraindication note: Do not give if systolic BP < 100 mmHg or patient has taken ED drugs (sildenafil, etc.) in past 24–48 hrs.

nitroglycerin

• MOA: Opioid antagonist at receptor sites.

• Indications: Suspected opioid overdose with respiratory depression.

• Dose: 0.4–2 mg (up to 4 mg intranasal per spray, repeat as needed).

• Route: Intranasal (IN), intramuscular (IM).

• Side effects: Withdrawal symptoms (agitation, nausea, vomiting, sweating, tachycardia), seizures (rare).

Naloxone (Narcan)

• MOA: Increases blood glucose by absorption in GI tract.

• Indications: Hypoglycemia in conscious patients able to protect airway.

• Dose: 15–25 g PO (usually one tube).

• Route: Oral/buccal.

• Side effects: Nausea, risk of aspiration if airway not intact

oral glucose

adrenergic

enhances the sympathetic nervous system

neurotransmitter: epinepherine/norepinephrine

effects: ↑ HR, ↑ BP, bronchodilation, pupil dilation

examples: epinephrine and albuterol

cholinergic

enhances the parasympathetic nervous system

neurotransmitter: acetylcholine

effects: ↓ HR, ↑ secretions, bronchoconstriction, digestion.

agonist

• A drug that stimulates/activates a receptor.

antagonist

• A drug that blocks/inhibits a receptor.

• Pulmonary edema/CHF

• COPD exacerbation

• Asthma+severe distress

• Hypoxic respiratory failure

• Low SpO2

• Increased RR, accessory muscle use, dyspnea

• Able to talk in short sentences

indication for CPAP