Common Illnesses Signs and Symptons

Emphysema

oPathophysiology: It is a loss of the elastic material in the lungs that occur when the alveolar air spaces are stretched due to inflamed airways and obstruction of airflow out of the lungs.

oSigns and Symptoms: Patients will chronically produce sputum, have a chronic cough, dyspnea on exertion, pursed lip breathing, wheezing, crackles, and rhonchi lung sounds. Thin, barrel chest appearance.

oRisk Factors: Smoking, asthma, and COPD

oEMT scope Treatment: Provide supplemental oxygen, prompt transport, and position the patient sitting up. Assist the patient with their prescribed inhaler.

Simple Pneumothorax

oPathophysiology: It is a pneumothorax that does not have a significant change in the cardiac physiology. Occurs from a blunt trauma.

oSigns and Symptoms: Sudden chest pain with dyspnea, decreased breath sounds on affected side, and subcutaneous emphysema (crackling sensation felt during palpation on the skin)

oRisk Factors: Blunt trauma

oEMT scope Treatment: Administer high concentration oxygen, treat any underlying injuries.

Asthma

oPathophysiology: It is a result of an allergic reaction to an inhaled, ingested, or injected substance. The bronchioles will spasms along with excessive mucus production and swelling of the mucous lining of the respiratory passages. Asthma affects people of all ages.

oSigns and Symptoms: Wheezing on exhalation through partially obstructed air passages. Increased respirations, pulse and blood pressure. Cyanosis or respiratory arrest in severe cases.

oRisk Factors: Children 5-17 years of age

oEMT scope Treatment: Administer Oxygen and Inhaler if patient has a prescription.

Pneumonia

oPathophysiology: It is a lung infection, often is a secondary infection, begins with a upper respiratory tract infection, such as a cold or sore throat.

oSigns and Symptoms: Dyspnea, chills, fever, cough, green, red, or rust colored sputum, localized wheezing or crackles. Children will have rapid and labored breathing with wheezing.

oRisk Factors: Intubation, tracheostomy, institutional residence (nursing home), recent hospitalization, chronic disease processes, immune system compromise, or history of COPD

oEMT scope Treatment: Airway support, humidified oxygen, and supplemental oxygen with appropriate adjuncts.

Pulmonary Edema

oPathophysiology: Fluids build up within the alveoli and in the lungs tissues between the alveoli and the pulmonary capillaries. The edema interferes with the exchange of carbon dioxide and oxygen. Can be caused by inhalation of large amounts of smoke or toxic chemical fumes.

oSigns and Symptoms: Dyspnea, rapid, shallow respirations, and in severe cases frothy pink sputum at the nose or mouth. Rhonchi or crackle "wet" lung sounds.

oRisk Factors: Patients with congestive heart failure, high blood pressure, low cardiac output, history of coronary artery disease and/or atrial fibrillation, a condition where the atria no longer contracts, instead quivers.

oEMT scope Treatment: Provide supplemental oxygen, prompt transport, and position the patient sitting up.

Tuberculosis (TB)

oPathophysiology: It is a bacterial infection caused by Mycobacterium tuberculosis. It is spread by cough and is resistant to antibiotics.

oSigns and Symptoms: Cough, fever, fatigue, productive/bloody sputum, weight loss, night sweats, if severe patient will have shortness of breath and chest pain

oRisk Factors: People who live in close contact, such as prison inmates, nursing home residents, and homeless shelters. People who abuse intravenous drugs or alcohol or people whose immune systems are compromised.

oEMT scope Treatment: Provide supplemental oxygen, humidified oxygen, prompt transport, and position the patient sitting up.

Chronic Bronchitis

oPathophysiology: It is caused by consistent inflammation in large airways. Excess mucus is produced, obstructing small airways (bronchioles) and alveoli. Protective cells and lung mechanisms that remove foreign particles are destroyed and weakens the airways.

oSigns and Symptoms: Chronic cough (with sputum production), wheezing, cyanosis, tachypnea (increased breathing rate)

oRisk Factors: Smoking

oEMT scope Treatment: Provide supplemental oxygen, prompt transport, and position the patient sitting up.

Spontaneous Pneumothorax

oPathophysiology: Air escapes into the pleural cavity and results in a loss of negative pressure. The natural elasticity of the lung tissue causes the lung to collapse. Occurs when a weak portion of the lungs ruptures.

oSigns and Symptoms: Dyspnea, pleuritic chest pain (sharp stabbing pain on one side that is worse during inspiration and expiration or with certain movement of the chest wall), absent or decreased breath sounds, hypotension, jugular vein distention (JVD), and cyanosis

oRisk Factors: Patients with chronic lung infections, young people born with weak areas of the lungs, patients with emphysema and asthma, and tall, thin men.

oEMT scope Treatment: Provide supplemental oxygen, prompt transport, and position the patient sitting up.

Croup

oPathophysiology: Caused by inflammation and swelling of the pharynx, larynx, and trachea. Typically seen in children between the ages 6 months to 3 years.

oSigns and Symptoms: Fever, barking cough, stridor, mostly seen in pediatric patients

oRisk Factors: An acute viral infection of the upper respiratory tract.

oEMT scope Treatment: Humidified oxygen and position of comfort.

Anaphylaxis

oPathophysiology: Severe allergic reaction characterized by airway swelling and dilation of blood vessels all over the body, leading to a lower blood pressure.

oSigns and Symptoms: Flushed skin or hives (urticaria), generalized edema, decreased blood pressure (hypotension), laryngeal edema with dyspnea, wheezing or stridor

oRisk Factors: Allergies

oEMT scope Treatment: Remove the offending agent, position of comfort, assist with the administration of epinephrine, supplemental oxygen, and rapid transport.

Pulmonary Embolus (PE)

oPathophysiology: A blood clot formed in the veins that breaks off. The clot moves into the right side of the heart and gets lodged in the pulmonary artery.

oSigns and Symptoms: Sharp chest pain, sudden onset, dyspnea, tachycardia, clear breath sounds initially

oRisk Factors: Patients whose legs are immobilized following a fracture or recent surgery, pregnancy, active cancer, and bed rest.

oEMT scope Treatment: Provide supplemental oxygen, prompt transport, and position of comfort.

Epiglottitis

oPathophysiology: Life-threating inflammatory disease of the epiglottis, most commonly caused by a bacterial infection. Often seen in infants and children.

oSigns and Symptoms: Dyspnea, high fever, stridor, drooling, difficulty breathing, severe sore throat, tripod or sniffing position

oRisk Factors: none

oEMT scope Treatment: Provide supplemental oxygen, Humidified oxygen, prompt transport, and position the patient sitting up or in a sniffing position.

Congestive Heart Failure

oPathophysiology: Often occurs a few days following a heart attack. Damaged ventricles and failure of heart as a pump. Attempt by heart to compensate with increased rate. Enlarged left ventricles. Backup of fluid into the body as the heart fails to pump adequately. Left sided leads pulmonary edema. Right sided causes fluid collecting in the body leading to dependent edema (legs or feet).

oSigns and Symptoms: Difficulty breathing with exertion, crackles and wheezing, abdominal distention, dependent edema (sacral or pedal), tachycardia, increased respiratory rate, anxiety, inability to lie flat, and ashen or cyanotic.

oRisk Factors: Hypertension and a history of coronary artery disease and/or atrial fibrillation, a condition in which the atria no longer contract, instead it quivers.

oEMT scope Treatment: Monitor patient's vital signs, supply oxygen through a nonrebreather, CPAP if available, position the patient sitting up.

Myocardial Infarction/Heart Attack

oPathophysiology: A narrowing or blockage in a coronary artery blocks the blood flow to a section of the heart muscle.

oSigns and Symptoms: Sudden onset of weakness, nausea/vomiting, sweating, chest pain/discomfort, usually crushing or squeezing, pain/discomfort or pressure in the lower jaw, arms, abdomen, or neck, irregular heartbeat, syncope, shortness of breath, dyspnea, pink, frothy sputum (possible pulmonary edema)

oRisk Factors: Smoking, hypertension, elevated cholesterol and glucose levels, lack of exercise, obesity, older age, family history of atherosclerotic coronary artery disease, race, ethnic, male sex, stress, excessive alcohol, and poor diet.

oEMT scope Treatment: Provide supplemental oxygen, prompt transport, and position the patient sitting up with legs down. If blood pressure is higher than 100 mm Hg may give nitroglycerin.

Cardiac Arrest

oPathophysiology: The sudden, unexpected loss of heart function, breathing and consciousness. Usually results from an electrical disturbance in your heart that disrupts its pumping action, stopping blood flow to the rest of your body.

oSigns and Symptoms: Sudden collapse, no pulse, no breathing, loss of consciousness

oRisk Factors: Smoking, high blood pressure. high blood cholesterol, obesity, diabetes, a sedentary lifestyle, drinking too much alcohol

Cardiac Arrest vs Heart Attack

A heart attack occurs when a blocked artery prevents oxygen-rich blood from reaching a section of the heart. If the blocked artery is not reopened quickly, the part of the heart normally nourished by that artery begins to die. The longer a person goes without treatment, the greater the damage. Symptoms of a heart attack may be immediate and intense. More often, though, symptoms start slowly and persist for hours, days or weeks before a heart attack. Unlike with sudden cardiac arrest, the heart usually does not stop beating during a heart attack. The heart attack symptoms in women can be different than men.

Sudden cardiac arrest occurs suddenly and often without warning. It is triggered by an electrical malfunction in the heart that causes an irregular heartbeat (arrhythmia). With its pumping action disrupted, the heart cannot pump blood to the brain, lungs and other organs. Seconds later, a person loses consciousness and has no pulse. Death occurs within minutes if the victim does not receive treatment.

These two distinct heart conditions are linked. Sudden cardiac arrest can occur after a heart attack, or during recovery. Heart attacks increase the risk for sudden cardiac arrest. Most heart attacks do not lead to sudden cardiac arrest. But when sudden cardiac arrest occurs, heart attack is a common cause. Other heart conditions may also disrupt the heart's rhythm and lead to sudden cardiac arrest. These include a thickened heart muscle (cardiomyopathy), heart failure, arrhythmias, particularly ventricular fibrillation, and long Q-T syndrome.

Hypertensive Emergency

oPathophysiology: Systolic blood pressure greater than 180 mm Hg or a rapid raise in the systolic pressure.

oSigns and Symptoms: Severe headache, strong bounding pulse, ringing in the ears, nausea and vomiting, dizziness, warm skin (dry or moist), nosebleed, alter mental status, sudden development of pulmonary edema.

oRisk Factors: Patients with hypertension.

oEMT scope Treatment: Monitor blood pressure, position the patient with the head elevated and rapid transport.

Aortic Dissection (Abdominal aortic aneurysm or Thoracic)

oPathophysiology: This occurs when the inner layers of the aorta become separated, allowing (at high pressures) to flow between the layers.

oSigns and Symptoms: Sudden onset of pain, difference in blood pressure between arms or diminished pulses in the lower extremities.

oRisk Factors: Uncontrolled hypertension

oEMT scope Treatment: Rapid transport and position of comfort.

Angina Pectoris (stable vs unstable)

oPathophysiology: Angina occurs when the heart's need for oxygen exceeds its supply, usually during periods of physical or emotional stress. Unstable angina is characterized by pain or discomfort in the chest of coronary origin that occurs in response to progressively less exercise or fewer stimuli than required. Can lead to AMI. Stable angina is characterized by pain in the chest of coronary origin relieved by rest or taking nitroglycerin.

oSigns and Symptoms: Crushing or squeezing pain felt in the mid portion of the chest, under the sternum. It can radiate to the jaw, arms (frequently the left), midportion of the back or the epigastrium. Pain usually lasts for 3-8 minutes, no longer than 15 minutes. Shortness of breath, nausea, or sweating. After a large meal or sudden fear.

oRisk Factors: Physical or emotional stress

oEMT scope Treatment: Provide supplemental oxygen, nitroglycerin, place patient in position of comfort and prompt transport.

Ectopic Pregnancy

oPathophysiology: When an embryo develops outside of the uterus, most often in a fallopian tube.

oSigns and Symptoms: Signs of internal bleeding, missed menstrual cycle, reports of sudden, severe, usually unilateral pain in the lower abdomen.

oRisk Factors: A history of pelvic inflammatory disease, tubal ligation, or previous ectopic pregnancy.

oEMT scope Treatment: Rapid transport

Abruptio Placentae

oPathophysiology: The placenta separates prematurely from the wall of the uterus.

oSigns and Symptoms: Severe pain, vaginal bleeding, present with signs of shock such as weak, rapid, pulse, and pale, cool, diaphoretic skin.

oRisk Factors: Hypertension and trauma.

oEMT scope Treatment: Rapid transport

Supine Hypotension Syndrome

oPathophysiology: This condition is caused by compression of the inferior vena cava by the pregnant uterus when the patient lies supine, reducing the amount of blood that is returned to the heart.

oSigns and Symptoms: Hypotension

oRisk Factors: Pregnant women.

oEMT scope Treatment: Transport the patient positioned on her left side.

Eclampsia

oPathophysiology: Seizures that occur as a result of hypertension.

oSigns and Symptoms: Seizures and hypertension

oRisk Factors: Hypertension

oEMT scope Treatment: Lay the patient on her left side, maintain her airway, administer supplemental oxygen, suction airway if needed, rapid transport, and call for ALS.

Gonorrhea

oPathophysiology: Caused by Neisseria gonorrhoeae, a bacterium that can grow and multiply rapidly in the warm, moist areas of the reproductive tract.

oSigns and Symptoms: More severe in men than women, 2-10 days after exposure. Painful urination with burning or itching, a yellowish or bloody vaginal discharge, usually with a foul odor. In more severe infections cramping and abdominal pain, nausea and vomiting.

oRisk Factors: More severe in men than in women.

oEMT scope Treatment: Provide transport.

Pelvic Inflammatory Disease (PID)

oPathophysiology: It is an infection of the upper female reproductive organs-specifically, the uterus, ovaries, and fallopian tubes- that occurs almost exclusively in sexually active women. Disease causing organism enter the vagina and migrate through the opening of the cervix and into the uterine cavity.

oSigns and Symptoms: Lower abdominal pain, vaginal discharge, fever, chills, general malaise, nausea and vomiting. Patients have a distinct gait that appears as a shuffle when they walk.

oRisk Factors: Sexually active women.

oEMT scope Treatment: Provide transport.

Placentia Previa

oPathophysiology: The placenta develops over and covers the cervix.

oSigns and Symptoms: Heavy vaginal bleeding, often without significant pain.

oRisk Factors: Early labor.

oEMT scope Treatment: Rapid transport, position patient on her left side, administer high flow oxygen, and place a sterile pad or sanitary pad over the vagina, and replace it as often as necessary.

Prolapsed Umbilical Cord

oPathophysiology: The umbilical cord comes out of the vagina before the fetus. Usually occurs early in labor when the amniotic sac ruptures.

oSigns and Symptoms: The umbilical cord comes out of the vagina before the fetus.

oRisk Factors: Early labor.

oEMT scope Treatment: Place the pregnant women supine with the foot end of the cot raised higher than the head, with her hips elevated on a pillow or folded sheet to keep the weight of the fetus off the prolapsed cord. Wrap a sterile towel, moistened with saline, around the exposed cord, administer high flow oxygen and rapid transport.

Preeclampsia

oPathophysiology: It is a pregnancy induced hypertension. Can develop after 20 weeks of gestation.

oSigns and Symptoms: Severe hypertension, severe or persistent headache, visual abnormalities such as seeing spots, blurred vision, or sensitivity to light, swelling in the hands and feet (edema), and anxiety

oRisk Factors: Hypertension

oEMT scope Treatment: Provide rapid transport and administer supplemental oxygen.

Breech Birth

oPathophysiology: The buttocks are delivered first.

oSigns and Symptoms: The buttocks is delivered first.

oRisk Factors: Pregnancy

oEMT scope Treatment: Provide prompt transport

Bacterial Vaginosis

oPathophysiology: Normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms.

oSigns and Symptoms: Itching, burning, or pain, "fishy", foul-smelling discharge. Pregnant woman may have premature babies or babies born with low birth weight. If untreated can result in PID.

oRisk Factors: Most common vaginal infection in women age 15 to 44.

oEMT scope Treatment: Provide transport.

Migraine Headache

oPathophysiology: Caused by changes in the blood vessel size in the base of the brain.

oSigns and Symptoms: Pain described as pounding, throbbing, or pulsating. Also associated with nausea/vomiting, visual warning signs such as flashing lights or partial vision loss. Can last for several hours to days.

oRisk Factors: Women are three times as likely as men to experience a migraine.

oEMT scope Treatment: Apply high flow oxygen, provide a darkened and quiet environment because patients are sensitive to light and sound. Do not use lights and siren during transport. Position patient of comfort.

Transient Ischemic Attack (TIA)

oPathophysiology: Blood flow to the brain is obstructed due to atherosclerosis or a small clot. When stroke-like symptoms resolve on their own in less than 24 hours. Sometimes called mini strokes. No actual death of tissue occurs.

oSigns and Symptoms: Facial drooping, sudden weakness/numbness in the face, arm, leg, or one side of the body, lack of muscle coordination (ataxia) or loss of balance, blurred or double vision, difficulty swallowing, difficulty expressing thoughts/using right words (aphasia), or slurred speech (dysarthria).

oRisk Factors: Patients with coronary artery disease and chest pain (angina).

oEMT scope Treatment: Rapid transport and position of comfort.

Concussion

oPathophysiology: It is a closed injury with a temporary loss or alteration of part or all of the brain's abilities to function without demonstrable physical damage to the brain.

oSigns and Symptoms: Confused or have amnesia, dizziness, weakness, or visual changes, nausea/vomiting, ringing in the ears, slurred speech, inability to focus, lack of coordination, delay of motor functions, or displays inappropriate emotional response, and headache.

oRisk Factors: Head injury

oEMT scope Treatment: Provide transport.

Generalized Seizure (Tonic-Clonic)

oPathophysiology: Result from abnormal electrical discharges from large areas of the brain, usually involving both hemispheres.

oSigns and Symptoms: Unconsciousness and generalized severe twitching of the body's muscle that lasts several minutes or longer and apnea. Patient may experience a tonic phase, a period of constant muscle contraction and trembling, tongue biting, bladder incontinence, or bowel incontinence. Bilateral movement with a cycle of muscle rigidity and relaxation for 1-3 minutes.

oRisk Factors: History of seizures

oEMT scope Treatment: Apply high flow oxygen, suction airway if needed, and rapid transport.

Stroke (CVA) hemorrhagic and Ischemic

oPathophysiology: It is an interruption of blood flow to an area within the brain that results in the loss of brain function. An ischemic stroke, most common, occurs when blood flow through the cerebral arteries is blocked. A hemorrhagic stroke, often fatal, occurs when a blood vessel ruptures and the accumulated blood causes increased pressure in the brain.

oSigns and Symptoms: Ischemic strokes symptoms are loss of movement on the side of the body opposite the side where the occlusion has occurred. Hemorrhagic strokes has a severe headache.

oRisk Factors: Ischemic strokes are people with atherosclerosis. Hemorrhagic strokes are common for people with stress or exertion. High risks are people with hypertension or long term untreated elevated blood pressure.

oEMT scope Treatment: Supplement oxygen, position of comfort, and rapid transport.

Increased Intracranial Pressure (Cushing's Reflex)

oPathophysiology: Accumulation of blood within the skull or swelling of the brain increasing the pressure within the cranial vault. The triad of increased systolic blood pressure, decreased pulse rate, and irregular respirations is called Cushing reflex.

oSigns and Symptoms: Cheyne-Stokes respirations (fast then slow respiration with periods of apnea), ataxic (Biot) respirations (characterized by irregular rate, pattern, and volume of breathing with intermittent periods of apnea), decreased pulse rate, headache, nausea, vomiting, decreased alertness, bradycardia, sluggish or nonreactive pupils and increased or widened blood pressure.

oRisk Factors: Head injury

oEMT scope Treatment: Provide supplemental oxygen and rapid transport.

Intracranial Bleed (Subdural and Epidural)

oPathophysiology: An epidural hematoma is an accumulation of blood between the skull and dura mater and a result of a blow to the head that produces a linear fracture of the thin temporal bone. A subdural hematoma is an accumulation of blood beneath the dura mater but outside the brain and is most common.

oSigns and Symptoms: An epidural hematoma will have immediate loss of consciousness and pupil on the side of the hematoma becomes fixed and dilated. A subdural hematoma will have a fluctuating level of consciousness or slurred speech.

oRisk Factors: Injury to the head

oEMT scope Treatment: Provide high flow oxygen and rapid transport.

Status Epilepticus

oPathophysiology: Seizures that continue every few minutes without regaining consciousness or last longer than 30 minutes.

oSigns and Symptoms: Seizures

oRisk Factors: History of seizure

oEMT scope Treatment: Suction airway, give oxygen through nonrebreather mask or BVM, place patient in recovery position, and rapid transport.

Heat Stroke

oPathophysiology: Occurs when the body is subjected to more heat than it can handle and normal mechanisms for getting rid of the excess heat are overwhelmed. The body temperature then rises rapidly to the level at which tissues are destroyed. Heat strokes can develop in patients during vigorous physical activity, or in a closed poorly ventilated space (geriatric patients).

oSigns and Symptoms: Hot, dry, flushed skin, patient no longer perspires.

oRisk Factors: Children, geriatric patients, patients with heart disease, COPD, diabetes, dehydration, and obesity, those with limited mobility.

oEMT scope Treatment: Administer high flow oxygen, position the patient to protect the airway, treat for shock, remove patient from heat, and rapid transport.

Decompression Sickness

oPathophysiology: Occurs when the bubbles of gas, especially nitrogen, obstruct the blood vessels. This condition results from too rapid an ascent from a dive, too long of a dive at a too deep a depth, or repeated dives within a short period of time.

oSigns and Symptoms: Abdominal and/or joint severe pain. Symptoms may not occur for several hours.

oRisk Factors: Divers

oEMT scope Treatment: High flow oxygen and rapid transport to a recompression facility with a hyperbaric chamber.

Heat Exhaustion

oPathophysiology: Most common heat emergency. Caused by heat exposure, stress, and fatigue, which is caused by hypovolemia as the result of the loss of water and electrolytes from heavy sweating.

oSigns and Symptoms: Dizziness, weakness, or syncope with nausea, vomiting, or head ache. Muscle cramping, cold, clammy skin with ashen pallor, dry tongue, thirst, normal vitals with a rapid and weak pulse.

oRisk Factors: Children, geriatric patients, patients with heart disease, COPD, diabetes, dehydration, and obesity, those with limited mobility.

oEMT scope Treatment: Remove patient from the heat, remove any excess clothing, administer high flow oxygen, cool the patient with misting and administration of ice packs to the trunk of the patient's body, and transport.

Cardiac Tamponade

oPathophysiology: Occurs when the protective membrane around the heart, the pericardial sac, fills with blood or fluid, from a rupture, torn, or lacerated coronary artery or vein. Patients has a decrease in systemic blood flow or cardiac output. From a penetrating chest trauma or blunt trauma.

oSigns and Symptoms: Beck's triad includes distended or engorged jugular veins seen on both sides of the trachea, a narrowing pulses pressure, and muffled heart sounds. Common sign is decreased mental status as blood flow decreases to the brain.

oRisk Factors: Cancer or an autoimmune disease such as lupus.

oEMT scope Treatment: High flow oxygen and rapid transport.

Flail Chest

oPathophysiology: Three or more ribs are fractured along with several ribs, a segment of chest wall may be detached from the rest of the thoracic cage.

oSigns and Symptoms: Paradoxical motion when the detached portion of the chest wall moves opposite of normal (in instead of out during inhalation). Hypoxemia can result.

oRisk Factors: Rib fractures

oEMT scope Treatment: Maintain the airway, provide supplemental oxygen, may also include positive pressure ventilation with a BVM, and rapid transport.

Traumatic Asphyxia

oPathophysiology: The sudden increase in intrathoracic pressure forcing blood from the great vessels back into the head. Results in a characteristic appearance, including distended neck veins, cyanosis in the face and neck, and hemorrhage into the sclera of the eye.

oSigns and Symptoms: Sudden, severe compression of the chest, which produces a rapid increase in pressure within the chest.

oRisk Factors: May occur in an unrestrained driver who hits the steering wheel, a pedestrian who is compressed between a vehicle and a wall, or a patient who is pinned under a vehicle.

oEMT scope Treatment: Provide supplemental oxygen, monitor patient's vitals, and rapid transport.

Myocardial Contusion

oPathophysiology: Bruising of the heart muscle.

oSigns and Symptoms: Chest pain or discomfort that is similar to cardiac symptoms, irregular pulse, ventricular tachycardia and ventricular fibrillation.

oRisk Factors: Blunt trauma to the chest.

oEMT scope Treatment: Provide supplemental oxygen and rapid transport.

Hemothorax

oPathophysiology: Blood can collect in the pleural space from bleeding around the rib cage or from a lung or great vessel.

oSigns and Symptoms: Decreased breath sounds on the affected side, signs of shock without an obvious signs of external bleeding.

oRisk Factors: From a blunt or penetrating chest injuries.

oEMT scope Treatment: Rapid transport.

Abdominal Evisceration

oPathophysiology: Severe lacerations of the abdominal wall may result in an evisceration, in which internal organs or fat protrude through the wound.

oSigns and Symptoms: Internal organs or fat protrude through the wound.

oRisk Factors: Trauma

oEMT scope Treatment: Cover organ with a sterile saline solution and secure with a bandage and tape, treat for shock by keeping the patient warm, and rapid transport placing the patient in a supine position.

Basilar Skull Fracture

oPathophysiology: Usually occurs following diffuse impact to the head, such as falls, motor vehicle accident. Generally results from extension of a linear fracture to the base of the skull and can be difficult to diagnose with a CT scan.

oSigns and Symptoms: CSF drainage from the ears, raccoon eyes, and Battle sign.

oRisk Factors: Falls and motor vehicle crashes.

oEMT scope Treatment: Supplemental oxygen and rapid transport.

Burns (Chemical and Thermal)

oPathophysiology: Chemical burns occur whenever a toxic substance contacts the body caused by strong acids or alkalis. Thermal burns can occur when skin is exposed to temperatures higher than 111°F.

oSigns and Symptoms: Damage to the skin, mucous membrane, or eyes, rashes, or lesions.

oRisk Factors: Unresponsive or paralyzed patients from innocent heating sources such as a heating pad.

oEMT scope Treatment: Remove any chemical from the patient by brushing off dry chemicals or flush it with water if a liquid chemical. Provide high flow oxygen and rapid transport.

Tension Pneumothorax

oPathophysiology: An accumulation of air or gas in the pleural space that progressively increases pressure in the chest that interferes with cardiac function with potentially fatal results.

oSigns and Symptoms: Chest pain, tachycardia, marked respiratory distress, absent or severely decreased lung sounds on the affect side, with signs of shock such as hypotension or altered level of mental status, jugular vein distention (JVD), cyanosis, or tracheal deviation.

oRisk Factors: Blunt trauma to the chest.

oEMT scope Treatment: High flow oxygen via nonrebreathing mask and rapid transport.

Commotio Cordis

oPathophysiology: It is a blunt chest injury caused by a sudden, direct blow to the chest (over the heart) that occurs only during a critical portion of a person's heartbeat.

oSigns and Symptoms: Can lead to cardiac arrest. Causes a lethal abnormal heart rhythm called ventricular fibrillation.

oRisk Factors: Sports related injuries

oEMT scope Treatment: Ventricular fibrillation and rapid transport.

Pulmonary Contusion

oPathophysiology: Severe blunt trauma to the chest that causes injury or bruising of the lungs.

oSigns and Symptoms: The pulmonary alveoli become filled with blood, and fluid accumulates in the injured area, leaving the patient hypoxic.

oRisk Factors: Flail chest

oEMT scope Treatment: Provide supplemental oxygen, positive pressure ventilation, and rapid transport.

Open Pneumothorax

oPathophysiology: When the hole in the chest wall makes a sucking sound as the patient inhales and the sound of rushing air as the patient exhales.

oSigns and Symptoms: Diminished breath sounds on affected side.

oRisk Factors: Chest injury.

oEMT scope Treatment: Clear and maintain airway, provide oxygen, seal the wound with an occlusive dressing, and rapid transport.

Compartment Syndrome

oPathophysiology: Develops when edema and swelling result in increased pressure within a closed soft tissue, may cut off blood flow or damage tissue.

oSigns and Symptoms: Signs of impaired circulation.

oRisk Factors: Open or closed injuries or when swelling occurs under restrictive immobilization devices such as a cast.

oEMT scope Treatment: Supply supplemental oxygen and rapid transport.

Obstructive Shock

oPathophysiology: Mechanical obstruction of the cardiac muscle causing a decrease in cardiac output.

oSigns and Symptoms: Tension pneumothorax, cardia tamponade, and pulmonary embolism.

oRisk Factors: Tension pneumothorax, cardia tamponade, and pulmonary embolism.

oEMT scope Treatment: Administer high flow oxygen and rapid transport.

Cardiogenic Shock

oPathophysiology: Inadequate heart function, disease of the muscle tissue, impaired electrical system, and disease or injury.

oSigns and Symptoms: Chest pain, irregular and weak pulse, hypotension, cyanosis, cool, clammy skin, anxiety, crackles (rales), and pulmonary edema.

oRisk Factors: Older age. A history of heart attacks or heart failure.

oEMT scope Treatment: Position comfortably, administer high flow oxygen, assist ventilations, and rapid transport.

Distributive Shock (septic, neuro, psychogenic, and anaphylactic)

oPathophysiology: Results when there is widespread dilation of the small arterioles, small venules, or both.

▪Septic: Severe bacterial infection

▪Neurogenic: Damaged cervical spine

▪Psychogenic: Temporary, generalized vascular dilation

▪Anaphylactic: Extreme life threatening allergic reaction

oSigns and Symptoms:

▪Septic: Warm skin or fever, tachycardia, hypotension

▪Neurogenic: Bradycardia, hypotension, and signs of neck injury

▪Psychogenic: Rapid pulse, normal or low blood pressure

▪Anaphylactic: Mild itching or rash, burning skin, vascular dilation, generalized edema, coma, and rapid death.

oEMT scope Treatment:

▪Septic: Administer high flow oxygen, keep patient warm, assist ventilation, and rapid transport.

▪Neurogenic: Secure airway, spinal immobilization, administer high flow oxygen, keep patient warm, and rapid transport.

▪Psychogenic: Determine duration of unconsciousness, position the patient supine, record vital signs and mental status, suspect head injury, and rapid transport.

▪Anaphylactic: Manage airway, administer high flow oxygen, determine cause, assist with administration of epinephrine, and rapid transport.

Hypovolemic Shock (hemorrhagic, non-hemorrhagic)

oPathophysiology: Loss of blood or fluid. Hemorrhagic involves injuries and bleeding. Non-hemorrhagic is caused by vomiting or diarrhea.

oSigns and Symptoms: Rapid, weak pulse, hypotension, change in mental status, cyanosis, cool, clammy skin, and increased respiratory rate.

oRisk Factors: Traumatic injuries

oEMT scope Treatment: Secure airway, administer high flow oxygen, control external bleeding, keep warm, and rapid transport.

Hyperglycemia Crisis

oPathophysiology: Occurs when blood glucose levels are very high. In type 1 diabetes can lead to ketoacidosis with dehydration from excess urination. In type 2 diabetes is can lead to nonketotic hyperosmolar state of dehydration.

oSigns and Symptoms: Polydipsia, polyuria, warm, dry skin, rapid, deep respirations (Kussmaul respirations), and sweet, fruity breath.

oRisk Factors: Patients with type 1 and 2 diabetes

oEMT scope Treatment: Administer high flow oxygen and rapid transport.

Diabetes Type I

oPathophysiology: An autoimmune disorder in which the individual's immune system produces antibodies against the pancreatic beta cells. They are missing the hormone insulin.

oSigns and Symptoms: Polyuria, polydipsia, polyphagia, weight loss, and fatigue.

oRisk Factors: Common metabolic disease of childhood.

oEMT scope Treatment: Provide transport.

Cholecystitis

oPathophysiology: Severe inflammation of the gallbladder.

oSigns and Symptoms: Constant, severe pain in the right upper or midabdominal region and may refer to the right upper back, shoulder area, or flank. Commonly symptoms occur 30 minutes after a fatty meal and at night. Nausea, vomiting, indigestion, bloating, gas, and belching.

oRisk Factors: Women, older adults, obese people, and people of Scandinavian, Native American, and Hispanic descent.

oEMT scope Treatment: Provide transport.

Pancreatitis

oPathophysiology: Inflammation of the pancreas. Caused by obstructing gallstone, alcohol abuse, and other diseases.

oSigns and Symptoms: Severe pain in upper left and right quadrants and may radiate to the back. Pain is worse after eating. Nausea, vomiting, abdominal distention, and tenderness. Sepsis or hemorrhage can occur and lead to fever and tachycardia.

oRisk Factors: Obstructing gallstone, alcohol abuse, and other disease.

oEMT scope Treatment: Provide transport and position patient of comfort.

Diverticulitis

oPathophysiology: Inflammation in small pockets at weak areas in the muscle walls. Can lead to peritonitis, severe infection, and septic shock.

oSigns and Symptoms: Abdominal pain localized to the left side of the lower abdomen. Signs of infection are fever, malaise, body aches, chills, nausea, vomiting, and constipation.

oRisk Factors: Decrease intake of fiber.

oEMT scope Treatment: Provide transport and place patient in position of comfort.

Peritonitis

oPathophysiology: Any foreign material, such as blood, pus, bile, pancreatic juice, or amniotic fluid, can cause irritation of the peritoneum. Also loss of body fluid into abdominal cavity, causing shift of fluid from bloodstream into body tissue.

oSigns and Symptoms: Ileus, or paralysis of the muscular contractions that normally propel material through the intestines, abdominal distention, nausea, and vomiting.

oRisk Factors: Diverticulitis and cholecystitis

oEMT scope Treatment: Provide transport and administer supplement oxygen.

Meningitis

oPathophysiology: An inflammation of the meningeal coverings of the brain and spinal cord.

oSigns and Symptoms: Fever, headache, stiff neck, and altered mental status, and can have red blotches on their skin.

oRisk Factors: Autoimmune disorder

oEMT scope Treatment: Provide rapid transport.

Febrile Seizure

oPathophysiology: Most pediatric seizures are the result of fever alone.

oSigns and Symptoms: Seizures that last less than 15 minutes.

oRisk Factors: Meningitis, common in children between the age of 6 months and 6 years.

oEMT scope Treatment: Carefully assess the ABCs, begin cooling measures with tepid (not cold) water, and provide rapid transport

Hypoglycemic Crisis

oPathophysiology: An acute emergency in which the patient's blood glucose level drops and must be corrected rapidly.

oSigns and Symptoms: Cool, clammy, pale skin, normal/shallow to rapid respiration, rapid pulse, altered mental status, aggressive, or unusual behavior.

oRisk Factors: Patients who inject insulin or use oral medication

oEMT scope Treatment: Give glucose and rapid transport.

Diabetes Type II

oPathophysiology: Caused by resistance to the effects of insulin at the cellular level. There are fewer insulin receptors.

oSigns and Symptoms: Increased levels of blood glucose, recurrent infection, change in vision, or numbness in the feet.

oRisk Factors: Obesity

oEMT scope Treatment: Provide transport.

Appendicitis

oPathophysiology: Inflammation or infection in the appendix. Can cause tissue to die and/or rupture, causing abscess, peritonitis, or shock.

oSigns and Symptoms: Pain initially is generalized, dull and diffuse to center in the umbilical area. Later localizes to lower right quadrant. Nausea, vomiting, anorexia (lack of appetite), fever, and chills. Symptom of rebound tenderness.

oRisk Factors: None

oEMT scope Treatment: Rapid transport.

Peptic Ulcer Disease (PUD)

oPathophysiology: The protective layer is eroded, allowing the acid to eat into the organ itself. A result of infection of the stomach with H. pylori. Affects both men and women, more often in the older population.

oSigns and Symptoms: Burning or gnawing pain in the stomach that subsides after eating, then reemerges 2-3 hours, nausea, vomiting, belching, and heartburn.

oRisk Factors: Chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, and smoking.

oEMT scope Treatment: Provide transport.

Gastrointestinal Bleeds (GI)

oPathophysiology: Bleeding in the gastrointestinal (GI) tract.

oSigns and Symptoms: Hematemesis, vomiting blood, appears like coffee grounds. The lower GI bleeding will have melena, or dark tarry stools.

oRisk Factors: Esophagitis, esophageal varices, liver failure Mallory-Weiss tear, bowel inflammation, diverticulosis, diverticulitis, cancer, and hemorrhoids.

oEMT scope Treatment: Provide transport.

Nerve Gas Exposure

oPathophysiology: Cholinergic agents are medications that overstimulate the normal body functions controlled by the parasympathetic nervous system.

oSigns and Symptoms: Excessive salivation or drooling, mucous membrane oversecretion, resulting in runny nose (rhinorrhea), excess urination, excessive tearing of the eyes, uncontrolled diarrhea, and an abnormal heart rate.

DUMBELS and SLUDGEM

oRisk Factors: Chemical warfare

oEMT scope Treatment: Provide rapid transport after the patient has been decontaminated and administer DuoDote Auto-Injector, an antidote.

Narcotic (opiate) OD

oPathophysiology: When taken in excess, depresses the central nervous system and causes respiratory arrest followed by cardiac arrest.

oSigns and Symptoms: Hypoventilation or respiratory arrest, pinpoint pupils, sedation or coma, and hypotension.

oRisk Factors: Patients who use opioids such as heroin and oxycodone.

oEMT scope Treatment: Administer naloxone, BVM ventilation, and rapid transport.

Hepatitis A

is a vaccine preventable hepatitis. It can be transmitted when a person unknowingly ingests the virus from objects, food, or drinks contaminated by small, undetected amounts of stool from an infected person.

Hepatitis B

a vaccine preventable hepatitis. It is transmitted through direct contact to infected blood, including dried infected blood for up to several days. Transmission factors include:

Exposure to infected blood through open wounds.

Accidental needle sticks.

Unsafe sexual practices with infected partners.

Hepatitis C

is not vaccine preventable. It is transmitted through direct contact to infected blood.

Transmission factors include:

Exposure to infected blood through open wounds.

Accidental needle sticks.

Unsafe sexual practices with infected partners.

Gallstones (cholelithiasis): what are they and what are their s/s?

they are hardened deposits of digestive fluid that can form in your gallbladder

s/s: Sudden and rapidly intensifying pain in the upper right portion of your abdomen

Sudden and rapidly intensifying pain in the center of your abdomen, just below your breastbone

Back pain between your shoulder blades

Pain in your right shoulder

Nausea or vomiting

Food poisoning

an illness caused by eating contaminated food. Infectious organisms — including bacteria, viruses and parasites — or their toxins are the most common causes of food poisoning.

Symptoms, which can start within hours of eating contaminated food, often include nausea, vomiting or diarrhea.

Type 1 diabetes

Type _ diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin. Insulin is a hormone needed to allow sugar (glucose) to enter cells to produce energy.

Different factors, including genetics and some viruses, may contribute to type _ diabetes. Although type _ diabetes usually appears during childhood or adolescence, it can develop in adults.

Type 2 diabetes

Type _ diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's important source of fuel.

With type _ diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain a normal glucose level.

More common in adults, type _ diabetes increasingly affects children as childhood obesity increases. There's no cure for type _ diabetes, but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise aren't enough to manage your blood sugar well, you also may need diabetes medications or insulin therapy.

Bacterial diseases examples:

What is a usual treatment?

Sinus infections, ear infections, bacterial pneumonia, strep throat, tuberculosis, UTIs. Treatment includes antibiotics

Viral diseases examples:

What is a usual treatment?

Common cold, flu, meningitis, eye infections, AIDS, HIV, Hepatitis A,B,C, viral pneumonia, severe acute respiratory syndromes (SARS), and chicken pox. There are no treatments for antibiotics, only ways of prevention like getting vaccines and wearing PPE

stomach ulcer s/s

-also called peptic ulcers

-Burning stomach pain

Feeling of fullness, bloating or belching

Fatty food intolerance

Heartburn

Nausea