EMR MIDTERM UNFAMMILIAR TERMS

Hypoxia Pathophysiology

A condition where the body or a region of the body is deprived of adequate oxygen supply at the tissue level.

Hypoxia Key Features

Restlessness, anxiety, cyanosis (blue skin), tachycardia, and altered mental status.

Hypoxia Management

Ensure a patent airway, provide high-flow supplemental oxygen, and assist ventilations if necessary.

Hypovolemia Pathophysiology

A state of low extracellular fluid volume in the body, typically due to blood loss or dehydration, leading to decreased tissue perfusion.

Hypovolemia Primary Causes

Hemorrhage, severe vomiting/diarrhea, excessive sweating, or major burns.

Hypovolemia Management

Control the source of fluid loss and initiate rapid fluid replacement or blood transfusions.

Hypothermia Pathophysiology

A medical emergency that occurs when the body loses heat faster than it can produce it, causing a dangerously low body temperature (below 35°C).

Hypothermia Key Features

Shivering (early), slurred speech, lethargy, "mumble-grumble" behavior, and eventual loss of consciousness or cardiac arrest.

Hypothermia Management

Move to a warm environment, remove wet clothing, provide passive or active rewarming, and handle the patient gently to avoid cardiac arrhythmias.

Toxins Pathophysiology

Poisonous substances produced within living cells or organisms, or introduced externally, that interfere with normal physiological functions.

Toxins Management

Identify the substance, contact Poison Control, manage the airway, and provide specific antidotes if available (e.g., Narcan for opioids).

Cardiac Tamponade Pathophysiology

Compression of the heart caused by fluid (blood or effusion) building up in the pericardial sac, preventing the ventricles from expanding fully.

Cardiac Tamponade Key Features

Beck’s Triad (muffled heart sounds, JVD, and narrowing pulse pressure/hypotension).

Cardiac Tamponade Management

Rapid transport for hospital-based pericardial window or pericardiocentesis.

Thrombosis Pathophysiology

The formation of a blood clot (thrombus) inside a blood vessel, obstructing the flow of blood through the circulatory system.

Thrombosis Examples

Deep Vein Thrombosis (DVT) or Coronary Thrombosis (leading to MI).

Thrombosis Management

Administer anticoagulants or "clot-busters" (fibrinolytics) as directed by medical control; rapid transport.

Tension Pneumothorax Pathophysiology

A life-threatening condition where air enters the pleural space but cannot escape, causing increasing pressure that collapses the lung and shifts the mediastinum.

Tension Pneumothorax Key Features

Severe respiratory distress, absent lung sounds on one side, JVD, and late-stage tracheal deviation.

Tension Pneumothorax Management

Immediate needle chest decompression to release trapped air.

Compartment Syndrome Pathophysiology

Increased pressure within a confined muscle space (compartment) that impairs blood flow and damages nerves and muscle cells.

Compartment Syndrome Key Features

The "6 Ps" (Pain out of proportion, Pallor, Paresthesia, Pulselessness, Paralysis, and Poikilothermia/coldness).

Compartment Syndrome Management

Keep the limb at heart level (not elevated), provide oxygen, and transport for surgical fasciotomy.

Paresthesia Definition

An abnormal sensation of the skin, such as tingling, pricking, chilling, or numbness (often called "pins and needles"), usually caused by nerve compression or damage.

The Seven Rights of Medication (TRAMPRD)

Time, Route, Amount (Dose), Medication, Patient, Refusal, and Documentation.

CFR (Certified First Responder)

A person trained to provide initial emergency medical care until more highly trained personnel arrive.

Pacemaker Cells Definition

Specialized cells in the heart (primarily in the SA node) that spontaneously generate electrical impulses to set the rhythm of heart contractions.

Hypovolemic Shock Pathophysiology

A significant loss of blood or fluid volume leads to decreased preload, reduced stroke volume, and inadequate tissue perfusion.

Hypovolemic Shock Causes

Traumatic hemorrhage, severe dehydration (vomiting/diarrhea), or "third-spacing" from burns.

Hypovolemic Shock Key Features

Tachycardia, hypotension, pale/cool/clammy skin, delayed capillary refill, and decreased urine output.

Hypovolemic Shock Management

Control external bleeding, provide high-flow oxygen, and rapid fluid resuscitation (IV crystalloids) or blood products.

Cardiogenic Shock Pathophysiology

The heart fails as a pump, resulting in decreased cardiac output despite adequate fluid volume; often involves a "power failure" of the left ventricle.

Cardiogenic Shock Causes

Myocardial infarction (heart attack), severe arrhythmias, or congestive heart failure (CHF).

Cardiogenic Shock Key Features

Chest pain, pulmonary edema (crackles in lungs), jugular venous distension (JVD), and weak peripheral pulses.

Cardiogenic Shock Management

Position of comfort (usually sitting up), supplemental oxygen/CPAP, and transport to a facility capable of cardiac intervention; avoid aggressive fluid boluses.

Distributive Shock Pathophysiology

Systemic vasodilation causes a "relative" hypovolemia; the container gets too big for the amount of fluid inside.

Distributive Shock Causes

Sepsis (infection), Anaphylaxis (allergic reaction), or Neurogenic (spinal cord injury).

Distributive Shock Key Features

Early stages may show "warm shock" (flushed skin); Anaphylaxis includes wheezing/hives; Neurogenic includes bradycardia and "dry" skin below the injury site.

Distributive Shock Management

For Anaphylaxis, use Epinephrine; for Sepsis, use IV fluids and vasopressors; for Neurogenic, stabilize the spine and manage airway.

Obstructive Shock Pathophysiology

Physical obstruction of the heart or great vessels prevents adequate blood flow and filling.

Obstructive Shock Causes

Tension pneumothorax, Cardiac tamponade, or Pulmonary embolism (PE).

Obstructive Shock Key Features

Muffled heart sounds and JVD (Tamponade); Absent lung sounds and tracheal deviation (Tension Pneumothorax); Sudden SOB and hypoxia (PE).

Obstructive Shock Management

Immediate decompression (needle thoracostomy for pneumothorax) or pericardiocentesis; primary goal is rapid transport to surgery/specialized care.

Airway Burns Pathophysiology

Inhalation of hot gases or steam causes supraglottic swelling (edema) and inflammation, leading to rapid airway occlusion.

Airway Burns Causes

Exposure to fire in enclosed spaces, steam inhalation, or hot smoke.

Airway Burns Key Features

Soot around the nose/mouth, singed nasal hairs, hoarseness, stridor, and "brassy" cough.

Airway Burns Management

Early intubation or airway management is critical before swelling closes the glottis; provide 100% humidified oxygen.

Electrical Burns Pathophysiology

Electricity follows the path of least resistance (nerves/vessels), converting to heat and causing deep tissue destruction and potential cardiac arrest.

Electrical Burns Causes

Contact with power lines, faulty wiring, or lightning strikes.

Electrical Burns Key Features

Entrance and exit wounds; internal "zigzag" damage; high risk for cardiac arrhythmias (V-fib).

Electrical Burns Management

Ensure the power source is off; monitor cardiac rhythm; treat for shock and cover visible wounds with dry sterile dressings.

Thermal Burns Pathophysiology

Heat energy causes cell proteins to denature and die; severity depends on temperature and duration of contact.

Thermal Burns Causes

Scalding liquids, open flames, or contact with hot objects.

Thermal Burns Key Features

Redness (1st degree), blistering (2nd degree), or charred/leathery skin with no pain (3rd degree).

Thermal Burns Management

Stop the burning process (cool water for <1 min); remove jewelry; cover with dry sterile dressings; prevent hypothermia.

Chemical Burns Pathophysiology

Caustic substances react with skin proteins; alkalis (liquefactive necrosis) typically penetrate deeper than acids (coagulative necrosis).

Chemical Burns Causes

Strong acids (cleaners) or alkalis (lye, concrete).

Chemical Burns Key Features

Persistent burning pain, localized discoloration, and skin sloughing.

Chemical Burns Management

Brush off dry powders first; flush with copious amounts of water for at least 20 minutes; remove contaminated clothing.

Flail Chest Pathophysiology

Two or more ribs broken in two or more places creating a free-floating segment that moves paradoxically to the rest of the chest wall.

Flail Chest Primary Causes

High-impact blunt force trauma such as motor vehicle accidents or falls from significant heights.

Flail Chest Key Features

Paradoxical motion (segment sucks in during inhalation and bulges out during exhalation), extreme pain, and respiratory distress.

Flail Chest Management

Stabilize the segment manually or with a bulky dressing, provide high-flow oxygen, and consider Positive Pressure Ventilation (BVM) to provide internal splinting.

Abdominal Evisceration Pathophysiology

A breach in the abdominal wall resulting in the protrusion of internal organs (viscera) to the outside of the body.

Abdominal Evisceration Primary Causes

Penetrating trauma such as stabbings or blast injuries.

Abdominal Evisceration Key Features

Visible loops of bowel or organs protruding through an open wound; high risk of infection and organ drying (desiccation).

Abdominal Evisceration Management

Do not push organs back in; cover with a moist, sterile dressing and secure with an occlusive dressing to retain moisture and heat.

Entonox Contraindications

Pneumothorax, air embolism, decompression sickness (the bends), bowel obstruction, or any condition where air is trapped in a body cavity.

Entonox Cautions

Head injuries with altered LOC, pregnancy, or patients with COPD who rely on hypoxic drive.

Entonox Dosage

Self-administered by the patient via a demand valve mask or mouthpiece until pain relief is achieved or the patient drops the mask.

Tylenol (Acetaminophen) Contraindications

Hypersensitivity/allergy to the drug or severe active liver disease (hepatic impairment).

Tylenol (Acetaminophen) Cautions

Chronic alcohol use, malnutrition, or patients already taking other medications containing acetaminophen to avoid toxicity.

Tylenol (Acetaminophen) Dosage

Typically 325 mg to 1000 mg every 4-6 hours for adults, not to exceed 4000 mg in a 24-hour period.

Advil (Ibuprofen) Contraindications

Active GI bleeding, peptic ulcer disease, aspirin-sensitive asthma, or late-stage pregnancy.

Advil (Ibuprofen) Cautions

Renal (kidney) impairment, patients on blood thinners (anticoagulants), or recent heart surgery.

Advil (Ibuprofen) Dosage

Typically 200 mg to 400 mg every 4-6 hours for adults, not to exceed 1200 mg per day for over-the-counter use.

Three Layers of the Meninges (Skull)

Dura Mater (outermost/tough), Arachnoid Mater (middle/web-like), and Pia Mater (innermost/delicate).

Occlusive Dressing

A non-breathable, air-and-watertight dressing (like plastic wrap or Vaseline gauze) used to seal wounds and prevent air or fluid movement, such as for sucking chest wounds or eviscerations.

Non-Occlusive Dressing

A breathable dressing (like standard gauze) that allows air and moisture to pass through, used for general bleeding control and to protect wounds from contamination.