Ch. 15: Medical Overview

Respiratory emergencies

when patients have trouble breathing or when the amount of oxygen supplied to the tissues is inadequate

Cardiovascular emergencies

caused by conditions affecting the circulatory system

Gastrointestinal conditions

refers to disorders affecting the digestive tract, including the appendicitis, diverticulitis, pancreatitis

Urologic emergency

can involve the kidney stones or a bladder infection

Endocrine emergencies

most commonly caused by complications of diabetes mellitus

Hemtologic emergencies

may be the result of sickle cell disease or various types of blood-clotting disorders, such as hemophilia

Immunologic emergencies

involve the body’s response to foreign substances

What top three things does medical patient assessment focus on?

1. Nature of illness (NOI)

2. Symptoms and signs

3. Chief complaint

What should you not do when using dispatch information to guide your initial response during patient assessment?

get locked into a preconceived does of the patient’s illness and only focus on one aspect (tunnel vision)

During a patient assessment, what should you do next after scene size-up?

use standard precautions

Index of suspicion

your awareness and concern for potentially serious underlying and unseen injuries or illness

Where should you check the pulse in a conscious patient?

The radial pulse in the wrist

Where should you check the pulse in an unconscious patient?

The carotid pulse in the neck

What should you focus on during secondary assessments for conscious patients?

Limited or detailed physical examination on patient’s chief complaint

What should you focus on during secondary assessments for unconscious patients?

A thorough head-to-toe physical examination

Apneic

referring to a state where a patient is not breathing or has no breath

What does the primary prehospital treatment for most emergencies address?

the patient’s symptoms more than the actual disease process

When should transportation include lights and siren?

if a life-threatening condition exists

Who are ground transport EMS units generally staffed by?

EMT’s and paramedics

Who are air transport EMS units generally staffed by?

critical care transport professionals and paramedics

Typical chief complaints in patients with an infectious disease include?

fever, rash, nausea, and difficulty breathing

epidemic

when new cases of a disease exceed what is expected

pandemic

a disease outbreak that occurs on a global scale

Which type of patients are most susceptible to influenza?

those with chronic medical conditions, compromises immune systems, and the very young and very old

What does herpes simplex cause?

eruptions of tiny fluid filled blisters (vesicles) on the lips or genitals

When is human immunodeficiency virus (HIV) considered a potential hazard? Is it easily transmitted in a work setting?

only when deposited on mucous membranes or directly into the bloodstream (by exposure to infected blood + fluids); it is NOT easily transmitted

What should you do if you think that a patient’s blood or secretions may have entered your system?

seek medical vice ASAP and notify your infectious disease officer

What is hepatitis?

A viral infection that causes inflammation of the liver, leading to symptoms such as jaundice, fatigue, and abdominal discomfort.

Why is hepatitis B vaccine highly reccommend for EMTs?

because it is far more contagious than HIV and there is no sure way to tell which hepatitis patients are contagious

What is meningitis and what is it characterized by?

an inflammation of the meningeal coverings of the brain and spinal cord, characterized by fever, confusion, and red blotches on skin

What is tuberculosis?

A chronic mycobacterial infection primarily in the lungs with persistent coughing

droplet nuclei

the remnants of the droplets produces by coughing after the excess water has evaporated

What is whooping cough and what type of patients does it mostly affect?

An airborne disease caused by bacteria, mostly affects children younger than 6 years (AKA pertussis)

What is the best way to prevent exposure to whooping cough?

vaccination with diphtheria, tetanus and pertussis (DPT) or TDaP

What is methicillin-resistant staphylococcus aureus (MRSA) and how is is transmitted?

A bacterium that causes (soft-tissue) infections and is resistant to many antibiotics; transmitted by unwashed hands

What are factors that increase the risk for getting MRSA?

antibiotic therapy, prolonged stays—especially in an intensive care or burn unit, exposure to infected patient

What kind of medical emergency is a seizure patient having?

neurologic

 If an injury distracts an EMT from assessing a more serious underlying illness, the EMT has suffered from?

tunnel vision

If a “frequent flier” calls 9-1-1 because of a suspected head injury, you should NEVER?

assume you know what the problem is; every case is different, and you don’t want to miss a potentially serious problem

If your medical patient is not in critical condition, how long should you spend on scene?

up to 20 minutes to assess and manage their condition (if 20 minutes is not an option then spend however long it takes to gather as much information as possible)

Your patient is having respiratory difficulty and is not responding to your treatment. What is the best method of transport?

with lights and siren, to the closest hospital

Your patient believes he has hepatitis and is now exhibiting signs of cirrhosis of the liver. He most likely has:

hepatitis C

What should you do if you are exposed to a patient who is found to have pulmonary tuberculosis?

Get a tuberculin skin test (almost 100% effective as preventative therapy)