EMT Final

increased intracranial pressure (ICP)

Increased pressure within the skull usually due to trauma

Cushing's Triad

• Dilation of one/both pupils\n- ALOC\n- Hypertension\n- Bradycardia\n- Irregular slow respirations

Cardiac Tamponade

Pressure on the heart due to fluid in the pericardial space\n- Usually caused by penetrating trauma, sometimes blunt\n- Beck's Triad: Hypotension, JVD, Muffled heart sounds\n- Treatment: Increase cardiac output BVM with oxygen and transport

Beck's triad

Signs and symptoms of Cardiac Tamponade: hypotension, JVD, muffled heart sounds

Pulmonary Edema

Buildup of blood in the lungs, usually due to CHF\n- Pink Frothy Sputum\n- Rhonchi, crackles\n- Chest Pain\n- Difficulty breathing\n- Treatment: O2 and transport

Pulmonary Embolism

Blocking of a pulmonary artery due to a blood clot\n- Common in sedentary patients (surgery, travel, etc.)\n- ACUTE ONSET\n- Low SpO2\n- Increased respirations\n- Shortness of breath\n- Chest pain\n- Tachycardia

Blood Flow order of operation

Veins go to the heart; Arteries go away

Cushing's Triad (again)

Signs and symptoms of increased intracranial pressure\n- Hypertension\n- Bradycardia\n- Irregular Slow Respirations\n- Opposite of decompensated shock symptoms

Superior and Inferior Vena Cava

Receives deoxygenated blood from the veins and carries it to the right atrium.

Wheezing sounds (AAC)

Due to Tight Lower Airways - Asthma - Anaphylaxis - COPD (Emphysema or Chronic Bronchitis)

Graves disease

Hyperthyroidism - Bulging eyes - Tachycardia - ALOC

RUQ organs

Liver, Gallbladder, Right Transverse Colon

LUQ organs

Stomach, Spleen, Pancreas, Left Transverse Colon

RLQ organs

Appendix, Right Ovaries and Fallopian tubes, Ascending Colon

LLQ Organs

Descending Colon, Sigmoid Colon, Left Ovaries and Fallopian Tubes

Diverticulitis

Inflammation of the diverticula - LLQ

Appendicitis

Inflammation of the appendix - RLQ

Tension pneumothorax

Air trapped in chest cavity affects heart/lungs - JVD - Tracheal Deviation - Diminished lung sounds - Hypotension - Treatment: NRB, 3-sided chest seal

Sucking chest wound

Air sucked into chest cavity - Can lead to tension pneumothorax

Asthma

Respiratory difficulty due to narrowed or obstructed airways\n- Wheezing\n- Coughing\n- Tightness\n- Treatment: Bronchodilator or EpiPen in severe cases

Ectopic Pregnancy

A pregnancy outside of the womb, usually in a fallopian tube\n- 2-12 week range 1st trimester\n- Abdominal pain and cramping\n- Vaginal bleeding\n- Shoulder Pain

Placentae Previa

Abnormal implantation of placenta, blocks the opening\n- Week 27-40 3rd trimester\n- Painless bleeding\n- Signs of shock\n- Treatment: OB center. Manage bleeding, Treat for Shock

Pre-eclampsia

Pregnancy induced Hypertension\n- Week 20-37 Usually 3rd trimester\n- Hypertension\n- Swelling of extremities\n- Visual abnormalities\n- Headaches, anxiety\n- Protein in urine

CHF (congestive heart failure)

Heart failure to pump adequately\n- Pulmonary Edema\n- Pink Frothy Sputum\n- Bilateral Cracking\n- JVD\n- Hypertension\n- Dyspnea\n- Swelling in legs\n- Treatment: Sit them up

Pneumonia

Inflammation of the lungs\n- Contagious\n- Green/yellow sputum\n- Productive cough\n- Rales (early), Rhonchi (later)\n- Tachycardia\n- Hypoxia

Narcan (naloxone)

Rule of 2 (2mg, 20 mins, 2-3 mins)\n- Dose: 2 mg (1/2 spray ea. nostril)\n- Duration: 20-120 mins\n- Onset: 2-3 mins\n- Indication: Opiate overdose with ALOC & RR<12\n- Contraindications: ALOC with norm. or increased RR

3 Phases of a seizure

Pre-ictal: sensory experience\nTonic-Clonic: jerking/twitching\nPost-ictal: exhaustion\n- Treatment: safe environment, oxygen, observe for second seizure

Hypoglycemia

Abnormally low blood sugar\n- Cool/Pale Skin\n- ALOC or Unresponsive\n- Agitated or aggressive

DKA

Critically high glucose levels >300\n- Type 1 diabetes\n- ALOC\n- Fruity breath\n- Kussmaul respirations (increased tidal volume)

START Triage

Mass casualty triage system\n- Green: Walk\n- Yellow: Can't walk but A&O\n- Red: RPM criteria\n- Black: No respirations after airway positioning

Rhonchi sounds

Low-pitched rattling lung sounds\n- Often due to mucus\n- Common in bronchitis, pneumonia

Rales (Crackles) sounds

High-pitched popping sounds\n- Caused by fluid in alveoli\n- Seen in CHF or Pulmonary Edema

Stridor sounds

High-pitched sound on inspiration\n- Caused by upper airway obstruction\n- Seen in croup or epiglottitis

Croup

Obstruction of larynx\n- Seal-like barking cough\n- Common in children\n- Stridor present\n- Treatment: Humidified oxygen

Epiglottitis

Inflammation of epiglottis\n- Severe sore throat\n- Stridor\n- Drooling and tripod position in children

Tripod position

Patient sits upright and leans forward\n- Common in respiratory distress

Pertussis/Whooping Cough

Contagious bacterial infection\n- Whooping sound on inspiration\n- Suction may be needed\n- Transport

Airway Adjuncts

Devices to maintain open airway\n- OPA, NPA, BVM

Blow-by technique

Oxygen delivery for children fearful of masks\n- Used in asthma, minor respiratory issues

Meningitis

Inflammation of meninges\n- Stiff neck\n- Fever\n- Nausea/Vomiting\n- Highly contagious

Febrile seizures

Seizures in young children due to high fever\n- Treatment: Cool with tepid water, support ABCs

Influenza (FLU)

Contagious viral illness\n- Fever, chills, fatigue\n- Supportive care and transport

Commotio Cordis

Cardiac arrest from blunt chest trauma\n- Seen in youth sports\n- Treat with CPR and AED

Blunt Trauma

Injury without skin penetration\n- Watch for internal bleeding or fractures

Penetration Trauma

Injury where object enters body\n- Stab or gunshot wounds\n- May require occlusive dressing

Closed Injuries

Internal injuries like bruises or sprains\n- Use RICE treatment

Open Injuries

Abrasions, lacerations, avulsions\n- Control bleeding, dress wound

RICE

Treatment for sprains/strains\n- Rest, Ice, Compression, Elevation

Inhalation burns

Signs: Stridor, singed nasal hair, facial burns, hoarse voice, black sputum\n- Monitor airway closely

Occlusive Dressings

Used to seal chest wounds, neck injuries, abdominal evisceration\n- Prevents air entry\n- Gauze can be alternative

Eye Injuries

Stabilize impaled object\n- Bandage BOTH eyes to prevent movement

Basilar Skull fracture

Fracture at base of skull\n- Raccoon eyes\n- Battle’s signs (bruising behind ear)

Epidural hematoma

Blood between skull and dura mater\n- Lucid interval, then unconsciousness\n- Transport to trauma center

Subdural hematoma

Blood under dura mater\n- Slurred speech, fluctuating LOC\n- More common and slower onset than epidural

Intracerebral hematoma

Bleeding within brain tissue\n- Caused by trauma or deceleration

Helmet Removal

Remove only if airway obstructed, CPR needed, or helmet interferes with assessment

Symptoms of Chest injuries

Pain, cyanosis, coughing blood\n- Rapid/shallow breathing\n- May show rib injury

Simple pneumothorax

Air in pleural space from blunt trauma\n- Diminished breath sounds on one side

Hemothorax

Blood in pleural space\n- Requires rapid transport

Hemopneumothorax

Both air and blood in chest cavity\n- Severe trauma

Flail Chest

2+ ribs broken in 2+ places\n- Paradoxical chest movement\n- Support with bulky dressing

Pulmonary contusion

Bruising of lung tissue\n- May cause hemorrhage and impaired oxygen exchange

Blunt myocardial injury

Bruised heart muscle\n- Monitor pulse, BP\n- Transport immediately

Myocardial Infarction

Blocked blood flow to heart\n- Chest pain, nausea, radiation to arm/jaw\n- Sweating and shortness of breath

Angina Pectoris

Temporary lack of oxygen to heart muscle\n- Triggered by stress or exertion\n- Relieved by rest or nitro

Acute Aortic Aneurysm

Rupture or tear of aorta\n- Sudden sharp pain\n- May feel pulsating mass\n- Fatal if not treated quickly

subcutaneous emphysema

Air trapped under skin\n- Feels like crackling on palpation

Gurgling sounds

Fluid in airway\n- Suction immediately

Cardiogenic shock

Heart fails to pump enough blood\n- Pulmonary edema\n- High-flow O2, transport

Atherosclerosis

Hardening/narrowing of arteries due to plaque buildup

Obstructive shock

Mechanical obstruction of heart/blood flow\n- Causes: tamponade, tension pneumothorax, PE

Activated Charcoal

Used for ingested poisons\n- Contraindicated for acids, alkalis, petroleum, or ALOC

Upper Airway Air flow

Nose, mouth, jaw, oral cavity, pharynx, larynx

Lower Airway air flow

Trachea, bronchi, bronchioles, alveoli

Acute Pulmonary Edema

Fluid in alveoli due to heart failure\n- Rapid, shallow respirations\n- Crackles/rales

COPD

Group of lung diseases: emphysema and chronic bronchitis

spontaneous pneumothorax

Air leaks from lung into pleural space without trauma\n- Sudden dyspnea\n- Decreased breath sounds

CO or pesticide inhalation

High-flow oxygen is primary treatment\n- Even if patient appears normal

Side effects of Broncodilators

Increased heart rate, jitteriness, muscle tremors

Acute Coronary syndrome (ACS)

Includes angina and MI\n- Caused by reduced blood flow to heart

Cardiac arrest during transport

STOP the vehicle immediately and begin CPR

Ischemic stroke

Blood clot blocks brain artery\n- Most common stroke type\n- Symptoms vary from mild to paralysis

Hemorrhagic stroke

Ruptured blood vessel in brain\n- “Worst headache of life”\n- High fatality rate

Postictal state of seizure

After convulsion ends\n- Confused, exhausted, slow to respond\n- Monitor ABCs

Stroke treatment

Support ABCs\n- Rapid transport to stroke center

Skin layers

Epidermis, Dermis, Hypodermis

Hepatitis

Inflammation of liver\n- A: fecal-oral\n- B: more contagious than HIV\n- Jaundice, fatigue

Cholecystitis

Gallbladder inflammation\n- RUQ pain\n- Often post-meal\n- Referred pain to right shoulder

Sedative-hypnotic overdose

CNS depressants (e.g., Valium, Xanax, Rohypnol)\n- Low RR and BP\n- Slurred speech\n- May be unresponsive

Migraine Headache

Throbbing head pain, often one-sided\n- Light/sound sensitivity\n- Treat with dim environment, O2, and transport

Hyperglycemia (Diabetic Coma)

High blood sugar\n- Slow onset\n- Warm, dry skin\n- Deep rapid respirations\n- Transport, no insulin given by EMT

Hypoglycemia (Insulin Shock)

Low blood sugar\n- Sudden onset\n- Pale, moist skin\n- ALOC or aggression\n- Give glucose

Type 1 Diabetes

Insulin-dependent\n- Starts in childhood\n- Polyuria, Polydipsia, Polyphagia\n- Risk for DKA

Type 2 Diabetes

Adult onset\n- Body can’t use insulin properly\n- Often obese\n- Risk for HHNS

HHNS (Hyperosmolar hyperglycemic nonketotic syndrome)

Extremely high blood sugar without ketones\n- Type 2 diabetes\n- Severe dehydration, AMS, seizures

DKA (Diabetic Ketoacidosis)

Type 1 diabetes\n- Blood glucose >300 mg/dL\n- Kussmaul respirations\n- Fruity breath\n- ALOC

Stimulant overdose

Drugs: Cocaine, Meth, Adderall\n- Agitation, High BP/pulse/temp, Dilated pupils\n- Seizures possible

Opioid/Narcotics overdose

Drugs: Heroin, Fentanyl, Oxy\n- Respiratory depression\n- Pinpoint pupils\n- ALOC/coma\n- Treat with Narcan

Sickle Cell anemia

Abnormal red blood cells\n- Chest pain, fatigue\n- Prone to infection\n- Pain management & transport

Heatstroke

Body can't cool down via sweat\n- Hot, dry skin\n- High risk of death\n- Cool immediately, transport