EMT Chapter 28 - Hematologic and Renal Emergencies

Red blood cells (RBCs)

predominant cells in blood, giving it a red color and containing hemoglobin for oxygen transport. Their quantity is assessed via a hemoglobin count.

White blood cells (WBCs)

essential blood cells that respond to infection and mediate the immune response. Key types include neutrophils, which fight bacterial infections, and eosinophils, linked to allergies.

Platelets

Cell fragments essential for clot formation. They rapidly aggregate to stop bleeding but can cause harmful clots in coronary arteries, leading to heart attacks. Aspirin is commonly used to prevent such aggregation during acute heart incidents.

Plasma

The liquid in which the blood cells and platelets are suspended; contains dissolved nutrients and also carries certain crucial proteins, such as the clotting factors.

coagulopathy

loss of the normal ability to form a blood clot with internal or external bleeding.

anemia

deficiency in the normal number of red blood cells in the circulation

Sickle cell disease (SCD)

an inherited disease in which patients have a genetic defect in their hemoglobin that results in an abnormal structure of the red blood cell.

sickle cell anemia (SCA)

an abnormally low number of RBCs in the circulation due to sickle cell disease.

pyelonephritis

an infection that begins in the urinary tract and ascends up the ureter into the kidney.

Urinary tract infections (UTIs)

Common bacterial infections affecting the urinary system, typically causing painful and frequent urination. If untreated, they can spread to the kidneys, leading to pyelonephritis.

Kidney Stones

Painful calcium deposits that form in the kidneys. They often remain asymptomatic until they move into the ureter, causing severe flank pain radiating to the groin, along with nausea and vomiting.

urinary catheter

a tube inserted into the bladder through the urethra to drain urine from the bladder.

renal failure

loss of the kidneys’ ability to filter the blood and to remove toxins and excess fluid from the body.

end-stage renal disease (ESRD)

irreversible renal failure to the extent that the kidneys can no longer provide adequate filtration and fluid balance to sustain life; usually requires dialysis.

dialysis

the process by which toxins and excess fluid are removed from the body by a medical system independent of the kidneys.

Hemodialysis

a machine filters blood to remove toxins and excess fluid. Two catheters are used: one for drawing blood out and another for returning it after filtration.

thrill

a vibration felt on gentle palpation, such as that which typically occurs within an arterial–venous fistula.

exchange

one cycle of filling and draining the peritoneal cavity in peritoneal dialysis.

Peritoneal Dialysis

a home treatment for ESRD that uses the abdominal cavity to filter waste and excess fluid, involving a catheter implanted in the abdominal wall.

continuous ambulatory peritoneal dialysis (CAPD)

a gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is raised above the level of an abdominal catheter to fill the abdominal cavity and lowered below the level of the abdominal catheter to drain the fluid out.

continuous cycler-assisted peritoneal dialysis (CCPD)

a mechanical process for peritoneal dialysis in which a machine fills and empties the abdominal cavity of dialysis solution.

peritonitis

bacterial infection within the peritoneal cavity.