Important NREMT stuff

Urticaria

Hives

Cellulitis

Part of skin is red, swollen, painful, warm to the touch, blistered, etc.

it is an infection

Acute coronary syndrome

Nitro & aspirin

Blood supply to the cells of the heart is blocked or disrupted

caused by sudden cardiac ischemia (heart is hypoxic)

Symptoms: dyspnea, pain could radiate to the jaw, neck, arm(s), nausea, syncope, abnormal bp, abnormal pulse

Coronary Artery Disease

Conditions that narrow or block the arteries of the heart Often results from fatty deposit buildup on the inner walls of arteries Buildup narrows the inner vessel diameter, restricting the flow of blood.

Thrombus

Blood clot

Embolism

The lodging of an embolus—a traveling mass of undissolved matter such as a blood clot, fat globule, air bubble, or tumor tissue—inside a blood vessel. It completely or partially blocks blood flow, depriving downstream tissues of oxygen.

Congestive heart failure

A chronic, progressive condition where the heart's muscle is too weak or stiff to pump blood efficiently. This causes blood and fluid to back up, leading to congestion in the lungs, liver, abdomen, and lower extremities

Symptoms: pulmonary edema, pedal edema

Right sided heart failure

Abdonimal distention

Pedal Edema

JVD

Left sided heart failure

Pulmonary Edema

Fluid leaks into alveoli

Aneurysm

the weakened sections of arterial walls begins to dilate

COPD

A progressive lung condition that causes obstructed airflow and breathing difficulties

CPAP

Opens alveoli; good for pulmonary edema, asthma, COPD, etc.

Contraindications are vomiting and hypotension

Emesis

Vommiting

Emphysema

Destroys alveoli

Primary symptom: dyspnea

other symptoms:

1. “barrel” chest

2. dry or unproductive cough

3. cyanosis

4. mucus

Type of COPD

Treatment: CPAP

Chronic Bronchitis

inflammation and irritation of the bronchial tubes

Primary symptom: A daily, persistent cough with heavy mucus production

Can cause cyanosis same stuff as emphysema

Baseline ETCO2

35-45mmHg

Vitals across all age groups

Paradoxical motion

The chest or abdomen moves inward during inhalation and outward during exhalation (the reverse of normal breathing)

Pneumothorax

occurs when air leaks into the space between your lung and chest wall

symptoms: tachy, hypoxia, etc

Tension pneumothorax

Cause: air continually leaks into the pleural space and cannot escape. This creates immense pressure, compressing the heart and unaffected lung

Symptoms: Absent breath sounds, JVD, hypotension, and tracheal deviation (late stage)

Carbon monoxide poisoning

Cherry red skin

Normal SPO2 levels (carbon monoxide binds to their heme (iron) molecules 200 x more then oxygen roughly, they won’t have enough oxygen, even though their SPO2 reading is in the normal range.)

AMS

Croup

Caused by a viral infection

Affects young children and infants

Primary Symptoms: Begins like a common cold, leading to a "seal bark" cough, noisy breathing, hoarseness, and low-grade fever.

Normally presents as inspiratory stridor that is suggestive of an upper airway occlusion caused by swelling. A patient with croup also experiences wheezes and is more than likely suffering from an infection that has spread to the lower airway.  A

Epiglottitis

Inflammation of the epiglottis caused by a bacterial infection

Symptoms are the 4ds: drooling, dysphagia, dysphonia, distress (respiratory)

Pyrexia

fever

Dysphagia

difficulty/discomfort swallowing

Aphasia

neurological disorder caused by brain damage that impairs a person's ability to speak, write, and understand language

AO X 4

person, place, time, event

kussmaul respirations

deep, rapid, and labored breathing pattern that acts as an emergency response to severe metabolic acidosis

Diabetic Ketoacidosis

life-threatening complication of diabetes where a severe lack of insulin forces the body to burn fat for energy. This produces toxic acids called ketones, which build up in the blood.

Symptoms: Kussmaul respirations, hyperglycemia, fruity breath, AMS, persistent vomiting

Battle’s sign

bruising over the mastoid bone (directly behind the ear). It is a critical, delayed indicator of a basilar skull fracture—a severe break at the base of the skull—and warns of potential underlying brain trauma

Cushing’s triad

Cushing's triad is a classic medical sign indicating severely increased intracranial pressure (ICP) and imminent brain herniation

1. widened pulse pressure

2. bradycardia

3. generally cheyne stokes respirations but could present with any respiratory difficulties

Chyene-stokes respirations

abnormal pattern of breathing characterized by a repeating cycle of progressively deeper, and sometimes faster, breathing that gradually slows down, followed by a temporary stop in breathing

Circulatory anatomy

What is considered the upper airway?

The Nasal cavity, Oral cavity, Nasopharynx, Oropharynx, Laryngopharynx, Epiglottis, and the Larynx.

What is considered the lower airway?

The Trachea, Bronchi, Bronchioles, and the Alveoli.

Lymphatic system

Helps to maintain the fluid balance of the body and contributes to the body’s immune system.

Nervous system

Receives sensory information and coordinates the body’s response.

Integumentary system

Forms protective barrier and aids in temperature regulation

Endocrine system

Regulates metabolic/hormonal activities of the body

Renal/Urinary System

Filters waste products out of the blood and removes them from the body.

RUQ

Liver is bigger on this side.
Only in this side: Gallbladder (looks like teardrop)
Shares pancreas with the left upper quadrant
Right kidney is split and shared with RLQ
Colon is in all 4Qs

LUQ

Liver is smaller on this side
Spleen & stomach are unique to this quadrant
Pancreas is shared with the RUQ
Colon is in all 4Qs
Shares left kidney with the LLQ

RLQ

Right kidney is shared with the RUQ
Colon is in all 4Qs
Small intestines is shared with LLQ
Major artery and vein to the right leg
Right Ureter connected to the Right Kidney and bladder
Appendix is unique to this RLQ
Bladder is in the RLQ and LLQ split by the midline.

LLQ

Left kidney is shared with the LUQ
Colon is in all 4qs
Small intestines is shared with the RLQ
Major artery and vein to the left leg
Ureter  connected to the Left Kidney and bladder
Bladder is in the RLQ and LLQ split by the midline.

Colon (large intestine)

removes water and waste products as they are eliminated from the body. Anything not absorbed at this point is moved through the colon and excreted

Kidney

Regulates fluid levels and filters blood. (renal system)

Gallbladder

Holds bile

Bile

digests fats

Small intestine

Receives food form the stomach and breaks it down for absorption. Nutrients are absorbed by the body through the wall of the small intestine.

Ureter

transport urine from kidney to the bladder

Stomach

holds food, gastric juices break it down

Appendix

Immune system gut health

Spleen

Filter Blood

Bladder

Stores and excretes urine

Dorsal/Ventral

Posterior/Anterior

Distal/proximal

Closer/further to the trunk (core) of the body or the origin of a limb.

Medial/lateral

Closer to the midline/Further from the midline

Metatarsals

foot bone leading up to the toes

Tarsals

Group of bones in your ankle

Femur

Leg bone Quads/hams attached

Phalanges

Toe/finger bone

Metacarpals

hand bone before the fingers

Carpals

wrist bones

Tibia

Medial/inside of your lower leg. Calf is attached

Fibula

Lateral/outside of your lower leg. Attatched to calf and proximal to the tibia

Malleolus

The ball on the inside of your foot

CNS

Brain and spine, process info and control body funcs

PNS

Network of nerves extending from the CNS to the rest of the body. Transmits feeling.

ANS

Involuntary motor functions

calcaneus

Heel bone

Trachea

air to lungs

Thorax

It is the chest. It holds the heart, lungs, and major blood vessels. The Thorax protects these. Contains the sternum.

Xiphoid process

Triangular tip of the sternum

Pelvis

Respiratory system

Larynx

Voice box

Liver

Produces bile, detoxifies harmful substances

Spine

Can (cervical 7), This (thoracic 12), Little (Lumbar 5), Servant (Sacrum 5), Cook (Coccyx 4).
Sacrum & coccyx are fused togethe

Nitro

.4mg/5min w/ max of 3 doses
Contra: systolic<90, ed meds, ICP
Vasodilator
Side effects: hypotension, and all the stuff associated w/ it, tachy

Aspirin

Contra: GI bleeding

Epi

Autoinjector
.15 child
.5mg adult
Side effects: tachy, palpitations, hypertension

Albuterol

2.5mg
Bronchospasm: sudden tightening of muscles in the airway walls (bronchi), causing severe breathing difficulty, wheezing, coughing, and chest tightness(asthma, COPD)
Side effects: Tachy, shaking, dizziness, headaches

Nalaxone (Narcan)

4mg
Sudden opioid withdraw and all side effects that come along w it
in/im

Oral glucose

15-25g oral
BS below 70mg/dL w/ altered mental

Activated Charcoal

1g/kg
Poisoning

Ibuprofen

Uses: mild to moderate pain, inflammation
400-800mg

5 rights

Right patient
Right time
Right medication
Right dose
Right route of administration

Acetaminophen

Mild pain or fever
325-650mg

Diphenhydramine

Benadryl
25-50mg

Glucagon

hypoglycemia when patient cannot swallow and unresponsive
1mg IM

Ondansetron

Zofran
Used for nausea and vomiting
4mg ODT (sublingual dissolved) or oral

Ipratropium Bromide

Atrovent
Bronchospasm (often used w/ albuterol)
0.5mg via nebulized inhalation

Stridor

High-pitched breathing sound, due to upper airway obstruction

Wheezes

High-pitched, almost musical in nature. Caused by air moving through narrowed air passages in the lungs. Can be caused by asthma. Usually heard during expiration

Crackles/Rales

sounds like crackles, caused by fluid in the alveoli, heard on inspiration

Rhonchi

Lower-pitched sounds that resemble snoring/rattling. They are caused by secretions in larger airways, as might be seen with pneumonia or bronchitis, or when materials are aspirated in to the lungs.

Absorbed poisons can include

Household cleaners
Insecticides

Activated Charcoal Contraindications

Altered Mental Status
Ingestion of acids, alkalis, or petroleum products
Active emesis
Inability to swallow

Caustic Materials & why they are contras for charcoal

Alkalis or acids may have severely damaged the mouth, throat, and esophagus.
Activated charcoal can not reverse this damage and swallowing it may cause further damage.
Examples of caustic materials are oven cleaners, drain cleaners, toilet bowl cleaners, and lye.
Patients who have consumed gasoline may also not take activated charcoal because they are likely coughing violently and possibly aspirating gasoline.

Delirium Tremens

A severe reaction that is apart of alcohol withdrawal, characterized by sweating, trembling, anxiety, and hallucinations. Severe alc withdrawal with the DTs may result in death if left untreated.