Emergency Medical Conditions: Stress, Infections, Shock Types & Treatments

Acute Stress Reaction - Description

Immediate stress response to a specific event/ "fight or flight"

Acute Stress Reaction - Signs/Symptoms

Tachycardia, increased BP, increased RR, dilated pupils, decreased blood flow to digestive tract

Acute Stress Reaction - Treatment

Recognition, calming, reassurance, focus on one task at a time

PTSD - Description

A psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event

PTSD - Signs/Symptoms

Flashbacks, severe anxiety, nightmares, emotional numbness, hyperarousal

PTSD - Treatment

Provide calm reassurance, reduce environmental stressors, psychological support, transport

Hepatitis - Description

Inflammation of the liver, often caused by a viral infection (A, B, C, etc.)

Hepatitis - Signs/Symptoms

Jaundice (yellowing of skin/eyes), RUQ abdominal pain, fatigue, dark urine, nausea

Hepatitis - Treatment

Supportive care, PPE (standard precautions, especially bloodborne), transport

HIV/ AIDS - Description

Viral infection that attacks the body's immune system, potentially leading to acquired immunodeficiency syndrome (AIDS)

HIV/ AIDS - Signs/Symptoms

Persistent fever, night sweats, swollen lymph nodes, unexplained weight loss, opportunistic infections

HIV/ AIDS - Treatment

Standard precautions (gloves, eye protection), supportive care, transport

Influenza - Description

A highly contagious viral infection of the respiratory passages

Influenza - Signs/Symptoms

Sudden onset fever, chills, muscle aches, dry cough, fatigue, sore throat

Influenza - Treatment

Droplet precautions (mask on patient and provider), supportive oxygen if needed, transport

Norovirus - Description

A very contagious virus that causes vomiting and diarrhea

Norovirus - Signs/Symptoms

Sudden onset severe vomiting, watery diarrhea, abdominal cramps, low-grade fever

Norovirus - Treatment

Contact precautions, manage dehydration, antiemetics (if protocols allow), transport

Lyme disease - Description

A tick-borne illness caused by the bacterium Borrelia burgdorferi

Lyme disease - Signs/Symptoms

Bull's-eye rash (erythema migrans), fever, chills, fatigue, joint aches, swollen lymph nodes

Lyme disease - Treatment

Supportive care, detailed history of outdoor activities, transport for antibiotic therapy

Tuberculosis - Description

A potentially serious infectious bacterial disease that mainly affects the lungs

Tuberculosis - Signs/Symptoms

Persistent cough (often bloody), night sweats, unexplained weight loss, fever, chest pain

Tuberculosis - Treatment

Airborne precautions (N95 for provider, surgical mask for patient), supportive oxygen, transport

Chicken pox - Description

A highly contagious viral infection causing an itchy, blister-like rash

Chicken pox - Signs/Symptoms

Itchy rash with fluid-filled blisters, fever, fatigue, loss of appetite

Chicken pox - Treatment

Airborne/contact precautions, supportive care, transport

Cardiogenic Shock - Description

Shock caused by the heart's inability to pump enough blood to meet the body's needs

Cardiogenic Shock - Signs/Symptoms

Chest pain, shortness of breath, weak/rapid pulse, hypotension, pale/cool/clammy skin, crackles in lungs

Cardiogenic Shock - Treatment

High-flow oxygen, position of comfort (usually Fowler's), rapid transport, ALS intercept

Distributive Shock - Description

Shock due to widespread vasodilation causing a decrease in systemic vascular resistance

Distributive Shock - Signs/Symptoms

Warm/flushed skin (initially), normal or decreased heart rate, altered mental status, low blood pressure

Distributive Shock - Treatment

Supine positioning, high-flow oxygen, prevent heat loss, rapid transport

Anaphylactic Shock - Description

Severe, life-threatening allergic reaction causing systemic vasodilation and airway compromise

Anaphylactic Shock - Signs/Symptoms

Hives, facial/airway swelling, wheezing, hypotension, severe respiratory distress

Anaphylactic Shock - Treatment

Epinephrine auto-injector (EpiPen), high-flow oxygen, ventilatory support if needed, rapid transport

Neurogenic Shock - Description

Distributive shock resulting from spinal cord injury causing loss of sympathetic nervous system tone

Neurogenic Shock - Signs/Symptoms

Hypotension, bradycardia or normal heart rate, warm/dry skin below injury site, priapism

Neurogenic Shock - Treatment

Spinal motion restriction, supine positioning, keep patient warm, high-flow oxygen, rapid transport

Septic Shock - Description

Distributive shock caused by a severe, systemic infection

Septic Shock - Signs/Symptoms

High fever or hypothermia, tachycardia, tachypnea, altered mental status, low BP

Septic Shock - Treatment

High-flow O2, supine positioning, prevent heat loss, rapidly transport to definitive care

Psychogenic Shock - Description

Sudden, temporary dilation of blood vessels causing fainting (syncope) due to psychological distress

Psychogenic Shock - Signs/Symptoms

Sudden collapse, pale skin, normal vitals once supine, rapid recovery of consciousness

Psychogenic Shock - Treatment

Supine position, evaluate for injuries from fall, check vital signs, transport for evaluation

Hypovolemic Shock - Description

Shock resulting from a severe lack of blood and fluid volume in the body

Hypovolemic Shock - Signs/Symptoms

Tachycardia, tachypnea, pale/cool/diaphoretic skin, hypotension (late sign), thirst

Hypovolemic Shock - Treatment

Control external bleeding, supine positioning, high-flow oxygen, keep warm, rapid transport

Hemorrhagic Shock - Description

A specific type of hypovolemic shock caused by severe internal or external bleeding

Hemorrhagic Shock - Signs/Symptoms

Profuse bleeding, rapid/weak pulse, pale/clammy skin, falling BP, altered mental status

Hemorrhagic Shock - Treatment

Direct pressure/tourniquet for external bleeds, high-flow O2, shock positioning, rapid transport

Obvious Death - Description

Signs incompatible with life where resuscitation is not indicated

Obvious Death - Signs/Symptoms

Decapitation, dependent lividity, rigor mortis, putrefaction/decomposition

Obvious Death - Treatment

Do not initiate CPR, protect the scene, notify law enforcement/coroner

Cardiac Arrest - Description

Sudden, unexpected loss of heart function, breathing, and consciousness

Cardiac Arrest - Signs/Symptoms

Unresponsive, pulseless, apneic or agonal gasps

Cardiac Arrest - Treatment

High-quality CPR, early AED use, airway management, rapid transport/ALS intercept

Respiratory Distress - Description

Increased work of breathing but the body is still compensating

Respiratory Distress - Signs/Symptoms

Tachypnea, use of accessory muscles, tripod position, nasal flaring, normal mental status

Respiratory Distress - Treatment

Administer supplemental oxygen (NC or NRB), position of comfort, coaching

Respiratory Failure - Description

The body's compensatory mechanisms fail to meet oxygen demands

Respiratory Failure - Signs/Symptoms

Altered mental status, shallow/slow breathing, cyanosis, decreasing SpO2, lethargy

Respiratory Failure - Treatment

Positive pressure ventilation with BVM and supplemental oxygen, rapid transport

Respiratory Arrest - Description

Complete cessation of breathing

Respiratory Arrest - Signs/Symptoms

Apnea, cyanosis, unresponsiveness, pulse may still be present initially

Respiratory Arrest - Treatment

Open airway (head-tilt/chin-lift or jaw-thrust), BVM ventilations (1 breath every 5-6 sec for adults)

Asystole - Description

"Flatline" - complete absence of ventricular electrical activity in the heart

Asystole - Signs/Symptoms

Pulseless, apneic, unresponsive, flat line on monitor

Asystole - Treatment

High-quality CPR, airway management, epinephrine (ALS), rapid transport (AED will NOT shock)

Ventricular Fibrillation - Description

Disorganized, chaotic electrical activity of the heart resulting in no blood flow

Ventricular Fibrillation - Signs/Symptoms

Unresponsive, pulseless, apneic

Ventricular Fibrillation - Treatment

High-quality CPR, early defibrillation via AED, ALS intercept

Pulseless Ventricular Tachycardia - Description

The heart beats too fast to pump blood effectively, resulting in loss of pulse

Pulseless Ventricular Tachycardia - Signs/Symptoms

Unresponsive, pulseless, apneic

Pulseless Ventricular Tachycardia - Treatment

High-quality CPR, early defibrillation via AED, ALS support

FBAO/Choking - Description

Foreign Body Airway Obstruction completely or partially blocking the airway

FBAO/Choking - Signs/Symptoms

Clutching the neck, inability to speak/cough (severe), stridor, cyanosis

FBAO/Choking - Treatment

Abdominal thrusts (conscious adult), back slaps/chest thrusts (infant), CPR if unconscious

ROSC - Description

Return of Spontaneous Circulation after cardiac arrest

ROSC - Signs/Symptoms

Patient regains a pulse, breathing may resume, movement, improvement in skin color

ROSC - Treatment

Manage airway, support ventilations, maintain oxygenation, rapid transport, avoid hyperventilation

Anaphylaxis - Description

Severe, multi-system allergic reaction

Anaphylaxis - Signs/Symptoms

Urticaria (hives), angioedema, wheezing, hypotension, GI distress

Anaphylaxis - Treatment

Epinephrine auto-injector (EpiPen), high-flow O2, rapid transport

Croup - Description

Viral infection causing inflammation of the pharynx, larynx, and trachea (common in kids)

Croup - Signs/Symptoms

"Barking" seal-like cough, stridor, low-grade fever, symptoms worsen at night

Croup - Treatment

Humidified oxygen, position of comfort, keep child calm, transport

Epiglottitis - Description

Bacterial infection causing inflammation of the epiglottis, threatening the airway

Epiglottitis - Signs/Symptoms

Sudden onset high fever, drooling, severe sore throat, tripod position, stridor

Epiglottitis - Treatment

High-flow O2, do NOT put anything in the mouth/airway, keep calm, rapid transport

Asthma - Description

Chronic inflammatory disease of the lower airways causing bronchospasm and mucus production

Asthma - Signs/Symptoms

Wheezing on exhalation, prolonged expiratory phase, chest tightness, tachypnea

Asthma - Treatment

Assist with prescribed MDI (Albuterol), supplemental oxygen, transport

Pneumonia - Description

Infection that inflames the air sacs in one or both lungs, which may fill with fluid/pus

Pneumonia - Signs/Symptoms

Productive cough (yellow/green sputum), fever, chills, unilateral chest pain, localized lung sounds (rhonchi)

Pneumonia - Treatment

Supplemental oxygen, position of comfort, transport

Pulmonary Edema - Description

Fluid accumulation in the lungs, often due to congestive heart failure

Pulmonary Edema - Signs/Symptoms

Severe dyspnea, pink frothy sputum, crackles (rales) upon auscultation, orthopnea

Pulmonary Edema - Treatment

High-flow oxygen, CPAP (if indicated/conscious), sit patient upright, rapid transport

COPD - Description

Chronic Obstructive Pulmonary Disease (Emphysema/Chronic Bronchitis) causing poor airflow